Clinical Pathway for Managing ADT-Induced Adverse Events in Prostate Cancer

12/19/17

A clinical pathway for patients with prostate cancer patients improved the implementation of evidence-based strategies for the management of androgen deprivation therapy (ADT)-induced side effects.

A group of researchers led by Renée Bultijnck, department of radiation oncology and experimental cancer research, Ghent University (Belgium), conducted a study to assess the effects of a prostate cancer clinical pathway on the implementation of evidence-based strategies for the management of ADT-induced side effects. In 2015, a clinical pathway was introduced at the hospital level that consisted of various strategies supported by evidence for the management of ADT-induced side effects. Data of recommended evidence-based strategies were retrospectively identified from electronic health records of all patients in the year before (2014) and the year of the pathway implementation (2015).

A total of 258 patients were enrolled in the clinical pathway who had a prostate cancer diagnosis and had received ADT for more than 6 months. In all, 126 patients were included in the control group and 132 patients in the intervention group.

Results of the study were published in BJUI International (online December 1, 2017; doi:10.1111/bju.14086).

After implementation of the clinical pathway, researchers reported more frequent application of metabolic (46% vs 4%), bone (58% vs 10%), and cardiac risk assessment screenings (61% vs 16%) in the intervention group compared with the control group, respectively (P < .001).

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Additionally, advice on strategies preventing ADT-induced adverse events was more frequently offered in the intervention group, including advice on exercise (62% vs 11% in the control group), nutrition (58% vs 10%), and psycho-education (54% vs 13%).

Researchers concluded that clinical pathways for patients with prostate cancer can improve the implementation of evidence-based strategies for the management of ADT-induced adverse events. In this population, “A clinical pathway could serve as a method to bridge the gap between evidence-based guidelines and daily clinical practice,” they wrote.—Zachary Bessette