In recent years, the overall survival from metastatic renal cell carcinoma (RCC) has improved, mainly in part due to immune checkpoint inhibitors (ICI) and tyrosine kinase inhibitors (TKI). TKI and ICI had distinct and high-impact side effect characteristics, and physicians’ information of patient tolerance and compliance to therapy, especially in rural and community conditions, was still lacking. Researchers created a telementoring program to enhance the knowledge and clinical care gaps in assessing and treating ICI and TKI toxicity in people with RCC. The Masonic Cancer Alliance, the outreach network of The University of Kansas Cancer Center, encouraged rural and community cancer care teams to engage in a five-session Program ECHO (Extension for Community Health Outcomes) didactic and case-based educational sessions. Among the topics covered were distress screening, collaborative decision-making for RCC therapy, ICI and TKI toxicity analysis and management, at-home ICI administration, and toxicity monitoring protocols. Participants’ data were collected using a mixed strategy before and after the TOQQ-RCC series. Clinician interviews were recorded and thematically analyzed to examine current practice guidelines. The Organizational Readiness for Implementing Change (ORIC) was used to evaluate readiness for change in toxicity monitoring and management procedures before and after the TOQQ-RCC intervention. Mean scores were derived to evaluate readiness for change. The level of participant involvement and satisfaction was measured using a Likert-like scale of bad, fair, average, excellent, and outstanding. The TOQQ-RCC seminars drew 52 people from 11 cancer treatment centers across Kansas and Missouri. Each session had an average of 15 people in attendance, including doctors, advanced practice physicians, nurses, and other professionals. Content and delivery were regarded as excellent or outstanding in session assessments. A qualitative study identified patient education as a significant obstacle to efficient toxicity detection and management. After the TOQQ-RCC series, one-third of volunteers completed an ORIC post-assessment, with mean ORIC scores dropping by 0.4 (10%), showing a lower preparedness to make modifications to toxicity monitoring and management techniques. Clinicians in rural and community oncology were eager to participate in telementoring to enhance their knowledge and clinical care gaps in the evaluation and management of ICI and TKI toxicity. Reduced ORIC scores after the TOQQ-RCC series might suggest a better knowledge of the complicated procedures and resources needed to enhance toxicity monitoring and treatment methods for patients in rural and community settings. Formal organizational needs evaluations were included in future approaches.
References
Using tele-mentoring to optimize quality of care and quality of life for patients with renal cell carcinoma (TOQQ-RCC)
https://meetings.asco.org/abstracts-presentations/205665