Identifying and addressing the supportive care needs of the ‘complex’ patient with Multiple Myeloma within a Nurse Practitioner led service (#212)
Multiple Myeloma is a predominantly incurable plasma cell disorder that accounts for approx 10% of all haematological malignancies. A definitive characteristic of myeloma is its propensity to affect primarily older individuals. The evolution of effective novel treatments has increased the potential for extended periods of disease control, allowing many to live with myeloma as a chronic condition.
The Haematology service identified a cohort of patients whom would be defined within the Fitch Model as having ‘complex care needs’ requiring more than the usual level of supportive care assessment and intervention (Victorian Supportive Care Policy 2009). The ‘complexities of care’ included being diagnosed with an incurable malignancy, commencing inherently complicated and potentially toxic drug therapies in the context of advanced age, multiple comorbidities, pre-existing polypharmacy, culturally and linguistically diverse backgrounds and geographic and/or social isolation.
This presentation outlines the experience of establishing a dedicated nurse-led service to support patients with these complex care needs. The specific objectives of the service are to ensure/improve adherence to the treatment regimen; increase patient satisfaction with the experience of care; improve coordination of care; facilitate early identification and intervention for treatment and disease related adverse effects; and facilitate early identification and management of supportive care needs within this context.
The service used resources including validated supportive care screening and symptom assessment tools within a Nurse Practitioner-led model of simultaneous Haematologist/Nurse Practitioner consultations to identify individual patient needs, facilitate timely appropriate referral and develop individualised, patient centred resources.
The presentation explores the conceptual framework for establishing the service, developing care pathways, addressing issues of supportive care, unmet needs of the cancer patient population, risks associated with oral chemotherapy treatment and requirements for establishing advanced practice nursing roles.
No conflict of Interest to disclose