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Team Quality Care in CML

CE / CME

Essentials to Deliver Quality Care for Patients With CML: A Team Approach

Pharmacists: 1.00 contact hour (0.1 CEUs)

Physicians: Maximum of 1.00 AMA PRA Category 1 Credit™

Nurses: 1.00 Nursing contact hour

Released: March 01, 2022

Expiration: February 28, 2023

CME/CE Information

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Treatment Adherence

Adherence is very important to maximize the benefit from CML treatment, and patients need to be educated on this to help them stay on track. It has been shown in clinical trials that among patients who achieved a CCyR, only those who maintain at least 90% adherence can obtain a deep molecular response.38 It doesn’t take much: Missing 10% means missing just 3 doses in a month.

This concern is important to communicate with the patient, and physicians need to identify what barriers a patient may have to adherence. Is the schedule too complicated? Do AEs need to be managed better? Are there financial considerations? In other words, a lack of adherence may not be solely due to a lack of compliance with the patient.

Prompt, proactive management of treatment-related AEs can help improve adherence; dose reductions or short treatment interruptions are unlikely to affect disease control.39

Patient Communication

It is very important that, from the beginning, patients are educated on the goals of therapy, what to expect with their selected treatment, what issues need to be communicated to their healthcare team, and what to expect at different steps during the course of treating their CML.

Of importance, the healthcare team (eg, physicians, oncology nurses/nurse practitioners, and an oncology pharmacist) needs to tailor treatment to the individual patient’s goals, and to stay in close communication with patients throughout their treatment journey to answer their questions and manage their AEs. Including patients in shared decision making helps optimize outcomes for both CML survivors and their caregivers.

The healthcare team should take care to make the treatment message consistent across disciplines and through the course of the patient’s illness. Trust, self-efficacy, and perceived physical and emotional well-being will facilitate patients’ participation in their care. This can mean that the entire healthcare team participates in supporting patients and their caregivers in making treatment decisions.

Involving Cancer Patients and Their Families in Their Treatment Choices

Patients’ families need to be involved in this journey, because a patient who has good support with shared decision-making typically does much better.39 To facilitate this process, the healthcare team needs to provide evidence-based information, identify uncertainties, identify patient preferences and expectations, and make follow-up arrangements per the patient’s action plan.

The patient also needs to understand the real risk of AEs. Some of them are only perceived by the patient; nobody can judge how much fatigue or pain a patient has. Physicians can assess the level of hemoglobin or platelets, but not the level of fatigue, unless we have good communication with the patient and his or her family.

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Patient Support Strategies

There are multiple ways that patients with CML can be supported while undergoing treatment.40,41 This includes patient support groups, but the patient will need information as to which support groups and sources of information are the most reliable. Patients can be a great help to other patients, especially when they’re dealing with difficult circumstances.

The patient’s healthcare team should also provide education throughout the course of treatment that is relevant to the patient’s needs at each point in time. Overall, it is very important to build trust with patients, maintain that trust, and provide proper communication throughout the course of therapy. This holistic approach goes beyond just PCR analysis and encompasses their other medical, social, and psychological needs.

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