Successful intervention to bridge the knowledge gap in recognizing and managing chemotherapy hypersensitivity reactions among oncology fellows in southeast Michigan.

Abstract

9022 Background: Recognizing hypersensitivity reactions (HSRs) to paclitaxel and carboplatin in patients receiving multi-drug chemotherapy regimens combined with monoclonal antibodies (mAb) and distinguishing them from infusion-related reactions (IRRs) is challenging due to overlapping clinical presentations, rarity, and severity. To address this, we designed a continuing professional development (CPD) activity to enhance knowledge and awareness of these life-threatening reactions. Methods: The CPD activity was designed using Kern’s six-step approach, targeting Hematology/Oncology (H/O) fellows, Gynecological Oncology (GO) fellows, and chemotherapy infusion center nurses (Chemo RNs). A questionnaire featuring real-life HSRs and IRRs scenarios was administered anonymously before and after a 60-minute, in-person, interactive educational lecture. Paired statistical comparisons were not performed, as both surveys were kept anonymous to encourage participation. Results: A total of 42 participants attended the CPD activity, including 30 H/O fellows from 3 fellowship programs, 3 GO fellows from 1 program, and 9 Chemo RNs from a comprehensive cancer center in Southeast Michigan. Participation in pre- and post-lecture questionnaires among fellows was 87.8% and 72.7%, respectively. Recognition rates among fellows improved from 82.7% to 100% for paclitaxel HSRs, 58.6% to 95.8% for carboplatin HSRs, and 93.1% to 91.6% for mAb IRRs, with the most notable improvement in recognizing HSRs to carboplatin. For Chemo RNs, paclitaxel HSRs and mAb IRRs recognition rates were 100% at baseline and post-lecture, while carboplatin HSRs recognition improved from 71.4% to 88.8%. Conclusions: A knowledge gap was identified among oncology fellows in recognizing HSRs to paclitaxel and carboplatin, while Chemo RNs demonstrated exceptional baseline knowledge of paclitaxel HSRs and mAb IRRs. CPD activities aimed at raising awareness of various HSRs and their management were effective and well-received by the healthcare staff, supporting their integration into H/O fellowship curricula. Key points from the educational lecture. Carboplatin Paclitaxel Timing Mostly occurs towards the end of infusion or up to daysafter. Cumulative effect, highest incidence by the 8th exposure. Occurs within the first 10 minutes during the first or second infusion. Most characteristic feature Itching, rash on palms and soles,abdominal cramps, back pain. Flushing and hemodynamic instability. Pre-medications Corticosteroids, H1/H2 antagonists do not prevent HSRs. Dexamethasone, diphenhydramine, H2 receptor antagonists before paclitaxel infusion decrease HSRs.