关于男性雄激素剥夺疗法综合护理的提案:来自多学科前列腺癌 360 工作组的建议。
A Proposal for the Comprehensive Care of Men on Androgen Deprivation Therapy: Recommendations From the Multidisciplinary Prostate Cancer 360 Working Group.
发表日期:2023 Nov 02
作者:
E David Crawford, Marc B Garnick, Robert H Eckel, Martin M Miner, Stephen J Freedland, Russell K Pachynski, Richard J Wassersug, Matthew T Rosenberg, Lauren M Walker, Ciaran Fairman, Tracy Curley, Michael Crosby, Pao-Hwa Lin, Jason M Hafron
来源:
DIABETES & METABOLISM
摘要:
为了在整个雄激素剥夺治疗 (ADT) 处方过程中促进对患者的全面护理,前列腺癌 360 (PC360) 工作组制定了监测和管理建议,旨在减轻或预防 ADT 相关不良事件。PC360 工作组包括 14 名跨学科专家对前列腺癌和 ADT 管理有专门的临床兴趣。该工作组明确了与 ADT 不良事件管理相关的挑战,然后协作制定了对 ADT 处方者实用的综合护理建议。PC360 工作组制定了 ADT 不良事件管理的总体建议以及跨 5 个领域(心脏代谢、骨骼、性、心理和生活方式)。该工作组建议采用跨学科、基于团队的方法,其中 ADT 处方者保留对 ADT 管理的监督作用,同时授权患者及其初级和专科护理提供者管理风险因素。 PC360 建议还强调了涉及合作伙伴或其他支持提供者的主动患者教育的重要性。还包括针对 5 个已确定领域的推荐监测和评估工具、风险因素管理和患者咨询要点,重点是生活方式和行为干预,可以提高生活质量并降低 ADT 相关并发症的风险。接受 ADT 的患者需要尽早并持续协调各个健康领域的管理,包括心脏代谢、骨骼、性、心理健康。患者教育和初级保健提供者的参与应在 ADT 开始之前开始,并持续到整个治疗过程,以改善患者和伴侣的生活质量。
To promote comprehensive care of patients throughout the androgen deprivation therapy (ADT) prescribing process, the Prostate Cancer 360 (PC360) Working Group developed monitoring and management recommendations intended to mitigate or prevent ADT-associated adverse events.The PC360 Working Group included 14 interdisciplinary experts with a dedicated clinical interest in prostate cancer and ADT management. The working group defined challenges associated with ADT adverse event management and then collaboratively developed comprehensive care recommendations intended to be practical for ADT prescribers.The PC360 Working Group developed both overarching recommendations for ADT adverse event management and specific recommendations across 5 domains (cardiometabolic, bone, sexual, psychological, and lifestyle). The working group recommends an interdisciplinary, team-based approach wherein the ADT prescriber retains an oversight role for ADT management while empowering patients and their primary and specialty care providers to manage risk factors. The PC360 recommendations also emphasize the importance of proactive patient education that involves partners or other support providers. Recommended monitoring and assessment tools, risk factor management, and patient counseling points are also included for the 5 identified domains, with an emphasis on lifestyle and behavioral interventions that can improve quality of life and reduce the risk for ADT-associated complications.Comprehensive care of patients receiving ADT requires early and ongoing coordinated management of a variety of health domains, including cardiometabolic, bone, sexual, psychological health. Patient education and primary care provider involvement should begin prior to ADT initiation and continue throughout treatment to improve patient and partner quality of life.