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Intra-Cardiac Injection of Human Prostate Cancer Cells to Create a Bone Metastasis Xenograft Mouse Model
Published on: November 4, 2022
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Improving Bone Health in Patients with Metastatic Prostate Cancer with the Use of Algorithm-Based Clinical Practice
Kamal Kant Sahu1,2, Eric D Johnson2,3, Katerina Butler1
1George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA.
Geriatrics (Basel, Switzerland)
|December 22, 2022
Summary
An algorithm-based tool improved bone health care for prostate cancer patients, ensuring correct medication dosing and dental screenings. This led to zero inappropriate bone-modifying agent dosing and universal dental evaluations before treatment.
Area of Science:
- Oncology
- Bone Metabolism
- Clinical Practice Improvement
Background:
- Prostate cancer patients face bone health risks from treatment and metastatic disease.
- Guidelines recommend denosumab or zoledronic acid for bone health, with dental evaluation crucial to prevent jaw osteonecrosis.
- Real-world practice shows limited evidence-based bone health care, with under-treatment and incorrect dosing posing risks.
Purpose of the Study:
- To implement an algorithm-based clinical practice tool to improve bone health care for prostate cancer patients.
- To ensure appropriate dosing and dental screening rates for bone-modifying agents.
- To minimize deviations from evidence-based guidelines in clinical practice.
Main Methods:
- Developed an algorithm-based clinical practice tool integrated into the electronic medical record system.
- The tool guides clinicians through a stepwise process for prescribing bone-modifying agents, including dental evaluation.
- Analyzed data from September 2019 to April 2022 to assess the tool's impact.
Main Results:
- Zero out of 35 patients received inappropriate bone-modifying agent dosing after tool implementation.
- 100% of patients had dental health addressed before treatment initiation.
- Significant reduction in incorrect dosing (24/41 to 0/35, p < 0.00001) and missed dental evaluations (12/41 to 0/35, p < 0.00001).
Conclusions:
- An evidence-based algorithm integrated into order sets significantly enhances clinical practice for bone-modifying agent prescription.
- The tool improved indication-appropriate dosing and dental screening rates for prostate cancer patients.
- Facilitated high-quality, evidence-based bone health care, reducing risks associated with treatment.
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