title: Optimising the management of anaemia in patients with cancer with practice guidelines using erythropoiesis-stimulating proteins.
abstract: Anaemia, a common problem in patients with cancer, usually leads to severe fatigue, which can dramatically impair patients' quality of life (QOL). Nurses are in the ideal position to assess and monitor cancer patients at risk of anaemia and recommend appropriate supportive care measures to alleviate anaemia-related symptoms. Erythropoiesis-stimulating proteins (ESPs) can increase haemoglobin levels, reduce the need for red blood cell transfusions, and improve QOL in patients with cancer and anaemia. Evidence-based guidelines published by national and international organisations make specific recommendations for the appropriate use of ESPs. Nurses are key members of the multidisciplinary teams that develop practice-specific protocols, which are based on the national guidelines. The practice guidelines should describe protocols to identify patients at risk for anaemia and interventions to correct anaemia, with specific details on the choice of ESP and when such interventions should be initiated and halted. In addition, nurses should also recommend strategies to reduce patient burden, such as patient self-administration with prefilled pens or synchronisation of visits for ESPs with chemotherapy visits, which is made possible with the once-every-3-weeks extended dosing with darbepoetin alfa. The implementation of such practice guidelines should improve the quality of care provided to patients.
authors.affiliation: University of Central England, 031 Bevan House, Westbourne Road, Edgbaston, Birmingham B15 3TN, UK. dion.smyth@uce.ac.uk
authors.forename: Dion
authors.initials: D
authors.lastname: Smyth
authors.forename: Sabine
authors.initials: S
authors.lastname: Zumbrink
mesh_terms: D000465:Algorithms; D000740:Anemia / Q000188:drug therapy* / Q000209:etiology / Q000451:nursing; D004921:Erythropoietin / Q000627:therapeutic use*; D006397:Hematinics; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000451:nursing; D017410:Practice Guidelines as Topic; D011994:Recombinant Proteins; D018570:Risk Assessment
chemical_list: D006397:Hematinics; D011994:Recombinant Proteins; D004921:Erythropoietin