Bisphosphonate therapy for metastatic bone disease: the pivotal role of nurses in patient education.
OBJECTIVE
To describe the role of bisphosphonate therapy for metastatic bone disease and skeletal-related events associated with some of the most common malignancies, and to highlight the importance and untapped potential of nurses intervening in the education and treatment of patients with these issues.


METHODS
Contemporary evidence-based studies on the prevalence and impact on quality of life in metastatic bone disease and skeletal-related events, and all major clinical trials describing the efficacy of bisphosphonates for the treatment of metastatic bone disease.


RESULTS
Metastatic bone disease is a common consequence of cancer that impairs patient quality of life. Bisphosphonate therapy is effective in preventing or delaying complications associated with metastatic bone disease.


CONCLUSIONS
Bisphosphonate therapy can help preserve functional independence and improve the quality of life for many patients with cancer. Poor adherence to bisphosphonate therapy frequently is caused by patients not understanding how the drug works or why they need it. Premature discontinuation of bisphosphonate therapy leaves patients at risk for painful and debilitating skeletal-related events, which reduces their functional independence and impairs their activities of daily living.


CONCLUSIONS
Nurses are uniquely positioned to educate patients and their caregivers about the need to begin or continue taking bisphosphonates for treatment of metastatic bone disease and associated skeletal-related events. Nurses often are the most appropriate healthcare providers for counseling patients with metastatic cancer about personal and family issues and for communicating the needs and concerns of patients to their physicians.
Fitch
Margaret I
MI
Oncology Nursing and Supportive Care, Odette Cancer Centre, Toronto, Canada. marg.fitch@sunnybrook.ca
Maxwell
Cathy
C
D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000523:psychology / Q000556:secondary / Q000628:therapy; D003142:Communication; D004164:Diphosphonates / Q000627:therapeutic use*; D006301:Health Services Needs and Demand; D006801:Humans; D024802:Nurse's Role / Q000523:psychology; D009723:Nurse-Patient Relations; D009859:Oncology Nursing / Q000458:organization & administration*; D010349:Patient Compliance / Q000523:psychology; D010353:Patient Education as Topic / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D011788:Quality of Life / Q000523:psychology; D016896:Treatment Outcome; D035502:Trust
D050071:Bone Density Conservation Agents; D004164:Diphosphonates