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10. A Structured Discharge Education Intervention for Parents of Newly Diagnosed Pediatric Oncology Patients

Author

Landier, Wendy, primary, York, Jocelyn M., additional, Wadhwa, Aman, additional, Adams, Kandice, additional, Henneberg, Harrison M., additional, Madan-Swain, Avi, additional, Benton, Beth, additional, Slater, Valencia, additional, Zupanec, Sue, additional, Miller, Jeneane, additional, Tomlinson, Kathryn, additional, Richman, Joshua S., additional, and Bhatia, Smita, additional

Published
2023
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12. Lymphoma

Author

Zupanec, Sue, Tomlinson, Deborah, editor, and Kline, Nancy E., editor

Published
2010
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14. A Structured Discharge Education Intervention for Parents of Newly Diagnosed Pediatric Oncology Patients

Author

Landier, Wendy, York, Jocelyn M., Wadhwa, Aman, Adams, Kandice, Henneberg, Harrison M., Madan-Swain, Avi, Benton, Beth, Slater, Valencia, Zupanec, Sue, Miller, Jeneane, Tomlinson, Kathryn, Richman, Joshua S., and Bhatia, Smita

Abstract

Background:Parents of children newly diagnosed with cancer require specialized knowledge and skills in order to safely care for their children at home. The Children's Oncology Group (COG) developed expert consensus recommendations to guide new diagnosis education; however, these recommendations have not been empirically tested. Methods:We used a sequential two-cohort study design to test a nurse-led Structured Discharge Teaching Intervention (SDTI) that operationalizes the COG expert recommendations in the setting of a tertiary children's hospital. Outcomes included parent Readiness for Hospital Discharge Scale (RHDS); Quality of Discharge Teaching Scale (QDTS); Post-Discharge Coping Difficulty (PDCD); Nurse Satisfaction; and post-discharge unplanned healthcare utilization. Results:The process for discharge education changed significantly before and after implementation of the SDTI, with significantly fewer instances of one-day discharge teaching, and higher involvement of staff nurses in teaching. Overall, parental RHDS, QDTS, and PDCD scores were similar in the unintervened and intervened cohorts. Almost 60% of patients had unplanned healthcare encounters during the first 30 days following their initial hospital discharge. Overall nurse satisfaction with the quality and process of discharge education significantly increased post-intervention. Discussion:Although the structure for and process of delivering discharge education changed significantly with implementation of the SDTI, parent RHDS and QDTS scores remained uniformly high and PDCD scores and non-preventable unplanned healthcare utilization remained similar, while nurse satisfaction with the quality and process of discharge education significantly improved, suggesting that further testing of the SDTI across diverse pediatric oncology settings is warranted.

Published
2023
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17. Perceptions of parents of pediatric patients with acute lymphoblastic leukemia on oral chemotherapy administration: A qualitative analysis

Author

Tang, Natalie, primary, Kovacevic, Anja, additional, Zupanec, Sue, additional, Sivananthan, Araby, additional, Patel, Rikesh, additional, Patel, Priya, additional, Vennettilli, Ashlee, additional, Paw Cho Sing, Edric, additional, Alexander, Sarah, additional, Sung, Lillian, additional, and Dupuis, L. Lee, additional

Published
2021
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25. A Sleep Hygiene and Relaxation Intervention for Children With Acute Lymphoblastic Leukemia

Author

Zupanec, Sue, Jones, Heather, McRae, Lyndsey, Papaconstantinou, Efrosini, Weston, Julie, and Stremler, Robyn

Subjects
Male, Sleep Wake Disorders, Relaxation, Canada, Leukemia, Sleep hygiene, Psychometrics, Pilot Projects, Articles, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Relaxation Therapy, Actigraphy, Parent, Randomized controlled trial, Child, Preschool, Humans, Female, Child, Sleep, Fatigue
Abstract

Background: Sleep disturbance and fatigue are common and distressing pediatric cancer-related outcomes. Sleep hygiene education and relaxation techniques are recommended to improve sleep in healthy children and adult cancer survivors. No studies have tested these interventions to improve sleep and fatigue for children with acute lymphoblastic leukemia (ALL) in the home setting. Objectives: The aim of this study is to establish the feasibility and acceptability of a sleep hygiene and relaxation intervention to improve sleep and fatigue for children receiving maintenance chemotherapy for ALL. The child's fatigue and sleep data were collected to inform sample size calculations for a future trial. Methods: In this pilot randomized controlled trial, 20 children were allocated randomly to the sleep intervention or control group. The sleep intervention group received a 60-minute educational session to discuss sleep and fatigue in children with cancer and strategies to improve sleep, including use of 2 storybooks to teach deep breathing and progressive muscle relaxation. Objective sleep data were collected using actigraphy and fatigue was measured using the Childhood Cancer Fatigue Scale. Results: The intervention was acceptable to families, and feasibility of the intervention and data collection was clearly established. Although not statistically significant, increases in mean nighttime sleep and decreases in mean wake time after sleep onset in the sleep intervention group represented clinically important improvements. Conclusions: This pilot study demonstrated the feasibility and acceptability of a sleep hygiene and relaxation intervention for children undergoing maintenance chemotherapy for ALL. Implications for practice: Given the clinically important improvements in sleep observed, replication in a larger, adequately powered randomized controlled trial is merited.

Published
2016

26. Supplemental Material2 - Supplemental material for Relative bioavailability of an extemporaneously prepared aprepitant oral suspension in healthy adults

Author

Patel, Priya, Nathan, Paul C, Walker, Scott E, Zupanec, Sue, Volpe, Jocelyne, and L Lee Dupuis

Subjects
FOS: Clinical medicine, fungi, biochemical phenomena, metabolism, and nutrition, 111599 Pharmacology and Pharmaceutical Sciences not elsewhere classified, 111299 Oncology and Carcinogenesis not elsewhere classified
Abstract

Supplemental material, Supplemental Material2 for Relative bioavailability of an extemporaneously prepared aprepitant oral suspension in healthy adults by Priya Patel, Paul C Nathan, Scott E Walker, Sue Zupanec, Jocelyne Volpe and L Lee Dupuis in Journal of Oncology Pharmacy Practice

Published
2019
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30. Chemotherapy-induced nausea and vomiting from oral chemotherapy for childhood acute lymphoblastic leukaemia: feasibility study

Author

Kovacevic, Anja, Sivananthan, Araby, Patel, Rikesh, Patel, Priya, Vennettilli, Ashlee, Paw Cho Sing, Edric, Zupanec, Sue, Alexander, Sarah, Sung, Lillian, and Dupuis, L Lee

Abstract

ObjectiveTo evaluate the feasibility of a large prospective trial aimed at improving chemotherapy-induced nausea and vomiting (CINV) control in paediatric patients undergoing oral chemotherapy during acute lymphoblastic leukaemia (ALL) maintenance therapy.MethodsEnglish-speaking children, 4.0–17.99 years old and undergoing ALL maintenance treatment with an English-speaking guardian, were eligible to participate in this observational, serial, cross-sectional feasibility study. Data were collected from participants over one to three 7-day periods during months 2–3, 5–6 and 11–12 of ALL maintenance treatment. A future trial was considered feasible if the mean time to enrol 10 patients in each of three data collection periods was ≤1 year with ≥80% of patients returning evaluable data. CINV control was described as a secondary endpoint.ResultsTwenty-nine of 31 consenting patients (median age: 6.5 years, IQR: 5.1–9.2) completed the study: 10 in months 2–3, 10 in months 5–6 and 9 in months 11–12. The total time to recruit 29 patients was 1.2 years. In each of the three data collections periods, 72% of the patients provided evaluable data. Complete CINV control was reported in 6/21 (29%) evaluable study periods.ConclusionsA future trial to evaluate interventions to improve CINV control in patients with ALL undergoing oral maintenance chemotherapy as designed in this study is not feasible. An electronic data capture method and deferring patient recruitment until the mid-maintenance to late-maintenance phase should be considered in the design of a future trial.

Published
2022
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31. High Vs. Low-Intensity Bridging Chemotherapy in Children with Acute Lymphoblastic Leukemia Awaiting Chimeric Antigen Receptor T-Cell Therapy: A Population-Based Study from Ontario, Canada

Author

Gupta, Sumit, primary, Alexander, Sarah, additional, Zupanec, Sue, additional, Athale, Uma, additional, Bassal, Mylene, additional, Edwards, Ethan, additional, Gibson, Paul J., additional, Johnston, Donna, additional, Marjerrison, Stacey, additional, Zorzi, Alexander, additional, Hitzler, Johann K., additional, Naqvi, Ahmed, additional, Punnett, Angela, additional, Whitlock, James A., additional, Grupp, Stephan A., additional, Maude, Shannon L., additional, and Krueger, Joerg, additional

Published
2018
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32. Blinatumomab use in pediatric ALL: Taking a BiTE out of preparation, administration and toxicity challenges.

Author

Bernhardt, Melanie B, Militano, Olga, Honeyford, Lisa, and Zupanec, Sue

Subjects
MEDICATION error prevention, DRUG approval, NEUROTOXICOLOGY, SYNDROMES, LYMPHOBLASTIC leukemia, MONOCLONAL antibodies, TUMORS in children, RISK assessment, T cells, DRUG toxicity, CHILDREN
Abstract

Blinatumomab is the first in its class bispecific T-cell engager monoclonal antibody, which binds to CD19 expressed on B-cells and CD3 expressed on T-cells, resulting in lysis of CD19-positive cells common in B-cell malignancies. Blinatumomab is Food and Drug Administration (FDA) approved for the treatment of adults and children with relapsed/refractory or minimal residual disease (MRD) positive precursor B-cell ALL (B-ALL). Despite impressive efficacy for the approved indications and favorable toxicity profile compared to standard-of-care chemotherapy, blinatumomab presents unique health-system challenges related to preparation, administration, toxicity monitoring and medication error prevention. Blinatumomab delivery also offers plethora of opportunities for interdisciplinary planning and collaboration. The purpose of this paper is to discuss practical considerations for safe blinatumomab delivery from the pharmacy and nursing perspectives. [ABSTRACT FROM AUTHOR]

Published
2021
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35. A Quality Approach to Blinatumomab Delivery in Pediatric Oncology: A Children's Oncology Group Study

Author

Montgomery, Kathleen E., Zupanec, Sue, Yun, Christine, Okada, Maki, Kubaney, Holly, Feehily, Erin, and Withycombe, Janice S.

Abstract

Background:Blinatumomab is a promising immunotherapy agent that has been shown to improve survival outcomes in children diagnosed with relapsed B-lineage acute lymphoblastic leukemia. Expanded use of blinatumomab in the treatment of childhood cancer is expected; however, clinician perspectives regarding administering this agent in healthcare and home settings have not been explored. Method:Semistructured interviews were conducted with clinicians (N= 13) from pediatric institutions across the United States and Canada. Qualitative data were analyzed using a constant comparative analysis three-stage method. Results:Participants were primarily nurses (92%), female (77%), and had greater than 10 years of pediatric oncology experience. The selective code and overarching theme identified was “A quality approach to blinatumomab delivery in pediatric oncology.” Clinicians described detailed processes that were created and implemented to promote a common goal of safe blinatumomab administration across the continuum of care. Clinicians shared how they engaged in planning activities and considered a variety of factors prior to and during blinatumomab administration. Clinicians also expressed a need to reflect and evaluate on previous patient experiences to create new or revise existing processes and workflows. Communication was also central to clinicians’ work. Clinicians provided recommendations to assist others with blinatumomab administration and offered suggestions for items that could help with implementing future clinical trials containing similar agents. Discussion:Findings suggest nurses are pivotal to establishing processes which support safe administration of immunotherapies, such as blinatumomab, while also considering patient-specific needs and promoting quality of life.

Published
2024
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39. Initial development of the Symptom Screening in Pediatrics Tool (SSPedi)

Author

Tomlinson, Deborah, primary, Dupuis, L. Lee, additional, Gibson, Paul, additional, Johnston, Donna L., additional, Portwine, Carol, additional, Baggott, Christina, additional, Zupanec, Sue, additional, Watson, Julie, additional, Spiegler, Brenda, additional, Kuczynski, Susan, additional, Macartney, Gail, additional, and Sung, Lillian, additional

Published
2013
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42. Psychometric and Clinical Assessment of the 10-Item Reduced Version of the Fatigue Scale—Child Instrument

Author

Hinds, Pamela S., primary, Yang, Jie, additional, Gattuso, Jami S., additional, Hockenberry, Marilyn, additional, Jones, Heather, additional, Zupanec, Sue, additional, Li, Chenghong, additional, McLaughlin Crabtree, Valerie, additional, Mandrell, Belinda N., additional, Schoumacher, Robert A., additional, Vallance, Kelly, additional, Sanford, Stacy, additional, and Srivastava, Deo Kumar, additional

Published
2010
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43. A Quality Approach to Blinatumomab Delivery in Pediatric Oncology: A Children's Oncology Group Study.

Author

Montgomery KE, Zupanec S, Yun C, Okada M, Kubaney H, Feehily E, and Withycombe JS

Abstract

Background: Blinatumomab is a promising immunotherapy agent that has been shown to improve survival outcomes in children diagnosed with relapsed B-lineage acute lymphoblastic leukemia. Expanded use of blinatumomab in the treatment of childhood cancer is expected; however, clinician perspectives regarding administering this agent in healthcare and home settings have not been explored. Method: Semistructured interviews were conducted with clinicians ( N  = 13) from pediatric institutions across the United States and Canada. Qualitative data were analyzed using a constant comparative analysis three-stage method. Results: Participants were primarily nurses (92%), female (77%), and had greater than 10 years of pediatric oncology experience. The selective code and overarching theme identified was "A quality approach to blinatumomab delivery in pediatric oncology." Clinicians described detailed processes that were created and implemented to promote a common goal of safe blinatumomab administration across the continuum of care. Clinicians shared how they engaged in planning activities and considered a variety of factors prior to and during blinatumomab administration. Clinicians also expressed a need to reflect and evaluate on previous patient experiences to create new or revise existing processes and workflows. Communication was also central to clinicians' work. Clinicians provided recommendations to assist others with blinatumomab administration and offered suggestions for items that could help with implementing future clinical trials containing similar agents. Discussion: Findings suggest nurses are pivotal to establishing processes which support safe administration of immunotherapies, such as blinatumomab, while also considering patient-specific needs and promoting quality of life., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Published
2024
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44. Chemotherapy-induced nausea and vomiting from oral chemotherapy for childhood acute lymphoblastic leukaemia: feasibility study.

Author

Kovacevic A, Sivananthan A, Patel R, Patel P, Vennettilli A, Paw Cho Sing E, Zupanec S, Alexander S, Sung L, and Dupuis LL

Subjects
Child, Humans, Child, Preschool, Adolescent, Feasibility Studies, Prospective Studies, Cross-Sectional Studies, Nausea chemically induced, Vomiting chemically induced, Vomiting drug therapy, Antiemetics therapeutic use, Antineoplastic Agents adverse effects, Precursor Cell Lymphoblastic Leukemia-Lymphoma drug therapy
Abstract

Objective: To evaluate the feasibility of a large prospective trial aimed at improving chemotherapy-induced nausea and vomiting (CINV) control in paediatric patients undergoing oral chemotherapy during acute lymphoblastic leukaemia (ALL) maintenance therapy., Methods: English-speaking children, 4.0-17.99 years old and undergoing ALL maintenance treatment with an English-speaking guardian, were eligible to participate in this observational, serial, cross-sectional feasibility study. Data were collected from participants over one to three 7-day periods during months 2-3, 5-6 and 11-12 of ALL maintenance treatment. A future trial was considered feasible if the mean time to enrol 10 patients in each of three data collection periods was ≤1 year with ≥80% of patients returning evaluable data. CINV control was described as a secondary endpoint., Results: Twenty-nine of 31 consenting patients (median age: 6.5 years, IQR: 5.1-9.2) completed the study: 10 in months 2-3, 10 in months 5-6 and 9 in months 11-12. The total time to recruit 29 patients was 1.2 years. In each of the three data collections periods, 72% of the patients provided evaluable data. Complete CINV control was reported in 6/21 (29%) evaluable study periods., Conclusions: A future trial to evaluate interventions to improve CINV control in patients with ALL undergoing oral maintenance chemotherapy as designed in this study is not feasible. An electronic data capture method and deferring patient recruitment until the mid-maintenance to late-maintenance phase should be considered in the design of a future trial., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2022
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