Abstract
Background and Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) affects up to 60% of cancer patients undergoing chemotherapy, yet current single-modality therapies yield limited efficacy. This project aimed to implement an evidence-based, interdisciplinary CIPN clinical pathway to increase advanced practice providers’ (APPs’) role understanding of the interdisciplinary team and referrals to the appropriate services. Methods: An interdisciplinary CIPN clinical pathway was implemented using a prospective pre-test and post-test quality improvement design over 12 weeks. The project included 53 outpatient APPs who care for adult patients with CIPN. Pre- and post-education surveys, as well as electronic health record data abstraction, assessed APPs’ role understanding, referral behavior, and the feasibility of the intervention. Results: Post-intervention survey analysis yielded a statistically significant difference in APPs’ role understanding median summary scores, from pre-test (19.00) to post-test (25.00) (Z = –4.228, p < .001). Electronic health record data revealed a clinically significant 43.48% increase in total patient referrals, with a statistically significant association between APP participation and the entry of one or more referrals to the appropriate services (X²(1, n = 31) = 7.86, p = .006). Lastly, the post-test Feasibility of Intervention Measure (FIM) mean summary score was 17.13. Conclusion: Implementing an evidence-based, interdisciplinary CIPN clinical pathway improved APPs’ role understanding and referral behavior within an ambulatory oncology setting. Implications: This intervention appears feasible and adaptable for similar clinical settings. Additional tailoring may be required based on organizational resources and workflows. Future work should evaluate patient-centered outcomes and long-term provider adherence.
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