Care Pathway- and Guideline-Consistent Care in Pediatric Cancer Symptom Management
Document Type
Article
Publication Date
4-23-2025
Publication Title
JCO: Oncology Practice
Abstract
PURPOSE: Ten pediatric cancer treatment sites previously implemented site-specific symptom management care pathways for 15 symptoms, which were based upon clinical practice guidelines (CPGs). The primary objective of this analysis was to describe the prevalence of care pathway- and CPG-consistent care for symptom management. The secondary objective was to identify factors associated with care pathway-consistent care. METHODS: Participants were patients age 8-18 years diagnosed with cancer within the previous 4 weeks. We identified any intervention to manage each of 15 symptoms during a 3-day period 8 weeks after enrollment. We determined whether the intervention appeared in that site's care pathway and whether it was recommended in the CPG. We determined whether type of symptom (observable v nonobservable) or patient characteristics were associated with care pathway-consistent care. RESULTS: Two hundred twenty participants were analyzed. The prevalence of care pathway-consistent care for each symptom ranged from 0% (problems thinking, body or face changes, and diarrhea) to 52.3% (throwing up) and was < 27% for 14 of 15 symptoms. Similarly, the prevalence of CPG-consistent care was < 50% across all symptoms. Participants received significantly more care pathway-consistent interventions for observable symptoms compared with nonobservable symptoms (difference 30% [95% CI, 3 to 54]). Factors associated with receipt of at least one care pathway-consistent intervention were age group, race, ethnicity, and cancer type. CONCLUSION: Care pathway- and CPG-consistent care were surprisingly uncommon. Care pathway-consistent interventions were more common for observable than nonobservable symptoms and were associated with patient characteristics. Future work should identify approaches to improve care pathway-consistent care delivery.
PubMed ID
40267372
Recommended Citation
Crellin-Parsons, Nicole; Dupuis, L Lee; Vettese, Emily; Aftandilian, Catherine; Agarwal, Vibhuti; Baggott, Christina; Bradfield, Scott M.; Freyer, David R.; Kelly, Kara M.; King, Allison A.; Kyono, Wade; Nagasubramanian, Ramamoorthy; Orgel, Etan; Roth, Michael E.; Sherani, Farha; Yu, Lolie; Grimes, Allison C.; Beauchemin, Melissa P.; Klesges, Lisa M.; Tomlinson, George A.; and Sung, Lillian, "Care Pathway- and Guideline-Consistent Care in Pediatric Cancer Symptom Management" (2025). School of Medicine Faculty Publications. 3796.
https://digitalscholar.lsuhsc.edu/som_facpubs/3796
10.1200/OP-24-00912