MP34-07 A QUALITATIVE ASSESSMENT OF ANDROGEN DEPRIVATION THERAPY DOCUMENTATION AND ADHERENCE PATTERNS IN A MULTIDISCIPLINARY SETTING

Abstract

You have accessJournal of UrologyHealth Services Research: Quality Improvement & Patient Safety II (MP34)1 Sep 2021MP34-07 A QUALITATIVE ASSESSMENT OF ANDROGEN DEPRIVATION THERAPY DOCUMENTATION AND ADHERENCE PATTERNS IN A MULTIDISCIPLINARY SETTING Emily Bochner, Robert Den, Nathan Handley, and Edouard J Trabulsi Emily BochnerEmily Bochner More articles by this author , Robert DenRobert Den More articles by this author , Nathan HandleyNathan Handley More articles by this author , and Edouard J TrabulsiEdouard J Trabulsi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002043.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Adherence to scheduled androgen deprivation therapy (ADT) has been shown to influence disease outcomes and overall survival. We evaluated ADT documentation and adherence patterns for patients undergoing ADT for advanced prostate cancer to assess for care discoordination and quality improvement opportunities in multidisciplinary clinical practice. METHODS: We performed a retrospective analysis of patients undergoing ADT for advanced prostate cancer at Sidney Kimmel Cancer Center from 7/2/2019-7/20/2020 as part of a quality improvement project. Electronic medical records were reviewed, and ADT care plan documentation was evaluated. Dose records were examined for missed doses. The ADT care plan was considered documented if the duration of ADT (intermittent ADT, continuous ADT, short duration ADT [6 months], or long duration ADT [2 years]) was clearly stated. Qualitative analyses were performed. RESULTS: One hundred randomly selected patients receiving ADT were included in the study. 70% of patients were White, 24% of patients were African American, 5% of patients were Asian, and 1% of patients were Hispanic. Fifty-five patients (55%) did not have a documented care plan for ADT. Ninety-eight patients (98%) received luteinizing hormone releasing hormone (LHRH) agonist or antagonist therapy (3 patients (3%) received Eligard, 92 patients (94%) received Lupron, and 3 patients (3%) received Firmagon). Of the 98 patients on LHRH agonist or antagonist therapy, 7 patients (7.1%) had a documented missed dose of the LHRH agonist. CONCLUSIONS: For patients undergoing ADT, proper documentation and close follow up are essential steps in maximizing ADT adherence. While 7.1% of patients in this study missed a dose of LHRH agonist therapy, only 45% of patients had an ADT care plan documented. The percentage of patients with a missed dose may have been subsequently underestimated in this study, as 55% of patients did not have an ADT care plan documented. Careful documentation of missed doses of LHRH agonist therapy is particularly important, as studies have shown delayed dosing of ADT has a negative impact on ADT efficacy and testosterone suppression (Crawford et al, Journal of Urology, 2020). Improving documentation patterns may help to improve ADT adherence and subsequent ADT-related outcomes. Further investigations into the effect of late or missed LHRH agonist doses should be performed. Source of Funding: N/A © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e618-e619 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Emily Bochner More articles by this author Robert Den More articles by this author Nathan Handley More articles by this author Edouard J Trabulsi More articles by this author Expand All Advertisement Loading ...