Abstract
Patients with colorectal cancer (CRC) can have chemotherapy with oxaliplatin postoperatively. Oxaliplatin can cause acute and chronic neurotoxicity. It is important to be aware of neurotoxic side effects so they can be documented and action taken at an early stage. The study aimed to identify and explore neurotoxic side effects documented in the medical records of patients with colorectal cancer treated with oxaliplatin-based adjuvant chemotherapy. Data in this study were medical records; presenting documentation about patients treated at the University Hospital in the south of Sweden between 2009 and 2010. A summative content analysis approach was used to explore the neurotoxic side effects. Identification and quantification of the content of medical records were carried out by using a study-specific protocol. “Cold sensitivity” and “tingling in the hands” were the most frequently documented neurotoxicity-related terms in the medical records. This identification was followed by interpretation. Three categories were identified in the interpretive part of the study: acute, chronic, and degree of neurotoxicity. The results show the importance of awareness of neurotoxic side effects so that they can be documented and action taken at an early stage. The documentation could be more reliable if patient-reported structured measurements were used, combined with free descriptions in the medical records. Being able to follow the progression of the symptoms during and after treatment would improve patient’s safety and also quality of life. The protocol that we developed and used in this review of medical records may be helpful to structure the documentation in the electronic system for documentation of neurotoxicity side effects.
Highlights
Colorectal cancer (CRC) is the third most common cancer type worldwide [1]
Studies show that the neurotoxic side effects greatly affect the duration of chemotherapy; deciding whether the dosage of oxaliplatin should be reduced or treatment stopped for fear of debilitating and prolonged neurotoxicity is an important issue [14]-[18]
This study aimed to identify and explore the neurotoxic side effects documented in the medical records of patients with CRC treated with oxaliplatin-based adjuvant chemotherapy
Summary
Colorectal cancer (CRC) is the third most common cancer type worldwide [1]. After prostate and breast cancer, CRC is the most common form of cancer in Sweden [2]. During the past five decades, a cornerstone of the treatment for CRC has been chemotherapy consisting of 5-fluorouracil (5FU) in combination with folinic acid (leucovorin). This regime has relatively low toxicity and most patients cope with treatment without severe side effects. Studies show that the neurotoxic side effects greatly affect the duration of chemotherapy; deciding whether the dosage of oxaliplatin should be reduced or treatment stopped for fear of debilitating and prolonged neurotoxicity is an important issue [14]-[18]. In order to increase the quality of care it is important to explore how the documentation of neurotoxic symptoms is carried out in the medical records. Written documentation is a necessity when judging the quality of care provided, and it facilitates provision of continuous and individualized care by the health care professionals
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