Florida Cancer Specialists & Research Institute Clinicians Demonstrate Effectiveness of Positive Quality Interventions to Improve Care for Patients with Blood Disorders

Viralkumar Bhanderi, MD

The use of best practice guidance and resources developed through the Positive Quality Intervention (PQI) initiative of NCODA improves the quality of care provided to patients with blood cancers and disorders, according to a recent assessment conducted with participation from clinicians at Florida Cancer Specialists & Research Institute, LLC (FCS).

FCS medical oncologist and hematologist Viralkumar Bhanderi, MD, FCS Oncology Nurse Practitioner Diane Cope, PhD, APRN, BC, AOCNP, and FCS Clinical Oncology Pharmacist Lauren Trisler, PharmD, BCOP, collaborated with colleagues from Massachusetts General North Shore Cancer Center in Danvers, MA to explore how their respective medically integrated teams incorporate PQIs as part of their daily workflow. Their focused review utilizing the Erythropoietin Stimulating Agent Ineligibility in Myelodysplastic Syndromes PQI was detailed in a recently published “PQI in Action” report.

PQIs are peer-reviewed clinical resources that provide guidance on quality standards and effective practices to promote higher quality care and experiences for cancer patients receiving oral or IV therapies, which currently comprise 25 to 35 percent of the oncology treatments provided to patients nationwide.

Dr. Bhanderi said, “This PQI is a really great document to guide optimal therapy for these patients. It also ensures that if patients are not responding that we are moving on to different therapies to ensure disease is not progressing.”

Myelodysplastic syndromes (MDS) are a group of blood cancers (including leukemia) in which the bone marrow produces blood cells that do not mature or become healthy blood cells. Erythropoietin (EPO) is a type of protein, called a growth factor, used to treat a low number of red blood cells (anemia) due to cancer or its treatment.

“The PQI is an extremely helpful document,” added Cope. “I love that it is quick, direct and clear information.” Trisler points to a stepwise algorithm contained in the PQI that walks the user through treatment options based on risk factors, mutations, EPO levels and other factors, making treatment decisions “effortless.” She noted, “This section within the PQI Process is extremely helpful in determining treatment of our MDS patients.”

The authors concluded that the PQI provides “a precise and concise reference document” for guiding the treatment of patients with lower-risk Myelodysplastic Syndromes (MDS) with symptomatic anemia, specifically those experiencing suboptimal responses or treatment failure with erythropoietin stimulating agents (ESA). The authors concluded, “Empowering the team with the tools to effectively educate, counsel and treat oncology patients with lower-risk myelodysplastic syndromes who fail ESA treatment meets NCODA’s Guiding Values of being Patient-Centered and Always Collaborative.” Additionally, their assessment pointed to the benefits of the medically integrated team approach utilized by FCS and Massachusetts General North Shore Cancer Center as “essential for the overall care of oncology patents.”