Dihydropyrimidine Dehydrogenase (DPD) Deficiency: A Case for Oncology Nursing Education

2.50
Hdl Handle:
http://hdl.handle.net/10755/164606
Category:
Abstract
Type:
Presentation
Title:
Dihydropyrimidine Dehydrogenase (DPD) Deficiency: A Case for Oncology Nursing Education
Author(s):
Moore, Susan
Author Details:
Susan Moore, RN, MSN, ANP, AOCN, Consultant, CancerExpertise, Chicago, Illinois, USA, email: smoore46@yahoo.com
Abstract:
Education: Dihydropyrimidine dehydrogenase (DPD) deficiency is an autosomal recessive metabolic disorder in which there is absent or decreased activity of DPD, an enzyme involved in the metabolism of fluoropyrimidines. Standard doses of 5-FU or capecitabine can result in severe mucositis, diarrhea, neutropenia, cerebellar dysfunction and death. The mortality rate is almost 100% in patients with complete DPD deficiency. Approximately 3 - 5% of cancer patients are partially DPD-deficient and 30-57% of severe 5-FU toxicities are attributed to DPD deficiency. Oncology nurses provide the majority of pre-treatment patient education and must be aware of DPD deficiency and the sequelae. The purpose of this project was to provide interactive casebased nursing education to promote prospective evaluation of patients scheduled for fluoropyrimidine-based therapy for DPD deficiency risk factors, and encourage discussion of screening with the oncologist and patient. Oncology nurses attended a one-hour educational session on management of colorectal cancer which included 15 minutes of material on pathogenesis, risk assessment, and screening for DPD deficiency. Exit learning assessments were collected from 97% of those who attended. Oncology nurses (N=249) with varied nursing education backgrounds attended case-based sessions that included information on DPD deficiency. Learning assessments included Likert scale (1-4, low to high) evaluation of comprehension of the information and preference for case-based learning experiences. Results: Comprehension: 84% ranked comprehension as 4 (excellent); 14% ranked as 3 (good); and 2% ranked as 2 (fair). Preference for casebased learning: 91% ranked preference as 4 (excellent); 9% ranked as 3 (good). 98% of respondents stated they would make practice changes as a result of this information. DPD deficiency testing is readily available to hospitals and community oncology practices and has the potential to lower the incidence of severe 5-FU toxicity by prospectively identifying atrisk patients. Awareness of high risk patient categories - female, African American, family history of severe 5-FU toxicities - should alert the nurse to discuss DPD deficiency testing with the oncologist prior to ordering chemotherapy. The high financial and QOL costs of supportive care for the complications encountered in DPD-deficient patients who receive 5-FU based therapy underscores the importance of screening for DPD deficiency.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2009
Conference Name:
34th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
San Antonio, Texas, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleDihydropyrimidine Dehydrogenase (DPD) Deficiency: A Case for Oncology Nursing Educationen_GB
dc.contributor.authorMoore, Susanen_US
dc.author.detailsSusan Moore, RN, MSN, ANP, AOCN, Consultant, CancerExpertise, Chicago, Illinois, USA, email: smoore46@yahoo.comen_US
dc.identifier.urihttp://hdl.handle.net/10755/164606-
dc.description.abstractEducation: Dihydropyrimidine dehydrogenase (DPD) deficiency is an autosomal recessive metabolic disorder in which there is absent or decreased activity of DPD, an enzyme involved in the metabolism of fluoropyrimidines. Standard doses of 5-FU or capecitabine can result in severe mucositis, diarrhea, neutropenia, cerebellar dysfunction and death. The mortality rate is almost 100% in patients with complete DPD deficiency. Approximately 3 - 5% of cancer patients are partially DPD-deficient and 30-57% of severe 5-FU toxicities are attributed to DPD deficiency. Oncology nurses provide the majority of pre-treatment patient education and must be aware of DPD deficiency and the sequelae. The purpose of this project was to provide interactive casebased nursing education to promote prospective evaluation of patients scheduled for fluoropyrimidine-based therapy for DPD deficiency risk factors, and encourage discussion of screening with the oncologist and patient. Oncology nurses attended a one-hour educational session on management of colorectal cancer which included 15 minutes of material on pathogenesis, risk assessment, and screening for DPD deficiency. Exit learning assessments were collected from 97% of those who attended. Oncology nurses (N=249) with varied nursing education backgrounds attended case-based sessions that included information on DPD deficiency. Learning assessments included Likert scale (1-4, low to high) evaluation of comprehension of the information and preference for case-based learning experiences. Results: Comprehension: 84% ranked comprehension as 4 (excellent); 14% ranked as 3 (good); and 2% ranked as 2 (fair). Preference for casebased learning: 91% ranked preference as 4 (excellent); 9% ranked as 3 (good). 98% of respondents stated they would make practice changes as a result of this information. DPD deficiency testing is readily available to hospitals and community oncology practices and has the potential to lower the incidence of severe 5-FU toxicity by prospectively identifying atrisk patients. Awareness of high risk patient categories - female, African American, family history of severe 5-FU toxicities - should alert the nurse to discuss DPD deficiency testing with the oncologist prior to ordering chemotherapy. The high financial and QOL costs of supportive care for the complications encountered in DPD-deficient patients who receive 5-FU based therapy underscores the importance of screening for DPD deficiency.en_GB
dc.date.available2011-10-27T12:03:43Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:03:43Z-
dc.conference.date2009en_US
dc.conference.name34th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationSan Antonio, Texas, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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