Scalp Cooling: Implementation of a Program at a Multisite Organization

Fischer-Cartlidge, Erica; Ross, Mikel; Hernandez, Karen; Featherstone, Ashley; Haase, Curt

doi:10.1188/18.cjon.534-541

Cited by 4 publications

(18 citation statements)

References 15 publications

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“…The studies were published between 1996 and 2020, all in English. Five are descriptive studies, 28–32 four narrative reviews, 33–36 three qualitative studies, 37–39 two mixed methods studies, 40,41 two theoretical articles about implementation experience 42,43 and one observational study 44 …”

Section: Resultsmentioning

confidence: 99%

Ethical, legal, organizational and social issues related to the use of scalp cooling for the prevention of chemotherapy‐induced alopecia: A systematic review

Rodríguez

Ramos‐García

Infante-Ventura

et al. 2022

Health Expectations

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Introduction: Scalp cooling (SC) aims to prevent chemotherapy-induced alopecia.The goal of this systematic review is to tackle ethical, legal, organizational and social issues related to SC.Methods: A critical appraisal of the literature was carried out using a systematic review design. MEDLINE, Embase and Web of Science databases were searched up until 2 June 2021. Studies addressing these aspects in English or Spanish were considered. Representatives of both patient associations and professional scientific societies related to the topic participated in the design of the protocol and the review of the findings.Results: A total of 17 studies were included. Articles were critically appraised using the MMAT and SANRA. Findings were organized into four categories: (1) ethical aspects focused on equal access, gender equity and doctor-patient communication supported by Patient Decision Aids (PtDAs); (2) patient perspective and acceptability;(3) professional perspective and acceptability; (4) organizational aspects focused on accessibility and feasibility. Conclusion:Cancer patients' expectations when using SC need to be adjusted to reduce the potential distress associated with hair loss. PtDAs could help patients clarify their values and preferences regarding SC. Equal access to technology should be guaranteed.

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Section: Resultsmentioning

confidence: 99%

Ethical, legal, organizational and social issues related to the use of scalp cooling for the prevention of chemotherapy‐induced alopecia: A systematic review

Rodríguez

Ramos‐García

Infante-Ventura

et al. 2022

Health Expectations

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“…8,18 Some institutions have published details about the development of their scalp cooling workflows, which combine efforts of providers and nurses to treat CIA, providing successful strategies for SCT adoption for other institutions. 36,37 Multiple studies have chronicled the adverse psychosocial effects of CIA on both men and women, with reports of at least 50% of patients defining hair loss as one of their most feared chemotherapy-related side effects. 6,[38][39][40][41][42][43] We found that more than 40% of surveyed providers stated that patients do not use SCT because of not being overly concerned about hair loss and may initiate these conversations principally in women and patients with breast cancer.…”

Section: Discussionmentioning

confidence: 99%

Identifying Barriers and Facilitators to Scalp Cooling Therapy Through a National Survey of the Awareness, Practice Patterns, and Attitudes of Oncologists

Novice

Henry

et al. 2022

JCO Oncology Practice

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PURPOSE: Scalp cooling therapy (SCT) is the most effective method to reduce chemotherapy-induced alopecia (CIA), a highly distressing side effect of cancer treatment. Despite data supporting SCT efficacy and safety, SCT use in the United States is not widespread. Oncologists' interactions with scalp cooling were examined to identify facilitators and barriers to SCT implementation. METHODS: A 33-question survey was distributed through the ASCO Research Survey Pool to a nationally representative, random sample of 600 oncology providers. Outcome measures included knowledge of SCT, frequency of initiating conversations about SCT with patients, degree of support, and barriers for SCT. Significance was defined as P < .001. RESULTS: Of 155 (25.8%) responding providers, 62% of providers were in favor of SCT always or most of the time, but only 26% reported initiating discussions about SCT always or most of the time. Providers who treat breast cancer ( P ≤ .0001), those who report being very familiar with SCT ( P ≤ .0001), those who report having read SCT literature in the past 2 years ( P ≤ .0001), and those who work at a facility with machine SCT ( P ≤ .0001) were significantly more likely to initiate conversations with patients about SCT. Financial concerns (58%) were the primary reason for not recommending SCT use; efficacy (31%), staff or facility (24%), and safety (15%) concerns were also noted. Although safety concerns have decreased markedly over time, 14% of providers report patients who continue to express these concerns and 17% of providers see safety issues as barriers to supporting SCT. CONCLUSION: Our findings suggest that oncology provider familiarity and experience with SCT lead to increased support for scalp cooling, which may ultimately result in greater availability and utilization of SCT when indicated.

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“…Together with nurse practitioners (NPs) and physician assistants (PAs), physicians must be aware of these factors and be able to discuss them with patients during a visit or after the patient returns home and has additional concerns. Some institutions have created a ''steps in the process'' sheet and a ''physician's talking points'' sheet with a checklist that serves as a guide for patient education and cap sizing [25].…”

Section: Discussionmentioning

confidence: 99%

“…Cooling continues throughout the infusion of chemotherapeutic agents and for up to 20-120 min after the infusion is completed, dependent on the chemotherapy regimen [14,23]. Treatment centers must incorporate the logistics of SC into facility workflows by coordinating physician general supervision of the patient, as defined by the 2020 Hospital Outpatient Prospective Payment System (HOPPS) final rule [24], scheduling additional chair time, planning for incremental nursing staff effort, and modifying the physical infusion suite to accommodate cooling machines (e.g., space, power requirements) [25].…”

Section: Introductionmentioning

confidence: 99%

Integration of Physician and Nursing Professional Efforts to Deliver Supportive Scalp Cooling Care to Oncology Patients at Risk for Alopecia

et al. 2020

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Scalp cooling (SC) is an effective and generally well-tolerated method for prevention of chemotherapy-induced alopecia (CIA). Initially studied in early-stage breast cancer, these devices have expanded US Food and Drug Administration (FDA) clearance in a broad range of solid tumors including ovarian, colorectal, and prostate. Introducing SC to eligible patients, including those distraught by concerns of CIA, requires an integrated effort on the part of the physician, nursing, and care manager medical team. This article presents a pragmatic workflow for collaborative efforts from physicians and allied health professionals in the USA to deliver supportive SC to reduce CIA in patients undergoing treatment regimens known to impact hair follicles. It further highlights the efforts required to identify appropriate patients, educate, and set expectations of patients. The supervisory role of the physician during the procedure, the nursing role in monitoring and documentation, and the post-procedure decision-making by the physician are also addressed. Lastly, it suggests that integrated physician and nursing efforts necessary for scalp cooling are similar to other care used in oncology.

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Scalp Cooling: Implementation of a Program at a Multisite Organization

Cited by 4 publications

References 15 publications

Ethical, legal, organizational and social issues related to the use of scalp cooling for the prevention of chemotherapy‐induced alopecia: A systematic review

Ethical, legal, organizational and social issues related to the use of scalp cooling for the prevention of chemotherapy‐induced alopecia: A systematic review

Identifying Barriers and Facilitators to Scalp Cooling Therapy Through a National Survey of the Awareness, Practice Patterns, and Attitudes of Oncologists

Integration of Physician and Nursing Professional Efforts to Deliver Supportive Scalp Cooling Care to Oncology Patients at Risk for Alopecia

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