RNSystematic ReviewJournal of advanced nursing2023

Nurse and pharmacist systemic anti-cancer therapy review clinics and their impact on patient experience and care: A systematic review.

Lisa Barrott, Theresa Wiseman, Vicki Tsianakas and 1 others

PMID 36448339

WHAT IT FOUND

Advanced practice nurse and pharmacist roles in cancer therapy clinics vary widely and lack standard qualifications.

Evidence for improved patient outcomes is limited, with no proof of better holistic care or adherence despite increased reviews.

Key findings

01There is significant variation in skills, qualifications, and autonomy for advanced practice nurses and pharmacists, with no minimum standards identified.

02Nurse-led clinics did not demonstrate improved holistic care; researchers observed task-oriented interactions despite nurses' perceptions of being holistic.

03Evidence does not support that advanced practice service provision improves patient adherence to therapy or clinical outcomes.

STILL TO COME

How it was doneWhat they foundWhat it means for RNs

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What it does not show

Only 15 papers met inclusion criteria, and many used generic role titles, making it difficult to compare specific practices. Findings are limited by international variation in regulation and prescribing rights, reducing transferability. Two papers used secondary analysis of the same primary dataset, potentially over-weighting one study's findings. Patient experience data was sparse, often not SACT-specific, or from underpowered studies. No papers were excluded based on quality, and the search strategy missed several included papers initially, suggesting potential retrieval bias.

Declared interests

The research was supported by funding from The Royal Marsden NHS Foundation Trust and University Hospitals Sussex NHS Foundation Trust. The authors declared no conflicts of interest.

The easy way to misread this

Do not assume that establishing a nurse or pharmacist-led clinic automatically improves patient adherence, holistic care, or clinical outcomes. The evidence shows these benefits are not proven, and clinics often remain task-oriented rather than truly patient-centered.

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