Optimizing Management of Rash Associated With EGFR Inhibitors: A Workshop for Oncology Nurses

This program was presented as a continuing education regional symposium for oncology nurses.

Release Date: March 2009
Expiration Date: February 2010
Estimated Time to Complete Activity: 36 minutes
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Target Audience

This activity has been designed to meet the educational needs of patient care oncology nurses and advanced practice oncology nurses.

Purpose

To educate nurses on effective strategies for the assessment and management of dermatologic toxicities related to treatment with epidermal growth factor receptor (EGFR) inhibitors.

Program Overview

This presentation will review the management of rash experienced by patients receiving the novel class of agents that target EGFR. Although generally well tolerated, EGFR inhibitors are associated with dermatologic reactions in most patients—yet no evidence-based management guidelines have been established. In this regional CE program, oncology nurse experts will provide thorough answers to oncology nurses’ most pressing questions related to the administration of EGFR inhibitors in clinical practice. The pathophysiology of cellular signaling pathways involved in EGFR inhibition and mechanisms of action of EGFR inhibitors will be presented in 3-D video animation. Thought leaders will review the clinical application and ongoing investigations of agents, and provide a comprehensive review of rash assessment and management. Case presentations will be used to support key learning objectives. At the commencement of each program, nurses will be encouraged to participate in a survey regarding experiences with rash assessment tools and management. The results of the survey will be collated, and will specifically evaluate variations in assessment and management based on demographics and practice setting. Results will highlight knowledge gaps and provide direction for subsequent CE programs.

Learning Objectives

Upon completion of this program, participants should be better able to:

Describe the mechanism of action of EGFR inhibitors
Identify current clinical applications for EGFR inhibitors
Describe the side-effect profiles of EGFR inhibitors
Discuss appropriate nursing assessment and management of rash experienced by patients receiving EGFR inhibitor therapy

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the U.S. Food and Drug Administration. IMER, Bristol-Myers Squibb Company and ImClone Systems, Inc. do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of IMER, Bristol-Myers Squibb Company and ImClone Systems, Inc. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patients’ conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Faculty

Theres Gillespie, PhD, RN
Dr. Gillespie is an associate professor in the Department of Surgery as well as the Department of Hematology and Medical Oncology at Emory University School of Medicine. She also serves as director of the Division of Health Services Research at the Veterans Affairs Medical Center in Atlanta. She obtained her doctorate in the Division of Educational Studies at Emory University. Dr. Gillespie’s research interests include the prevention and control of symptoms associated with cancer and cancer therapy. With more than 27 years experience in clinical oncology, she has published and presented extensively. Dr. Gillespie is a manuscript reviewer for numerous journals, including Oncology Nursing Forum, Oncology Clinical Practice, and Journal of General Internal Medicine.

Disclosure of Conflicts of Interest

The Institute for Medical Education & Research (IMER) assesses conflict of interest with its instructors, planners, managers, and other individuals who are in a position to control the content of CE/CME activities. All relevant conflicts of interest that are identified are thoroughly vetted by IMER for fair balance, scientific objectivity of studies utilized in this activity, and patient care recommendations. IMER is committed to providing its learners with high quality CE/CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CE/CME activity:

Theresa W. Gillespie, PhD, RN, reported no areas of conflict.

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this educational activity:

The following IMER planners and managers, Michael Bramwell; Lourdes Briz, BS; Timothy J. DiChiara, PhD; Ninotchka Doleyres, MPH; Dorothy Dulko, PhD, RN, AOCNP-C^®; Elisheva Hertz, BSN, RN, OCN^®; Madelyn T. Herzfeld, BSN, RN, OCN^®; Davecia Ragoonath-Cameron, MS; Matthew Weeks, BA, reported no financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this educational activity.

Accreditation Statements

This educational activity for .6 contact hours will be provided by IMER. IMER is an approved provider of continuing education by the Georgia Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

A statement of credit will be issued only upon receipt of a completed activity evaluation form.

Safeguards Against Commercial Bias

IMER affirms that the content and format of its CE activities and related materials promote improvements and quality in healthcare and do not promote a specific proprietary business interest of a commercial entity. To this end, IMER employs several strategies to ensure the absence of commercial bias, including but not limited to review of all planned content for CE activities sponsored by IMER to ensure adherence to the American Nurses Credentialing Center’s criteria and operational requirements and the Accreditation Council for Continuing Medical Education’s content validation statements and resolution of any actual or perceived conflict of interest that exist. We employ three metrics as we review materials:

1. Fair balance

a.
Recommendations or emphasis must fairly represent and be based on a reasonable and valid interpretation of the information available on the subject matter

b.
No single product or service is overrepresented when other equal competing products or services are available for inclusion

2.	Scientific objectivity of studies mentioned in the materials or used as the basis for content

3. Appropriateness of patient care recommendations made to learners

Privacy Policy

When you participate in an educational activity provided by IMER (“we”), we ask you for your name, degree, affiliation, street address, telephone number, fax number, and e-mail address (the “Information”). We use that Information in the following ways:

We use the Information to grade your posttest and to send you a certificate of completion of the educational activity. If we use a third-party company to grade your posttest and issue certificates of completion, we will give the Information to that company for that purpose only.

For each educational activity that you take, you must complete an evaluation questionnaire. That questionnaire asks if you are willing to participate in a follow-up survey. If you answer yes, we will use your name and contact information to send you the survey.

We may use the Information to invite you to participate in other educational activities that IMER or its affiliates may offer.

On occasion, the commercial supporter of a educational activity will ask us for a list of the people who participated in that activity, so that it may document the first level of outcomes-based evaluation in the educational activity (ie, who attended, which medical specialties/practices were represented, how this compares to the target audience, and whether the activity needs to be repeated because significant numbers of the target audience did not attend). In that event, we will provide the supporter with your name, title and affiliation, but we will request in writing that the supporter not contact you directly for any purpose.

If our company is acquired or merged into another company, we may make the Information available to the new owner/entity to use in the ways described above, to enable it to continue our business.

Any changes to our privacy policy will be posted here.

Method of Participation

There are no fees for participating and receiving CME credit for this activity.

During the period March, 2009 through February, 2010, participants must
(1) read the learning objectives and faculty disclosures; (2) study the educational activity; (3) complete the posttest by recording the best answer to each question in the answer key on the evaluation form; and (4) complete the evaluation form;

Once you finished your test and completed the subsequent evaluation form, click submit test to send your responses to us. Your test will be immediately reviewed and if you receive a passing grade of 70% or better, you will then be directed to print your certificate online.

Media

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