Management of immune-related dermatologic toxicities in cancer patients receiving PD-1/PD-L1 blockade: a best practice implementation project

INTRODUCTION: Immune checkpoint inhibitors (ICIs) have been widely used as an important approach to treat tumors. However, about 30% patients receiving ICIs develop immune-related dermatologic toxicities (IDTs), which may lead to treatment interruption and poor prognosis. OBJECTIVES: This evidence implementation project was carried out in the Department of Radiation Oncology at Nanfang Hospital in Guangzhou, China and aimed to improve the management of IDTs in cancer patients treated with PD-1/PD-L1 inhibitors. METHODS: The project used the JBI Evidence Implementation Framework, which is based on an audit and feedback process. Criteria for audits were derived from JBI Best Practice Evidence Summaries. The baseline audit was used to identify gaps in compliance with best practices and barriers and facilitators of implementation. After the implementation of change strategies, a follow-up audit was conducted to measure changes in compliance. RESULTS: Gaps between evidence and practice were noted for six of the criteria, and five barriers to implementation were identified. The follow-up audit revealed that compliance with audit criteria 1-5, 7, and 8 reached 100%, while criterion 6 partially improved from 36.7% to 50%. CONCLUSIONS: The results indicate that this project improved compliance with evidence-based practices for the management of IDTs by standardizing clinical practices and improving the quality of nursing management. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A550.