Yumin Li and Fang Wang*

Department of Oncology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province 225000, China

*Corresponding Author:
Fang Wang
Department of Oncology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province 225000, China
E-mail: anionyz@163.com
This article was originally published in a special issue, “Exploring the Role of Biomedicine in Pharmaceutical Sciences”
Indian J Pharm Sci 2024:86(1) Spl Issue “196-199”

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms

DOI: 10.36468/pharmaceutical-sciences.spl.839

Abstract

A study is being conducted to examine the effectiveness of continuous intervention in conjunction with bevacizumab in managing individuals with non-small cell lung cancer. In this study, we recruited 100 lung cancer patients who underwent treatment at our hospital between June 2020 and June 2022. Subsequently, these individuals were randomly allocated into two groups; control group and an observation group, comprising 50 patients in each group. Routine care was given to the control group, whereas the observation group received enhanced care continuously along with the routine care offered to the control group. Following a 6 mo follow-up period, the self-developed "Disease Knowledge Questionnaire" was utilized to assess the level of disease knowledge awareness in both groups. The quality of life evaluation scale was utilized to gauge the survival quality of the patients, taking into consideration their physiological, psychological, social, and health education aspects. Adverse reactions, including diarrhea, rash, nausea/vomiting, and elevated transaminases, were also monitored and documented. The observation group exhibited a notably higher disease knowledge awareness rate compared to the control group (p<0.05). Additionally, in terms of physiological, psychological, social, and health education domains, the observation group achieved remarkably better scores than the control group (p<0.05). However, no substantial difference was found in overall adverse reactions between the two groups (p>0.05). The outcomes of this research affirm the effectiveness and suitability of integrating continuous care and bevacizumab as a treatment approach for non-small cell lung cancer. By implementing continuous care measures, individuals experienced an improvement in disease knowledge awareness and an enhancement in their physiological, psychological, and social functions. Importantly, these measures did not exert a significant negative impact on the management of adverse reactions.

Keywords

Continuous intervention, targeted therapy, non-small cell lung cancer, bevacizumab, life quality

Being the foremost cause of cancer-related fatalities[1], lung cancer predominantly manifests as Non-Small Cell Lung Cancer (NSCLC), comprising 80 %-85 % of cases, and approximately 30 % of these cases involve sensitive gene mutations. When contrasted with traditional chemotherapy, targeted therapy has shown significant advancements in the prognosis of NSCLC patients who harbor sensitive gene mutations. Nevertheless, research indicates that following discharge, several patients face challenges such as inadequate supervision, irregular lifestyles, and delays in identifying abnormal physical conditions, ultimately influencing treatment outcomes and potentially exacerbating the disease[2]. With the intention of diminishing the incidence of the aforementioned scenarios, a continuous intervention model has been advocated in clinical practice. This model ensures that patients receive consistent healthcare even after being discharged, thereby safeguarding the effectiveness of their treatment[3-5]. Through continuous monitoring and intervention, the aim of continuous intervention is to optimize treatment outcomes and minimize treatment-related adverse reactions. Continuous intervention typically involves regular disease monitoring, medication management, nursing support, and symptom management for patients. It also entails effective communication and education with patients and their families to help them better understand disease progression and treatment plans[6,7]. The application effectiveness of the continuous care model was evaluated through a group analysis involving 100 NSCLC patients as the main focus of this study. Within the period of June 2020 to June 2022, a retrospective study was undertaken on 100 lung cancer patients who underwent treatment at our hospital. These patients were then allocated randomly into two groups; a control group and an observation group, comprising 50 patients each. Among the participants, the control group included 29 males and 21 females, with an age varying from 40 y to 70 y old, and an average age of (54.73±6.25) y. Meanwhile, the intervention group consisted of 26 males and 24 females, ranging in age from 39 y to 72 y, with an average age of (55.16±6.18) y. The general data showed no statistically remarkable disparities between groups, confirming their comparability (p>0.05). Approval for conducting this research was granted by the hospital’s ethics committee, ensuring adherence to ethical principles. All patients were fully informed and willingly participated in the study, as indicated by their signed consent forms. The inclusion criteria pathologically confirmed diagnosis of NSCLC; age range between 20 y and 75 y; need for ongoing intravenous targeted drug therapy post-discharge and follow-up period duration of >6 mo. In exclusion criteria, coexistence of other malignant tumors; severe liver or kidney dysfunction, as well as cardiovascular and cerebrovascular diseases; pregnant or breastfeeding female patients and existence of evident mental disorders were excluded. Routine care, in addition to standard chemotherapy combined with bevacizumab treatment, was provided to patients in the control group. Conversely, the study group received continuous care, following the identical treatment protocol as the control group. In preparation phase, continuous care team was established, consisting of a head nurse as the team leader and three nurses as team members. The team received training on the continuous care for NSCLC patients treated with bevacizumab. Anticipated issues in care were discussed and explained. Health records were established for patients upon discharge, documenting personal information, family situation, economic status, tumor staging, pathological type, and past treatment history. Patients were educated on daily diet, exercise, emotional well-being, and regular follow-up before discharge. Intervention measures patients received biweekly phone follow-up, with detailed recordings of bevacizumab usage and the occurrence of adverse drug reactions. Patients were educated on the importance and necessity of molecular targeted drug treatment for the disease, as well as adverse reaction monitoring and selfcare knowledge. They were instructed to maintain clean skin, follow a light diet, and ensure sufficient sleep. Communicating with patients, their level of disease knowledge awareness, and their psychological status were evaluated. Patients were guided in self-emotional management, and family members were encouraged to provide additional psychological support, ensuring patients were in the best psychological state. Patients were advised to visit the hospital for regular check-ups or hospitalization on a monthly basis. Follow-up hotlines, WeChat groups, and other communication channels were established to promptly address patient questions. Disease knowledge awareness rate a self-developed "Disease Knowledge Questionnaire" was utilized, covering awareness of etiology and risk factors, major clinical symptoms, complications, treatment methods, and pain management strategies. Quality of life evaluation scale was employed to evaluate patient’s life quality across multiple domains, including physiological function, psychological function, social function, and health education. A higher score on the scale signified a greater quality of life[8]. Adverse reactions these included were diarrhea, rash, nausea/vomiting, and elevated transaminases. Statistical Package for the Social Sciences (SPSS) 25.0 will be employed to perform the statistical analysis in this research. Mean and standard deviation will be reported for continuous variables and analyzed through t-tests, while frequencies and percentages n (%) will be used to represent categorical variables and assessed using Chi-square (χ2) tests. The significance level of p<0.05 will be applied to determine statistical significance. A 6 mo follow-up conducted after the intervention indicated that the observation group displayed a notably higher awareness rate concerning the etiology and risk factors, major clinical symptoms, complications, treatment methods, and pain management strategies, in comparison to the control group (p<0.05) as shown in Table 1. As a result of the intervention, the study group achieved notably higher scores in physiological function, psychological function, social function, and health education in contrast to the control group (p<0.05) as shown in Table 2. During the 6 mo follow-up period, there was no remarkable difference in the occurrence rates of diarrhea, rash, nausea/vomiting, elevated transaminases, and overall adverse reactions between the two groups (p>0.05) as shown in Table 3. NSCLC patients not only undergo surgery, chemotherapy, and other treatments but also require long-term use of targeted drugs. Due to the prolonged duration of treatment, patients are prone to experiencing anxiety, irritability and other negative emotions, which can significantly impact their treatment and life quality[9,10]. To improve the quality of care and provide better services to patients, continuous care can be implemented after discharge. During the medication period, close communication with patients is maintained, paying attention to their psychological status, medication adherence, and lifestyle. Disease and health knowledge are disseminated, guiding patients on self-care and self-health management. Scientific guidance and assistance are tailored to each patient’s specific condition, helping to increase their confidence in fighting the disease and ultimately facing it with a positive attitude. Continuous care is an extension of hospital care, ensuring that scientific and effective care measures continue beyond the patient’s discharge, providing targeted services that allow patients to receive subsequent treatment in the best possible state[11,12]. The results of this study revealed that, in the treatment of NSCLC using continuous care combined with bevacizumab, the observation group had significantly higher awareness rates regarding disease etiology and risk factors, major clinical symptoms, complications, treatment methods, and pain management strategies compared to the control group. Therefore, it can be concluded that continuous care is more effective than routine care in improving comprehensive understanding of NSCLC, facilitating symptom control, and enhancing the quality of life. Extensive evidence has shown that the implementation of continuous care plays a crucial role in enhancing disease awareness, managing patient symptoms, and mitigating adverse emotional responses in various chronic diseases[13,14]. Additionally, the observation group exhibited markedly higher scores in physiological function, psychological function, social function, and health education compared to the control group (p<0.05). These findings suggest that the combination of continuous care and bevacizumab treatment has a favorable impact on enhancing the life quality and facilitating overall recovery. The results emphasize the importance of continuous care and the necessity for patients to receive comprehensive support and education throughout the treatment process. Similarly, Guo et al.[15] reported that patients in the continuous intervention group had higher scores in physiological function, overall health, social function, and mental health quality of life dimensions compared to the conventional intervention group. Moreover, the analysis revealed no statistically significant distinction in the overall occurrence of adverse reactions between the two groups (p>0.05). This implies that the integration of continuous care and targeted drug treatment exhibits satisfactory safety acceptability and does not noticeably heighten the occurrence of adverse reactions as compared to traditional treatment methods. However, individual adverse reactions such as diarrhea, rash, nausea/ vomiting, and elevated transaminases require further observation and control to ensure patient’s treatment experience and safety. Overall, this study confirms the effectiveness and acceptability of adopting continuous care in conjunction with bevacizumab for treating individuals with NSCLC. The implementation of continuous care measures improves patients' awareness of disease etiology and risk factors, major clinical symptoms, complications, treatment methods, and pain management strategies, as well as their physiological, psychological, and social functions, without significant adverse effects on the control of adverse reactions. These findings provide further evidence and guidance for clinical practice and serve as a reminder for clinical teams to pay attention to patient’s comprehensive needs during the treatment process. Nevertheless, further research comprising large-scale samples and prolonged follow-up periods is warranted to verify these findings and investigate the long-term repercussions of continuous care measures on patient prognosis.

Group n Etiology and risk factors Main clinical symptom Complication Treatment method Ways to reduce pain
Observation 50 45 (90.00) 49 (98.00) 42 (84.00) 47 (94.00) 48 (96.00)
Control 50 34 (68.00) 40 (80.00) 31 (62.00) 35 (70.00) 34 (68.00)
χ2 7.294 8.274 6.139 9.756 13.279
p 0.007 0.004 0.013 0.002 0.000

Table 1: Comparison of Disease Knowledge Awareness Rate

Group n Physiological function Psychological function Social function Health education
Observation 50 53.29±3.85 49.75±4.74 51.38±4.85 46.48±3.01
Control 50 41.27±3.39 41.57±4.13 42.38±4.64 37.48±2.86
t -3.837 -4.381 -2.394 -4.292
p 0.001 0.02 0.000 0.000

Table 2: Comparison of Life Quality

Group n Diarrhea Rash Nausea and vomiting Elevated transaminase Overall adverse reactions
Observation 50 2 (4.0) 2 (4.0) 1 (2.0) 2 (4.0) 7 (14.0)
Control 50 1 (2.0) 2 (4.0) 2 (4.0) 3 (6.0) 8 (16.0)
χ2 6.173
p 0.736

Table 3: Comparison of Adverse Reactions

Conflict of interests:

The authors declared no conflict of interests.

References