Quality Improvement Initiative to Develop Individualized Management Strategies for HER2+ MBC

A quality improvement initiative was conducted to identify and address real-world challenges faced by healthcare professionals (HCPs) in individualizing treatment plans, adverse event management, and patient-centered care for HER2+ metastatic breast cancer (MBC).

To assess practice patterns, challenges, and attitudes related to individualized and patient-centered care for HER2+ MBC, tethered surveys were completed by 22 HCPs who treat patients with breast cancer as well as 51 patients with HER2+ MBC from 2 large US community oncology clinics between September 2022 to December 2022. Patient chart audits (n=100) were performed to assess current practice patterns and track changes. Eligible patients had confirmed HER2+ MBC diagnosis, prescription for ≥2 lines of HER2+ breast cancer treatment, and 1 visit in the 1-year chart abstraction period.

In tethered surveys, the most common challenges reported by HCPs when caring for patients with HER2+ MBC were coordination of care (41%) and individualizing treatment plans (32%), whereas challenges reported by patients receiving care for HER2+ MBC were feeling confident in treatment plan (30%) and being unable to meet work or home responsibilities (22%).

Discordance was noted between patient and HCP perceptions related to treatment goals, patient education, and patient-centered care. Although 82% of HCPs indicated that treatment preferences were often or always discussed with patients, only 8% of patients reported such discussions with their HCP. In contrast to the perception of HCPs (82%) that prolonging survival was the top treatment goal for patients, improving quality of life (57%) and controlling symptoms (41%) were reported as patients’ top treatment goals. Similarly, HCPs perceived that patients found management of nausea/vomiting (68%) and diarrhea (59%) to be the most difficult, whereas patients reported that they have the most difficulty in managing fatigue (46%) and hair loss (44%).

Several gaps in guideline-aligned care were identified in baseline chart audits relating to treatment selection, sequencing, and supportive care. Action plans were developed and implemented based on these areas for improvement; these included increased one-on-one or group educational sessions with patients (50%), increasing use of patient navigators (33%), patient referral to palliative care at time of diagnosis (33%), incorporation of multidisciplinary team–based approaches (42%).

Based on findings of this quality improvement initiative, several gaps in guideline-aligned, patient-centered care were identified for patients with HER2+ MBC, providing opportunities to implement individualized management strategies that improve patient outcomes in the community setting.

Source:

Mahtani R, Hamilton E, Dewald I, et al. Empowering oncologists to develop individualized management strategies for HER2+ metastatic breast cancer: findings from a quality improvement initiative. Presented at the 46th San Antonio Breast Cancer Symposium Annual Meeting, December 5-9, 2023; San Antonio, TX: Abstract PO4-04-03.