Clinical and economic impact of the advanced practice nurse in lung cancer patients receiving immunotherapy-based treatments: A quantitative study

Abstract

Purpose: To evaluate the impact of an advanced practice nurse (APN) intervention on the reduction of emergency department visits due to immune-related adverse events (irAEs) in patients receiving immunotherapy-based treatments. Also, to analyze changes in hospitalization and hospital costs due to adverse effects of treatment and in the time to action against these. Methods: The study compared a prospective sample of patients who received APN support (intervention) and a retrospective sample of patients with lung cancer without APN support (control). Toxicity-related emergency room visits, time to action on an irAE, and need for hospitalization were the most relevant key health indicators. Data were collected partly retrospectively from a patient database before the implementation of the APN role and partly through a consecutive convenience sampling of patients who had access to the APN in the consultation. Data were analyzed using descriptive statistics and comparisons between the two samples. Results: Key results indicated a 92% reduction in emergency department visits with APN monitoring (OR 0.08), 73% reduction in hospital admission, 78.57% faster action on an irAE, and €195,982.8 (54.8%) cost savings over 12 weeks. Conclusion: APN intervention improves the management of irAEs and the quality of care for lung cancer patients. There is a decrease in the need for emergency care and hospitalizations. Also, reduced hospital costs.