Perspectives on Quality Initiatives

Hello, I’m Dr. Robyn Scherber and I’m happy to be partnering with Incyte to provide a physician’s perspective on the importance of Quality Initiatives in patients with myeloproliferative neoplasms, or MPNs.

Quality care means that every patient who comes into my clinic gets the best care possible to cover all aspects of that patient’s life. That means that I have to have the optimum tools at my disposal to make this care efficient. Quality Initiatives are one of those tools.

Patients with MPNs can be more complex than we realize and there are a lot of nuances that warrant a more tailored approach. This can only be achieved when the extended care team, including pharmacists and practice managers, collaborate to ensure patients are getting timely, thorough, and quality care.

Community oncologists may not diagnose and treat these patients with rare cancers like MPNs often. Patients with MPNs are unique because they can live for many years and have the potential to maintain a high quality of life. On the flip side, the consequences can be very distressing for patients if their full clinical picture is overlooked. Ideally, Quality Interventions should help address patients’ needs in a way that is relevant to their daily life.

There are three areas where I think we can focus—symptom assessment, risk stratification at diagnosis, and spleen assessment. First, symptom assessment; it is something that I passionately advocate for in the field of MPNs. I truly believe there is an underappreciation of symptoms in these patients, so the identification of specific symptoms is an ideal focus for quality interventions.

It’s so important to educate everyone on the patient’s care team on what symptoms to look for in your patients with myelofibrosis, polycythemia vera, and essential thrombocythemia. In my practice, the extended care team includes nurses, pharmacists, and phlebotomy staff, and they are all actively involved in recognizing MPN-related symptoms.

Number two is risk assessment. Understanding your patients’ risk level at diagnosis and on an ongoing basis is another area to target for Quality Interventions. In myelofibrosis, for example, clinicians need to be able to recognize important risk factors associated with shorter survival, shown here, and have a way to document them in the electronic health records so that patients can be managed appropriately.

Number three is spleen palpation. Spleen palpation should be a part of every physician exam in patients with MPNs. Screening for splenomegaly can help monitor for disease progression, including new or worsening splenomegaly, and associated symptoms such as abdominal pain, abdominal discomfort, early satiety, and weight loss.

Sharing knowledge among staff and having pathways embedded into your electronic health record systems to address patient issues is critical to delivering optimized care for patients with MPNs.