Review Article

How Can Oncology Nurses and Advanced Practice Providers Reduce the Burden of Chemotherapy-Induced Febrile Neutropenia in the US?

Kristi Kay Orbaugh,(1) MSN, NP, AOCNP®, Sandra Cuellar,(2) PharmD, BCOP, FHOPA, FASHP, and Lisa Kennedy Sheldon,(2,3,4) PhD, APRN-BC, AOCNP®, FAAN

From (1)Community Hospital Oncology Physicians, Indianapolis, Indiana; (2)University of Illinois Chicago College of Pharmacy, Chicago, Illinois; (3)St Joseph Hospital, Boston, Massachusetts; (4)UI Health, Chicago, Illinois

Authors’ disclosures of conflicts of interest are found at the end of this article.

Correspondence to: Kristi Orbaugh, MSN, NP, AOCNP®, Community Hospital Oncology Physicians, 7979 Shadeland Ave Ste 200, Indianapolis, IN, 46250 E-mail: cmorb@aol.com

Background: Neutropenia and febrile neutropenia (FN) are serious complications of myelosuppressive chemotherapy and present a considerable burden to patients with cancer. Febrile neutropenia is associated with increased risks of infection and hospitalization, a particular concern during the coronavirus disease 2019 (COVID-19) pandemic. Oncology nurses and advanced practice providers (APPs; including nurse practitioners, physician assistants, advanced practice nurses, and pharmacists) play a vital role in the management of patients with cancer and the prevention of infections. Objectives: The objectives of this article are to summarize the burden of chemotherapy-related neutropenia and FN in patients with cancer in the US and to evaluate the role of oncology nurses and APPs in preventing and managing FN. Methods: This article provides a narrative review of US studies reporting on the burden of FN, FN during COVID-19, adherence to guidelines for the use of prophylactic granulocyte colony-stimulating factors (G-CSFs), the involvement of oncology nurses in FN prevention, management, and patient quality of life, and inappropriate and/or incomplete G-CSF treatment. Findings: Despite advances in supportive care for patients with cancer receiving myelosuppressive chemotherapy, neutropenia and FN present a considerable burden to patients, particularly during the COVID-19 pandemic. Oncology nurses and APPs play a vital role in the appropriate and timely delivery of supportive care, which can improve patient outcomes and minimize treatment costs.

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