Survivorship In Brain Metastases Patients: The Role Of The Neuro-Oncology Team In Addressing Educational Needs In Non-Neuro-Oncology Professionals?

Outcomes of patients treated for brain metastases are improving, with growing numbers of long-term survivors following surgery and stereotactic radiosurgery (SRS). Most patients continue longer-term care predominantly under their site-specific oncology team (breast, lung etc). It was proposed that survivorship in brain metastases patients might be enhanced by addressing neuro-oncology-specific educational needs in less specialised health professionals. AIMS: To identify educational needs of health care professionals caring for patients following treatment for brain metastases. To provide a comprehensive educational package to meet needs identified. Educational needs were evaluated via a baseline survey addressing confidence in managing neuro-oncology problems. The questionnaire was electronically disseminated to an unselected, diverse group of health professionals including primary care physicians, nurses and allied health professionals in hospital and community settings. The results were collated to inform the content of the training. Surveys of attendees’ confidence in managing aspects of care were completed at registration, end of day and 5 weeks later. A two-sample Wilcoxon rank-sum (Mann-Whitney) test was applied to compare the data. 266 responses were received, although as it was disseminated electronically, response rate cannot be calculated. A whole-day training event was designed around the responses. Topics covered the acute and late toxicity of brain metastases treatments, management of epilepsy, emergencies and the role of rehabilitation in preserving function and enhancing quality of life. Results from the 90 attendees showed statistically significant improvement in confidence above baseline across all aspects at both time-points (end of day and 5 weeks later), suggesting that the attendees benefitted on the day and that benefit was retained. Significant unmet educational need was demonstrated in the confidence of non-neuro-oncology professionals caring for brain metastases patients. Targeted educational intervention achieved durable, measurable improvement. Further work to addressing survivorship in brain metastases populations is warranted.