Management of Malignant Bowel Obstruction (MBO) in Patients with Advanced Gynecological Cancers
Guidelines for the management of patients with Malignant Bowel Obstruction(MBO) are not available and as such, there remains an urgent need for a collaborative approach to streamline patient care and optimize use of hospital resources. This study will focus on management of MBO in advanced gynecological cancers.If patients with MBO can be effectively managed in an ambulatory setting, this may improve quality and consistency of patient care, and help reduce volume and duration of bed occupancy.
Study Type
OBSERVATIONAL
Enrollment
96
a proposed management algorithm for MBO has been developed to provide a pathway that safeguards quality and continuity of care for patients under a multidisciplinary team. It will engage key-stakeholders and foster an inter-professional approach. It incorporates an in-patient management algorithm and a novel nursing-led ambulatory management algorithm to supplement patient's medical management
Princess Margaret Cancer Centre
Toronto, Ontario, Canada
Optimization of multidisciplinary care
To optimize the multidisciplinary care management of MBO in patients with advanced gynecological cancer treated at University Health Network (UHN) which include in-patient and ambulatory management algorithm for MBO • Measured by a ratio of days alive and out of hospital compare to days in hospital within the first 60 days after diagnosis of MBO
Time frame: 2 years
Evaluation of treatment outcomes
To evaluate the treatment outcomes of patients with MBO * Measured by resolution of MBO and overall survival * Measured by transition through specific bowel management colour code system
Time frame: 2 years
Evaluation of impact of MBO management on hospital visits
To evaluate the impact of MBO management on number of emergency room visits, hospital admission and number of days alive and outside of hospital within the first 168 days (6 months) after the diagnosis of MBO
Time frame: 2 years
Evaluation of impact of MBO management on patient reported outcomes
To evaluate the impact of ambulatory MBO management on patient reported outcomes using the Distress Assessment \& Response Tool (DART)
Time frame: 2 years
To evaluate nutritional status of patients with MBO
To evaluate the nutritional status of patients with MBO • Measured by monthly albumin and weight
Time frame: 2 years
Evaluation of clinico-pathological factors
To evaluate the clinico-pathological factors that may predict benefit from palliative surgery, chemotherapy and total parenteral nutrition (TPN)
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Time frame: 2 years
Improve patient understanding and awareness of MBO
To improve patients' understanding and awareness of MBO with patient education material.
Time frame: 2 years
Determine percentage number of patient microbiome sample analyses completed
To record the percentage of patients who agree to, and for whom sample collection and analysis is completed
Time frame: 1.5 years
Record changes in the sum and types of gut microbiome from baseline to study end
Changes in the sum as well as types of microbiomes as recorded at baseline, initiation of total parenteral nutrition, incidence of an MBO and end of study are to be recorded
Time frame: 1.5 years
Evaluate cannabis use in patient population
Assess for any relationship between cannabis use and MBO
Time frame: 1.5 years