Why Using a Step-by-Step Adverse Event Blueprint?
Healthcare providers sometimes find it difficult to manage adverse events successfully. Although there are a number of treatment options available, adverse events are not always well-controlled. In many cases this leads to dose modifications or in the worst case scenario, to a discontinuation of the treatment. It is important to emphasize that with appropriate measures most of the adverse events can be managed without dose modification or discontinuation, both of which may negatively impact clinical outcome. If the symptoms persist without any signs of improvement, the adverse events should be systematically evaluated after 48 hours and before treatment modification. Initiation of the most appropriate treatment is more likely to occur if the following steps are taken: Terminology, Assessment, Reporting of Characteristics, Grading, Education of the patient, Treatment.
- Terminology – identify correct diagnosis of the adverse event.
- Assessment – identify signs and symptoms of the adverse event and the impact of an adverse event for a particular patient.
- Reporting of characteristics – collect and report more in-depth information about the adverse event.
- Grading – classify the severity of the adverse event.
- Education of the patient – reconfirm general measures and educate the patient about the treatment to be initiated.
- Treatment – institute most appropriate and effective treatment strategies.
To support this process, the TARGET Strategy was developed. The letters of this system stand for Terminology, Assessment, Reporting, Grading, Education, and Treatment. The TARGET Strategy provides a roadmap that supports implementing appropriate treatment options for adverse events with special attention to immuno-oncology & targeted therapy. If both the healthcare professional and the patient follow the steps of this system, it is much more likely that the most appropriate treatment will be chosen. If treatment is initiated early after the onset of an adverse event, it is probable that the symptoms will remain controllable for most of the time.
In the book The TARGET System common targeted therapy-associated mucocutaneous adverse events are discussed in detail.