The paper “Evaluation of Collaborative Care by CL” provides a very clear picture of the issues of endocrine therapy as part of the treatment for hormone receptive breast cancer and providing an overview of what drugs are available, including what some of the side effects are…
CL notes that postmenopausal women, particularly with hormone-positive tumors, do better with third-generation aromatase inhibitors (AI), such as Arimidex® (anastrozole), rather than tamoxifen. Ovarian suppression would not be done in this case, although if a patient had a family history of ovarian cancer, then an Oophorectomy would be strongly suggested (John Hopkins, 2014b). It is also important to note that tamoxifen would be prescribed if the postmenopausal patient had early-stage non-invasive breast cancer (DCIS), in order to prevent breast cancer occurring in the unaffected breast. Therefore, it is very important to note the two groups of women and why they are prescribed different drugs, and not just from the side effects.
It is clear from CL’s plan outline that the program specifically refers to postmenopausal women with either ER or PR-positive receptor breast cancers who are undergoing endocrine therapy and that this will be a pilot program, along with a research outlook. The plan outlines obtaining a suitable group of participants, the requirement of key stakeholders, finding a suitable time frame to obtain enough data and results, and also determining a meaningful data collection tools. The only component missing is a mention of where funding will be obtained.
The patient is the focal point of the research and pilot program and therefore, as CL notes, other key stakeholders are the Cardiac Nurse, Dietician, Medical Social Worker, Occupational and Physical Therapists. Yet, the hospital and clinic leadership group, which includes the CEO or President, the Director of Nurses, and the head of Quality Control or Enhancement in the facility, must be the first step of engagement, along with the Financial Officer, who will oversee expenditures (Melnyk & Fineout-Overholt, 2011). ...
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