Implementation of an Interdisciplinary Clinical Pathway to Treat Chemotherapy-Induced Peripheral Neuropathy

Abstract

Background and Purpose:: Chemotherapy-induced peripheral neuropathy (CIPN) affects up to 60% of cancer patients undergoing chemotherapy, yet current single-modality therapies yield limited efficacy. This project aimed to implement an evidence-based, interdisciplinary CIPN clinical pathway to increase advanced practice providers' (APPs') role understanding of the interdisciplinary team and referrals to the appropriate services.

Methods:: An interdisciplinary CIPN clinical pathway was implemented using a prospective pre-test and post-test quality improvement design over 12 weeks. The project included 53 outpatient APPs who care for adult patients with CIPN. Pre- and post-education surveys, as well as electronic health record data abstraction, assessed APPs' role understanding, referral behavior, and the feasibility of the intervention.

Results:: Post-intervention survey analysis yielded a statistically significant difference in APPs' role understanding median summary scores, from pre-test (19.00) to post-test (25.00) (Z = –4.228, p < .001). Electronic health record data revealed a clinically significant 43.48% increase in total patient referrals, with a statistically significant association between APP participation and the entry of one or more referrals to the appropriate services (X2(1, n = 31) = 7.86, p = .006). Lastly, the post-test Feasibility of Intervention Measure (FIM) mean summary score was 17.13.

Conclusion:: Implementing an evidence-based, interdisciplinary CIPN clinical pathway improved APPs' role understanding and referral behavior within an ambulatory oncology setting.

Implications:: This intervention appears feasible and adaptable for similar clinical settings. Additional tailoring may be required based on organizational resources and workflows. Future work should evaluate patient-centered outcomes and long-term provider adherence.

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BibTeX RIS

BibTeX

@article{preti2026implementation,
  title = {{Implementation of an Interdisciplinary Clinical Pathway to Treat Chemotherapy-Induced Peripheral Neuropathy}},
  author = {Kelly Preti and Rita D'aoust and Deborah Baker and Shila Pandey and Vivek Malhotra},
  journal = {Journal of the Advanced Practitioner in Oncology},
  year = {2026},
  month = sep,
  doi = {10.6004/jadpro.2026.17.7.24},
  url = {https://doi.org/10.6004/jadpro.2026.17.7.24},
  note = {CC BY-NC-ND 3.0},
}

RIS

TY  - JOUR
TI  - Implementation of an Interdisciplinary Clinical Pathway to Treat Chemotherapy-Induced Peripheral Neuropathy
AU  - Kelly Preti
AU  - Rita D'aoust
AU  - Deborah Baker
AU  - Shila Pandey
AU  - Vivek Malhotra
PY  - 2026
DA  - 2026/09/01
JO  - Journal of the Advanced Practitioner in Oncology
DO  - 10.6004/jadpro.2026.17.7.24
UR  - https://doi.org/10.6004/jadpro.2026.17.7.24
AB  - Background and Purpose:: Chemotherapy-induced peripheral neuropathy (CIPN) affects up to 60% of cancer patients undergoing chemotherapy, yet current single-modality therapies yield limited efficacy. This project aimed to implement an evidence-based, interdisciplinary CIPN clinical pathway to increase advanced practice providers' (APPs') role understanding of the interdisciplinary team and referrals to the appropriate services.  Methods:: An interdisciplinary CIPN clinical pathway was implemented using a prospective pre-test and post-test quality improvement design over 12 weeks. The project included 53 outpatient APPs who care for adult patients with CIPN. Pre- and post-education surveys, as well as electronic health record data abstraction, assessed APPs' role understanding, referral behavior, and the feasibility of the intervention.  Results:: Post-intervention survey analysis yielded a statistically significant difference in APPs' role understanding median summary scores, from pre-test (19.00) to post-test (25.00) (Z = –4.228, p < .001). Electronic health record data revealed a clinically significant 43.48% increase in total patient referrals, with a statistically significant association between APP participation and the entry of one or more referrals to the appropriate services (X2(1, n = 31) = 7.86, p = .006). Lastly, the post-test Feasibility of Intervention Measure (FIM) mean summary score was 17.13.  Conclusion:: Implementing an evidence-based, interdisciplinary CIPN clinical pathway improved APPs' role understanding and referral behavior within an ambulatory oncology setting.  Implications:: This intervention appears feasible and adaptable for similar clinical settings. Additional tailoring may be required based on organizational resources and workflows. Future work should evaluate patient-centered outcomes and long-term provider adherence.
SN  - 2150-0878
SN  - 2150-0886
ER  -

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