Clinical Scorecard: Oral Presentations from the Nurses Group at the 46th Annual European Society for Blood and Marrow Transplantation Meeting (Sessions NO001-NO015)

At a Glance

Key Highlights

• Family caregivers of allo-HSCT patients report persistent unmet support needs related to information about the illness, future expectations, and emotional coping up to 16 weeks post-transplant.
• Pain and anxiety during BMAs are significant concerns; local analgesia is universally used but sedation practices vary, especially between pediatric and adult centers in Italy.
• Many Italian transplant centers lack standardized operating procedures (SOPs) for BMA pain management and do not provide adequate patient educational materials.

Guideline-Based Recommendations

Diagnosis

• Assess family caregivers’ support needs longitudinally using validated tools such as the Carer Support Needs Assessment Tool (CSNAT).
• Evaluate pain and anxiety levels associated with BMAs to tailor management strategies.

Management

• Provide tailored interventions addressing family caregivers’ personal support needs prior to allo-HSCT to reduce strain.
• Use local analgesia prior to BMAs consistently, respecting the onset time for effectiveness.
• Implement sedation protocols especially in pediatric patients; consider sedation in adult patients based on individual needs and requests.
• Offer informational and educational sessions to patients and caregivers before procedures.

Monitoring & Follow-up

• Monitor family caregivers’ support needs over time, noting that some needs may persist or increase post-transplant.
• Regularly assess pain and anxiety during BMAs to improve patient experience and adjust pain management protocols.

Risks

• Inadequate pain control and anxiety management during BMAs can lead to increased patient distress and negative procedural memory.
• Unmet support needs in family caregivers may contribute to psychological strain and reduced coping capacity.

Patient & Prescribing Data

Patients undergoing bone marrow aspirations in Italian transplant centers

Local analgesia is universally used but oral pain therapy before BMAs is rarely administered; sedation is standard in pediatric centers but underutilized in adult centers.

Clinical Best Practices

• Use validated assessment tools like CSNAT to identify and address family caregivers’ support needs throughout the allo-HSCT trajectory.
• Ensure local analgesia is administered with adequate time before BMAs to maximize pain relief.
• Develop and implement SOPs for pain and anxiety management during BMAs across transplant centers.
• Provide comprehensive patient and caregiver education about procedures and expected outcomes to reduce anxiety.
• Consider sedation options tailored to patient age and preference to improve procedural comfort.

References

• European Society for Blood and Marrow Transplantation Annual Meeting