Fertility preservation toolkit: implementing & evaluating a resource to assist clinical discussion & decision making regarding fertility in paediatric oncology — ASN Events
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Fertility preservation toolkit: implementing & evaluating a resource to assist clinical discussion & decision making regarding fertility in paediatric oncology (#402)

Harene Ranjithakumaran 1 2 , Yasmin Jayasinghe 2 , Lynn Gillam 3 4 , Maria McCarthy 5 , Leanne Super 5 , Jayne Harrison 5 , Sarah Drew 6 , Sarah McQuillan 7 , Lisa Orme 5 8
  1. University of Melbourne, Melbourne, Victoria, Australia
  2. Department of Obstetrics & Gynaecology, Royal Women’s Hospital, University of Melbourne, Melbourne, Victoria, Australia
  3. Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
  4. Children's Bioethics Centre, Royal Children's Hospital, Melbourne, Victoria, Australia
  5. Children's Cancer Centre, Royal Children's Hospital, Melbourne, Victoria, Australia
  6. Centre for Adolescent Health, Department of Paediatrics, Royal Children's Hospital , University of Melbourne, Melbourne, Victoria, Australia
  7. Obstetrics & Gynecology Pediatric Gynecology , Alberta Health Services, South Health Campus, Calgary, Alberta, Canada
  8. Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia

Aims: As over 80% of paediatric patients are cured of cancer, survivorship issues including fertility preservation are of great importance. Oncology clinicians find fertility discussions difficult due to a range of factors including urgency to commence treatment, and lack of: specific training, knowledge, clinical pathway, policy and long term efficacy data. We are evaluating a tool-kit resource for clinicians involved in fertility preservation discussions with young oncology patients/parents. By providing a suite of reference information alongside a practical guide for fertility discussion and referral, we aim to promote consistent, up-to-date knowledge among clinicians and clearer conversations about fertility risk and preservation.

Methods:
Clinician surveys at 3 timepoints:
1. Baseline: To determine understanding, perceived strengths/ weaknesses prior to implementation.
2. After each toolkit use.
3. End of evaluation period, to assess feasibility, sustainability and impact of the toolkit on clinical practice

Results:
Fifty-nine multidisciplinary clinicians completed the baseline survey anonymously after toolkit education. Dissatisfaction with the “current system of fertility information, referral and preservation was reported by 64.96% clinicians (31/47) ”; 56.65% (34/57) did not feel confident in their ability to provide up-to-date knowledge regarding fertility preservation; 100% (58/58) agreed to use and/or promote the kit. Potential weaknesses of the toolkit were perceived to be potentially poor compliance, poor access to the kit, and lack of use due to physicians’ personal views.  

However over 90% of staff surveyed agreed the kit is an acceptable tool to improve: adherence to policy and consistent clinical pathway; clinician knowledge and consistency in verbal/written fertility information; patient/family understanding, decision making and experience.

Conclusions:
This is the first study to evaluate a fertility preservation toolkit. Baseline data demonstrates desired improvement among staff and perception that the toolkit is an appropriate vehicle for change. Subsequent surveys will assess toolkit utility, feasibility and impact on clinical practice in fertility discussion for paediatric oncology patients and families. 

Acknowledgments: Financial support by the Victorian Government through the Victorian Cancer Agency Research Funding.

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