Construction of a management and prevention program for targeted therapy-induced hand-foot skin reaction.

Aims: To construct a management and prevention program for targeted therapy-induced hand-foot skin reactions (HFSR). Design: A systematic review with meta-analysis. Methods: Based on a literature review and expert consensus meetings, a two-round expert panel discussion involving 10 experts was conducted to finalize the HFSR management and prevention program. Data sources: Articles were systematically searched on the CNKI, Wanfang Database, VIP, PubMed, UpToDate, Embase, and Cochrane Library, and guideline publication websites, NGC, NCCN, NICE, SIGN and ESMO databases from inception up to June 2023. Results: The final program comprised 8 primary indicators, 16 secondary indicators, 36 tertiary indicators, and 54 quaternary entries. These include baseline level and hand-foot skin assessment, skin erythema care, skin keratosis care, skin blister management, skin ulcer care, skin pain management, management of other accompanying symptoms, and hand-foot protection and prevention education. Conclusion: This management and prevention program, constructed based on evidence and expert discussion, is scientifically sound and clinically applicable, providing reliable guidance for the management and prevention of HFSR in clinical practice. Impact: Based on the best available evidence for managing and preventing hand-foot skin reactions induced by targeted therapies, we recommend that nursing leaders implement personalized symptom management plans tailored to the common symptoms of these reactions. Such an approach may help in the early detection of hand-foot skin reactions and alleviate patients' skin pain effectively.