1541P - A network monitoring program to improve safety and management in ambulatory chemotherapy unit

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Supportive Care
Bioethics, Legal, and Economic Issues
Presenter Florian Scotte
Citation Annals of Oncology (2014) 25 (suppl_4): iv517-iv541. 10.1093/annonc/mdu356
Authors F. Scotte1, R. Elaidi2, C. Thibault2, H. Aboudagga3, C. Gervais4, M. Kfoury4, B. Bonan5, J. Stevens2, V. Tual2, P. Leroy4, S. Oudard6
  • 1Medical Oncology And Supportive Care Unit, Hopital European George Pompidou, 75015 - Paris/FR
  • 2Oncology, hospital G.Pompidou, 75015 - paris/FR
  • 3Pharmacy, hospital G.Pompidou, 75015 - paris/FR
  • 4Supportive Cancer Care Unit, hospital G.Pompidou, 75015 - paris/FR
  • 5Pharmacy, Hopital Foch Service d'Oncologie, 92 - Suresnes/FR
  • 6Medical Oncology And Supportive Care Unit, Hospital G.Pompidou and Rene Descartes University, 75015 - Paris/FR

Abstract

Aim

The PROCHE [Programme for optimisation of the chemotherapy network] initiative is an innovative oncology-monitoring program designed to reduce patient waiting time and chemotherapy wastage, ultimately improving patient care. Laboratory test results and side effects data are collected for patients in the PROCHE monitoring program 2 days prior to scheduled chemotherapy visits, allowing oncologists to confirm or delay each patient's chemotherapy.

Methods

This prospective study compared the program Data from patients entered in the PROCHE program with 513 control patients. Primary objective was to evaluate the evolution of delay between arrival and start of chemotherapy from 2008 to 2013. Secondary objectives were evolution of toxicity incidence and patient satisfaction along 4 years of activity. Incidence per year was compared using the Maentel-Haenszel Khi-2.

Results

Between Oct 2008 and Dec 2013, 2 040 patients participated in the program, representing 21,920 scheduled chemotherapy. Results demonstrated significant reductions in mean hospital stay with a decrease of 53 min (116 min in 2008 compared to 63 min in 2013) allowing 30% activity enhancement to reach a 95% of patient satisfaction. Drug wastage was decreased by a factor 2 compared to another ambulatory chemotherapy department in the same hospital (5.4% vs 10.9%). Main adverse events (AE) incidence was collected on an ongoing basis (percentages are rounded to nearest integer). Fatigue was the most incident, with a decrease between 2009 and 2013, respectively 81% vs 54% (p < 0.0001). Incidence of other disorders also decreased following this program between 2009 and 2013: pain: 37% vs 21% (p < 0.0001); nausea: 21% vs 9% (p < 0.0001) and infection: 5% vs 3%, (p = 0.0008). Anticipating anti-cancer treatment adaptation as well as intervention of supportive team (pain, nutrition, psychological) in response to the PROCHE program, may explain these positive results.

Conclusions

the PROCHE initiative resulted in improved patient quality of care and improvement of hospital as well as pharmacy efficiency.

Disclosure

All authors have declared no conflicts of interest.