1377P - Patterns of treatment and rates of admission in a specialist oncology clinic

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Bioethics, Legal, and Economic Issues
Presenter Mark Doherty
Citation Annals of Oncology (2014) 25 (suppl_4): iv486-iv493. 10.1093/annonc/mdu353
Authors M. Doherty1, L. Keenan2, J. McHugh2, M.M. O'Brien3, A. O'Reilly1, C. Reilly1, E. Hannan1, P. De La Harpe Golden1, E. O'Connor1, D. Hannon1, N. Tierney1, R. Henderson1, P. Doyle1, C. McHugh1, W.M. Grogan1, B. Hennessy1, P. Morris1, O.S. Breathnach3
  • 1Dept Of Medical Oncology, Beaumont Hospital, 9 - Dublin/IE
  • 2Dept Of Medical Oncology, Beaumont Hospital, Dublin/IE
  • 3Medical Oncology, Beaumont Hospital, 9 - Dublin/IE

Abstract

Aim

Medical Oncology practices face greater demand on services, with increased focus on Day Care Treatments and oral therapies. To address this, we recently developed specialist oral chemotherapy clinics (SOCC) and instigated an Electronic Patient Record (EPR) system. We examined treatment patterns, admission rates and impact of SOCC in a tertiary referral centre with a Neuro-Oncology interest.

Summary results of data

CNS Breast Lung Colorectal Upper GI
N (%) N (%) N (%) N (%) N (%) N (%) N (%) N (%) N (%) N (%)
Encounters 199 626 257 413 235
Chemotherapy 188 (95) 549 (88) 207 (80) 361 (87) 185 (79)
Intravenous 70 (37) 528 (96) 193 (93) 352 (97) 181 (98)
Oral 118 (73) 21 (4) 14 (7) 9 (3) 4 (2)
Procedures 0 8 (1) 2 (1) 7 (2) 1 (0.5) 0
Urgent Care 11 (5) 69 (11) 48 (19) 45 (11) 49 (21)
Admitted 5 (45) 10 (15) 9 (19) 6 (13) 10 (20)
Discharged 6 (55) 59 (85) 39 (81) 39 (87) 39 (80)

Methods

Using the EPR, we developed a questionnaire and prospectively examined each patient encounter. This form was used to collect information on disease type and reason for encounter: 1) IV therapy, 2) oral therapy, 3) urgent care (admit/discharge), 4) procedure. Patterns of attendance were examined for common malignancies; Central Nervous System (CNS), Breast, Lung, Colorectal, Gastrointestinal (GI) cancers. Data were compared using Fischer's Exact Test.

Results

Between August and December 2013, 1,730 encounters were recorded. The breakdown by disease subtype was: Breast 626 (35%), Colorectal 413 (24%), Lung 257 (15%), Upper GI 235 (14%), CNS 199 (12%). Across all disease types, most encounters were for chemotherapy (table 1). Oral chemotherapy encounters were more frequent in CNS patients than other diseases (73% vs 4%, p < 0.001). Urgent care encounters were more frequent in patients with lung (19%) and upper GI cancers (21%) than other cancers (10%) [p < 0.001]. Urgent care encounters were relatively uncommon in CNS patients (5%), however these resulted in a higher admission rate compared with other cancers (45% vs 17%, p = 0.03). Overall, a high proportion of urgent care attendances resulted in patient discharge (82%).

Conclusions

The use of the Oncology Day Ward as an urgent care centre facilitates patient discharge. This study highlights the high rate of oral chemotherapy usage in patients with CNS malignancies. SOCC may be of benefit in these patients, providing regular specialist care, as evidenced by the low urgent care rate. Patients with lung or upper GI cancers were more likely to present for urgent care, highlighting the need for a supportive care structure in this population.

Disclosure

All authors have declared no conflicts of interest.