Oral therapies, and an increase of patient involvement have shifted the follow-up of patients with cancer from hospital to home. As a consequence, the number of incoming phone calls (IPC) has increased. To understand the source, reasons, management and burden of IPC, we underwent a French national survey. The objective was to describe IPC and to understand the way they are managed in oncology departments.
The study was a prospective survey in a representative sample of 51 French oncology specialists (Sp) treating patients with oral therapies. Data on all IPC was collected during a one-week period in 2014. Characteristics of centers were also registered.
Among 51 participating onco/radiotherapy departments, 86% of Sp were oncologists or hematologists and 14% radiation oncologists. 80% were from public centers and 20% from private ones. 41%, 39% and 20% treated less than 250, 251 to 1000 and more than 1000 new metastatic patients per year, respectively. The number of IPC/week was 17 to 64, 65 to 130 and over 130 for respectively 33%, 35% and 31% of centers (mean = 119/week). 66% of IPC were from patients and families and 23% from general practitioners. Upon IPC reception by the secretaries, half of them correspond to a medical question. A majority (65%) of centers did not have an established specific procedure and 70% of responders did not specifically train their teams (secretaries and nurses) to address the management of IPC. 65% of the sp spent more than 30 min/day. Most of them considered it disturbing medical activities. 66% of patients IPC were related to adverse effects (AE) of treatments. 22% of Sp declared at least one severe AE linked to some misinterpretation of an IPC. Centers with IPC procedures and outgoing systematic phone calls had much less IPC.
With the increase of oral therapies, incoming phone calls in French oncology centers (mainly patient calls who need exchanging information on AE) represent an important burden of work. To improve IPC management, recommendations are produced including dedicated procedures, trained telephone triage personnel (secretaries and dedicated nurses), standardized management of AE and documentation of answers.
Clinical trial identification
Legal entity responsible for the study
F. Joly Lobbedez, A. Guillot, Y. Vano, D. Spaeth, D. Topart, P. Roffet, R. El Amarti, A. Hasbini, A. Flechon: Pfizer.