Abstract 539P
Background
Concurrent chemoradiation (CCRT) is part of standard treatment for patients (pts) with locally advanced rectal cancer. Pts are routinely reviewed phyiscally in clinic for treatment related toxicity check at the middle and end of CCRT by the Medical Oncology team. The Radiation Oncology team also reviewed patients weekly prior to radiation. Therefore, a Gastrointestinal (GI) Oncology Advanced Practice Nurse (APN)-led teleconsultation (TC) service was introduced with the aim of reducing clinic visits (CV) without compromising patient safety.
Methods
The GI Oncology APN worked in collaboration with the GI Oncology Consultants to develop this service for GI Oncology clinic pts ongoing CCRT to reduce clinic visits (CV). TC slots were scheduled in the APN’s clinic in the middle and end of CCRT, with blood test appointments scheduled 1 day before. An escalation workflow was created to ensure timely review of pts with Grade 2-3 toxicities. Rectal and anal cancer pts who underwent CCRT as part of neoadjuvant or adjuvant treatment were included. CCRT pts requiring weekly 5FU infusion were excluded. Data was extracted from the colorectal tumor board RedCap database and CPSS/EPIC. APN TC and doctor (Dr) CV from March 2020 till May 2022 were retrospectively reviewed. The number of admissions and additional CV were also tracked.
Results
71 pts completed CCRT and 30 pts were independently reviewed by APN TC. 4 pts were co-managed by APN TC and Drs CV due to patient's preference. The remaining 36 pts were seen in clinics by Drs only while 1 pt had no follow up during CCRT. There were 134 consultations with 60 APN TC and 74 CV. 13% CV were additional visits and <1% of TC pts managed by APN was referred for clinic review for symptoms. No TC pts developed G2 toxicities or were admitted. 5 pts seen by Drs alone were admitted for fever (n=3), epistaxis (n=1) and giddiness (n=1). The 34 pts managed by APN TC created an additional 60 GI clinic slots for other pts to be reviewed.
Conclusions
APN-led TC service for pts on CCRT is safe and has reduced CV, increasing capacity for other acute pts. The success of the program has motivated other Senior Residents to consider CCRT TC for their pts. The Oncology GI APN has also utilized TC for pts with other GI cancers undergoing CCRT.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.