Background: Chemotherapy is prescribed according to protocols of several cycles. These protocols include not only therapeutic agents but also adjuvant solvents and inherent supportive care measures. Multiple errors can occur during the prescription, the transmission of documents and the drug delivery processes, and lead to potentially serious consequences. Objective: To assess the effect of a computerised physician order entry (CPOE) system on the number of errors in prescription recorded by the centralised chemotherapy unit of a pharmacy service in a university hospital. Patients and methods: Existing chemotherapy protocols were standardised by a multidisciplinary team (composed of a doctor, a pharmacist and a nurse) and a CPOE system was developed from a File Maker Pro database. Chemotherapy protocols were progressively introduced into the CPOE system. The effect of the system on prescribing errors was measured over 15 months before and 21 months after starting computerised protocol prescription. Errors were classified as major (dosage and drug name) and minor (volume or type of infusion solution). Results: Before computerisation, 141 errors were recorded for 940 prescribed chemotherapy regimens (15%). After introduction of the CPOE system, 75 errors were recorded for 1505 prescribed chemotherapy regimens (5%). Of these errors, 69 (92%) were recorded in prescriptions that did not use a computerised protocol. A dramatic decrease in the number of errors was noticeable when 50% of the chemotherapy protocols were prescribed through the CPOE system. Conclusion: Errors in chemotherapy prescription nearly disappeared after implementation of CPOE. The safety of chemotherapy prescription was markedly improved. M edical prescription is the result of a complex cognitive process.1 As such, it must integrate several elements-namely, patient's characteristics and medical conditions, treatment goals and particulars, institutional rules and habits, and the preferences of medical and nursing staff and of the patient. Medical order sheets are an essential way of communication between doctors, nurses and pharmacists. Medication errors refer to errors in the processes of ordering, transcribing, dispensing, administering or monitoring drugs.2 They can lead to adverse drug events, some of which are preventable. Recent studies have shown that about 50% of preventable adverse drug events during treatment occur during the prescribing phase.3-5 In a study specifically on ordering of drugs, about 20% of orders were found to be poorly legible and 24% were incomplete. Chemotherapy is given according to protocols and for repeated cycles. Potent and potentially toxic drugs are used, usually given with infusion solutions. The dosage is commonly adapted to the patient's body surface area and/ or renal function. Given the complexity of existing protocols, multiple errors can occur during prescribing, transmission of documents and drug delivery, potentially leading to serious consequences. Therefore, recommendations have been published to decre...

Administration of intensive chemotherapy regimens at home was feasible and safe. Quality of life was not affected; satisfaction of patients and relatives was very high. A psychosocial benefit was observed for patients and relatives. Furthermore, a cost-benefit of home care compared to hospital treatment was demonstrated.

Background The aims of the study were (a) to assess individual meaning in life (MiL) in a mixed sample of cancer patients with the Schedule for Meaning in Life Evaluation (SMiLE), (b) to evaluate the acceptability of its French version, and (c) to compare it to a student sample. Materials and methods Consecutive cancer patients (N = 100) treated as outpatients in the University Hospital Lausanne (N = 80) and in a nearby hospice (N = 20) were evaluated with the SMiLE, a reliable and validated respondent-generated instrument for the assessment of MiL. The respondents list three to seven areas, which provide meaning to their life and rate the level of importance (weighting) and satisfaction of each area. Indices of total weighting (index of weighting (IoW), range 20-100), total satisfaction (index of satisfaction (IoS), range 0-100), and total weighted satisfaction (index of weighted satisfaction (IoWS), range 0-100) are calculated. Results Patients most often indicated areas related to relationships as providing MiL, while material things were listed less often. Since satisfaction with relevant areas was high, cancer patients reported the same level of weighted satisfaction (IoWS) as a healthy student sample, assessed with the SMiLE in a prior validation study. Patients judged the SMiLE as reflecting well their MiL, not distressing to fill in and were moderately positive with regard to its helpfulness. Conclusions MiL of cancer patients was surprisingly high, possibly due to the "response shift" of the severely ill. The SMiLE might become a useful tool for research and an opener to communication between patients and clinicians about this highly relevant topic in cancer care. Further studies with larger sample sizes and different designs, complemented by qualitative research, are needed to deepen our understanding of this so characteristically human topic, which is so easy to perceive and so difficult to grasp.

Background: Head and neck cancer (HNC) patients experience distressing symptoms that can significantly impact their health-related quality of life (HRQoL). We analyzed the implementation of a nurse-led consultation (NLC) and explored potential associations with symptom burden in HNC patients. Methods: We retrospectively analyzed routinely collected data to describe the implementation of the nurse-led interventions and the evolution of the M.D. Anderson Symptom Inventory scores as patient-reported outcome measures (PROMs). Patients who received routine care (n = 72) were compared with patients in the NLC group (n = 62) at a radiation oncology unit between 2017 and 2019. PROMs were measured at T0 (between simulation and the first week of radiotherapy), T1 (week 3–4), and T2 (week 5–6). Results: Screening for nutrition, smoking, oral cavity status, and capacity for swallowing/chewing, but not for pain, was applied in > 80% of patients in the NLC group from T0 to T1. Education (16%) and care coordination (7%) were implemented to a lesser extent. Symptom burden increased over time with no significant differences between groups. Conclusions: The nurse-led consultation was not associated with symptom burden over time. A larger implementation study including a detailed process evaluation, larger sample size, and a focus on long-term effects is needed.