Optimisation of chemotherapy prescription and preparation in an ambulatory unit: Validation of the OPTIMA program

Abstract

Objective We implemented the two‐step OPTIMA program to anticipate chemotherapy prescription which aims to assess the discrepancy rate between anticipated and real prescription and its impact on waiting time and quality of care. Methods This prospective study included cancer patients receiving any intravenous chemotherapy. The OPTIMA program consists in a nurse phone call and a blood sample two days before the planned treatment. Collected information and biological results were used by a physician to issue a non‐effective (step 1) or effective (step 2) anticipated prescription the day before the consultation. The real prescription was given as usual by another physician on the day of the consultation. Waiting time was collected, and patients’ satisfaction with care was assessed with the OUT‐PATSAT35 questionnaire. Results Respectively, 540 and 979 consultations (283 and 294 patients) were analysed in both steps. The discrepancy rate was 8.7% (step 1). In routine practice, the OPTIMA program (step 2) reduced patients’ waiting time (median time 55 vs. 95 min, p < 0.001). A high general care satisfaction score was observed in both steps (80.7% and 80.2%). Conclusions This anticipation program demonstrated the accuracy of chemotherapy prescription, whatever the regimen and cancer site, and its impact on waiting time optimisation.

Advance Approval of Outpatient Chemotherapy via Phone Call Optimizes Healthcare Delivery without Compromising Patient Satisfaction with Care

“…This is an important finding given that the purpose of the new procedure was to remove the need for such consultation. Our results confirm the findings of the study by Dos Santos et al [ 29 ], which highlighted high general score of satisfaction with care for patients included in a program aimed to anticipate the prescription of ambulatory CT.…”

“…The aim of this study was to determine whether advance approval of outpatient CT via phone call the day before CT can optimize healthcare delivery without compromising patient satisfaction with care, as compared to approval via face-to-face consultation on the day of CT. To date, few studies have described and assessed the implementation of a phone-based procedure for CT approval. Indeed, studies have most often demonstrated that phone calls constitute a safe and feasible strategy for the management of CT side effects [ 22 , 23 , 24 , 25 ], but few have examined their safety and feasibility for approval of outpatient CT [ 26 , 27 , 28 ], and only one analyzed the impact of advance CT approval on patient satisfaction [ 29 ].…”

Advanced prescription of injectable anticancer drugs: Safety assessment in a European Comprehensive Cancer Centre using the risk matrix approach

“…The minimum CI was 1 (i.e., negligible criticality: acceptable risk situations as they are, corresponding to a low risk) and the maximum CI was 25 (i.e., maximum criticality: risky situations that are not acceptable as they are, requiring analysis and corrective measures to reduce the risk to at least one risk to watch). Criticality was classified as minor (1-5), medium (6)(7)(8)(9)(10)(11)(12)(13)(14)(15) or maximal (16)(17)(18)(19)(20)(21)(22)(23)(24)(25). See Table 1d in Appendix S2 (Supporting Information)…”

“…At the end of the procedure, the RC and CI values were used to calculate the residual criticality index rCI = RC * CI. The residual criticality index was classified as acceptable (1-9), to monitor (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29) or to process . Each score was reviewed twice by the working team.…”

“…This enables advanced compounding by the Pharmacy Compounding Unit and may reduce patient waiting time for treatment in the day oncology unit. [23][24][25] Thus, advanced prescription can be carried out without having all the standard clinical and biological criteria, and sometimes before medical consultation. This generates a clinical risk for the patient and an economic risk through the loss of advanced preparations.…”