Stakeholders' perceptions of a community‐based advanced nurse practitioner‐led integrated oncology care model for adults receiving oral anti‐cancer medication—A qualitative study

Abstract

Oral anti-cancer medications (OAMs) are increasingly prescribed in oncology, and although administered at home, ongoing monitoring generally requires the patient to attend an acute hospital. With the requirement to provide safe yet convenient care and to increase hospital capacity, the potential exists to transition this cohort of patients to the community to be assessed by oncology health care professionals (HCPs). The onset of COVID-19 facilitated this planned transition.Objective: The primary objective was to understand stakeholders' perceptions of a community-based advanced nurse practitioner (ANP)-led integrated OAM care model for adults.Methods: Qualitative data from interviews and focus groups were obtained from 33 individuals; either service users who attended ANP-led OAM clinics or stakeholders involved in OAM care. Data were subsequently analysed using thematic analysis.Results: Four themes were identified and included reflection on pre-COVID-19 system, role of ANP in current OAM care, importance of robust communication and infrastructural requirements for transition to an integrated OAM care model. Conclusion:This study demonstrated that patients and HCPs perceived the proposal positively. They identified the ANP as the appropriate HCP to care for this cohort and the importance of communication and strategic planning for transitioning this model of care to the community setting.

A community-based Advanced Nurse Practitioner-led integrated oncology care model for adults receiving oral anticancer medication: A pilot study

“…Our prior qualitative study found that patients have a desire for the same HCP to assess them at each clinic visit (Richmond et al, 2022b), something guaranteed in the ANP-led clinic. In addition, as patients received their rst 2 cycles of OAM treatment in the acute hospital setting, they had already experienced exceptionally long wait times of 3-4 hours (most of which was waiting for blood results/ to be reviewed by a doctor), compared to approximately 45-minutes in the ANP-led clinic.…”

“…This enabled development of best practice standards, clinical guideline and audit tools (Richmond et al, 2022a) and a base-line audit was performed (Richmond et al, 2023). Thirdly, to determine the acceptability of ANP-led care and possible transition to an integrated context, a qualitative study was performed which involved all relevant stakeholders (Richmond et al, 2022b). Analysis of the data using thematic analysis generated four themes resulting in agreement that an integrated model of ANP-led care had signi cant bene ts for patient care and the wider organisation of clinical oncology (Richmond et al, 2022b).…”

Advanced Nurse Practice: Present and Future: Where to now?

“…Oncology is an increasing area of practice for Advanced Practitioners. Richmond et al [31] explore stakeholders' perceptions of a community-based ANP-led integrated oncology care model for adults receiving oral anti-cancer medication in an Irish hospital (n = 33). This study demonstrates that patients and health care providers (HCPs) perceived the proposal positively.…”