Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2022

Designing for implementation: co-design of a paediatric oncology medicines database (ProCure) to support complex care provision for children with a hard-to-treat cancer (#443)

Carolyn G Mazariego 1 , Mark Dobson 2 , Skye McKay 3 , Brittany McGill 4 5 , Rebecca Daly 4 5 , Claire Wakefield 4 5 , David Ziegler 2 4 , Natalie Taylor 3
  1. The Daffodil Centre, a joint venture with Cancer Council NSW, The University of Sydney , Sydney , NSW , Australia
  2. Kids Cancer Centre, Sydney Children's Hospital , Randwick , NSW, Australia
  3. School of Population Health, UNSW Medicine and Health, Sydney, NSW, Australia
  4. School of Clinical Medicine, UNSW Medicine and Health, Sydney, NSW, Australia
  5. Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia

Aims: Treatment options identified through precision medicine trials are often unapproved (i.e., ‘off-label’) for paediatric use. Access pathways to these cancer medicines are generally opaque and time-consuming for paediatric oncology healthcare professionals (HCPs). The ALIGN study aims to support HCPs through a suite of resources, including ProCure, a database which aims to streamline access to novel medicines. Specifcally, this study aimed to i) explore HCPs’ perceived role in identifying and accessing experimental medicines and apply implementation science methods to identify barriers and facilitators encountered, and ii) explore HCPs’ perceived acceptability of ProCure, elicit end-user needs and facilitate co-design.

Methods: Paediatric oncology HCPs were recruited to participate in semi-structured interviews, guided by The Consolidated Framework for Implementation Research (CFIR). Qualitative interview data were coded to the CFIR to identify key barriers, end-user needs, and the gaps ProCure addresses. Beta version of ProCure was designed. 

Results: 16 HCPs (10 oncologists, 6 nurse consultants) have been interviewed to date. Interim analysis indicates that barriers include resource-intensive applications to access medicines, time-sensitive decision-making, and complicated pharmaceutical information. Key facilitators include Drug Access Navigators, precision medicine Molecular Tumour Boards, and a multi-disciplinary approach to care. HCP end-user needs addressed by ProCure include information about medicines being centralised within a well-supported platform. Additional features recommended by HCPs included blood-brain-barrier penetrability data and examples of successful applications.

Conclusions: Interim data indicate that ProCure is acceptable to HCPs and has potential to streamline off-label medicines access. The next phase is end-user beta-testing of the developed database, then pilot testing to evaluate the acceptability, feasibility, effectiveness, and implementation of the ProCure database.