Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2022

Review of utilisation of Oral Chemotherapy Clinic (OCC) to improve quality of care for metastatic breast cancer patients receiving oral anti-cancer agents. (#368)

Priyadarshini Sinha 1 , Caitlin Murphy 1
  1. Oncology , Western Health, MELBOURNE, VICTORIA, AUSTRALIA

Background

The symptom urgent review clinic (SURC) was established at Western Health in 2013 to assess chemotherapy patients presenting with new symptoms or treatment complications. Based on this model, the oral chemotherapy clinic (OCC) was established in 2015 to educate patients and provide timely reviews for those on oral cancer therapies.

Aims

  1. Assess the utilisation of the OCC by metastatic breast cancer (MBC) patients prescribed non-hormonal oral treatments (Capecitabine, Cyclophosphamide, Palbociclib, Ribociclib, Abemaciclib)
  2. Investigate the number of unplanned episodes of care provided by OCC which would otherwise have occurred in Emergency, outpatient departments or general practitioners

Methods

Between April 2015 - May 2022, episodes of care for MBC patients receiving oral agents were extracted from the SURC databases. Data were reviewed for presenting complaint and episode outcomes; all data was de-identified. Data were missing May 2017 – January 2018 during database redesign.

Results

91 patients were identified with total of 171 unplanned SURC encounters. Of these, 19 (11%) encounters were escalated for either review by SURC registrar or admission. During Apr 2015 – Apr 2017, in 9 of 21 (43%) toxicity reviews, phone advice was sufficient to address concerns.  From 2018-2022, 133 of 151 (88%) encounters were successfully managed with phone advice alone.  Only 9 (6%) encounters were advised to present to their general practitioner/Emergency with fever and respiratory distress the most common complaints requiring escalation of care.

Conclusion

This review demonstrates utility of the OCC in diverting patients to the oncology department and facilitating admission where appropriate. By proactively managing symptoms and toxicities from oral agents it is likely the OCC, similar to SURC, reduces presentations to Emergency and general practitioners. This data suggests increasing clinician referrals and uptake of the OCC would benefit patients by centralising their management in the oncology department where they are well known.