There has been an explosion of oral anti cancer therapies in the last few years. With oral therapy, the burden of treatment administration is shifted to the patient or family making it more difficult to assess treatment adherence and monitor side effects compared to patients receiving intravenous treatments. Supportive care resources are also more difficult to access for patients in the outpatient setting. Improving access and removing variations in care are identified priorities of the ICS. To meet these needs the following process has been put in place:
• All patients are screened for supportive care needs and an assessment is completed by oncology nurse. All patients provided with contact numbers. Patients with high level of distress and supportive care needs are case managed by an advanced practice nurse.
• Medical assessment and informed consent for therapy obtained. A chemotherapy referral form detailing treatment plan, prescription and GP letter is completed by medical oncologist. The Medical Oncologist will refer patients at high risk of complications or those requiring blood count checks prior to dosing to an advanced practice nurse.
• Oncology Pharmacist provides education to patient, reviews concurrent medication for potential interaction and sends information to the GP. During education if pharmacist concerned about patient understanding of medication, a referral is made to advanced practice nurse for monitoring.
• Ongoing clinical review, monitoring blood results prior to therapy and assessing compliance is conducted by advanced practice nurse via telephone or Nurse-Led clinic. The clinic is co-located with medical oncology clinic.
This multidisciplinary holistic approach to caring for patients receiving oral anti cancer therapies has resulted in early identification of supportive care needs, problems with compliance and side effects. This has led to early supportive care interventions, effective management of side effects and modification of therapy. An audit of results to date will be presented.