Improving Oral Oncolytic Patient Self-Management

Area of Science:

• Oncology
• Quality Improvement
• Patient Management

Background:

• Managing patients on oral oncolytics presents challenges due to a shift from intensive supervision to periodic observation.
• The Michigan Oncology Quality Consortium (MOQC) Oral Oncolytics Collaborative was formed to address these management gaps.

Purpose of the Study:

• To identify opportunities for improving the management of patients receiving oral oncolytic therapy.
• To implement and evaluate new office procedures and patient support resources.

Main Methods:

• A baseline self-assessment and medical record audit were conducted for 25 patients on oral oncolytics.
• Implementation of MOQC resources included a patient tracking system, self-care guidelines, symptom assessment tools, and adherence questionnaires.
• Workflow modifications involved standardized teaching and consistent follow-up calls.
• A retrospective post-implementation audit was performed.

Main Results:

• Baseline audits revealed issues with start date documentation (52%) and high rates of unsupervised medication discontinuation (48%).
• Post-implementation, 100% of patients had documented start dates, and no patients discontinued medication without physician consultation.
• Seventeen percent of patients experienced dose reductions due to toxicity, as physician-directed.

Conclusions:

• New office procedures facilitate identification of patients on oral therapy.
• Enhanced patient self-care through guidelines improves symptom management and overall care for oral oncolytics.
• Quality improvement initiatives can significantly enhance the management of oral oncolytic therapy.