Providing community oral chemotherapy services

Abstract

VIDALL C. (2010) European Journal of Cancer Care19, 29–34 Providing community oral chemotherapy services A plethora of oral chemotherapeutic agents have been introduced in recent years leading to new challenges for chemotherapy services, especially in supporting patients to manage their treatment safely in their own homes. Recent UK documents have highlighted patient safety issues with oral chemotherapy, underlining the principle that oral chemotherapy should be managed to the same standards as intravenous chemotherapy. In order to help address these issues, independent health care providers have developed collaborative programmes working with National Health Service Cancer Centres to provide care locally and deliver cancer treatments to patient's homes. Some of the key objectives of these home services are optimal patient education, contact with chemotherapy trained home nurses, toxicity management and adherence with therapy, while maintaining the clinical responsibility for the patient's overall care with the Consultant oncologist at the Cancer Centre. The provision of oral chemotherapy drugs using this or similar models of care, offers a more cost effective way for the purchasers of healthcare services to deliver an effective oral chemotherapy service. This is facilitated by preferable taxation arrangements in the UK for medication delivered to the patient's own home which reduces both cost and demand on acute hospital facilities, and greatly improves the quality of life for patients who no longer need to make frequent and prolonged visits to hospital for their treatment to be prescribed and dispensed.

Introducing the United Kingdom Oncology Nursing Society's (UKONS) Position Statement on Oral Chemotherapy'

“…She also refers to the UK Colorectal Practical Guidance Group guidelines on the use of capecitabine in colorectal cancer in order to identify appropriate dosing regimens and the rationale for dose modifications. In the following papers, Oakley et al (2010b) outline the patient experience of oral chemotherapy and the development of an oral chemotherapy patient diary to assist them in managing their own treatments, and Vidall (2010) outlines the development of community oral chemotherapy nursing support roles. In the final paper, So (2010) outlines the cost effectiveness of delivering oral therapies in the home from the perspective of the hospital pharmacy service in line with the requirements of the UK Chemotherapy Services in the Community (DOH 2010) report, which urges the commissioners of healthcare services to consider how chemotherapy services may be better provided to patients in their own homes.…”

Implementing oral chemotherapy services in community pharmacies: a qualitative study of chemotherapy nurses' and pharmacists' views

“…Such services would extend the choice for patients regarding treatment options and care. Additionally, significant savings would be achieved; oral chemotherapy drugs prescribed and dispensed to an individual within the community setting would be VAT exempt, unlike those supplied in hospitals [10,11]…”

“…Additionally, significant savings would be achieved; oral chemotherapy drugs prescribed and dispensed to an individual within the community setting would be VAT exempt, unlike those supplied in hospitals. [10,11] Currently, there is little literature relating to involving CPs in supplying OAMs to people with cancer. What is known about their involvement has been based upon questionnaire surveys undertaken in USA, Canada and Ireland.…”

Is a nurse-led telephone intervention a viable alternative to nurse-led home care and standard care for patients receiving oral capecitabine? Results from a large prospective audit in patients with colorectal cancer

“…() demonstrated in their audit of a nurse‐/pharmacy‐led capecitabine clinic that this approach was safe, effective and acceptable to most patients. Vidall () has highlighted how an independent home care provider can be used as a model for delivering community oral chemotherapy services that meet the needs of the patients and can produce healthcare saving.…”