A hematologic multidisciplinary oral chemotherapy clinic (MOCC) established at a community hospital identified adverse events early and reduced emergency department (ED) visits, according to a study presented at the 2017 American Society of Oncology (ASCO) Quality Care Symposium.1
Previously reported studies have demonstrated that MOCCs improve the care of patients with solid tumors like prostate cancer and gastrointestinal malignancies; however, little is known about the impact of MOCCs in the hematologic malignancy setting.
Therefore, researchers at Michael Garron Hospital/Toronto East Health Network in Ontario, Canada formed a MOCC to evaluate if its implementation would lead to a reduction in ED visits and hospital admissions among patients with hematologic cancers receiving oral therapies.
The MOCC consisted of a nurse and a pharmacist with a physician backup and clinicians used drug- and disease-specific checklists for treatment initiation, follow-up, and monitoring of patients being treated with lenalidomide, ibrutinib, dasatinib, nilotinib, and idelalisib.
Investigators enrolled 30 patients with hematologic malignancies during the MOCC’s 10-month implementation period. After a median follow-up of 7 months, results showed that there was 100% medicine reconciliation and 92% compliance with treatment protocols. In addition, clinicians identified adverse events requiring dose modification that would not have otherwise been documented or addressed in 47% of patients.
The study further demonstrated that there was a 33% reduction in ED visits and hospital admissions but a 20% increase in unscheduled assessments with physicians. Both patients and the nursing staff were satisfied with the multidisciplinary approach of the MOCC.
The findings support the implementation of MOCCs in community hospitals for patients with hematologic malignancies receiving oral anticancer therapies to reduce ED visits, admissions, and potentially health care costs.
Disperati P, Kagramanov D, Bjorkman H, Horsley R, Thede K. Effect of the establishment of a hematological multidisciplinary oral chemotherapy clinic at a community hospital on the number of emergency department visits. J Clin Oncol. 2017; 35 (suppl 8S; abstract 50).