Porcher Laura, Perron Valérie, Blanc Julie, Kaderbhai Courèche-Guillaume, Tharin Zoé, Schmitt Antonin, Gallet Matthieu
Pharmacy Department, 55482Centre Georges François Leclerc, Dijon, France.
Day Hospital Department, 55482Centre Georges François Leclerc, Dijon, France.
J Oncol Pharm Pract. 2022 Aug 8:10781552221117731. doi: 10.1177/10781552221117731.
The increasing use of oral anticancer agents over the past years has necessitated changes in monitoring toxicities to ensure patients' adherence and tolerance at home. The aim of this study was to describe nurses' interventions and medical changes after alerts triggered by a web-based platform designed to support the management of oral anticancer agents-related toxicities.
This retrospective study included patients undergoing oral anticancer agents in a cancer center from September 2018 to September 2019 (excluding hormonal therapy). In this cancer center, the standard of care included symptoms' collections for 1 month thanks to a web platform based on patient-reported outcomes. Patients had to fill a weekly questionnaire (Q1 to Q4). The web-based platform triggered orange alerts when patients reported moderate symptoms and red alerts when severe toxicities were declared. The rate of orange and red alerts, the rate of patients with medical changes consecutively to an orange or a red alert, and the different types of nurses' interventions and medical changes were assessed.
A total of 524 patients were extracted but the final number of 436 patients were included in this study and 1488 questionnaires were filled in. More than 90% of patients declared that they took their medication as prescribed. Up to 60% of patients recorded all grade symptoms, including 8% of patients who recorded Grades 3-4 symptoms during the month, mostly anorexia, fatigue, and diarrhea. The web platform system triggered 700 orange and 212 red alerts: 305/700 (44%) of orange alerts resulted in nurses' interventions, most frequently phone counseling (78%), and 65/212 (31%) of red alerts resulted in medical changes, most frequent treatment interruptions (48%).
Implementing an e-health (electronic-health) system can be helpful for monitoring symptoms in patients under oral anticancer agents, enhancing that this organization should be a standard of care in every cancer centers.
在过去几年中，口服抗癌药物的使用日益增加，因此有必要改变毒性监测方式，以确保患者在家中的依从性和耐受性。本研究的目的是描述在一个旨在支持口服抗癌药物相关毒性管理的网络平台触发警报后，护士的干预措施和医疗调整情况。
这项回顾性研究纳入了2018年9月至2019年9月在某癌症中心接受口服抗癌药物治疗的患者（不包括激素治疗）。在该癌症中心，护理标准包括借助一个基于患者报告结果的网络平台收集1个月的症状信息。患者必须每周填写一份问卷（问题1至问题4）。当患者报告中度症状时，该网络平台会触发橙色警报；当宣布出现严重毒性时，则触发红色警报。评估橙色和红色警报的发生率、因橙色或红色警报而连续进行医疗调整的患者比例，以及护士干预措施和医疗调整的不同类型。
共提取了524例患者，但本研究最终纳入436例患者，共填写了1488份问卷。超过90%的患者表示他们按规定服药。高达60%的患者记录了所有级别的症状，其中8%的患者在该月记录了3 - 4级症状，主要是厌食、疲劳和腹泻。网络平台系统触发了700次橙色警报和212次红色警报：305/700（44%）的橙色警报导致护士进行干预，最常见的是电话咨询（78%），65/212（31%）的红色警报导致医疗调整，最常见的是治疗中断（48%）。
实施电子健康系统有助于监测口服抗癌药物患者的症状，强化了该组织应成为每个癌症中心护理标准的观点。
