Bristol Myers Squibb France, Rueil-Malmaison, France.
Oncostat, U1018, CESP, Inserm, Paris-Saclay University, "Ligue Contre le Cancer" Labeled Team, Villejuif, France.
JCO Glob Oncol. 2023 Aug;9:e2300026. doi: 10.1200/GO.23.00026.
In 2020, the French National Authority for Health () published a methodologic guide called organizational impact (OI) cartography to define and structure assessment of the OI of health technologies. As immunotherapies are associated with extended survival and improved quality of life in advanced cancer, we aimed to identify OIs that immunotherapies had on health care systems and professionals. To our knowledge, we suggest the first implementation for OI assessment on the basis of the cartography.
A literature review was conducted, and interviews with health care professionals (HCPs) were performed to identify OIs of immunotherapies. They were asked if immunotherapies had OIs classified into three macrocriteria, namely, impact on the care process (six criteria), impact on capacities and skills required (six criteria), and impact on society (four criteria). If an OI was mentioned for a criterion, information on its impact (minor/moderate/major) and its timing was collected. We considered that an OI existed when 75% of HCPs mentioned an impact for a given criterion.
Overall, 27 HCPs were interviewed. For 12 of 16 criteria, most HCPs mentioned an impact, whereas the literature identified impacts for 11 criteria. Four criteria (skills and transfer between HCPs, scheduling capabilities, and social relationship) had consensus among HCPs and a high impact; two criteria (rhythm or care duration, working/living conditions) showed consensus but a moderate impact; two criteria (funding and scheduling capabilities cross-structure) had a high impact but no consensus. For eight criteria (as environment or inequity), there was no consensus and moderate impact.
The introduction of immunotherapies for advanced cancer has had an important OI in France, regarding capacities and skills. Further research using qualitative analysis of interviews will provide more information regarding OI.
2020 年，法国国家卫生管理局（Haute Autorité de santé）发布了一份名为“组织影响（OI）制图法”的方法学指南，旨在定义和构建卫生技术的 OI 评估。由于免疫疗法可延长晚期癌症患者的生存期并提高其生活质量，我们旨在确定免疫疗法对医疗保健系统和专业人员产生的 OI。据我们所知，这是首次基于该制图法进行 OI 评估的应用。
进行文献回顾，并对医疗保健专业人员（HCPs）进行访谈，以确定免疫疗法的 OI。他们被问及免疫疗法是否具有分类为三个宏观标准的 OI，即对护理过程的影响（六个标准）、对所需能力和技能的影响（六个标准）以及对社会的影响（四个标准）。如果一个标准提到了 OI，则收集有关其影响（轻微/中度/严重）和时间的信息。我们认为，当 75%的 HCPs 提到给定标准存在影响时，就存在 OI。
总共对 27 名 HCP 进行了访谈。对于 16 个标准中的 12 个，大多数 HCPs 提到了影响，而文献则确定了 11 个标准的影响。四个标准（技能和 HCP 之间的转移、安排能力和社会关系）在 HCP 中达成共识并具有重大影响；两个标准（护理节奏或持续时间、工作/生活条件）达成共识但影响中等；两个标准（资金和跨结构安排能力）具有重大影响但没有共识。对于八个标准（如环境或不公平），没有共识且影响中等。
免疫疗法在法国被引入用于治疗晚期癌症，对能力和技能产生了重要的 OI。使用访谈的定性分析进行进一步研究将提供有关 OI 的更多信息。
