Enhanced supportive care and communication in the initial treatment of curable cancer: Evaluation of the SCOOP (Supportive Care of Oncology Patients) pathway, a retrospective cohort study.

PURPOSE

This study was designed to determine whether a series of interventions selected for our institution after systematic analysis of the cancer treatment process could decrease emergency room visits and hospital admissions in cancer patients treated with curative intent. A clinical pathway was devised with five key interventions designed to enhance supportive care, increase communication among providers, and quantify nurse navigator accountability.

METHODS

Patients with solid tumors treated with concurrent chemotherapy and radiation with curative intent were eligible for the study. They were identified in the multidisciplinary clinics of the Helen F. Graham Cancer Center of the Christian Care Health System (HFGCCRI). A total of 318 consecutive pathway patients were analyzed and compared to 455 historical controls. Pathway patients were selected from the beginning of the program in 2016 until 2019 and followed from the onset of radiotherapy until 1 month after the completion of radiotherapy. Emergency room (ED) visits and inpatient admissions were the primary outcomes of the study. The independent variables-including age, performance status, sex, race, insurance status, and diagnosis-were analyzed using regression-based adjustment for covariates.

RESULTS

The expected number of ED visits during the study period was 46% lower for SCOOP patients than for controls. Likewise, the expected number of hospitalizations was 50% lower for SCOOP patients. Both were statistically significant. Reanalysis after propensity score matching yielded similar results.

CONCLUSION

Pathway interventions specifically selected for our institution appeared to curtail ED visits and admissions in patients treated with exacting treatment regimens.