Cancer Clinical Trial
Official title:
Optimize the Requirements and Preparations in Outpatient Chemotherapy
A prescription of injectable anticancer therapy requires the collection of medical data
(interview and physical examination) and often allied (laboratory tests). This requirement
is made on the day of the arrival of the patient to not prepare these treatments
incorrectly.
After receiving the prescription of treatment, it will take about 1 hour to prepare for
pharmacy and more in times of high activity, to provide the day hospital pockets treatment,
incompressible time when the patient waits to have his treatment.
A process has been selected (Optima) to anticipate prescribing injectable cancer treatments
and their manufacturing to reduce patient waiting times on the day of his coming François
BaclesseCentre day hospital.
Given the investigators daily activity evaluated patients received 65-70 day hospital,
assessing the feasibility of the project with an internalized platform seems most relevant
to completely control the process and costs.
This project will consist of anticipation paramedic telephone consultation followed by a
medical prescription validation will trigger the production of chemotherapy prematurely
before the coming of the patient.
The François Baclesse Center therefore supports the idea of an early day hospital, that is
to say a prescription and production pockets of chemotherapy before the arrival of the
patient in the service.
This project was named PROJECT OPTIMA for "Optimize requirements and preparations
chemotherapy Ambulatory Medicine" with a paramedic telephone consultation.
So this ambitious project is the first experience of a French advance routine injectable
anticancer therapies, all protocols combined in a Centre for the Fight against Cancer but
also in a hospital reference competent oncology and chemotherapy and whose preparation
process of chemotherapy administered by injection is fully internalized and centralized.
Before starting this program routine, it is essential to validate through a research project
concordance between paramedic telephone consultation structured using tools and medical
consultation but also define the profiles of patients and types of chemotherapy injectable
likely to benefit safely from this program.
This study will be conducted in two parts:
• Part 1: where are compared two tools:
- paramedical examination conducted by telephone two days before the arrival of the
patient by a trained nurse, according to a predetermined grid, as a basis for medical
decisions prescription "virtual" or non-treatment;
- medical examination performed on the day of the coming of the patient for treatment.
This component will run for three months and will evaluate the rate of discrepancies between
these 2 types of prescription.
During this period, any prescription or administration of treatment will be validated at the
end of the paramedical examination phones.
This component will also detect and specify protocols suitable injectable cancer treatment
and develop a typology of patients for whom the anticipation process is more efficient and
more secure.
Indeed, the investigators can think that the anticipation process will not be effective for
all patients.
For example, a patient with a brain tumor will often diminished cognitive abilities
including its memory abilities. Responses to the telephone interview conducted by the nurse
may be incomplete or even false due to its memory disorders.
At the same time, waiting times and patient satisfaction will be evaluated and used as a
reference for the second part of the study whose objective is to evaluate the benefits of
this early prescription used routinely.
• 2nd part: It is an assessment process routinely used after defining the profile of
patients and types of treatment protocols, including the phone call from the nurse, the
early prescription of chemotherapy, early production and day, medical consultation control
before administration.
In this step will be compared to expectations time, patient satisfaction and treatment
wrongly prepared before and after the launch of Optima.
Prerequisites:
- All nurses to conduct telephone interviews will be trained on two days conducted by
EFEC (European School of Oncology Training) whose purpose is to explain the issues of
the telephone interview for resulting prescription chemotherapy for the patient.
- Nurses phone platform dedicated to the call of patients will experience in service,
allowing them to develop acuity to identify clues that signpost to important pieces of
information for the management of patients.
Feasibility:
This study will be conducted in two stages for a period of three months each, which should
allow in the investigators activity to include 450 patients by step, based on 3 patient came
through, about 1350 came by step ..
The homepage of the day hospital service capacity is 40 places for activity 65-70 patients
per day. Approximately 300 patients are admitted each week with about 42 new patients each
week.
The investigators welcome all specialties outside of Hematology (digestive oncology, ENT and
Pneumology, urogynecologic, breast screening, brain tumors and sarcomas).
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