| Sumario: | Introduction The introduction of CHARM® has provided the opportunity to standardise protocols, including desensitisation regimens, across our oncology infusion centre. In this study we examine the impact of standardising desensitisation chemotherapy regimens, and its impact on administration, data collection and clinical practice, compared to the previous method of administration within our centre Aims Describe how the protocol was implemented at our centre including stakeholder liaison and staff education, resulting in the utilisation of an online Oncology Information Management Solution (OIMS) (Citadel Health, 2022), improving patient satisfaction and patient outcomes, optimising clinical resources and health data collection. Further study aims include demonstration of successful completion of desensitisation chemotherapy treatment with the use of streamlined premedication regimen and without ICU admission for administration. Methodology Data will be collected on the following outcomes before and after the introduction of CHARM® * Tumour type, line and intent of therapy * Rationale for a desensitisation regimen: 1) Nature and severity of prior reaction if present; 2) Centre of prior treatment and rationale for treatment at SJGSH) * Oncology outcomes: 1) Safety of delivery and number of cycles delivered on desensitisation protocol; 2) Toxicity of therapy with a particular focus on subsequent reactions; 3) Was the therapeutic goal achieved? (eg. completion of planned regimen in early stage, response to therapy in late stage); 4) Reason for drug discontinuation (Progression, hypersensitivity Reaction, end of treatment, ongoing, other). * Presence of a protocol for desensitisation * Uniformity/consistency of prescribing based on chart review * Resource management before and during treatment administration * Errors or potential errors in management Results 320 episodes of desensitisation treatment were identified in the six-year period prior to the induction of OIMS. Review of these documents identified inconsistencies in the prescribing of desensitation regimens, limited use of protocol for administration and prescribing and the absence of data, including missing charts, rationale for desensitisation use, and outcomes associated with desensitisation use. Since the introduction of OIMs, 79 episodes of desensitisation over a 14-month period have been administered. Positive outcomes of its introduction can be surmised into the following: 1. OIMS has resulted in standardised desensitisation prescribing, including premedication administration, and improved length of stay times. 2. Data transparency and availability. 3. Decrease in errors identified associated with desensitisation administration 4. Increased nurse knowledge, confidence and competency. 5. Patient satisfaction Conclusion Our findings have identified that the introduction of OIMS has resulted in a positive impact in the cancer centre, resulting in increased clinician and patient satisfaction, streamlined processes resulting in decreased length of stay and decreased errors associated with desensitisation treatments. However, further work is required regarding documentation that is not currently able to be upload onto the OIMs system. The impact on overall survival and progression-free survival rate were not investigated within this study but would be ideal, as pursuing this line of treatment is challenging with the potential for further infusion related reactions and resource availability. It is also recommended that further studies be conducted surrounding patient education and psychological impacts associated with individuals requiring desensitisation treatments.
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