Oncological supportive-care unit (OSU): An effective toxicity management model.

Media type: E-Article

Title: Oncological supportive-care unit (OSU): An effective toxicity management model

Contributor: Mirabile, Aurora; Foglia, Emanuela; Frigo, Fiorenza; Del Grosso, Elisabetta; Barbarini, Lucia; Bovio, Antonella; Butti, Chiara; Ciambelli, Fabrizio; Pauli, Sergio; Ricci, Isabella; Gargiola, Elisabetta; Aloisio, Enrica; Oliva, Giovanna; Artale, Salvatore Agatino

imprint: American Society of Clinical Oncology (ASCO), 2017

Language: English

DOI: 10.1200/jco.2017.35.15_suppl.e18301

ISSN: 0732-183X; 1527-7755

Keywords: Cancer Research ; Oncology

Origination:

Footnote:

Description: e18301 Background: Oncological patients (pts) frequently experience treatment-related toxicities worsening outcome. According to literature data, 23% - 50% emergency department (ED) and/or hospital admissions in this setting could be avoidable and hesitate in higher management costs and worse quality of life (QoL). Cancer treatment adherence rate is 27% - 87%, mostly related to chemotherapy and post-surgical side effects. Since May 2014 we established an OSU to improve clinical outcome and treatment adherence, to reduce ED access/hospital admissions and toxicities management costs. Methods: All OSU data have been recorded in a database which includes daily management costs into an Italian regional regimen called MAC (Complex Ambulatory Macro-activities). ED accesses were recorded by our “First aid ED operative system”. Hospitalizations costs were evaluated according to regional DRG (Diagnosis Related Group) value and Hospital Discharge Register (HDR). All pts admitted to OSU should answer to two validated questionnaires regarding QoL and anxiety: FACT-G (General FunctionalAssessment Cancer Therapy) and HADS (Hospital Anxiety and depression Scale). We compared toxicities management costs 20 months before and 20 months during OSU. Results: From May 2014 to December 2015, 302/719 pts were admitted to OSU for a supportive care therapy. We obtained the reduction of the costs of the ED access/hospital admission to 52%, while the gain in management was 59% (see table). PS ECOG improved in 9 (18%) pts while it was unchanged in 41 (82%) pts. Adherence to oncologic treatment was satisfactory (95%) and the average values of total FACT and HADS in the follow-up phase improved compared to baseline in 63% and 43% of pts respectively. Conclusions: The interim analysis suggests that OSU improves clinical outcome in terms of QoL and treatment adherence. Moreover, our OSU model demonstrated the possibility to reduce toxicity-related ED accesses/hospital admissions and management costs. [Table: see text]

Access State: Open Access

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