Implementation of an approach : « Patient actor of his treatment»
A prescription for parenteral chemotherapy is validated by the oncologist according to several parameters (weight, height, complete blood count, side-effects …).
We have encountered prescription errors because of these parameters on several occasions.
In order to deal with the dysfunction of the system, we have decided to establish a post-chemotherapy monitoring form to be handed over to patients. We drafted the monitoring forms in close cooperation with the oncologists and adapted them to each protocol. The criteria requested in the form are the following: patient’s identity (family name, first name, date of birth), weight, contact details of the healthcare professionals close to the patient (doctor, pharmacist), a list of the possible side effects, a chart listing the patient’s side effects by date, a patient’s satisfaction scale for his/her diet and general health. A blood sample must be taken before the appointment for chemotherapy.
The monitoring form is handed back to the doctor during the consultation. The doctor can then refer to a list of the side effects suffered by the patient between chemotherapy cycles and can review his/her variation in weight. This system is currently being evaluated for patients suffering from colorectal cancer. Two monitoring form templates were drafted encompassing the FOLFOX, FOLFIRI protocols, plus or minus bevacizumab or cetuximab. 32 monitoring forms were distributed to the patients over a one-month period, 14 forms being handed back during the consultation. The reasons for failing to hand back the forms were: The non-submission of the form by patients who did not had side effects and oversights during the appointment.
At the medical level, the monitoring form meets the expectations of the patients /doctors and also is in accordance with our personalised care programme. Further to this experiment we are going to promote awareness of the process among patients and to extend it to other protocols (such as FEC, Docetaxel etc.). Finally, the related documents and blood counts will be scanned in order to allow them to be entered into CHIMIO® software, so as to then carry out a clinical pharmacy procedure.