A regional harmonization of chemotherapy, antiemetic and hydration protocols

4 octobre 2012

P. Savary1, J. Delage1, M. Adam2, B. Chéru3, L. Bastit3, M. Daouphars3, J. Doucet1, E. Rémy1 1 OMéDIT Haute-Normandie, CHU de Rouen, 1 rue de Germont, 76031 ROUEN CEDEX, FRANCE
2 Pôle Pharmacie, CHU de Rouen, 1 rue de Germont, 76031 ROUEN CEDEX, FRANCE
3 Réseau Onco-Normand, 2 avenue de la liberté, 76300 SOTTEVILLE-LES-ROUEN, FRANCE

The OMEDIT (a regional health observatory) and the Oncology Network of upper Normandy (ONN), lead a project to harmonize chemotherapy protocols, related to the national cancer plan and the good use policy. The objective is to produce a regional thesaurus intended to ensure quality and equal access to cancer treatments.

At the end of 2011, the OMEDIT collected chemotherapy regimens’ thesaurus, included antiemetic treatments and hydration protocols, of all involved institutions. An exhaustive inventory of protocols was collected by organ. Working groups, piloted by ONN and OMEDIT, are composed of oncologists and pharmacists of public and private establishments. They define shortlists by organ of updated protocols respecting authorization marketing products. Harmonization of antiemetic and hydration protocols is also produced in partnership with regional federation of cancer.

For breast cancer, 97 protocols were identified, 139 for lung cancer and 121 for digestive cancer. There are many differences affecting the following criteria : periodicity, dosage, solvent, duration of administration. A first working group eliminated around two-thirds of breast cancer protocols. Concerning associated treatments, 68 hydration protocols were counted, with variations between regional establishments and for one establishment between the different care units. Standardization proposals are still going on. For antiemetic treatments, harmonized protocols related to emetic risk and international guidelines are tested in one establishment.

The multidisciplinary elaboration of harmonized cancer treatments’ thesaurus will optimize patients’ management. Its integration in the shared medical file for cancer will assure its diffusion.

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