Posted June 06 2017 03:02pm
May 2017 - The Algoma District Cancer Program (ADCP), in partnership with the Northeast Cancer Centre (NECC) in Sudbury, has worked collaboratively to launch the Start Right Program. Cancer Care Ontario funding was allocated under the New Models of Care for Nurse–Led initiatives for cancer care in the province of Ontario.
The Program at SAH is led by a registered nurse in the ADCP. It focuses on education and follow-up for patients who are starting oral chemotherapy treatment. “The goal of the Start Right Program is to ensure that we are providing oral chemotherapy patients with information about their medication, safe handling, storage and symptom management,” says Kathleen Weir, Supervisor ADCP.
Like intravenous chemotherapy, oral chemotherapy must be managed. “It is important to remember that oral chemotherapy carries similar risks and side effects as when it is given in a vein and it is important to follow the same safety precautions,” explains Weir. “Since approximately 40% of chemotherapy treatment is now orally administered by the patient, it is vital that these patients understand how to properly and safely take their medication.”
According to Weir, when patients receive intravenous (IV) therapies, there is a formal teaching process and they under the supervision of care providers. However, when patients take oral chemotherapy, they are doing so unsupervised at home so it’s very important that patients are properly informed about the administration of their medication. “Prior to starting oral treatment, the patient will see a nurse who generally spends at least 2 hours providing education, information and answering any questions or concerns the patient/family may have,” she says.
Patients are also provided with a medication card which they are to present if attending the Emergency department. “The card outlines the record of their medications including the drug name, when they started, the dose, etc.,” says Weir. After 2 weeks, the patient returns again for an assessment and in the intervening time, if the patient is experiencing side effects or they have questions, they can call the telephone triage line. For the first month, weekly phone calls from the oral chemotherapy nurse are also part of the program.
The ADCP has worked jointly on this initiative with the NECC via the Ontario Telemedicine Network (OTN). “We worked with the team in Sudbury to establish an evidence-based and consistent education program including the development of teaching tools such as handouts,” she says. “Working together via OTN was a very interesting way to work together and although our programs are uniquely tailored to our respective facilities, there are many similarities in how we deliver this program to our patients.”
Recently, SAH opened a specialty pharmacy within the existing pharmacy location. This pharmacy services predominantly oral chemotherapy patients and some outpatients from the renal and mental health departments. Their focus is on assisting patients with the administration and management of oral chemotherapy to ensure we meet increasing oral chemotherapy standards. The iCcare pharmacy is now fully accredited and is staffed with a pharmacist Monday to Friday from 9 am to 5 pm. The pharmacy collaborates with the entire ADCP team to provide a standard of care for oral chemotherapy similar to our IV chemotherapy.
“We do a full medication review with the patient and we ensure that all proper medications are ordered,” says Sarah Johnson, Lead Pharmacist, iCcare Pharmacy. “We make sure that patients who are administering their own oral chemotherapy drugs do so properly and follow all the latest medication handling guidelines.” Patients benefit from the pharmacy’s blister packing services. “Blister packing oral chemotherapy medications makes it easier for patients, especially the elderly, to adhere to their medication schedules and generally helps compliance,” explains Johnson.
The retail pharmacy works closely with the nurses in the Oral Chemotherapy Clinic and the rest of Cancer Program’s team to support the patient’s treatment. “It’s important to work closely with the entire care team to ensure consistency for the patient and we try to provide as much support as possible to the care team and the patient.”
Since the launch of the Start Right Program in March 2016, more than 100 patients have come through the clinic and so far, evaluation results are very positive. “We have received very positive feedback from our patients and they are validating that this work is important and beneficial,” says Weir.
SAH salutes the team at the ADCP on implementing this patient-centred program through an innovative partnership with the NECC!
Rose Calibani is the Public Affairs Officer at Sault Area Hospital. We welcome comments and suggestions for future column topics. Please call Public Affairs at (705) 759-3671.