Anticancéreux oraux : retour d’expérience après six années de consultations tripartites dans un centre hospitalier

Abstract

Tripartite consultations with a coordination between hospital and community care givers were implemented within hospital center for patients who start an oral anticancer regimen. Six years after the implementation, we wanted to assess this patient's pathway and describe how adjustments were necessary over the time. A total of 961 patients received tripartite consultations. The medication review process revealed that nearly half of patients had polypharmacy (≥5 drugs/day). A pharmaceutical intervention was formulated in 45% of cases and they were all accepted. For 33% of patients, a drug interaction was identified and required for 21% of them, discontinuation of one drug of their personal treatment. Coordination with general practitioner and community pharmacists were achieved for all patients. 390 patients benefitted from nursing telephone follow-up which represents approximately 20 calls per day to assess tolerance and compliance with treatments. Over time, organisational adjustments were necessary to adapt to the increase in activity. The scheduling of consultations has been improved thanks to the creation of a shared agenda and consultation reports have been expanded. Finally, an hospital functional unit was created to facilitate the financial valuation of this activity. The feedback collected from the teams showed a real desire to perpetuate this activity even if it would seem that an improvement in human resources is still relevant as well as a better optimisation of the coordination between all the participants.