Abstract
Oncology has been undergoing a profound transition in the last ten years with the increased usage in oral anti-cancer medication. Approximately 25% of all anti-cancer medication is now designed for oral use and this is likely to increase prospectively. These treatments are convenient for patients and are often preferred by them, yet there are similar safety and toxicity concerns as there are to intravenous treatment. Oral anti-cancer medications (OAMs) have the potential to alleviate capacity issues in cancer treating units as patients receive their treatment at home, however there remains a requirement for safe and efficient assessment and care. Consequently, the management of patients on OAMs is of paramount importance.The optimum setting, whether within primary or secondary care, in addition to the appropriate health care professional to carry out patient assessment and monitoring needs to be established. This paper presents a protocol for a scoping review which aims to systematically and comprehensively map the literature on the current management of adults receiving OAMs. The review will follow the published guidance to direct the various steps involved. The protocol will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) framework to ensure methodological and reporting quality.Independent full text review will be performed by two reviewers and any disagreements resolved through discussion with a third reviewer. The process will be iterativein nature. This scoping review will provide a narrative synthesis and map theliterature on the management of individuals receiving OAMs.This work is an appropriate initial stage in presenting the literature to inform the subsequent steps in a multi-phased research study which aims to establish and analyse the safety and efficacy of an integrated care model for themanagement of patients receiving OAM in the community by an advanced practitioner.
Highlights
The authors note that the types of Oral anti-cancer medications (OAMs) medications have become more diverse over time and most of the earlier publications focused on capecitabine in patients with breast or colorectal cancers. As this scoping review aims to consider contemporary management of care for this patient population who are receiving all OAMs it is sufficient to focus on studies published from 2010–2020 inclusive
The scoping review protocol is an essential component in the process of performing a scoping review of a chosen topic (Moloney et al, 2020) and provides an outlined method for exploring and mapping relevant literature (Lafferty et al, 2019)
Individuals being treated with OAM require on-going assessment and monitoring (NCCP, 2018) yet with increasing numbers of patients on OAMs there is a requirement to improve hospital efficiency and reduce overcrowding in cancer units yet provide safe, appropriate and timely patient care
Summary
They have the required expertise and skills to undertake caseload management of a cohort of patients requiring advanced level decision making, such as those receiving OAMs. Currently, advanced nursing assessment in cancer care is largely performed within a hospital context. This review concluded that community-based nurse-led clinics have largely shown positive impact on patient outcomes, patient satisfaction and access to care despite the evidence base for such a key universal policy aim being limited Extrapolating this to more specific care of individuals receiving OAMs, community-based care or integrated care models for this cohort of patients do not appear to be well established in national or international healthcare landscapes. The aim of this scoping review is to identify how patients receiving OAM are currently managed from an international perspective
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