The MMUH is the National Referral Centre for patients with Cancer.
This service provides specialist care to patients with a cancer diagnosis who are prescribed OAMS.
It is estimated that the number of patients receiving oral SACT for the treatment of their cancer will increase by 42-48% between 2015 and 2025 (NCCP).
The population of adults with Cancer who are prescribed OAMS continues to grow rapidly with 200 new referrals to the MMUH OAMS Clinic service annually (2021).
The Oral Anti-Cancer Medication Clinic service at the MMUH was set up in response to the large volume of patients to provide specialist care to the OAMS population lost to follow up.
The CNSp in the OAMS clinic reviews approx.
35 patients on OAMs per a week.
Appropriate patients are referred by Clinical Nurse Specialists to the OAMS clinic.
Patients are reviewed in OAMS clinic, in line with local KPI, and their medications are reviewed.
A SACT nursing assessment, weight, vital signs, medication history and completed in OAMS clinic.
The CNSp in OAMS clinic liaises with community pharmacy.
Appropriate referrals are sent to dietetics, social work, palliative care, psycho-oncology etc after a discussion with the patients.
OAMS patient information leaflet and triage details are given to the patient.
Patient is followed up in OAMS clinic based on drug monitoring protocol.
Phone line is available for patients to contact OAMS CNSp.
OAMs CNSp attends consultant rounds weekly to discuss patients care and drug toxicities.
Research indicates that close monitoring (or follow-up) of individuals receiving OAMs is crucial to achieve intended therapeutic outcomes.
Such patient monitoring is required to maximise patient safety and adherence and to reduce toxicity, adverse events and health care costs (Battis et al., 2017).
Patient monitoring requires co-ordination of care, is time intensive and consequently expensive.
Patient satisfaction levels are high with specialist or advanced practice in nursing clinics (Liljeroos and Stromberg, ¨ 2019; Linedale et al., 2020) and with specific reference to OAM care, Bordonaro and colleagues provide a strong conclusion that, "nursing … is a fundamental aspect of a high quality home based chemotherapy (service)" (Bordonaro et al., 2012).
A study using data obtained from the National Cancer Patient Experience Survey (NCPES) has shown that cancer patients who have good access to care from a designated clinical nurse specialist (CNS) could improve their chances of survival.
The study, published in the British Medical Journal of Supportive & Palliative Care, identified 99,371 patients with colorectal, lung, breast and prostate cancer who reported their care experience of having a CNS from the National Cancer Patient Experience Survey (2010–2014) and a linked dataset from the English cancer registration.
The prognosis for patients prescribed OAMS is better when cared for within a specialist Oral Clinic service rather than a general day unit.
As an influential member of the MDT, the CNSp in OAMS clinic is fundamental to the delivery of this service.
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