Evaluation of interprofessional care processes for patients treated with oral anticancer drugs

ABSTRACT

Information on interprofessional team composition and functioning in the care for patients on oral anticancer drugs (OACDs), and how healthcare professionals (HCPs) evaluate in-hospital care processes is scarce. We aimed to investigate interprofessional care processes for OACD-patients in a partially mixed-methods study. A combination of (a) the CareProces Self-Evaluation Tool (CPSET), completed by HCP-team members by health profession who were either currently involved in care processes (oncologists and nurses) or potentially involved in future care (pharmacists, psychologists, social workers), and by hospital managers (N = 87) and (b) semi-structured interviews in a subsample of oncologists, nursing staff, and pharmacists (N = 26) were used. Care process coordination was evaluated poorly, mainly by nurses, pharmacists, and psychologists. Nurses and pharmacists believed that they were not engaged in the organization of OACD care, lacked role clarity, and perceived no meaningful interprofessional practice. HCPs had different perceptions toward timing and planning of patient education and follow-up. Monitoring of care processes occurred only occasionally and was unstructured resulting in apoor complication-management and variance within care processes. Care processes for OACD-patients showed opportunities for optimization of interprofessional practice in timing, planning, and monitoring. Rethinking care processes through co-design is needed.

KEYWORDS:

• Oral anticancer drugs
• healthcare process assessment
• interprofessional teamwork
• patient education and counseling
• oncology nursing
• oncology pharmacy practice

Acknowledgments

We gratefully acknowledge Britt Beckers and Hannelore Bervoets for their support in transcribing the qualitative data. We thank Maxim Nelis for his contribution in the input of CPSET-data in excel and in the preliminary descriptive statistical analysis.

Disclosure statement

None to declare.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website

Additional information

Funding

Funding for this study was provided by Kom Op Tegen Kanker, an organization in Flanders (Belgium) who supports psychosocial research projects in cancer care. This funding was provided by Kom Op Tegen Kanker for the overarching CONTACT-study.

Notes on contributors

Lise-Marie Kinnaer

Lise-Marie Kinnaer is a community pharmacist and obtained her PhD in Pharmaceutical Sciences at KU Leuven, Belgium where she studied change and implementation processes for patients treated with oral anticancer drugs. Currently, she is a postdoctoral researcher at the department of Public Health and Primary Care at Ghent University (BE). As a starting researcher, Lise-Marie Kinnaer is still exploring research opportunities. Her research interest focuses on the development and implementation of innovations in interprofessional care for specific patient populations and more specifically in interprofessional collaborations between pharmacists and nurses. 

Ilyse Kenis

Ilyse Kenis graduated from KU Leuven, Belgium in 2018 as a pharmacist. Now, she is a PhD researcher at the Department of Pharmaceutical and Pharmacological Sciences, Clinical Pharmacology and Pharmacotherapy, KU Leuven. In her PhD project, cshe studies the development and implementation of a care pathway for patients treated with oral anticancer drugs in eleven hospitals in Belgium. Furthermore, she is involved in an educational initiative, EDUcation to support COllaborative Networks to Take responsibility for oral AntiCancer Therapy (EDU-CONTACT), to improve education and counseling on oral anticancer drugs for healthcare professionals from primary and secondary care.

Veerle Foulon

Veerle Foulonis a professor in pharmaceutical care and vice dean at the Faculty of Pharmaceutical Sciences at KU Leuven (Belgium). Her research domain includes the broad topic of pharmaceutical care and the role and added value of pharmacists in interprofessional teams. She is involved in different educational activities for pharmacy students: from clinical pharmacotherapy, to counseling for over-the-counter drugs and patient education and counseling.

Ann Van Hecke

Prof. dr. Ann Van Heckeis currently co-leading the University Center for Nursing and Midwifery (UCVV), a scientific unit within the Department of Public Health and Primary Care, Ghent University. Her research focuses on the development and implementation of advanced practice nurses, NP-led care, self-management in chronic and cancer care, co-design/patient participation on micro and meso level, and is highly multidisciplinary. She has been intensively involved in the strategic thinking around the future of nursing and Advanced Practice Nurses/NPs in Belgium which resulted in a new legal framework for Advanced practice nurses/NPs in Belgian legislation (2019). Ann Van Hecke is board member of the Belgian Association for Advanced Practice Nurses, member of the planning committee regarding the nursing workforce of the current minister of Health in Belgium and the federal Council of nursing, and board member of the European Academy of Nursing Science. Besides her appointment at Ghent University, she is staff member in Nursing director department at Ghent University Hospital.