title: A nurse-/pharmacy-led capecitabine clinic for colorectal cancer: results of a prospective audit and retrospective survey of patient experiences.
abstract: Oral chemotherapy agents provide patients with choice and home-based therapy but demand greater emphasis on patient support and education to minimise toxicities. To meet this demand, a nurse-/pharmacy-led clinic was established at the Beatson Oncology Centre in 2003 for the provision of oral capecitabine to metastatic colorectal cancer patients to provide a controlled and supportive environment. We conducted a prospective audit of 52 patients attending the clinic from March 2003 to June 2004 and a retrospective survey of patient experiences to assess clinic effectiveness. Of 52 patients, 79% completed at least 3 cycles of treatment (mean 3.5). Capecitabine was well tolerated. The dose was reduced on at least one occasion in 15 (29%) patients and 17 (30%) patients experienced at least one delay. Patient satisfaction, indicated by questionnaire responses (n=27), was high. Most patients (> or =85%) thought that the service provision was useful and well organised. The results indicate that a nurse-/pharmacy-led clinic for the provision of home-based oral capecitabine is safe, effective and acceptable to most patients. The success of this clinic can provide a model for use in other centres and in other types of cancer, such as breast cancer, where oral chemotherapy is a treatment option.
authors.affiliation: Beatson Oncology Center, Dumbarton Road, Glasgow, G11 6NT, UK. alice.macleod@northglasgow.scot.nhs.uk
authors.forename: A
authors.initials: A
authors.lastname: MacLeod
authors.forename: A
authors.initials: A
authors.lastname: Branch
authors.forename: J
authors.initials: J
authors.lastname: Cassidy
authors.forename: A
authors.initials: A
authors.lastname: McDonald
authors.forename: N
authors.initials: N
authors.lastname: Mohammed
authors.forename: L
authors.initials: L
authors.lastname: MacDonald
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D002173:Cancer Care Facilities; D000069287:Capecitabine; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000451:nursing / Q000523:psychology; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016903:Drug Monitoring; D005260:Female; D005472:Fluorouracil / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018575:Home Care Services, Hospital-Based / Q000458:organization & administration; D006801:Humans; D007857:Leadership; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D009731:Nursing Audit; D015403:Nursing Evaluation Research; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration*; D017060:Patient Satisfaction; D010607:Pharmacy Service, Hospital / Q000458:organization & administration*; D015397:Program Evaluation; D011446:Prospective Studies; D012189:Retrospective Studies; D012606:Scotland; D011795:Surveys and Questionnaires
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil