The oncology acute toxicity unit (OATU): an outpatient facility for improving the management of chemotherapy toxicity.
OBJECTIVE
To provide an outpatient facility to improve the management of chemotherapy toxicity in cancer patients.


METHODS
We set up an oncology acute toxicity unit (OATU) to improve toxicity management. A telephone helpline was the initial contact which filters out inappropriate non-toxicity-related events. Patients were provided an information booklet describing the possible side effects of the chemotherapy and the helpline telephone number. A specialist nurse received the calls and consulted the doctor if necessary. Depending on requirements, the patient's problem was resolved by telephone, or a consultation visit at the OATU was arranged.


RESULTS
Between February 1999 and August 2001, 1126 patients made 2007 contacts with the OATU. The most common tumours were breast (26%), colorectal (20%) and lung (20%). The telephone helpline was used in 87% of contacts and 37% were considered inappropriate. Of the 1263 appropriate contacts, the most frequent chemotherapy schedules that had been administered were 5FU-leucovorin (11.2%) and CMF (10.4%). The most frequent side effects were fever (35.5%), diarrhoea (18.5%), mucositis (16.2%) and emesis (13%). The problem was resolved by telephone in 48% of cases and 52% required attendance in the OATU, of which 40% required hospital admission, i.e., 21.1% of the initial appropriate helpline contacts. The most frequent reason was Grade 3-4 neutropenic fever (56.5%).


CONCLUSIONS
The OATU enables prompt and efficient access of patients to medical oncology facilities in the event of toxicity due to chemotherapy. Unnecessary emergency room use is avoided while oncology outpatient and hospitalisation facilities are optimised.
Majem
M
M
Department of Medical Oncology, Institut Català d'Oncologia L'Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain.
Galán
M
M
Pérez
F J
FJ
Muñoz
M
M
Chicote
S
S
Soler
G
G
Navarro
M
M
Martínez-Villacampa
M
M
García del Muro
X
X
Dotor
E
E
Laquente
B
B
Germà
J R
JR
D000293:Adolescent; D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems / Q000458:organization & administration*; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D015277:Hotlines / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D009369:Neoplasms / Q000188:drug therapy*; D016522:Oncology Service, Hospital / Q000458:organization & administration*; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration*; D013689:Telephone; D014116:Toxicology / Q000458:organization & administration*; D014839:Vomiting / Q000139:chemically induced
D000970:Antineoplastic Agents