title: Administration of oral chemotherapy: results from three rounds of the quality oncology practice initiative.
abstract: OBJECTIVE
  Although use of oral chemotherapy is becoming more prevalent, little is known about the quality of care that patients receive when these agents are prescribed. Moreover, few practice-level systems are in place to ensure safe management of oral chemotherapy in the vulnerable population of patients with cancer.
  
  
  METHODS
  We analyzed results from 155 practices that were voluntarily participating in the American Society of Clinical Oncology Quality Oncology Practice Initiative (QOPI) program on 17 test measures of oral chemotherapy administration and management in at least one of three collection periods: spring or fall of 2012, or spring of 2013. The 17 test measures cover three domains: treatment plan documentation, patient education, and adherence/toxicity monitoring. We defined composite scores for each of the three domains. We analyzed the composite scores by secular trend and tested the difference in composite scores for the three domains. Additionally, we tested change in scores over time among practices that participated at least twice.
  
  
  RESULTS
  The majority of data was provided by QOPI-certified practices. Overall, mean practice composite scores ranged from 66% to 68% for treatment plan documentation, 51% to 57% for patient education, and 75% to 81% for adherence/toxicity monitoring. Composite scores for practices that participated more than once did not improve significantly.
  
  
  CONCLUSIONS
  The collection of oral chemotherapy test measure data is feasible. Composite scores for treatment plan documentation and patient education were not only lower, but had greater variability compared with adherence/toxicity monitoring. Improvement opportunities exist for patients who are prescribed oral chemotherapy.
authors.affiliation: Beth Israel Deaconess Medical Center; Dana-Farber Cancer Institute, Boston, MA; American Society of Clinical Oncology, Alexandria, VA; Michigan Oncology Quality Consortium, Ann Arbor, MI; and Stanford Cancer Institute, Stanford, CA jzerillo@bidmc.harvard.edu.
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Zerillo
authors.affiliation: Beth Israel Deaconess Medical Center; Dana-Farber Cancer Institute, Boston, MA; American Society of Clinical Oncology, Alexandria, VA; Michigan Oncology Quality Consortium, Ann Arbor, MI; and Stanford Cancer Institute, Stanford, CA.
authors.forename: Trang H
authors.initials: TH
authors.lastname: Pham
authors.affiliation: Beth Israel Deaconess Medical Center; Dana-Farber Cancer Institute, Boston, MA; American Society of Clinical Oncology, Alexandria, VA; Michigan Oncology Quality Consortium, Ann Arbor, MI; and Stanford Cancer Institute, Stanford, CA.
authors.forename: Pamela
authors.initials: P
authors.lastname: Kadlubek
authors.affiliation: Beth Israel Deaconess Medical Center; Dana-Farber Cancer Institute, Boston, MA; American Society of Clinical Oncology, Alexandria, VA; Michigan Oncology Quality Consortium, Ann Arbor, MI; and Stanford Cancer Institute, Stanford, CA.
authors.forename: Jane Alcyne
authors.initials: JA
authors.lastname: Severson
authors.affiliation: Beth Israel Deaconess Medical Center; Dana-Farber Cancer Institute, Boston, MA; American Society of Clinical Oncology, Alexandria, VA; Michigan Oncology Quality Consortium, Ann Arbor, MI; and Stanford Cancer Institute, Stanford, CA.
authors.forename: Emily
authors.initials: E
authors.lastname: Mackler
authors.affiliation: Beth Israel Deaconess Medical Center; Dana-Farber Cancer Institute, Boston, MA; American Society of Clinical Oncology, Alexandria, VA; Michigan Oncology Quality Consortium, Ann Arbor, MI; and Stanford Cancer Institute, Stanford, CA.
authors.forename: Joseph O
authors.initials: JO
authors.lastname: Jacobson
authors.affiliation: Beth Israel Deaconess Medical Center; Dana-Farber Cancer Institute, Boston, MA; American Society of Clinical Oncology, Alexandria, VA; Michigan Oncology Quality Consortium, Ann Arbor, MI; and Stanford Cancer Institute, Stanford, CA.
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Blayney
mesh_terms: D000284:Administration, Oral; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004282:Documentation; D006801:Humans; D008495:Medical Oncology / Q000458:organization & administration / Q000592:standards*; D010349:Patient Compliance; D010353:Patient Education as Topic; D011785:Quality Assurance, Health Care; D058996:Quality Improvement
chemical_list: D000970:Antineoplastic Agents