title: [Care pathways of cancer patients: Modeling and risks analysis induced by oral anticancer drugs].
abstract: The care pathway of cancer patients is complex and therefore difficult to define. The oral anticancers (AKPO) have shown their benefits to patients and health professionals, however, the risks induced on the care pathway remain unknown. The objective of the study is to define, quantify the risks from AKPO and their effects on the care pathway (breakdown [Ds], rupture [Rt]). From the proposed care pathway model, FMEA method is used to analyze risks. For the 3 identified processes (1 monotherapy, 2 bitherapies: 2 AKPO or 1 AKPO/1 AKIV), analysis revealed an average of 91 risks, 173 Ds, 147 Rt, increased for 1 AKPO/1 AKIV therapy. The administration and delivery are the most risky steps. The lack of training and information of patients and healthcare professionals generates 80% of Ds and Rt. This model confirms the complexity, variability of the care pathway. The development of actions to improve town-hospital coordination and exchange of information is required to optimize and secure the route, confirming the objectives of "Plan Cancer 3".
authors.affiliation: Groupe hospitalier La Pitié-Salpétrière, réseau régional de cancérologie d'Île-de-France (ONCORIF), 47, boulevard de l'Hôpital, 75013 Paris, France; Hôpitaux universitaire Paris Sud, hôpital Antoine-Béclère, service de pharmacie, 92141 Clamart cedex, France. Electronic address: sophie.renet@gmail.com.
authors.forename: Sophie
authors.initials: S
authors.lastname: Renet
authors.affiliation: Groupe hospitalier La Pitié-Salpétrière, réseau régional de cancérologie d'Île-de-France (ONCORIF), 47, boulevard de l'Hôpital, 75013 Paris, France; Groupe hospitalier Paris-Saint-Joseph, unité chimiothérapies et essais cliniques, service de pharmacie, 75014 Paris, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Maritaz
authors.affiliation: AP-HP, hôpitaux universitaires de l'Est Parisien, hôpital Tenon, service d'oncologie médicale et de thérapie cellulaire, pôle onco-hématologie, 4, rue de la Chine, 75970 Paris cedex 20, France; Université Pierre-et-Marie-Curie, institut universitaire de cancérologie, 75013 Paris, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Lotz
authors.affiliation: Groupe hospitalier La Pitié-Salpétrière, réseau régional de cancérologie d'Île-de-France (ONCORIF), 47, boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Burnel
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, institut droit et santé, Inserm UMR S 1145, faculté de pharmacie de Paris, Paris, France; Assistance publique-Hôpitaux de Paris, agence générale des équipements et produits de santé, service évaluations pharmaceutiques et bon usage, 7, rue du Fer-à-Moulin, 75005 Paris, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Paubel
mesh_terms: D000284:Administration, Oral; D000553:Ambulatory Care; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D019091:Critical Pathways; D011307:Drug Prescriptions; D006801:Humans; D015233:Models, Statistical; D009369:Neoplasms / Q000188:drug therapy*; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data
chemical_list: D000970:Antineoplastic Agents
keywords: Analyse des risques; Anticancéreux oraux; Cancérologie; Care pathway; Model; Modèle; Oral anticancer drugs; Parcours de soins; Risks analysis