Review of an innovative health service approach, the Symptom Urgent Review Clinic (SURC), to improve efficiency and quality of care for breast cancer patients receiving adjuvant chemotherapy — ASN Events
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Review of an innovative health service approach, the Symptom Urgent Review Clinic (SURC), to improve efficiency and quality of care for breast cancer patients receiving adjuvant chemotherapy (#321)

Edmond Kwan 1 , Jessica Phillips 1 , Ilana Hornung 1 , Sally Greenberg 1
  1. Medical Oncology, Western Health, Melbourne

BACKGROUND

Breast cancer patients undergoing adjuvant chemotherapy commonly experience toxicity.  Patients at a Victorian metropolitan hospital are encouraged to phone or present to the recently instituted, SURC when they develop symptoms.  SURC facilitates triage, review and treatment of symptoms, resulting in reduced emergency department (ED) presentations.  Analysing details of breast cancer patient presentations to SURC may allow our health service to provide targeted education to reduce treatment-related side effects, thus improving quality and efficiency of care.

METHODS

Details of each SURC encounter are prospectively recorded in an electronic database.  Breast cancer patients that received adjuvant chemotherapy during the period of 1/9/2013 – 28/2/2015 were identified and data analysed.

RESULTS

138 breast cancer patients received adjuvant chemotherapy during the study period.  93 (67%) patients utilised the SURC service on 265 interactions.  187 (70.6%) interactions were phone-based.  Of the physical attendances, the majority (78.2%) were managed without requiring inpatient admission.  None required transfer to ED.  The most common primary complaints reviewed were gastrointestinal (GI) toxicities and generalised unwellness.  FEC-D regimen accounted for the highest proportion of presentations (38.9%).  TC was associated with greatest G1-3 toxicity in the categories of nausea (48.57%), stomatitis (25.71%) and fatigue (65.71%).

CONCLUSIONS

The SURC service is frequently utilised by breast cancer patients.  The phone service allows general supportive care advice, and determines if hospital presentation is required.  A majority of patients that physically presented to SURC had their symptoms successfully managed, and avoided a hospital admission. Without SURC a significant proportion may have presented to the ED or required admission.  Future preventative strategies should be based upon improving gastrointestinal toxicity and non-specific chemotherapy side effects, especially in patients receiving FEC-D or TC chemotherapy.

#COSA2015