Oral Chemotherapy Metric Performance in Quality Oncology Practice Initiative Practices: Updated Trends and Analysis

Authors:
Victoria S. Blinder Memorial Sloan Kettering Cancer Center, New York, New York;

Search for other papers by Victoria S. Blinder in
Current site
Google Scholar
PubMed
Close
 MD
,
Elizabeth Garrett-Mayer American Society of Clinical Oncology, Alexandria, Virginia;

Search for other papers by Elizabeth Garrett-Mayer in
Current site
Google Scholar
PubMed
Close
 PhD
,
Paul B. Jacobsen Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland;

Search for other papers by Paul B. Jacobsen in
Current site
Google Scholar
PubMed
Close
 PhD
,
Mary May Kozlik American Society of Clinical Oncology, Alexandria, Virginia;

Search for other papers by Mary May Kozlik in
Current site
Google Scholar
PubMed
Close
 CPHQ
,
Merry Jennifer Markham University of Florida College of Medicine, UF Health Cancer Center, Gainesville, Florida;

Search for other papers by Merry Jennifer Markham in
Current site
Google Scholar
PubMed
Close
 MD
,
Robert D. Siegel Bon Secours St. Francis Cancer Center, Greenville, South Carolina;

Search for other papers by Robert D. Siegel in
Current site
Google Scholar
PubMed
Close
 MD
,
Arif H. Kamal Duke Cancer Institute, Durham, North Carolina; and

Search for other papers by Arif H. Kamal in
Current site
Google Scholar
PubMed
Close
 MD, MHS, MBA
,
Stephanie T.S. Crist American Society of Clinical Oncology, Alexandria, Virginia;

Search for other papers by Stephanie T.S. Crist in
Current site
Google Scholar
PubMed
Close
 RN, BSN, MHSA
,
Jon Rosenthal American Society of Clinical Oncology, Alexandria, Virginia;

Search for other papers by Jon Rosenthal in
Current site
Google Scholar
PubMed
Close
 MS, MBA
,
Anne C. Chiang Yale Cancer Center, Yale University School of Medicine, New Haven, Connecticut.

Search for other papers by Anne C. Chiang in
Current site
Google Scholar
PubMed
Close
 MD, PhD
, and
on behalf of the ASCO Quality Publications Task Force*
Search for other papers by on behalf of the ASCO Quality Publications Task Force* in
Current site
Google Scholar
PubMed
Close
Restricted access

Background: Oral chemotherapy performance measures were first introduced into ASCO’s Quality Oncology Practice Initiative (QOPI) in 2013. This study examined performance on these measures among QOPI-participating practices and evaluated whether it differed among practices based on meeting QOPI Certification Program standards. Methods: A total of 192 QOPI-participating practices (certified, n=50 [26%]; not certified, n=142 [74%]) reported performance on oral chemotherapy measures in 2017 and 2018. Inclusion was limited to practices reporting on ≥3 charts for ≥1 oral chemotherapy measure. Performance was defined as the percentage of charts examined that adhered to the measure. Descriptive analyses were used to characterize performance within and across practices, and mixed-effects logistic regression models were conducted to compare performance based on certification status. Results: Median performance across practices for the 9 oral chemotherapy measures examined ranged from 44% (education before the start of treatment addressing missed doses, toxicities, and clinical contact instructions [composite measure]) to 100% (documented dose, documented plan, and education about toxicities). Certified practices were more likely to provide education about clinic contact instructions than noncertified practices (odds ratio, 4.87; 95% CI, 1.00–24.0). Performance on all other measures was not significantly associated with certification status. Conclusions: There is wide variability in quality related to performance on oral chemotherapy measures across all QOPI-participating practices, and several areas were identified in which administration of oral chemotherapy could be improved. Our findings highlight the need for the development and implementation of appropriate standards that apply to oral chemotherapy and address the complexities that set it apart from parenteral treatment.

Submitted November 3, 2021; final revision received April 7, 2022; accepted for publication April 29, 2022.

To view the members of the ASCO Quality Publications Task Force, see supplemental eAppendix 1 (available with this article at JNCCN.org).

Author contributions: Conception and design: Blinder, Jacobsen, Kozlik, Markham, Siegel, Kamal, Crist, Chiang. Administrative support: Kozlik, Crist. Collection and assembly of data: Garrett-Mayer, Kozlik, Crist, Rosenthal. Data analysis and interpretation: Blinder, Garrett-Mayer, Jacobsen, Kozlik, Markham, Siegel, Kamal, Rosenthal, Chiang. Manuscript writing: All authors. Final approval of manuscript: All authors. Accountable for all aspects of the work: All authors.

Disclosures: The authors have disclosed that they have not received any financial consideration from any person or organization to support the preparation, analysis, results, or discussion of this article.

Disclaimer: The views expressed are those of the authors and do not represent the official views of the NCI.

Correspondence: Mary May Kozlik, CPHQ, American Society of Clinical Oncology, 2318 Mill Road, Suite 800, Alexandria, VA 22314. Email: marymay.kozlik@asco.org

Supplementary Materials

    • Supplemental Materials (PDF 464 KB)
  • Collapse
  • Expand
  • 1.

    Weingart SN, Brown E, Bach PB, et al. NCCN task force report: oral chemotherapy. J Natl Compr Canc Netw 2008;6(Suppl 3):S114.

  • 2.

    US Food and Drug Administration. Advancing health through innovation: new drug therapy approvals 2021. Accessed March 1, 2022. Available at: https://www.fda.gov/media/155227/download

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    US Food and Drug Administration. Novel drug approvals for 2020. Accessed March 1, 2022. Available at: https://www.fda.gov/drugs/new-drugs-fda-cders-new-molecular-entities-and-new-therapeutic-biological-products/novel-drug-approvals-2020

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    US Food and Drug Administration. Advancing health through innovation: new drug therapy approvals 2019. Accessed March 1, 2022. Available at: https://www.fda.gov/media/134493/download

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Neuss MN, Polovich M, McNiff K, et al. 2013 updated American Society of Clinical Oncology/Oncology Nursing Society chemotherapy administration safety standards including standards for the safe administration and management of oral chemotherapy. J Oncol Pract 2013;9(Suppl):5s13s.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    American Society of Clinical Oncology. QOPI-related measures. Accessed October 2, 2019. Available at: https://practice.asco.org/quality-improvement/quality-programs/quality-oncology-practice-initiative/qopi-related-measures

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    McNiff KK, Bonelli KR, Jacobson JO. Quality oncology practice initiative certification program: overview, measure scoring methodology, and site assessment standards. J Oncol Pract 2009;5:270276.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Greer JA, Lennes IT, Gallagher ER, et al. Documentation of oral versus intravenous chemotherapy plans in patients with metastatic non-small-cell lung cancer. J Oncol Pract 2014;10:e103106.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Zerillo JA, Pham TH, Kadlubek P, et al. Administration of oral chemotherapy: results from three rounds of the quality oncology practice initiative. J Oncol Pract 2015;11:e255262.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    American Society of Clinical Oncology. QOPI certification program standards. Accessed February 22, 2019. Available at: https://practice.asco.org/sites/default/files/drupalfiles/2018-06/QOPI%20Certification%20 Standards%20June%202018.pdf

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Neuss MN, Malin JL, Chan S, et al. Measuring the improving quality of outpatient care in medical oncology practices in the United States. J Clin Oncol 2013;31:14711477.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Siegel RD, Castro KM, Eisenstein J, et al. Quality improvement in the national cancer institute community cancer centers program: the quality oncology practice initiative experience. J Oncol Pract 2015;11:e247254.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Simmons C, Power S. Using ASCO QOPI and the QTP as an improvement model in a small safety net cancer center [abstract]. J Clin Oncol 2018;36(Suppl):Abstract 78.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Brown JS, Hershman DL, O'Neil D, et al. A standardized workflow to improve the consent process among patients initiating an oral anticancer drug [abstract]. J Clin Oncol 2019;37(Suppl):Abstract 259.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Jeffers K, Walde A. Harnessing the electronic health record to optimize oral anticancer therapy monitoring and follow-up [abstract]. J Clin Oncol 2018;36(Suppl):Abstract 305.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Conti RM, Fein AJ, Bhatta SS. National trends in spending on and use of oral oncologics, first quarter 2006 through third quarter 2011. Health Aff (Millwood) 2014;33:17211727.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Gustafson E, Kettle JK. Analyzing trends in oral anticancer agents in an academic medical facility. J Hematol Oncol Pharm 2015;5:3437.

  • 18.

    Mackler E, Segal EM, Muluneh B, et al. 2018 Hematology/Oncology Pharmacist Association best practices for the management of oral oncolytic therapy: pharmacy practice standard. J Oncol Pract 2019;15:e346355.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Zerillo JA, Goldenberg BA, Kotecha RR, et al. Interventions to improve oral chemotherapy safety and quality: a systematic review. JAMA Oncol 2018;4:105117.

  • 20.

    Rosenberg SM, Petrie KJ, Stanton AL, et al. Interventions to enhance adherence to oral antineoplastic agents: a scoping review. J Natl Cancer Inst 2020;112:443465.

Metrics

All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 2542 844 97
PDF Downloads 1321 282 22
EPUB Downloads 0 0 0