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

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

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Elizabeth Garrett-MayerAmerican Society of Clinical Oncology, Alexandria, Virginia;

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Paul B. JacobsenDivision of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland;

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 PhD
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Mary May KozlikAmerican Society of Clinical Oncology, Alexandria, Virginia;

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Merry Jennifer MarkhamUniversity of Florida College of Medicine, UF Health Cancer Center, Gainesville, Florida;

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Robert D. SiegelBon Secours St. Francis Cancer Center, Greenville, South Carolina;

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Arif H. KamalDuke Cancer Institute, Durham, North Carolina; and

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Stephanie T.S. CristAmerican Society of Clinical Oncology, Alexandria, Virginia;

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Jon RosenthalAmerican Society of Clinical Oncology, Alexandria, Virginia;

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Anne C. ChiangYale Cancer Center, Yale University School of Medicine, New Haven, Connecticut.

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 MD, PhD
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on behalf of the ASCO Quality Publications Task Force
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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

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