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Craig A. Bunnell, Katya Losk, Sarah Kadish, Nancy Lin, Judith Hirshfield-Bartek, Linda Cutone, Kristen Camuso, Mehra Golshan, and Saul Weingart

The authors sought to measure the timeliness of care for patients with breast cancer at Dana-Farber/Brigham and Women’s Cancer Center throughout the treatment continuum, and to identify sources of variation that may serve as targets for improving care delivery. This report describes the methods that were developed to measure and analyze baseline performance.

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Saul N. Weingart, Elizabeth Brown, Peter B. Bach, Kirby Eng, Shirley A. Johnson, Timothy M. Kuzel, Terry S. Langbaum, R. Donald Leedy, Raymond J. Muller, Lee N. Newcomer, Susan O’Brien, Denise Reinke, Mark Rubino, Leonard Saltz, and Ronald S. Walters

Oral chemotherapy is emerging as a new option for well-selected patients who can manage potentially complex oral regimens and self-monitor for potential complications. If a choice between oral and parenteral therapy is available, patients may opt for oral chemotherapy because it is more convenient to administer, allows them to avoid multiple office visits, and gives them a sense of control over their own cancer care. Whether these potential advantages are maintained in regimens that combine oral and parenteral drugs is less clear. The use of oral chemotherapeutic agents profoundly affects all aspects of oncology, including creating significant safety and adherence issues, shifting some traditional roles and responsibilities of oncologists, nurses, and pharmacists to patients and caregivers. The financing of chemotherapy is also affected. To address these issues, the NCCN convened a multidisciplinary task force consisting of oncologists, nurses, pharmacists, and payor representatives to discuss the impact of the increasing use of oral chemotherapy. (JNCCN 2008;6[Suppl 3]:S1–S14)