Poster Presentations


P-7: A Pilot Study of a Nurse and Pharmacist Led OTN (Ontario Telemedicine Network) Based Clinic for Management of Prostate Cancer Patients on Oral Therapy

Ms. Carla Girolametto

Carla Girolametto*,
Tom McFarlane,
Anna Granic,
Jennifer Lounsbury,
Stacey Hubay

Grand river HosPital
Research and Clinical Trials

Topic: Health Technology Assessment

Background
Accessibility to a skilled oncology care providers will be of paramount importance as the demand for oncology care continues to rise. The number of emergent oral therapies in the oncology milieu is increasing; this treatment approach shifts the care delivery to empower the patient to administer their own oral therapies and to seek out their own follow up with an oncology care provider. Patients may be exposed to significant toxicities of oral chemotherapy outside of the ambulatory setting.

This presentation will illustrate a pilot study to evaluate a pharmacist/nurse led telemedicine clinic for patients receiving oral chemotherapy.
The presentation will highlight the role of specialized oncology pharmacists/nurses as expert clinicians and novice researchers in contributing to a randomized, open-label comparison study of a cohort metastatic prostate cancer patients on oral abiraterone and enzalutamide therapy. The primary outcomes of patient satisfaction with overall care utilizing a validated scale between the group of patients using the OTN clinic and a matched group of control patients receiving conventional care will be discussed. Data will also be shared on the number and types of toxicity related interventions made and will be reported in a descriptive fashion.

Methods
This study is a prospective, randomized comparison of a cohort of prostate cancer patients on abiraterone or enzalutamide receiving care via a pharmacist/nurse led remote teleconference based clinic (OTN) and a matched cohort of patients receiving standard care at Grand River Regional Cancer Centre (GRRCC) in Kitchener, Ontario, Canada. The OTN clinic is conducted by providing the patient with a link via email which allows the patient to access OTN teleconferencing and meet virtually with a pharmacist/nurse during a previously scheduled appointment. Patients randomized to the OTN arm of the study can attend the virtual clinic from their home or other locations of their choice. Virtual clinic appointments are 30 minutes long and will consist of a patient assessment and open ended questions about the patient health status using a modified version of the validated MOATT (MASCC Oral Agent Teaching Tool). Interventions are tracked by number and type for descriptive presentation. Standard care will consist of the approach currently followed for prostate cancer patients who have in person clinic appointments at GRRCC. At each clinic visit, patients will be asked to complete a modified version of the E-PREMS tool validated by Cancer Care Ontario to assess patient satisfaction with care. The ordinal data from this tool will be statistically compared with the data collected from the same tool by the matched cohort of standard care patients. At the end of the 12 month study period, patients randomized to the OTN cohort will be asked to complete the Feasibility of use of Ontario Telemedicine Network Survey. The content of the survey will be examined using inductive content analysis. The trial is in progress and 20 of a planned 80 patients have been randomized as of April 2018. [Clinicaltrials.gov identifier NCT03413865]