Multidisciplinary Care at Outpatient Infusion Center Improved TRAEs

By Leah Lawrence - Last Updated: July 27, 2022

The development of a multidisciplinary treatment-related adverse events management program resulted in improvement of treatment-related toxicities in ambulatory infusion centers, according to the results of a recent study.

“Currently, there is no best practice on how to manage and monitor these TRAEs for ambulatory patients with cancer in between their clinic visits and/or infusion center treatments,” study researchers wrote.

To better address this, a management program of TRAEs was developed on the basis of collaboration between oncologists, infusion center oncology nurses, and a board-certified oncology clinical pharmacist. In this program, patients received either multidisciplinary interventions or oncologist-driven interventions based on symptoms reported. The patients were then followed regularly for further symptom management interventions.

To evaluate this program, researchers conducted a retrospective chart review using data from two entities where the program was implemented: Houston Methodist West Hospital (HMW) and Houston Methodist Baytown Hospital (HMB). Data were collected on the number and nature of TRAEs and outcomes after intervention were assessed up to 3 months after initial encounters.

During the 3-year period evaluated, 308 patients received 469 interventions initiated by the multidisciplinary team or by an oncologist.

Compared with the oncologist-led interventions, the number initiated by the multidisciplinary team was statistically significant (P=.004). Additionally, the interventions initiated by the multidisciplinary team also significantly reduced the occurred of TRAEs (P=.03) such as dermatological toxicities, diarrhea, immune-related adverse effects, mucositis, and nausea after 1-month follow-up.

The team captured about 40% of TRAEs that were escalated to oncologists for further management, which led to an overall improvement in management of TRAEs.

“Our conclusions were in line with recent findings that clinical pharmacists improved supportive care,” the researchers wrote.

The researchers also collected data on patient satisfaction before and after implementation of the multidisciplinary program and found “improvement in patient and provider satisfaction” without adversely affecting provider workflow.

“This type of symptom management is valuable for hospitals with limited resources,” the researchers wrote. “It supports oncologists by realigning clinical pharmacy services from the clinic to the infusion center, without incurring additional labor cost. Our oncologists may also follow-up patients in the infusion center at their discretion.”



Optimizing multidisciplinary treatment-related adverse effects detection and reduction in patients undergoing active cancer treatments in ambulatory infusion centers