The “side effects”: New insights
Everyone benefits from PROCHE. For one thing, it improves safety, thanks to the standardized approach, in which the medical details are supplied in advance. And the program not only saves time but also material. “Now the pharmacy department provides most of the preparations before the patients come into our clinical ward thanks to the improved communication”, says Scotté. Another advantage came as a surprise to everyone, prompting Scotté to even report on it at the Annual Meeting of the American Society of Clinical Oncology (ASCO) in 2010.
Prior to the introduction of the program, doctors didn’t know how much the treatment would affect patients’ daily lives. As Secretary General of the Association Francophone pour les Soins Oncologiques de Support AFSOS (French Association for oncology Supportive Care), Scotté regards such information as very important. After all, it makes it easier to effectively combat the attendant symptoms. “Patients forget to mention so many things when they are at the hospital,” says the oncologist, which is why the call center nurse finds out more about the patients than do the doctors who speak to them in person.
In spite of all its advantages, PROCHE has one drawback: the program’s costs. For more than two years now, Merck Serono in France has been helping to fund the program for the more than 1,000 cancer patients at the HEGP who have benefited from the system to date. No one at the hospital would want to do without the program anymore.
From the prescription to the infusion bag |
Staff members at the HEGP use an isolator as they fill chemotherapy drugs into injection syringes or infusion bags under sterile conditions. The steps involved, from the time the oncologist makes a prescription until the patient receives the treatment, are as follows:
• The doctor determines the appropriate chemotherapy dose
• The call center asks the patient to gather all the relevant details and forwards this information to the pharmacists
• The dose is given pharmaceutical approval after it has been confirmed by the oncologist: He checks the dose, then the pharmacist checks all of the parameters, including the dose actually contained in the bag or injection syringe
• The required drug packages and IV bags for compounding and dilution are sterilized and inserted into a sterile box (isolator). The technicians are located outside the chamber and use sterile sleeves and gloves extending into the box to mix the medication in accordance with the data sheet concerning the compounding, which is derived from the prescription
• The medication is mixed and the preparations are labeled and checked (analytical control of the drug and the dose)
• The containers are removed from the isolator and delivered to the clinical ward
• Staff members once again check the dose in the bag or injection syringe according to the medical prescription
• Staff members examine the patient and speak with him or her
• The drug is infused according to the protocol |