Episode 386: Interprofessional Navigation and the Oral Anticancer Medication Care Compass

“This was a panel of subject matter experts of various nurses and pharmacists. We often found common ground but also discovered new ideas, different touchpoints, and key junctures along that oral anticancer medication journey. For example, the pharmacists were able to share their insights into their unique workflows within their practice setting. What resulted is a resource that truly reflects that collaborative effort between the disciplines,” ONS member Mary Anderson, BSN, RN, OCN^®, senior manager of nursing membership and professional development at the Network for Collaborative Oncology Development and Advancement (NCODA) in Cazenovia, NY, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS^®, manager of oncology nursing practice at ONS. Weimer spoke with Anderson and Kris LeFebvre, DNP, RN, NPD-BC, AOCN^®, oncology clinical specialist at ONS, about the Oral Anticancer Medication Care Compass: Resources for Interprofessional Navigation, a project created as a collaboration between ONS and NCODA.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0 

Episode Notes 

• This episode is not eligible for NCPD contact hours.
• ONS Podcast™ episodes:
  • Episode 215: Navigate Updates in Oral Adherence to Cancer Therapies
  • Episode 16: Navigating the Challenges of Oral Chemotherapy
• ONS Voice articles:
  • As Institutions Establish Oral Agent Workflows, Savvy Educators Help Nurses Apply Them to Practice
  • Maintain Oral Adherence With ONS Guidelines™
  • The Oncology Nurse’s Role in Oral Anticancer Therapies
• ONS book: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (Second Edition)
• ONS courses:
  • ONS Fundamentals of Chemotherapy and Immunotherapy Administration™
  • ONS/ONCC^®Chemotherapy Immunotherapy Certificate™
• Clinical Journal of Oncology Nursing article: Implementation of an Oral Antineoplastic Therapy Program: Results From a Pilot Project
• Oncology Nursing Forum articles:
  • Domains of Structured Oral Anticancer Medication Programs: A Scoping Review
  • Interventions to Support Adherence to Oral Anticancer Medications: Systematic Review and Meta-Analysis
  • ONS Guidelines™ to Support Patient Adherence to Oral Anticancer Medications
• Other ONS resources:
• ASCO/ONS Antineoplastic Therapy Administration Safety Standards
• Oral Anticancer Medication Care Compass: Resources for Interprofessional Navigation
• Oral Anticancer Medication Learning Library
• Drugs@FDA
• Hematology/Oncology Pharmacy Association Oral Chemotherapy Collaborative
• National Comprehensive Cancer Network homepage
• NCODA homepage
• Patient Education Sheets website

To discuss the information in this episode with other oncology nurses, visit the ONS Communities. 

To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library.

To provide feedback or otherwise reach ONS about the podcast, email [e-mail].

Highlights From This Episode

LeFebvre: “There are five different elements to the care compass itself. The first is called the OAM [oral anticancer medication] workflow analysis tool. ... This [tool] allows an OAM program to really study where their processes are. Where are the gaps in the process and where might their patients be at risk? It’s something that you can use within your setting to analyze your current processes and see where you can strengthen them. The second tool is something focused on patient and caregiver education. This includes a lot of information about what should be taught, how it could be taught, the best timing and so forth, according to the literature. ... The third tool is an assessment and grading tool. It’s a fun tool that approaches symptom management using the Common Terminology Criteria for Adverse Events grading tool. ... The fourth tool is a specialty pharmacy and patient assistance contact directory template. This is a spreadsheet that can be used by anyone navigating patient care with OAMs to keep track of their professional contacts. ... The final [tool] is the OAM adherence blueprint. This has a lot of important information on adherence, methods to assess adherence, and calculate adherence rate.” TS 7:15

LeFebvre: “Interprofessional collaboration is so essential just in day-to-day care, and OAM care is no different in that regard. Oncology nurses work in so many different settings and their role may be very different even if they have the same title. You can have OAM navigation that is completely handled in the pharmacy. I’ve talked with nurses who have said, ‘We don’t even touch it.’ But they do. Because when a patient has a combination regimen, they might have an infusion regimen that goes along with an oral therapy. Or that patient might just know that infusion room nurse so much better and they feel more comfortable [contacting them] when they have a side effect from their oral therapy. So, infusion nurses need to be aware of what the patients are on and what the potential side effects are.” TS 14:14

Anderson: “The resource for OAM education that we created is literally a blueprint of many resources out there to help nurses, pharmacists, and oncology professionals educate their patients on taking OAMs. ... [The OAM Care Compass] also helps with communication channels. It helps knowing that all the documentation is occurring and when everybody is documenting within their role and according to those key touchpoints, there’s less opportunity to lose track of your patients because we know what’s happening.” TS 16:33

Anderson: “I think the biggest misconception we see is that people think taking OAMs is easier than infusion therapies. And while it’s true that OAMs do offer significant benefits such as the convenience and the ability for patients to take their medication at home, we are also placing a huge burden on our patients. They need to navigate that very complex health system to obtain their medication and understand their treatment plan and adhere to that precise regimen. Additionally, we are seeing more and more complex treatment regimens with combination therapies, which further increases the need for that early and ongoing education, monitoring, and support.” TS 20:38