ASCO/ONS create standards for chemotherapy administration

Standardized care in administration of chemotherapy in outpatient settings key to safety, efficacy.

The American Society of Clinical Oncology and the Oncology Nursing Society have developed 31 standards for the administration of chemotherapy to adult patients in the outpatient setting.

“Administration of chemotherapy is a complex process, and safety challenges will only grow as the number and complexity of chemotherapeutic regimens increases and oral chemotherapy drugs become more commonplace,” said Joseph Jacobson, MD, lead author of the Journal of Clinical Oncology article highlighting the standards and the immediate past chair of ASCO’s Quality of Care Committee. “Adhering to standards for safe chemotherapy administration should be a goal of all cancer care providers.”

ASCO and the Oncology Nursing Society reviewed existing literature from the past decade to aid in creating the standards and worked collaboratively to develop chemotherapy administration safety standards using a multidisciplinary, consensus-building process. A steering group of volunteer leaders and staff assembled in the summer of 2008. More recently, consensus of the final standards was reached through a structured workshop, an open public comment period of six weeks and systematic review of collated data.

The steering group selected experts among diverse stakeholders, including oncologists, nurses, pharmacists, social workers, practice administrators and patient advocates to attend the workshop where final decisions were made.

Sixty-four standards were defined during day one of the workshop. The steering group reduced the list to 35 standards, which were then open to public comment. The group reviewed 321 comments from the open public.

The remaining standards were assessed resulting in 31 final standards encompassing seven domains:

Review of clinical information and selection of treatment regimen.
Treatment planning and informed consent.
Ordering of treatment.
Drug preparation.
Assessment of treatment compliance.
Administration and monitoring.
Response and toxicity monitoring.

“We suggest that medical oncology practice staff assess their own compliance with each of the standards. For areas requiring improvement, practice members should prioritize time and resources to set achievable goals,” the researchers said.

ASCO and the Oncology Nursing Society provide tools and resources for assistance in practice implementation at www.asco.org/safety and www.ons.org/clinical.

“Regular review of these standards will be needed as their practice of medical oncology continues to evolve rapidly,” the researchers said.

Jacobson JO. J Clin Oncol. 2009;doi:10.1200/JCO.2009.25-1264.