Streamlining Cancer Treatment Pathways: Organizational Responses to Rising Chemotherapy Volumes
Author(s)
Anne-Cécile Régin, Msc1, Léopoldine du Manoir de Juaye, PharmD2, Isabelle BORGET, PhD3, Christos CHOUAID, PhD4, Nicolas Cormier, PharmD5, Aurélie de Lehvenfehlt, Msc2, Hugo Zamolo, PharmD1.
1IQVIA OPERATIONS FRANCE SAS, Courbevoie, France, 2F. Hoffmann-La Roche Ltd, Boulogne-Billancourt, France, 3Epidemiology / INSERM CESP U1018 Oncostat, Labelisé Ligue Contre le Cancer, Institut Gustave Roussy, Villejuif, France, 4Service de pneumologie, CHI Creteil France, Créteil, France, 5CHU de Nantes, Nantes, France.
1IQVIA OPERATIONS FRANCE SAS, Courbevoie, France, 2F. Hoffmann-La Roche Ltd, Boulogne-Billancourt, France, 3Epidemiology / INSERM CESP U1018 Oncostat, Labelisé Ligue Contre le Cancer, Institut Gustave Roussy, Villejuif, France, 4Service de pneumologie, CHI Creteil France, Créteil, France, 5CHU de Nantes, Nantes, France.
OBJECTIVES: Between 2018 and 2024, in France, the number of chemotherapy sessions increased by 17%, rising from 10.6 to 12.4 million. This exploratory study aimed to identify and describe the processes and devices that hospitals have implemented to manage this growth.
METHODS: A qualitative study using semi-structured interviews, following the COREQ guidelines, was conducted. Interviews focused on workflows in daycare units and pharmacy services related to intravenous and subcutaneous cancer treatments. A total of 27 healthcare professionals from 9 organizations were interviewed between April 24 and June 25, 2025.
RESULTS: In day care units, anticipatory treatment prescriptions and pre-assessment of patients' biological tests or clinical condition the day before treatment are used by most of the surveyed organizations. Few centers have initiated anticipatory medical consultations or scheduled patient administration based on treatment duration.The identified processes and technological implementations varied widely among the participating organizations. Beyond workflow optimization, these innovations aimed to reduce patient waiting times and outpatient stay duration. In pharmacy services, the most frequently implemented processes were, in order, preemptive treatment preparation, dose banding, early treatment distribution, and anticipatory prescription validation. Certain optimizations were applicable only to treatments with high stability and/or high-volume treatment. The integration of intelligent video systems into isolators, widely used, has also improved process flow. Few organizations acquired isolators with specialized airlocks to expedite their sterilization process.Most organizations have implemented and developed home hospitalization. Some centers created dedicated pathways for subcutaneous treatments, with specific boxes and waiting areas, time slots, and prioritized treatment preparation. Several organizations extended opening hours and adapted staff schedules.
CONCLUSIONS: To address the rising number of chemotherapy sessions, hospitals have developed diverse local initiatives to manage patient volume while streamlining care pathways in day hospital. Nevertheless, there are currently no national guidelines to standardize these practices.
METHODS: A qualitative study using semi-structured interviews, following the COREQ guidelines, was conducted. Interviews focused on workflows in daycare units and pharmacy services related to intravenous and subcutaneous cancer treatments. A total of 27 healthcare professionals from 9 organizations were interviewed between April 24 and June 25, 2025.
RESULTS: In day care units, anticipatory treatment prescriptions and pre-assessment of patients' biological tests or clinical condition the day before treatment are used by most of the surveyed organizations. Few centers have initiated anticipatory medical consultations or scheduled patient administration based on treatment duration.The identified processes and technological implementations varied widely among the participating organizations. Beyond workflow optimization, these innovations aimed to reduce patient waiting times and outpatient stay duration. In pharmacy services, the most frequently implemented processes were, in order, preemptive treatment preparation, dose banding, early treatment distribution, and anticipatory prescription validation. Certain optimizations were applicable only to treatments with high stability and/or high-volume treatment. The integration of intelligent video systems into isolators, widely used, has also improved process flow. Few organizations acquired isolators with specialized airlocks to expedite their sterilization process.Most organizations have implemented and developed home hospitalization. Some centers created dedicated pathways for subcutaneous treatments, with specific boxes and waiting areas, time slots, and prioritized treatment preparation. Several organizations extended opening hours and adapted staff schedules.
CONCLUSIONS: To address the rising number of chemotherapy sessions, hospitals have developed diverse local initiatives to manage patient volume while streamlining care pathways in day hospital. Nevertheless, there are currently no national guidelines to standardize these practices.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
OP23
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Organizational Practices
Topic Subcategory
Best Research Practices
Disease
Oncology, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)