New Pathway in Anti-HER2 Treatments’ Administration in Breast Cancer in France: Which Impacts of the Involvement of an Advanced Practice Nurse in Hospital at Home Program?
Author(s)
Pozzar M1, Couillerot AL1, Gherardi A2, Marchand L2, Le Lay K2, Pallaro S3, Bigas M3, Maillan G3, Deluche E3
1Alira Health, Paris, France, 2Roche, Boulogne-Billancourt, France, 3Department of oncology, CHU de Limoges, Limoges, France
Presentation Documents
OBJECTIVES: Since 2018, a delegation of tasks is authorized in France from a physician to an advanced practice nurse (APN), which allows APN to expand their role and responsibilities.
The aim of this study is to measure organizational and economic impacts of the involvement of an APN in home hospitalization (HH) setting for anti-HER2 treatment administration for breast cancer, instead of a standard administration in hospital.METHODS: Resources and time consumed for treatment administration in HH with APN and in hospital were identified at all stages (examination, patient follow-up, travel, treatment preparation, administration, monitoring) and healthcare professionals involved, with a particular interest of the APN role as well.
An Excel tool was developed to quantitatively measure differences between both pathways in terms of time and costs. Impacts were measured over a 1-year horizon from a hospital, patient, and healthcare system perspective; time and cost resources came from national data and were validated by a pilot hospital. Structural elements were taken into account in the tool: stage of the disease, anti-HER2 treatments considered and duration of treatment.RESULTS: In general, the APN replaces the consultation with the doctor for follow-up (consultations every 3 to 6 months) and coordination time in HH as well. Moreover, all consultations and exchanges set up by the APN with the patient are by telephone implying no travel.
Therefore, it is expected that the APN provides the same patient follow-up than a standard pathway in hospital, with an expected organizational impact for hospitals equipped with a HH on time and costs. These hypotheses in terms of time and costs impacts will be proved by the final results of the Excel tool in July.CONCLUSIONS: Involving an APN in HH may lead to changes for hospital, patient and health insurance and enable better resource allocation in hospitals.
Conference/Value in Health Info
Value in Health, Volume 26, Issue 11, S2 (December 2023)
Code
HSD63
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology