Ambulatory care for patients with myeloid blood cancers

Streamlining ambulatory care for patients with myeloid blood cancers

This project is a collaboration between the Haematology units at Monash Health and Peninsula Health aiming to streamline processes for ambulatory care of patients with myeloid blood cancers, with a focus of improving safety for patients on oral anti-cancer therapies through co-development of a care pathway, as well as bringing cancer care closer to home.

A unique challenge has emerged in the recent years with PBS listings of multiple novel oral anti-cancer therapies especially in myeloid malignancies. It is important to note that these agents, despite being oral in route of administration, do have significant toxicities (eg myelosuppression and consequences of that, QTc prolongation etc) that require close monitoring not dissimilar to that of parenteral (SC/IV) anti-cancer therapies.

However, this is often under-recognised, and the conventional model and funding of “day oncology units” do not cater for patients on oral anti-cancer therapies. There are no existing model-of-care for these patients, who are treated in the ambulatory care setting. In addition, these blood cancers are mostly in older patients (median age of diagnosis of 68-72 years old), who often require additional support through their blood cancer journey.

With both health services located in the southeast of Victoria covering a broad geographical catchment, clinicians often see cross pollination of patients to both services. Both haematology services recognise the importance of providing cancer care closer to home, with both providing haematology clinics and infusion units across multiple sites, as well as chemotherapy-at-home programs. However, currently there are no processes to direct patients to services (eg clinics, chemotherapy-at-home, blood transfusions) closest to home, with additional administrative barriers often faced when trying to cross refer across health services.

This project is a collaboration between the Haematology units at Monash Health and Peninsula Health aiming to streamline processes for ambulatory care of patients with myeloid blood cancers, with a focus of improving safety for patients on oral anti-cancer therapies through co-development of a care pathway, as well as bringing cancer care closer to home.