This document summarizes a prospective study that aims to implement and evaluate a care pathway to increase self-management in cancer patients taking oral anticancer drugs. The study will involve multiple hospitals in Flanders. It will use a 7-phase model to develop the care pathway through mixed methods like interviews, questionnaires, and focus groups. It will assess the impact of the care pathway on self-management, drug therapy quality, interdisciplinary communication, and healthcare professional skills/confidence. The study has received ethics approval and initial screening and project management phases are complete. Patient recruitment and baseline assessments will begin in September 2016.

1. A prospective interventional multicenter
before-after study for the implementation of a care pathway
to increase self-management of patients with cancer
who are treated with oral anticancer drugs (OACD)
Lise-Marie Kinnaer
Supervisor: Prof. Dr. Veerle Foulon

2. Background
• Cancer therapy has evolved over the last decades from acute to
chronic treatment
• 20-25% of all anticancer therapies are being administered orally
o Linked to many advantages
o Poses important challenges for patients, caregivers and healthcare
professionals (HCP)
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3. Background
• Challenges for patients:
o Complex therapeutic regimens
o Integration in existing therapy plan
o Adherence
o Management of side effects
o Safety issues
• No guidelines on care processes and coordination of care
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4. Objectives of the study
Studying the impact of the development and implementation
of a care pathway for patients treated with OACD on:
• The level of self-management
• The quality of the drug therapy
• The interdisciplinary communication in the hospital
• Involvement of healthcare professionals from ambulatory care
• The level of self-efficacy, counseling skills and self-confidence of
HCPs
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5. Methods
General lead throughout study:
7-phase model by Vanhaecht et al., 2012 for the development and
implementation of a care pathway in six hospitals in Flanders
(1) Vanhaecht et al., 2012 The 7-phase method to design, implement and evaluate care pathways. 5

6. Methods
Phase 1 – 4: setting the scene and development of the care pathway
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Aim: to map current practice in detail using mixed methods
• Evaluating current practice by means of validated key interventions
• Semi-structured interviews with patients, HCPs and external partners
• Outcome assessments in patients and HCPs using validated questionnaires
• Training and feedback sessions on counseling skills in HCPs
• Development during 5 working moments by local project team per hospital

7. Methods
Phase 5 and 6: implementing and evaluating the care pathway
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Aim: to evaluate practice as prescribed by the care pathway using mixed
methods
• Outcome assessments in patients and HCPs using validated questionnaires
• Evaluation of counseling skills in HCPs
• Focus group discussion with participating HCPs and local project team
• Interview with coordinating HCPs
Before-after comparison of outcome assessments to evaluate impact of
care pathway

8. Status
• Approval Ethics Committee UH Leuven June 23th 2016
• Phase 1 (initial screening) and phase 2 (project management) have
been conducted
• Phase 3 (detailed mapping of current practice) is in preparation
 Recruitment and baseline assessments in HCPs
 Start patient inclusion in September 2016
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