Systemic Anti Cancer Therapy Study

Background
This study will examine the process of care of all patients who die within 30 days of systemic anti-cancer therapy (SACT), looking for areas where their care might have been improved. It will not concentrate solely on those patients whose death may have been treatment-related.

This work is supported by the Joint Collegiate Council for Oncology (JCCO), a joint group between the Royal College of Radiologists and Royal College of Physicians; and the Joint Specialty Committee (JSC) for Medical Oncology at the Royal College of Physicians.

Originally it was proposed that the study would focus on those patients in which it was thought that the toxic effects of the patient’s therapy contributed to their death. Whilst this is an extremely important group of patients to study, it would only be possible to identify this cohort of patients following close examination of individual sets of case notes. As stated above, the study will include all patients who die within 30 days of systemic anti-cancer therapy and will therefore include many patients who die from progressive disease as well as those who suffer iatrogenic disease. Patient management should adhere to guidelines and standards, which aim to reduce risk. This expanded study will enable NCEPOD to obtain a large dataset on patient care from which to identify remedial factors and make meaningful recommendations.

The 30 day period will be defined as 30 days from Day 1 of the SACT cycle immediately prior to death. If SACT is given continuously - 30 days from the date of the last prescription.

A pilot study, with voluntary participation, was conducted in September 2006. Data was collected retrospectively on all patients that received SACT in April 2006 (i.e. Day 1 of a cycle in April) and died 30 days afterwards. However, for those that did not have electronic systems to enable quick and easy data retrieval, we suggested pharmacy data of drug administration was collected prospectively from 1st September 2006 to 30th September 2006 inclusive, with data collected on any deaths occurring within 30 days from the end of September.

The main study commenced in February 2007. A starter pack with local reporter instructions, organisational questionnaire, protocol, specialty codes, ICD-10 codes, and case note extract requirements, was posted to all local reporters on 19th February 2007. The data collection spreadsheet was emailed to all local reporters on 20th February 2007. Please note that intravesical treatment is included in our SACT definition.

The protocol has been approved by the Expert Group and NCEPOD Steering Group and is available to download here.

We can only accept data for the study submitted using our master spreadsheet for the study. For submitting data the spreadsheet can be downloaded here.

Deadlines:

Further questions about the study may be directed to: cancertherapies@ncepod.org.uk