Comparison of quality oncology practice initiative metrics in solid tumor oncology clinic with or without concomitant supportive oncology consultation

Abstract

Purpose :The Quality Oncology Practice Initiative (QOPI) is a quality measurement and improvement program designed to assess practice performance for various consensus-based and evidence-based measures. In this study, we evaluated differences in QOPI metrics met among patients with advanced solid cancer receiving routine oncologic care alone (routine care) compared with patients receiving integrated oncology and specialty-level palliative care (supportive care). Methods: We conducted a retrospective chart review of 100 randomly selected patients treated between June 2013 and June 2015 from our supportive care group and matched these patients to 100 routine care group patients on the basis of tumor type and initial oncology visit date. We used the electronic medical record to collect data regarding patient demographics, palliative care-specific QOPI metrics, intensive care unit admissions, and hospice enrollment. We performed multivariate analysis comparing differences between the two groups. Results: A total of 200 patients were included. Both groups had similar baseline characteristics. Supportive care consultation improved the absolute number of QOPI metrics met (P = .01). The QOPI metrics more likely to be met included the following: pain appropriately addressed (P, .01), advance care directives documented by third office visit (P, .01), and longer hospice enrollment (P, .01). Conclusion: Integrating palliative care consultation with routine oncologic care improved pain management and end-of-life planning and care. Properly addressing pain and guiding advance care discussions require specialized skills. These data support the need for increased primary palliative care education for oncologists and further development of supportive oncology practices.