OBJECTIVES

Time-to-treatment initiation (TTI) is an important quality metric in cancer patient care. Delay in TTI could worsen oncologic outcomes, decrease survival, and is associated with wait-related anxiety and distress for patients and their families.

Prolonged wait times to receive treatment has been reported for oncology infusion therapies, administered largely in public sector hospitals and cancer centres in Canada. Privately-run community infusion clinics could potentially ease this wait time burden. Here, we report the TTI for oncology patients receiving treatment at private community infusion clinics.

METHODS

Data was obtained from patients enrolled in the Innomar Clinics program and treated with immuno-oncology agents within the Innomar infusion clinic network. TTI was defined as time from physicians’ signature on the patient registration and prescription form (as proxy for medical oncology consult) to the patients’ first infusion. A literature review was also conducted to identify published Canadian wait times (specifically time from medical oncology consult to first treatment) in the last 10 years.

RESULTS

Between July 2016 and Dec 2019, 107 patients (mean[SD] age, 63.5[11.5] years, 44.2% male) treated within the Innomar Clinics program received either of two immuno-oncology therapies at 14 community infusion clinics. The median TTI was 10 days (interquartile range, 6-20 days).

In comparison, published literature from chart reviews and health databases reported median wait times of 16 days in Ontario for breast cancer, and 24 days in British Columbia for NSCLC. A 2018 medical oncologists survey reported median wait times of >20 days in Alberta and British Columbia for all cancers, and 35 days in Nova Scotia.

CONCLUSIONS

Private community infusion clinics may have a shorter TTI – a mixed use of public and private infusion centres could help improve delays. Careful integration of these two environments (e.g. through e-data sharing) is necessary to ensure continuity of care and optimal patient experience.