[Care pathways of cancer patients: Modeling and risks analysis induced by oral anticancer drugs]

Bull Cancer. 2016 Apr;103(4):345-52. doi: 10.1016/j.bulcan.2015.12.001. Epub 2016 Feb 15.
[Article in French]


The care pathway of cancer patients is complex and therefore difficult to define. The oral anticancers (AKPO) have shown their benefits to patients and health professionals, however, the risks induced on the care pathway remain unknown. The objective of the study is to define, quantify the risks from AKPO and their effects on the care pathway (breakdown [Ds], rupture [Rt]). From the proposed care pathway model, FMEA method is used to analyze risks. For the 3 identified processes (1 monotherapy, 2 bitherapies: 2 AKPO or 1 AKPO/1 AKIV), analysis revealed an average of 91 risks, 173 Ds, 147 Rt, increased for 1 AKPO/1 AKIV therapy. The administration and delivery are the most risky steps. The lack of training and information of patients and healthcare professionals generates 80% of Ds and Rt. This model confirms the complexity, variability of the care pathway. The development of actions to improve town-hospital coordination and exchange of information is required to optimize and secure the route, confirming the objectives of "Plan Cancer 3".

Keywords: Analyse des risques; Anticancéreux oraux; Cancérologie; Care pathway; Model; Modèle; Oral anticancer drugs; Parcours de soins; Risks analysis.

Publication types

  • English Abstract

MeSH terms

  • Administration, Oral
  • Ambulatory Care
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Critical Pathways*
  • Drug Prescriptions
  • Humans
  • Models, Statistical
  • Neoplasms / drug therapy*
  • Risk Assessment / methods
  • Risk Assessment / statistics & numerical data


  • Antineoplastic Agents