Care pathway and quality of life

For many years, Unicancer has committed to improving the healthcare offer in oncology, by especially focussing on the healthcare pathways offered to our patients and on their quality-of-life. The knowledge and experience of patients are at the heart of this approach.

Healthcare pathways and quality-of-life

The main focus on the quality-of-life of patients, at every stage of their healthcare pathway, is a determining element for all of our Centres. The improvement in the conditions and quality-of-life of patients treated for cancer and the prevention of sequelae are part of the advances brought by the recently-launched ten-year French cancer strategy that involves better support for patients, mainly through:

• Involvement of patients in their healthcare pathway, in the reinforcement of adverse event reports and in the production of healthcare safety monitoring indicators
• Training of medical and paramedical professionals in quality of care
• Intensification of research efforts to identify new somatic mutations and the development of less toxic targeted drugs adapted to them
• Reduction of side effects in patients, by an overall conception of treatment and support: development of proton therapy (a type of treatment which reduces the adverse effects compared to radiotherapy), facilitate the return to work, fund an appropriate physical activity, develop structures to prevent the after-effects of paediatric cancers and identifying them systematically and early.

The Unicancer network acts at several levels through:

• “Patient-partner” approaches in health, education, research and e-health
• Tools for monitoring adverse effects and the use of Patient Reported Outcomes (PROMs), for integrating patient evaluations and feedback. To this end, Unicancer has developed the digital platform “Clic’Consult” to help patients evaluate their symptoms, adverse effects of their treatment and their quality-of-life (see section below)
• Routine and early detection of treatment-related consequences, with continued research on the prevention of those consequences and second cancers
• Appropriate physical activity and nutritional assessments
• Support for patients to facilitate the return to work
• Psychological care for patients
• Possibility for patients to join a clinical trial 

“Unicancer has a global conception of patient care and support: by guaranteeing the right to be forgotten, by facilitating the return to work, by encouraging adapted physical activities and by developing structures to prevent the side effects of cancers and their treatment”

Sophie Beaupère, CEO

Initiatives within the French Comprehensive Cancer Centres

The Unicancer network has developed numerous initiatives related to the healthcare pathway and quality-of-life. Among them, we can name:

• Project Traid’Union (Centre Léon Bérard, Lyon) to improve treatment of patients from different cultures
• Project by Gustave Roussy, Villejuif : rethinking the patient pathway based on the experience of patients included in clinical research trials (Phase I)
• Project by Institut Curie, Paris : day hospitals and supportive care for patients at the end of life

Unicancer rewards its cancer Centres’ innovative projects every year at the Prix Unicancer de l’Innovation. As a category was dedicated to the healthcare pathway, numerous projects in this field have been rewarded, which certifies the commitment of and the actions undertaken by the network:

• 2018: MIRIO, oncological monitoring and therapeutic response assessment solution – Centre Léon Bérard, Lyon
• 2017: Securing the return home after outpatient gynaecological surgery – Institut Paoli-Calmettes, Marseille
• 2016: three joint award winners on the same theme: follow-up of patients on oral therapy
• 2015: New technologies in home pain management – IUCT Oncopole – Institut Claudius Regaud, Toulouse
• 2014: Unité d’Accueil Non Programmé (UANP) – Institut Curie, Paris

“Onco-Link oral therapies” pilot project

• To improve the quality of patient follow-up on oral cancer treatments
• To reduce the amount of care consumed due to complications and insufficient follow-up of these patients’ treatment, because of the lack of a liaison between private practices and hospitals
• To progressively transfer the management of patients from the hospital team to professionals in the city

Representing a major innovation, this pilot project covers a new model for the follow-up at home of patients undergoing oral anticancer treatment with:

• An organisational innovation: implementation of a multi-professional private-practice hospital circuit for patients, supported by weekly exchanges with the patient, monitoring of compliance and treatment follow-up
• A financial innovation, with the setting up of innovative funding for treatment

Clic’Consult: helping each patient prepare their medical consultation

Unicancer and the French Comprehensive Cancer Centres (FCCCs) set up a digital platform in 2021 to help patients prepare their medical consultation. A unique digital tool bringing several added values: 

• Helps patients prepare their medical consultation: they complete a questionnaire online beforehand which they use to evaluate their symptoms, tolerance to and adverse effects of their treatment and their quality-of-life. The summary of answers is available at the consultation, patients having identified the subjects they wish to discuss with their doctor
• Offers rapid reading of symptoms: appearing directly in the computerised patient file, the information reported by the patient is presented in a synthetic manner for a quick analysis, by the Centre’s professionals, of the points of vigilance since the last medical consultations
• Advises and orients patients: access to more than 100 documents validated and certified by a scientific committee, so the patient can better manage concerns relating to their treatment between two consultations, or be referred to other professionals (social assistants, psychologist, etc.)

This tool demonstrates the importance given by the Unicancer network to patient-reported outcomes (PROs) which improve quality-of-life and overall survival of patients. 5 pilot cancer centres are working on this programme: Centre Jean Perrin, Centre Oscar Lambret, Centre Léon Bérard, Centre Henri-Becquerel and Institut Godinot. It is to be rolled out rapidly in all French Comprehensive Cancer Centres.