Appendix D. Detail on criteria for audit of the use of capecitabine and tegafur with uracil for metastatic colorectal cancer

Appendix D. Detail on criteria for audit of the use of capecitabine and tegafur with uracil for metastatic colorectal cancer

Possible objectives for an audit

An audit on the treatment of people with metastatic colorectal cancer could be carried out to ensure that capecitabine and tegafur with uracil are being used appropriately.

Possible people to be included in an audit

An audit could be carried out on people with metastatic colorectal cancer referred over a suitable time period, for example 6 months or a year.

Measures that could be used as a basis for audit

The measures that could be used in an audit of capecitabine and tegafur with uracil for the treatment of metastatic colorectal cancer are as follows.

Criterion

Standard

Exception

Definition of terms

1. For the first-line treatment of metastatic colorectal cancer an individual is given the option of oral therapy with either capecitabine or tegafur with uracil (in combination with folinic acid)

100% of people diagnosed as having metastatic colorectal cancer

None

Clinicians will have to agree locally on how the offer of the option of oral therapy as an alternative to intravenous 5-FU/FA regimens is documented for audit purposes.

2. The individual and the clinician(s) responsible for treatment decide jointly on the choice of regimen after an informed discussion of the following:

a. the relative clinical and cost-effectiveness of each treatment option and

b. the side-effect profile of each treatment option and

c. the preferences of the individual

100% of people diagnosed as having metastatic colorectal cancer

None

Clinicians will have to agree locally on how the joint decision will be documented for audit purposes.

3. An oncologist specialising in colorectal cancer supervises the use of capecitabine and tegafur with uracil

100% of the people receiving capecitabine or tegafur with uracil

None

Clinicians will have to agree locally on how supervision of the use of capecitabine and tegafur with uracil is defined and documented for audit purpose

Calculation of compliance

Compliance (%) with each measure described in the table above is calculated as follows.

Number of patients whose care is consistent with the criterion plus number of patients who meet any exception listed

x 100

Number of patients to whom the measure applies

Clinicians should review the findings of measurement, identify whether practice can be improved, agree on a plan to achieve any desired improvement and repeat the measurement of actual practice to confirm that the desired improvement is being achieved.