eviq.org.au A/Prof Jeremy Shapiro Cabrini Hematology and Oncology Centre Chair EVIQ Medical Oncology Committee PCPA 2017 Jeremy Shapiro

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1 eviq.org.au A/Prof Jeremy Shapiro Cabrini Hematology and Oncology Centre Chair EVIQ Medical Oncology Committee

2 What is eviq? Provides evidence-based best practice cancer treatment information Point of care clinical information resource (NOT a guideline) Primary audience is health professionals Free online access

3 What is eviq? Began in 2004 as a NSW Cancer institute resource - CanSTAT Formally endorsed and funded by all states Formally endorsed and supported by MOGA, HSANZ, RANZCR Widely used across Australia and overseas in > 150 countries

4 Eviq front page eviq.org.au

5 Cancer genetics Radiation oncology Bone marrow transplantation Primary health care eviq CONTENT STREAMS Medical oncology Patient information Haematology Nursing content

6 Cancer Genetics Page 6 Optional Footer

7 Primary Health Care eg colorectal Page 7 Optional Footer

8 Palliative Care area Page 8 Optional Footer

9 Opioid Conversion Calculator Page 9 Optional Footer

10 Nursing (more useful than you might think!) Page 10 Optional Footer

11 Oncology emergencies Page 11 Optional Footer

12 Extravasation This module provides education for health professionals on the uncommon event of an antineoplastic drug extravasation injury. Page 12 Optional Footer

13 Patient information in 9 languages

14 Cancer information for patients Introduction to chemotherapy Introduction to radiotherapy Mouth problems during cancer treatment Nausea and vomiting during cancer treatment Infection during cancer treatment Hair loss during chemotherapy Feeling tired during cancer treatment Available from Page 14 Optional Footer

15 Patient information

16 eviq online free Education courses Effective cultural communication in oncology Central venous access devices Oral Chemotherapy role of community pharmacists Malnutrition in cancer Antineoplastic drug administration course Geriatric oncology Page 16 Optional Footer

17 Medical Oncology section main page Page 17 Optional Footer

18 Medical Oncology - colorectal Page 18 Optional Footer

19 Colorectal mfolfox6bev Page 19 Optional Footer

20 mfolfox6bev clinical info Page 20 Optional Footer

21 mfolfox6bev treatment schedule Page 21 Optional Footer

22 mfolfox6bev dose modifications Page 22 Optional Footer

23 mfolfox6bev administration Page 23 Optional Footer

24 mfolfox6bev interactions Page 24 Optional Footer

25 mfolfox6bev monitoring and s/effects Page 25 Optional Footer

26 mfolfox6bev evidence (efficacy and tox) Page 26 Optional Footer

27 Number of protocols per content area Cancer Genetics Rad Onc Haem/HPCT Med Onc Total Jan-17 Dec-13 Page 27 Optional Footer

28 >75000 registered users across Australia Northern Territory 1 % Australian Capital Territory 2 % Tasmania 4 % South Australia Western Australia 6% 7 % (2009 jan2017) Overseas 10 % Queensland 17 % Victoria 18 % New South Wales 35 % Page 28 Optional Footer Total users = 75, 214

29 Top 20 of countries (OS use now 10%) Page 29 Optional Footer

30 eviq international users survey April 2014 A survey of international users in April 2014 showed: Highly regarded Usage in countries with limited access to current evidence-based cancer treatment protocols and information Also used as a secondary check for local protocols and to gain a more global perspective Page 30 Optional Footer

31 Registered Users by Professional Role Oct 2009 January 2017 Radiation Therapy 3% Academic 2% Allied Health 3% Clinical Information Manager 1% Pharmacy 12% Medical 16% Medical Physicist 1% Not Specified 15% Nursing 47% Page 31

32 eviq Governance Development of all content is compliant with a strict governance framework Content is clinically relevant, evidence based and consensus driven in areas of limited evidence Adherence maintains both quality and scope and provides a degree of legal protection Page 32 7

33 Remains Clinician Owned and Driven Reference Committees supported by EVIQ content authors 2004 Medical Oncology 2005 Haematology 2006 Nursing 2007 Radiation Oncology and Primary Health 2008 Cancer Genetics 2010 Bone marrow Transplantation Reference committee meeting at CINSW Page 33

34 Reference Committees clinicians now contribute to content development across Aust ACT 2% NT 1% VIC 13% SA 5% TAS 3% WA 7% QLD 12% NSW 57% Page 34

35 Page 35

36 do I really need to follow EVIQ? EVIQ is widely considered as the national standard BUT - Evidence for protocol doses come from fit trial pts without co-morbidities - Dose reductions are taken from clinical papers or expert opinion and often vary between papers. - In some situations only expert consensus opinion was best evidence - Treatment intent (Cure v Palliation) and willingness of pts to accept sideeffects are other important variables Page 36

37 do I really need to follow EVIQ? => EVIQ not appropriate for all patients in all circumstances But must then clearly document rationale in medical record and ensure pt and treating team understand and are aware of variance Pge 37

38 Challenges for EVIQ new protocol development Maintaining existing as data changes levels of evidence Geography Voluntary/unpaid Page 38

39 How you can help! Join a reference committee. Develop a new protocol under guidance of EVIQ content authors (MOGA and oncology SAC strongly encourage trainees to do this) Let us know of errors/area of improvement we will listen New protocol requests Page 39 Optional Footer

40 Registrar and trainees homepage Page 40 Optional Footer

41 eviq.org.au team