Developing quality indicators for supportive care in cancer treatment: a modified Delphi method

BACKGROUND: Quality indicators for supportive cancer care remain unclear. In this study, we aimed to clarify quality indicators for supportive care addressing side effects experienced by patients undergoing treatment from the perspectives of oncologists and pharmacists. METHODS: We conducted a three-round modified Delphi study, including online discussions, to develop indicators for supportive care related to treatment-associated side effects in adult patients with cancer. An initial list of indicators was developed from a systematic review, conducted based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement, to identify existing quality indicators for managing treatment-induced toxicities in adult patients with cancer. Panelists were oncologists or pharmacists with at least 5 years of experience providing care to patients with cancer. Panelists evaluated the importance of each indicator using a 4-point Likert scale. Indicators rated as "strongly agree" or "agree" by at least two-thirds of participants were adopted. RESULTS: In total, 11 panel members (three oncologists and eight pharmacists) participated. In Round 1, 25 potential indicators were reviewed, six new indicators were proposed, and the scope of three indicators was revised (response rate: 100%). In Round 2, all indicators were re-examined, with 11 indicators receiving responses of "strongly agree" or "agree" from all participants (response rate: 100%). In Round 3, conducted via an online meeting, 24 indicators were ultimately adopted (response rate: 81.8%). CONCLUSIONS: This study identified 24 indicators for supportive care, particularly process indicators, from the perspectives of oncologists and pharmacists. Further research is needed to develop indicators relevant to patients and families.