Opportunities for improvement shown for pharmacists dealing with patients on oral chemotherapy

A recent study has underscored ways for pharmacists to improve treatment of patients newly initiated on oral chemotherapy.

“Opportunities exist to increase patient education, ensure appropriate follow-up and assess adherence while preventing and managing treatment-related toxicities,” the investigators said.

A total of 100 patient charts in an outpatient cancer centre were reviewed. Median time to oral chemotherapy receipt by the patient from the day the order was given was 8 days. Of the patients, 27 percent received education from a clinical pharmacist before treatment initiation.

The provider carried out toxicity checks at 30, 60 and 90 days for 80 percent, 65 percent and 48 percent of patients, respectively. Seventy-nine percent of patients reported treatment-related toxicities secondary to oral chemotherapy, of which 55 percent were classified as severe. Potential drug interactions presented in 55 percent of the patients.

This single-centre, retrospective chart review was conducted to estimate the prevalence of drug-related problems among patients treated with oral chemotherapy agents. Those prescribed oral chemotherapy between 1 January 2017 and 31 August 2017 were included.

The incidence of drug-related toxicities within 90 days of treatment initiation was the primary endpoint, while secondary endpoint included incidence of drug–drug interactions, proportion of patients receiving medication education by a clinical pharmacist and quantification of issues related to medication access.

“Although oral chemotherapy offers advantages over intravenous chemotherapy, it creates a unique set of challenges,” the investigators noted. “Potential barriers include treatment complexity, patient responsibility for medication adherence and monitoring, reduced healthcare contact, and increased financial burden.”