Adherence to Oral Anticancer Medications: Evolving Interprofessional Roles and Pharmacist Workforce Considerations

Abstract

Interprofessional care is exhibited in outpatient oncology practices where practitioners from a myriad of specialties (e.g., oncology, nursing, pharmacy, health informatics and others) work collectively with patients to enhance therapeutic outcomes and minimize adverse effects. Historically, most ambulatory-based anticancer medication therapies have been administrated in infusion clinics or physician offices. Oral anticancer medications (OAMs) have become increasingly prevalent and preferred by patients for use in residential or other non-clinic settings. Self-administration of OAMs represents a significant shift in the management of cancer care and role responsibilities for patients and clinicians. While patients have a greater sense of empowerment and convenience when taking OAMs, adherence is a greater challenge than with intravenous therapies. This paper proposes use of a qualitative systems evaluation, based on theoretical frameworks for interdisciplinary team collaboration and systems science, to examine the social interactionism involved with the use of intravenous anticancer treatments and OAMs (as treatment technologies) by describing patient, organizational, and social systems considerations in communication, care, control, and context (i.e., Kaplan’s 4Cs). This conceptualization can help the healthcare system prepare for substantial workforce changes in cancer management, including increased utilization of oncology pharmacists.

Management of Adverse Events During Rucaparib Treatment for Relapsed Ovarian Cancer: A Review of Published Studies and Practical Guidance

“…As rucaparib is an oral medication taken in an outpatient setting, it is important to maintain regular clinical followup with patients, such as monthly follow-up during the first 3 months, with less frequent (e.g., every 3 months) follow-up thereafter for patients with good tolerability. Follow-up may be achieved through direct interactions with treating clinicians, interactions with other members of a multidisciplinary team (e.g., nurses and pharmacists), or through web-based applications [22][23][24][25]. Notably, recent surveys indicate that patients taking oral anticancer medications are interested in technologies to help them manage their treatment, such as pill reminders and apps that allow reporting of symptoms to physicians [24,26].…”

Improving adherence to endocrine hormonal therapy among breast cancer patients: Study protocol for a randomized controlled trial

“…Of the 330,080 women diagnosed with breast cancer each year, approximately 75% will have hormone receptor-positive breast cancers (ER+ and/or PgR+) [ 1 , 3 , 4 ]. Shifts in oncological practice have seen a rise in self-administered adjuvant hormone therapy pills after primary treatment (i.e., surgery, chemotherapy, radiation) [ 5 , 6 ]. Although considered a prolonged self-management strategy, adjuvant hormone therapy with Tamoxifen and aromatase inhibitors (AIs) is highly effective and appropriate for nearly all women with ER+ and PgR + tumors [ 3 , 4 ].…”

Oncology Pharmacists Can Reduce the Projected Shortfall in Cancer Patient Visits: Projections for Years 2020 to 2025

“…In addition, OPs would enhance efficiency by providing expertise on investigational new drugs and the many new oral oncology drugs, immunologic agents, and supportive care medications that are being used in practice. OPs have the ability to oversee the administration of oral oncology drugs because of their extensive knowledge of drug administration, monitoring of therapy, toxicity management, adherence assessments, and issues concerning pre-authorizations and reimbursement [18]. While data about OP involvement in follow-up visits were not available, it is likely that OPs can provide the services listed above to cancer survivors and those undergoing recurrent medication therapy.…”