Improved Adherence Rates and Clinical Outcomes of an Integrated, Closed-Loop, Pharmacist-Led Oral Chemotherapy Management Program

Muluneh, Benyam; Schneider, Molly; Faso, Aimee; Amerine, Lindsey B.; Daniels, Rowell; Crisp, Brett; Valgus, John M.; Savage, Scott V.

doi:10.1200/jop.17.00039

Cited by 74 publications

(117 citation statements)

References 9 publications

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“…A follow-up phone call to the patient should be made within 2 weeks of starting treatment to assess the patient’s adherence to and tolerance of the medication and provide education reinforcement. 23 - 25 …”

Section: Educationmentioning

confidence: 99%

2018 Hematology/Oncology Pharmacist Association Best Practices for the Management of Oral Oncolytic Therapy: Pharmacy Practice Standard

Mackler

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Muluneh

et al. 2019

JOP

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PURPOSE: The aim of the current work was to present a pharmacy practice standard from the Hematology/Oncology Pharmacy Association (HOPA) on the management of oral oncolytic therapy. METHODS: The HOPA Standards Committee organized a work group of oncology pharmacist specialists to create a pharmacy practice standard for the management of oral oncolytic therapy that describes the pharmacist’s role on the cancer care team, provides examples of practice tools and resources, summarizes current data related to outcomes, and discusses opportunities to enhance the care of patients with cancer who receive oral oncolytic therapy. We reviewed primary literature, including currently published oral oncolytic guidelines and HOPA’s Scope of Hematology/Oncology Pharmacy Practice. RESULTS: Management of oral oncolytic therapy was divided into the following primary areas: prescribing, education, dispensing and distribution, and monitoring and follow-up. Pharmacists’ roles were summarized in each area with a focus on interprofessional collaboration, communication, patient safety, and quality of patient care. Standards describe the best practices in each area ( Table 1 ). CONCLUSION: Multiple opportunities exist for pharmacists to enhance the care of patients with cancer who receive oral oncolytics through collaboration with oncology care team members. The role of the oncology pharmacist in the care of this patient population is critical given the complexities related to cost, tolerability, and safety of oral oncolytic medications; issues of access; and the monitoring and follow-up of patients receiving this therapy.

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Section: Educationmentioning

confidence: 99%

2018 Hematology/Oncology Pharmacist Association Best Practices for the Management of Oral Oncolytic Therapy: Pharmacy Practice Standard

Mackler

Segal

Muluneh

et al. 2019

JOP

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“…In 2018, Muluneh et al reported patient satisfaction among patients included in an integrated, closed-loop, pharmacist-led oral chemotherapy program [3]. The authors concluded that 97.8% of the patients in this study reported the teaching provided to them was "good" or "excellent."…”

Section: Discussionmentioning

confidence: 68%

“…2 The pharmacist made sure that my medicines are safe (possible side effects and avoiding drug interactions). 3 The pharmacist helped me understand the best way to take my cancer medication. 4 After speaking with my pharmacist, I feel more confident about taking my cancer medication.…”

Section: Resultsmentioning

confidence: 99%

“…Lam and Cheung evaluated an oncology pharmacist-managed oral anticancer therapy program for patients with chronic myeloid leukemia and reported higher adherence rates compared to usual care and approximately ten interventions per patient [2]. Muluneh et al published their results including increased treatment comprehension, adherence, and interventions [3]. Given these positive findings, a pilot program was created to evaluate the effectiveness of a pharmacist-led oral chemotherapy clinic, which aimed to provide in-person educations to patients with gastrointestinal (GI) malignancies starting an oral chemotherapy agent.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of a Pharmacist Led Oral Chemotherapy Clinic: A Pilot Program in the Gastrointestinal Oncology Clinic at an Academic Medical Center

et al. 2020

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Oral chemotherapy represents a major patient-centric advancement in therapy convenience. However, ownership of safe and correct administration of these agents requires significant patient education. To address this challenge, an in-person pharmacist-led oral chemotherapy education clinic in gastrointestinal oncology patients within an academic medical center was created and assessed. In this pilot program, a medication-specific quiz was administered to patients before and after education performed by a pharmacist to assess patient understanding of their new oral chemotherapy. A five-question satisfaction survey was also administered at the conclusion of the pharmacist clinic visit. Primary outcome was the percentage difference between pre-and post-education quiz scores. Secondary outcomes included patient satisfaction, time to treatment initiation, and number of pharmacist interventions. Frequencies and medians were used to describe categorical and continuous variables, respectively. Of the 18 patients analyzed, 50% were male and median age was 59.5 years. Approximately 28% had colon cancer, and 61% were treated with capecitabine. The median post-education scores improved from a pre-education score of 75% to 100%. Overall, seventeen of the eighteen patients responded with “strongly agree” to all satisfaction survey statements. An in-person oncology pharmacist-led oral chemotherapy education session demonstrated an improvement in patients’ understanding of their new oral chemotherapy treatment.

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“…Often, a strong partnership between clinical pharmacists and specialty pharmacists is necessary to create a closed-loop, patient-centered system. Having pharmacists involved operationally and clinically ensures patients are able to have timely access to and delivery of their drug as well as management of non-adherence and toxicities, which can lead to improved patient outcomes [4,5]. Pharmacists can also play a key role in educating patients and caregivers on the risks and benefits of treatment options, allowing for shared decision making and increased patient engagement [6].…”

Section: Introductionmentioning

confidence: 99%

Pharmacists’ Role in Managing Patients with Chronic Lymphocytic Leukemia

et al. 2020

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Chronic lymphocytic leukemia (CLL) is a hematologic malignancy that has seen significant advances in care over the last 5 years with the approval of oral agents such as ibrutinib and venetoclax for the treatment of this disease. As such, there has been a substantial shift away from the traditional chemotherapy infusions which have allowed patients greater autonomy with oral cancer therapies. This paradigm shift poses new challenges for the medical team, including drug–drug interactions, adherence counseling, and financial toxicity. Pharmacists are uniquely trained and equipped to help to manage the changing landscape of CLL care. From identifying common medications which may impair ibrutinib clearance to ensuring patients are on the appropriate anti-infective prophylaxis while receiving obinutuzumab, pharmacists can play a vital role in ensuring the highest quality of patient care. Furthermore, additional credentialing of clinical pharmacists in select states allows for independent visits with the pharmacists, allowing for greater involvement, particularly for initiation of venetoclax and management of ibrutinib-induced toxicities. Pharmacists are essential to both expanding and enhancing the care of patients with CLL and should be leveraged to improve patient outcomes whenever possible.

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Improved Adherence Rates and Clinical Outcomes of an Integrated, Closed-Loop, Pharmacist-Led Oral Chemotherapy Management Program

Cited by 74 publications

References 9 publications

2018 Hematology/Oncology Pharmacist Association Best Practices for the Management of Oral Oncolytic Therapy: Pharmacy Practice Standard

2018 Hematology/Oncology Pharmacist Association Best Practices for the Management of Oral Oncolytic Therapy: Pharmacy Practice Standard

Evaluation of a Pharmacist Led Oral Chemotherapy Clinic: A Pilot Program in the Gastrointestinal Oncology Clinic at an Academic Medical Center

Pharmacists’ Role in Managing Patients with Chronic Lymphocytic Leukemia

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