Needs of chemotherapy regimen checks procedure: from the survey on chemotherapy regimen checks performed by pharmacists in hospitals other than designated cancer hospitals in Japan

Abstract

Introduction: Pharmacists perform regimen checks of physicians’ prescription orders in hospitals for providing appropriate chemotherapy. Details of these steps and procedures are confined to reports within individual facilities. Methods: In July 2016, a questionnaire was sent to the 33 pharmacists of the total 33 National Hospital Organization hospitals that were not cancer hospitals in Japan to survey the items checked in regimen checks and to assess whether the regimen checks are performed for oral anticancer drugs (OACDs) and injected anticancer drugs (IACDs) according to prescription category. The questionnaires included items on characteristics of respondents and their facilities and the 7 items related to regimen checks. Results: All facilities responded to the questionnaires, and 15 and 22 of the facilities performed chemotherapy regimen checks for OACDs and IACDs, respectively. Regimen checks for OACDs were performed for 80% (12/15) of internal and 27% (4/15) of external prescriptions for outpatient care and 93% (14/15) of prescriptions for inpatient care. Regimen checks for IACDs were performed for 91% (20/22) of prescriptions for outpatient care and 100% (22/22) of inpatient care. Conclusions: The surveyed facilities differed in terms of items checked, suggesting that procedures of regimen checks followed protocols unique to each facility. It is vital to establish an adequate procedure to perform safe chemotherapy.

Cancer-Chemotherapy-Related Regimen Checks Performed by Pharmacists of General Hospitals Other than Cancer Treatment Collaborative Base Hospitals: A Multicenter, Prospective Survey

“…It is clear that the checking of such regimens requires prior knowledge of a wide variety of anticancer drugs. A study by Ohta et al shows that the most common source of information used for regimen checks is package inserts [19]. However, finding information on regimen checklist items used as criteria for administration and required for expertise, such as supportive medications and laboratory values, is challenging only in package inserts.…”

“…Griffin et al reported 57 systematic checks used for parenteral anticancer drugs [18]; however, they did not define the selection criteria for confirmation items. Using this background, Ohta et al prepared and used a questionnaire to examine confirmation items recommended for regimen checks [19]. The results yielded 19 recommended items, which comprised items that are commonly confirmed via pharmacists and those that the authors determined to be essential for regimen checks, regardless of the frequency at which checks are performed by pharmacists ( Confirm whether all premeditations described in the package inserts are prescribed according to anticancer drugs Latest treatment history Confirm whether a regimen is performed on a patient to prevent a regimen error (e.g., the use of a previous treatment regimen for the initial treatment) Laboratory test Confirm examination date (if there is an institution-specific rule, e.g., within the last several months, confirm whether the examination is performed within that period) Urinalysis Allergy history Confirm whether a drug used in a regimen can be administered safely by checking a patient's allergy history Medical history Confirm whether a drug used in a regimen can be administered safely by checking the side effects of the drug and a patient's medical history Concomitant drug Confirm whether a drug used in a regimen can be administered safely by checking a patient's concomitant drugs (drug interaction, duplicate medication, and contraindications for co-administration) Oral anticancer drug Confirm days on therapy, dosage, and dose interval in a regimen that concomitantly uses an oral anticancer drug History of hepatitis B virus Confirm examination date (if there is an institution-specific rule, e.g., within the last several months, confirm whether the examination is performed within that period) Confirm whether HBV-DNA levels are measured within 1-3 months (periods vary depending on each anticancer drug) if a patient tested positive for HBs antibodies or HBc antibodies…”