Background: Although most cancer medicines are administered parenterally, there has been a large increase in the availability of oral antineoplastic. It is widely recognized that oral antineoplastic drugs are considered hazardous medications that carry with them potential safety and quality of care issues. Patients prescribed oral chemotherapy and targeted therapies should be supported, educated, and monitored with the same vigilance as those receiving chemotherapy. In 2017, we identified that this is an area that requires attention. We aimed to create a standardized program for oral anti-neoplastic medications in two stages at our institution:
Stage I: Identify the gaps in our system
Stage II: Intervention of creating a new Clinical Nurse Consultant Liaison role to help streamline this process. We aim to find out if creating this position provides value.
Methods: A chartered multidisciplinary task force met over the course of 2 months to reach the goal of developing a specific program for patients prescribed oral chemotherapy that would help standardize the process of the oral chemotherapy prescriptions.
Stage I: A three months’ audit (1st April 2017 to 30th June 2017) of our top 5 most prescribed oral anti-neoplastic medication at our institution was done. The audit was conducted by comparing our in-house pharmacy dispensing list to our medical records software (MOSAIQ). The number of patients who did not have a care plan applied, no additional cycles added on prescribing day or care-plan applied after start of first cycle were counted. A driver diagram was also utilized to identify the gaps in our current system.
Stage II: Our CNC Liaison role was created in February 2018 and a three months’ audit (1st April 2018 to 30th June 2018) was conducted.
Results: Stage 1: Out of 52 patients audited, 21 patients had no orders prescribed in the medical record. Of those, 11 patients were on hormonal therapy, 1 patient was on targeted therapy, 5 patients were on chemotherapy.
Stage II: Please note that this is still ongoing. Results will be out by October'2018. A standardized process will also be in this section