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How Pharmacists Can Better Manage Take-Home Cancer Drugs

By: Carla Beaton, VP Quality Improvements & Innovations, Pharmapod and Lisa Rambout, PhDHQ Queen’s University

An estimated two in five Canadians will get cancer in their lifetime. The number of new cancer cases in Canada is expected to increase about 40 percent in the next 15 years, resulting in more patients needing treatment, more treatments being offered, and more patients living longer with multiple chronic diseases.

To help ease the strain on our healthcare system, take-home cancer drugs (THCD) are becoming the norm, with more than half of new cancer drugs now formulated to be taken orally or injected instead of infused in a hospital or private clinic setting.

This new model — though convenient for patients — poses some potential safety risks.

Previously, specialized hospital oncology pharmacists would screen medications administered in healthcare facilities for accuracy and safety — today, the majority of orders for THCD are sent directly to community pharmacies from prescribers, a shift that’s caused some unease among pharmacists. Data shows 90 percent of publicly funded THCD in Ontario are now dispensed from community pharmacies, yet less than 20 percent of those pharmacists are comfortable with THCD.

How can pharmacists adapt to this new normal while limiting the risk for THCD medication errors?

PHARMACISTS AND HCPs: Learn more about how to reduce medication errors and improve patient safety. Register for our webinar, Mission Impossible: Can Reporting Medication Errors and Learning from Data be Easier?

Recommendations to Enhance Safety

To improve pharmacist confidence and patient safety with take-home cancer drugs, Cancer Care Ontario recommends the following steps:

Oncology Training

Healthcare providers involved in prescribing, dispensing, patient education and/or monitoring of take-home cancer drugs should have specific and standardized training in oncology care. It’s also recommended that at least one oncology health professional — preferably a pharmacist with oncology training — verify the prescription following a set of standardized steps and document the verification was completed before it is sent to the dispensing pharmacy.

Computerized Orders

Computerized prescriber orders for intravenous cancer drugs have shown to save millions in healthcare costs by preventing hospitalizations, deaths, or adverse events. Equivalent standards for THCD should also be implemented.

Clear Care Plan

To facilitate an integrated care approach, a communication plan should be developed to ensure that patients and/or caregivers and all members of the cancer care team across the treatment continuum have access to the same information. Numerous factors, including complex treatments, literacy, lack of understanding, and cognitive issues in patients can increase the risk of medication errors occurring that could cause harm. To prevent avoidable errors, pharmacists must be sure patients and/or caregivers have a clear understanding of their care plan.

Proper Guidance

Pharmacists can use standardized tools, including the Multinational Association for Supportive Care in Cancer (MASCC) Oral Agent Teaching Tool (MOATT) to access frameworks for effective patient education and communication strategies.

Patients and/or care providers should also be given clear guidance for proper medication storage, handling, disposal, side effects, potential interactions, and strategies for maintaining medication adherence.

Closing the Care Gap

Transitions in care and medication delivery always pose potential safety risks. For the THCD model to work — and for pharmacists to feel comfortable — it is imperative that acute care sites and community pharmacies communicate all patient safety events to each other.

Incident management platforms such as Pharmapod make it easy for pharmacy and healthcare professionals to report and track medication incidents and monitor trends and causes behind the errors to improve their practice over time.The intuitive cloud-based platform analyzes collected data and disseminates the learnings back to users, preventing the recurrence of patient harm. Book a custom demo today to learn more.

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