High Patient, Physician Satisfaction With Pharmacy-Led Monitoring Program for Oral Antineoplastic Agents

Patients taking oral antineoplastic agents (OAAs) expressed a satisfaction with a pharmacy-led adherence and symptom monitoring program, according to the results of a recent study.

The findings were presented as late breaking research at the Hematology/Oncology Pharmacy Association Annual Conference, which is being held virtually April 13 to 17.

In a virtual presentation, Stefan Allen, PhD candidate, University of Texas (UT) Austin College of Pharmacy/UT Health San Antonio (PERC), noted that although OAAs can be beneficial in reducing office visits and avoiding infusion-related complications, many of these regimens are challenging for patients and can cause significant adverse reactions.

For the study, the research team aimed to evaluate the feasibility and physician and patient perceived benefit of a pharmacist-delivered adherence and symptom monitoring program for patients taking OAAs through patient participation in a pilot program.

The study was conducted at the Mays Cancer Center, a University of Texas outpatient cancer clinic, over a time period of 6 months. Enrolled patients were receiving any of 6 OAAs: capecitabine, sorafenib, regorafenib, osimertinib, afatinib, or erlotinib. A pharmacist contacted enrolled patients twice each cycle or month, between clinic visits, for symptom or adherence monitoring over a 3-month follow-up. In collaboration with physicians, pharmacists managed or triaged symptoms such as diarrhea, mucositis, rash, nausea, and vomiting. Physicians and patients completed satisfaction surveys.

According to the results, 47 patients were eligible for participation. Patients had a median age of 59 and were predominantly male and Hispanic.

Of the 252 expected encounters with patients, 231 were performed. The pharmacy administered the Edmonton Symptom Assessment Scale (ESAS-FS) 102 times with the average total severity score decreasing over time. With an acceptance rate of 98%, 48 symptom management recommendations were made to patients and physicians by pharmacists. Ninety-six percent of patients and 90% of physicians agreed the program was beneficial and easy to use. Additionally, 97% of patients indicated they would recommend the programs to others, but only 45% agreed it improved communication with their physicians.

Overall, this pilot project suggests that a pharmacist monitoring program for patients newly prescribed OAAs is both feasible and perceived to be beneficial, according to Allen.

“The methods utilized in this program are easily scalable to include more OAAs, more pharmacists with greater scope of practice through collaborative practice agreements, and more clinic physicians,” he concluded. However, further research is needed to evaluate whether this program improves safety, adherence, and outcomes.

Reference

1. Allen S, Cervantez S, Tenner L, et al. A retrospective cohort study of patients on oral antineoplastic agents. Presented at: HOPA Annual Conference 2021; April 13-17; virtual. https://www.eventscribe.net/2021/HOPAAnnualConference/searchbyposterbucket.asp?f=PosterCustomField17&pfp=Topic