Impact of an integrated oral chemotherapy program on patient adherence

Abstract

As the use of oral chemotherapy continues to rise, the issue of patient adherence is a concerning aspect of cancer treatment. In this concurrent prospective and retrospective study, we assessed oral chemotherapy adherence in patients receiving their prescriptions at an institutional specialty pharmacy, with an integrated oral chemotherapy program. The primary endpoint is medication possession ratio. Secondary endpoints include self-reported adherence comparing survey data before and after the introduction of the oral chemotherapy program to assess the impact of the comprehensive pharmacy services provided. Patients receiving their oral chemotherapy from the institutional specialty pharmacy have a mean medication possession ratio of 0.92, indicating excellent adherence rates. The oncology clinical pharmacist, in collaboration with the specialty pharmacy, has also decreased the rates of patient-reported non-adherence.

Keywords

Oral chemotherapy adherence specialty pharmacy clinical pharmacy practitioner

Get full access to this article

View all access options for this article.

References

Bedell

. A changing paradigm for cancer treatment: the advent of new oral chemotherapy agents. Clin J Oncol Nurs 2003; 7: 5–9.

World Health Organization. Adherence to long term therapies: evidence for action, Geneva: World Health Organization, 2003.

Partridge AH, Kato PM, DeMichele A. Clinical Trials. Adherence to oral cancer therapies: Challenges and opportunities. In: ASCO Educational Book, 2009. Alexandria, VA: ASCO.

Marin

Bazeos

Mahon

. Adherence is the critical factor for achieving molecular responses in patients with chronic myeloid leukemia who achieve complete cytogenetic response to imatinib. J Clin Oncol 2010; 28: 2381–2388.

Darkow

Henk

Thomas

. Treatment interruptions and non-adherence with imatinib and associated healthcare costs: a retrospective analysis among managed care patients with chronic myelgenous leukemia. Pharmacoeconomics 2007; 25: 481–496.

McCowan

Shearer

Donnan

et al.

Cohort study examining tamoxifen adherence and its relationship to mortality in women with breast cancer. Br J Cancer 2008; 99: 1763–1768.

Muluneh B, Deal A, Alexander MD, et al. Patient perspectives on the barriers associated with medication adherence to oral chemotherapy. J Oncol Pharm Practice. Epub ahead of print 28 November 2016. DOI:10.1177/0178155216679026.

Karve

Cleves

Helm

et al.

Prospective validation of eight different adherence measures for use with administrative claims data among patients with schizophrenia. Value Health 2009; 12: 989–995.

Greer

Amoyal

Nisotel

et al.

A systemic review of adherence to oral antineoplastic therapies. Oncologist 2016; 21: 354–376.

10.

Atkinson

Rodriquez

Gordan

et al.

The association between patient reported and objective oral anticancer medication adherence measures: a systemic review. Oncol Nurs Forum 2016; 43: 576–582.

11.

Unnikrishnan

Veeraiah

Mani

et al.

Comprehensive Evaluation of adherence to therapy, its associations, and its implications in patients with chronic myeloid leukemia receiving imatinib. Clin Lymphoma Myeloma Leuk 2016; 16: 366–371.

12.

Gebbia

Bellavia

Banna

et al.

Treatment monitoring program for implementation of adherence to second-line erlotinib for advanced non-small cell lung cancer. Clin Lung Cancer 2013; 14: 390–398.

13.

Noena

van Lierde

De Bock

et al.

Prevalence, determinants, and outcomes of nonadherence to imatinib therapy in patients with chronic myeloid leukemia: the ADAGIO study. Blood 2009; 113: 5401–5411.