Title: Evaluating the impact of an Oral Chemotherapy Standardized Process Improvement Tool on patient-perceived ability to adhere to oral chemotherapy treatment plans
Background: Recent progress in cancer treatment has seen the growing use and accelerated development of oral chemotherapy agents.
•The shortage of practice-level systems to ensure the safe management of oral chemotherapy poses a challenge to patients and practitioners, especially at the first transition of care. It has been well-established that care transitions are error-prone periods in healthcare delivery.1
•In 2013, ASCO/ONSa updated the Chemotherapy Administration and Safety Standards to encompass the safe management of oral chemotherapy. Thus far, no study has evaluated institutional compliance with these standards.
•A review of 155 sites participating in the ASCO QOPIb identified significant gaps in adherence and toxicity monitoring measures, with the worst overall performance observed in patient education.2
•At the University of Maryland Greenebaum Comprehensive Cancer Center (UMGCCC), there are prescription processing procedures in place at discharge, but the extent and format of patient education and adherence monitoring are not currently known.
•To describe the impact of a standardized education process tool on patient-perceived ability to adhere to oral chemotherapy treatment plans or handle medication safely
•To describe the impact of a standardized education process tool on patient-reported barriers and facilitators to adherence
Study Design•Prospective, single center, patient survey-based study conducted at UMGCCC
Patient Population•Patients admitted to the hematologic malignancy service aged 18 years and older who were newly initiated on an oral chemotherapy agent from November 1, 2015 - February 15, 2017 and consented to participate
Intervention•The Oral Chemotherapy Standardized Process Improvement Tool, an original counseling checklist encompassing medication administration, food/drug interactions, side effects, storage and handling, was administered by a study investigator before hospital discharge.
Primary Endpoint•Mean composite value of patient-reported understanding before and after administration of a standardized education process tool by a pharmacist on a scale of 1-5 (where 1= “Not confident at all” and 5= “Very confident”)•Means were compared and confidence intervals determined using the paired sample student’s t-test.
Secondary Endpoint •Mode response (i.e. medication-related factor identified most often as a “Barrier” vs. “Neutral” or “Facilitator”) before and after administration of a standardized education process tool