Evaluation of Inpatient Oral Chemotherapy: An Academic Medical Center Experience.

Autor: Cascone, Vincent J., Hosmer, Kane M., Mahmoudjafari, Zahra, Henry, David W., Grauer, Dennis W.
Předmět:
Zdroj: Journal of Hematology Oncology Pharmacy; Dec2020, Vol. 10 Issue 6, p359-363, 5p
Abstrakt: BACKGROUND: Oral chemotherapy continues to be an attractive treatment modality, with new agents being approved by the US Food and Drug Administration at increasing rates. However, studies evaluating the safe use of oral chemotherapy for patients admitted to a hospital are not as well described as intravenous (IV) chemotherapy. OBJECTIVES: To determine the incidence rate of oral chemotherapy treatment deviation among the 10 most common oral chemotherapy classes and to identify predictive factors for treatment deviations. METHODS: We performed a retrospective, electronic medical record review of inpatient oral chemotherapy orders in a single center and administered between December 2016 and June 2018. We defined treatment deviations as at least 1 of the 4 following conditions related to inpatient oral chemotherapy treatment continuation in the setting of (1) abnormal treatment parameter(s), (2) potential oral chemotherapy-related adverse event(s), (3) clinically relevant category D or X drug-drug interaction(s), or (4) dosing error(s) compared with the prescription before admission. RESULTS: Oral chemotherapy treatment deviations were evident in 106 (50.7%) of 209 inpatient orders identified during the study period. The most common (69.8%) type of deviation was abnormal treatment parameter. Treatment deviations occurred most often within the oral chemotherapy class of vascular endothelial growth factor tyrosine kinase inhibitors (100%) and Bruton tyrosine kinase inhibitors (92.9%). Oral chemotherapy co-administered with IV chemotherapy was predictive of fewer treatment deviations (33.0% vs 67.9%; P <.001). Oral chemotherapy ordered within 24 hours of admission (P = .032) and continued inpatient from before admission (P = .003) were predictive of deviations. CONCLUSION: Clinical literature describing the safe use of oral chemotherapy for hospitalized patients is still evolving. Established protocols used for IV chemotherapy may aid in the safe use of oral chemotherapy in the inpatient setting. Our findings suggest that further scrutiny is needed for oral chemotherapy ordered within 24 hours of hospital admission or continued from the outpatient setting, as transitioning to the inpatient setting may be a critical point for the safe administration of oral chemotherapy. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index