Quality improvement for oral oncolytics Public Deposited

For obvious reasons, oncologic care has worked to move away from the toxic inpatient intravenous chemotherapy treatment strategies and toward the development of more convenient oral therapies that patients self-manage at home. Mercaptopurine and methotrexate were the first oral chemotherapy agents approved in 1953 (Mancini, & Wilson, 2012). Since that time, the use and development of new oral agents has increased in cancer care and has resulted in a shift in the way cancer care is provided. In 2012, up to 35% of the new oncology drugs were oral agents (Mancini, & Wilson, 2012). As of 2013, more than 50 oral anticancer drugs had obtained Federal Drug Administration (FDA) approval and were available on the market (Geynisman & Wickersham, 2013). Due to the recent increase in the quantity of FDA approved oral therapy regimens for the treatment of cancer, drug choice has transitioned from infused or injectable medications to oral agents. Albeit more convenient for many patients, the preparation of oral chemotherapy regimens is complex and permits for a variety of opportunities for error, largely in part because more responsibility has been shifted to the patient. Therefore, evaluating appropriateness of medication, ordering and routing the prescription, verification of insurance benefits, monitoring and managing side effects, drug-drug interactions, patient education and adherence are fundamental components to oral chemotherapy management and will need to be address to meet growing population and drug options (Zerillo et al., 2015). Although all of these barriers exist, the focus of this project was to evaluate the systemic barriers that providers and staff have to an optimal oral chemotherapy process.

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