An Automated System for Detecting Nonadherence in Laboratory Testing and Monitoring for Myelosuppression in Patients Receiving Self-Administered Oral Chemotherapy

Morrell, Robert; Tooze, Janet A.; Harmon, Michele; Carter, Annette F.; DeTroye, Alisha; Lesser, Glenn J.

doi:10.1200/jop.2012.000834

Cited by 8 publications

(9 citation statements)

References 10 publications

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“…There is currently no established standard of practice for oral chemotherapy in the United States; however, some countries have implemented measures to manage oral chemotherapy. [4][5][6] For example, the National Patient Safety Agency in the United Kingdom issued a Rapid Response Report in 2008, recommending that the prescribing, dispensing, and administration of oral chemotherapy be implemented and monitored by the same standards as intravenous chemotherapy. 7 In 2010, the Quality Oncology Practice Initiative Quality Certification Program, established by the American Society of Clinical Oncology, was implemented in the United States to standardize cancer care.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the prescribing patterns, adverse effects, and drug interactions of oral chemotherapy agents in an outpatient cancer center

Solomon

Ajewole

Schneider

et al. 2018

J Oncol Pharm Pract

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Purpose Although oral chemotherapy offers advantages over intravenous chemotherapy, it creates a unique set of challenges. Potential barriers include treatment complexity, patient responsibility for medication adherence and monitoring, reduced healthcare contact, and increased financial burden. The purpose of this study is to estimate the prevalence of drug-related problems among a sample of patients treated with oral chemotherapy agents. Methods A single-center, retrospective chart review was conducted on patients prescribed oral chemotherapy at our institution between 1 January 2017 and 31 August 2017. The primary endpoint was the incidence of drug-related toxicities within 90 days of starting treatment. Secondary endpoints included incidence of drug-drug interactions, proportion of patients receiving medication education by a clinical pharmacist, and quantification of issues related to medication access. Results Charts of 100 patients were reviewed. Median time to oral chemotherapy receipt by the patient from the day the order was written was eight days. Prior to initiating therapy, 27% of patients received education by a clinical pharmacist. Toxicity checks were conducted by the provider at 30, 60, and 90 days for 80%, 65%, and 48% of patients, respectively. Treatment-related toxicities secondary to oral chemotherapy were reported by 79% of patients, with 55% classified as severe. Potential drug interactions were in 55% of the patients. Conclusion Data from this study have highlighted avenues for pharmacists to make an impact on patients newly started on oral chemotherapy. Opportunities exist to increase patient education, ensure appropriate follow-up, and assess adherence while preventing and managing treatment-related toxicities.

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Section: Introductionmentioning

confidence: 99%

Evaluation of the prescribing patterns, adverse effects, and drug interactions of oral chemotherapy agents in an outpatient cancer center

Solomon

Ajewole

Schneider

et al. 2018

J Oncol Pharm Pract

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show abstract

“…However, these studies have been limited to individual disease groups and specific drugs, describing an unclear treatment plan in 37%, 36 nonadherence in 22% to 23%, 36,37 and a gap in monitoring in 29%. 38 Further studies are clearly needed that correlate achievement on process measures and standards to outcome measures to ensure that any observed improvement is not just an improvement in documentation or processes, but translates to improved patient care. 12 There are opportunities not only to improve on existing QOPI measures but also to develop new QOPI measures and standards to more comprehensively capture existing ASCO/ ONS standards.…”

Section: Discussionmentioning

confidence: 99%

Administration of Oral Chemotherapy: Results From Three Rounds of the Quality Oncology Practice Initiative

Zerillo

Pham

Kadlubek

et al. 2015

JOP

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“…1 However, these agents also have destructive effects on normal rapidly proliferating cells such as blood cells, stomach cells, and especially hematopoietic stem cells (HSCs) while destroying cancer cells. 2 Cyclophosphamide (CTX) is the most widely used medicine with a high therapeutic index in chemotherapy. CTX can act against a variety of cancers by damaging intracellular DNA molecules directly, 3 affecting cell division and inducing apoptosis of HSC.…”

Section: ■ Introductionmentioning

confidence: 99%

“…Chemotherapy is the most widely used treatment for cancer since chemotherapeutic agents can act on the abnormally active cancer cells throughout the whole body . However, these agents also have destructive effects on normal rapidly proliferating cells such as blood cells, stomach cells, and especially hematopoietic stem cells (HSCs) while destroying cancer cells . Cyclophosphamide (CTX) is the most widely used medicine with a high therapeutic index in chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

Study of the Effects and Mechanisms of Ginsenoside Compound K on Myelosuppression

Han

Wang

Cai

et al. 2019

J. Agric. Food Chem.

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Ginsenoside compound K (CK) is not a ginsenoside that naturally exists in Panax ginseng Meyer. However, CK is a major metabolite of ginsenoside Rb1, Rb2, or Rc in the intestine under the effects of bacteria. In this study, we first investigated the effects of CK on myelosuppression in mice induced by cyclophosphamide (CTX). The respective quantities of white blood cells, blood platelets, and bone marrow nucleated cells (BMNCs) were determined to be 8.54 ± 0.91 (109/L), 850.90 ± 44.11 (109/L), and 1.45 ± 0.22 (109/L) in the CK-H group by detecting peripheral blood cells and BMNCs. CK-H and CK-L both increased the thymus index by up to 0.62 ± 0.06 (mg/g) and 0.52 ± 0.09 (mg/g), respectively, and significantly increased the yields of colony formation units-granulocyte monocyte and colony formation units-megakaryocytic. According to our study, CK could control apoptosis and promote cells to enter the normal cell cycle by the bcl-2/bax signaling pathway and MEK/ERK signaling pathway. Therefore, the BMNCs could proliferate and differentiate normally after entering the normal cell cycle. So the peripheral blood cells could show a trend of returning to normal. The recovery of peripheral blood cells resulting in the level of cytokines tended to normal. This process may be the mechanisms of CK on myelosuppression. This study provides a reference for ginseng in the treatment of myelosuppression.

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An Automated System for Detecting Nonadherence in Laboratory Testing and Monitoring for Myelosuppression in Patients Receiving Self-Administered Oral Chemotherapy

Abstract: Introduction: Patient compliance with routine monitoring for

Cited by 8 publications

References 10 publications

Evaluation of the prescribing patterns, adverse effects, and drug interactions of oral chemotherapy agents in an outpatient cancer center

Evaluation of the prescribing patterns, adverse effects, and drug interactions of oral chemotherapy agents in an outpatient cancer center

Administration of Oral Chemotherapy: Results From Three Rounds of the Quality Oncology Practice Initiative

Study of the Effects and Mechanisms of Ginsenoside Compound K on Myelosuppression

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