<i>A Pharmacist-Managed</i> Oral Chemotherapy Program

Mancini, Robert; Wilson, Dave

doi:10.1080/10463356.2012.11883635

Cited by 19 publications

(19 citation statements)

References 5 publications

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“…The initial oral cancer therapy agents, methotrexate and mercaptopurine, were approved in 1953 and have been obtainable in the United States for over half a century. 34 To date, the number of oral cancer therapy drugs approved by the Food and Drug Administration has continued to increase, with more than 60 currently approved for use. 35 Given the increasing incidence of cancer, it is expected that more patients will receive oral cancer treatment in the coming decades.…”

Section: Discussionmentioning

confidence: 99%

Geraniin inhibits oral cancer cell migration by suppressing matrix metalloproteinase‐2 activation through the FAK/Src and ERK pathways

Yeh

Hsieh

Yang

et al. 2019

Environmental Toxicology

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Geraniin has been reported to have numerous biological activities, including antiviral, antihypertensive, antihyperglycaemic, liver protective, antidiabetic, and apoptotic activities. However, the anti‐migration effects of geraniin on oral cancer remain elusive. In this study, we revealed the potential antitumor mechanisms of geraniin through the inhibition of the migration and invasion of human oral cancer cell lines SCC‐9 and SCC‐14. The results of gelatin zymography and Western blot assays revealed that geraniin significantly reduced the activity and expression of matrix metalloproteinase‐2 (MMP‐2) of oral cancer cells in a concentration‐dependent manner. Furthermore, geraniin potently suppressed the phosphorylation of focal adhesion kinase (FAK), Src, and extracellular signal‐regulated kinase (ERK)1/2 but did not affect the phosphorylation of p38 mitogen‐activated protein kinase (MAPK) and c‐Jun N‐terminal kinase 1/2. Moreover, blocking the MAPK/ERK1/2 pathway significantly enhanced the anti‐migration ability of geraniin in oral cancer cells. In conclusion, we demonstrated that geraniin inhibits the motility of SCC‐9 and SCC‐14 cells in vitro through a molecular mechanism that involves the attenuation of MMP‐2 expression and activity mediated by decreased FAK/Src and ERK1/2 pathways.

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Section: Discussionmentioning

confidence: 99%

Geraniin inhibits oral cancer cell migration by suppressing matrix metalloproteinase‐2 activation through the FAK/Src and ERK pathways

Yeh

Hsieh

Yang

et al. 2019

Environmental Toxicology

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“…4 This is accomplished by regular adherence checks, toxicity monitoring, and improving patient access to medications. [4][5][6] Other evolving fields such as precision medicine (e.g., pharmacogenomics) may include pharmacists who provide direct patientor population-based care, by individualizing therapy based on tumor genetics. 7 The specific role and core duties of the oncology pharmacist can vary depending upon an institution's or healthcare system's pharmacy practice model, size, and setting (e.g., academic, community).…”

Section: Introductionmentioning

confidence: 99%

Demonstrating the value of the oncology pharmacist within the healthcare team

Segal

Bates

Fleszar

et al. 2019

J Oncol Pharm Pract

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Introduction Although many oncology pharmacists are embedded members within the healthcare team, data documenting their contributions to optimal patient outcomes are growing. The purpose of this paper is to demonstrate the value of the oncology pharmacist within the healthcare team and describe the knowledge, skills, and functions of the oncology pharmacist. Methods A systematic literature review of articles that were published on PubMed between January 1951 and October 2018 was completed. Identified abstracts were reviewed and included if they focused on measuring the value or impact of the oncology pharmacist on provider/patient satisfaction, improvement of medication safety, improvement of quality/clinical care outcomes, economics, and intervention acceptance. Review articles, meta-analysis, and studies not evaluating oncology pharmacist activities were excluded. Studies were thematically coded into four themes (clinical care, patient education, informatics, and cost savings) by 10 oncology pharmacists. Results Four-hundred twenty-two articles were identified, in which 66 articles met inclusion criteria for this review. The selected literature included 27 interventional and 38 descriptive studies. The value of the oncology pharmacist was demonstrated by published articles in four key themes: clinical care, patient education, informatics, and cost savings. Conclusion With an expected shortage of oncology physicians and the ongoing development of complex oncology therapies, the board-certified oncology pharmacist is well suited to serve as a physician extender alongside nurse practitioners and/or physician assistants as the medication expert on the oncology care team. The demonstrated value of the oncology pharmacist supports their role as frontline providers of patient care.

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“…However, any economic impact from the prescription would not be provided to that clinic to help fund these and other services. 9 By implementing IOD, clinic staff are able to provide patients on oral chemotherapy with greater continuity of care as well as the convenience of receiving the medication at a clinic visit.…”

Section: Introductionmentioning

confidence: 99%

“…An article published by Robert Mancini, et al found that more than $200,000 could be saved annually by using IOD of oral chemotherapy at St Luke’s MSTI. 9 However, only medications returned to stock prior to being dispensed to patients were included in this analysis. There are many other interventions that pharmacists at St Luke’s MSTI are involved in that may prevent waste or avoid excess costs to patients and third-party payers.…”

Section: Introductionmentioning

confidence: 99%

Financial impact from in-office dispensing of oral chemotherapy

Howard

Kerr

McLain

et al. 2018

J Oncol Pharm Pract

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Background Oral chemotherapy agents are being prescribed more frequently in many cancer types. In-office dispensing of oral chemotherapy agents has demonstrated clinical benefits and also shown financial benefit to third-party payers. A previous publication estimated over $200,000 in cost savings annually from in-office dispensing solely from medications returned to stock for credit. However, pharmacists in the in-office setting perform many other interventions that may affect financial outcomes. Objective Assess financial impact of oral chemotherapy in-office dispensing by a clinic-based oral chemotherapy program serving five outpatient cancer centers in Southern Idaho. Outcomes include calculated monetary waste and cost avoidance of oral chemotherapy prescriptions from in-office dispensing and mail-order pharmacies. Methods Prescriptions received by the clinic-based oral chemotherapy program for filling through in-office dispensing and mail-order pharmacies were monitored for monetary waste and cost avoidance events from December 2016 through May 2017. Information was collected on the number of returned medications, therapy discontinuations, and dose adjustments. Monetary outcomes were calculated using average wholesale price. Results During the six-month evaluation, prescriptions filled through in-office dispensing had a total cost avoidance of $1,020,193 ( n = 154) and total waste of $154,985 ( n = 36) resulting in an estimated net cost avoidance annually of $1,730,416. Prescriptions filled through mail-order had a total cost avoidance of $20,497 ( n = 4) and a total waste of $80,394 ( n = 15) resulting in an estimated $119,794 net annual waste. Conclusions In-office dispensing of oral chemotherapy provided significant cost savings to third-party payers compared to mail-order pharmacy dispensing. Continued evaluation may help further justify the importance and value of in-office dispensing.

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A Pharmacist-Managed Oral Chemotherapy Program

Cited by 19 publications

References 5 publications

Geraniin inhibits oral cancer cell migration by suppressing matrix metalloproteinase‐2 activation through the FAK/Src and ERK pathways

Geraniin inhibits oral cancer cell migration by suppressing matrix metalloproteinase‐2 activation through the FAK/Src and ERK pathways

Demonstrating the value of the oncology pharmacist within the healthcare team

Financial impact from in-office dispensing of oral chemotherapy

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