Standardizing the expression and nomenclature of cancer treatment regimens

Abstract

Guidelines for describing cancer chemotherapy regi mens in all aspects of drug development, including treatment protocols, order forms, and product labels, are proposed. To complement the approaches to reducing medication errors that have been recommended by the American Society of Health-System Pharmacists and others, pharmacists at the National Institutes of Health and the National Cancer Institute, with the input of oncology pharmacists from diverse areas of practice, developed guidelines for expressing chemo therapy dosage schedules and treatment regimens. The guidelines present standards that are broadly applicable and can be adopted by other institutions. Clear and unambiguous expression of all medication orders and consistency of treatment descriptions are suggested. Written treatment plans and orders should contain enough information to allow health care providers from diverse disciplines to compare them with published treatment descriptions and investiga tional protocols and must therefore include planned dosages and schedules expressed in patient-specific units. In general, drug dosages should be expressed as the amount of drug administered from a single con tainer. When ordering drugs that are part of complex or combination-drug regimens, prescribers should write as many of the orders at one time as is possible so that continuity might be preserved. Standard rules are proposed for describing che motherapy regimens.

ASHP Guidelines on Preventing Medication Errors with Chemotherapy and Biotherapy

“…Medication orders should specify the drug dosage and calculated dose according to the "container rule" (i.e., the specified and calculated dose is the amount prepared in and administered from a single container). 20 …”

“…Providers should recognize that medication-order verification and other system safeguards ensure patients' safety. 11,20,37 Lack of information about patients and their medications has been described as the most frequent cause of medication errors. 24,39 In order to independently verify prescribers' orders for medications, all persons who prepare and administer chemotherapy medications and those who monitor patients who have received chemotherapies should also have access to complete, up-to-date copies of treatment protocols and patient-specific data, including home medication lists.…”

“…11,20,21 For investigational chemotherapy treatments, standardized forms should also include the study name, protocol number, and patient-specific study number, as applicable. Colorcoded forms, for example, may be used to designate different types of treatment, such as commercially marketed chemotherapy and investigational medications.…”

Ten Simple Strategies to Prevent Chemotherapy Errors

“…Safety measures advocated by the authors of these articles included using preprinted chemotherapy order forms, systematically calculating and verifying doses, establishing dosage limits, eliminating the use of trailing zeros in doses (e.g., 2.0 mg), standardizing the prescribing vocabulary, requiring nurse certifi cation in chemotherapy administration, and improving communication (Cohen et al, 1996;Fischer, Alfano, Knobf, Donovan, & Beaulieu, 1996;Kohler et al, 1998;Olsen, 1997;Schulmeister, 1997Schulmeister, , 1999a.…”

What's in a Name? Lack of Pronunciation in Consumer Medicine Information

“…Much of the focus has been on standardising the prescribing, preparation, and handling of these drugs. 1,2 While the education, competency and credentialing of health professionals is essential, the education of patients is of equal importance. Well-informed patients are a vital link in the safety chain to prevent errors related to antineoplastic drugs.…”