Evaluation of Oncologic Pharmacotherapy and Implementation of a Pharmacist-Managed Monitoring Protocol at a Community-Based Outpatient Clinic

Article Type
Changed
Mon, 09/11/2017 - 14:22
Abstract 51: 2017 AVAHO Meeting

Purpose: The purpose of this evaluation was to assess current lab monitoring and medication adherence in patients on oral oncologic pharmacotherapy at the Milo C. Huempfner CBOC and implement a pharmacist-managed monitoring protocol.

Background: The realm of cancer therapy has changed significantly with the increased availability and use of oral oncologic agents. Oral agents offers patients a convenient, non-invasive option compared with intravenous therapy. In addition, oral agents offers flexibility in timing and location of administration. However, disadvantages of utilizing oral agents include reduced clinical supervision, loss to follow-up, and potentially decreased adherence. Furthermore, oral agents can be associated with significant drug-drug interactions and require lab monitoring to minimize toxicities and treatment lapses. Therefore, regular follow-up of patients on oral agents is crucial. Current practice at the Milo C. Huempfner CBOC does not include a defined monitoring protocol for patients who are on oral oncologic agents.

Methods: A list was generated of all veterans with a current prescription for an oral oncologic agent at the Milo C. Huempfner CBOC between April 2016 to April 2017. Forty-four patients were identified and 29 patients were included. Data was collected via retrospective chart review. Medication adherence and lab monitoring was determined by a refill and labs obtained every 30 days, respectively. Data is being collected to assess the impact of a pharmacist-managed monitoring protocol on medication and lab adherence and pharmacist interventions.

Results: There were 7 agents included in the study, and it was concluded that patients have good medication adherence (97.01%) but poor compliance with lab monitoring (61.92%). Since the implementation of the pharmacist-managed protocol, medication adherence and lab monitoring are 100%. In addition, various interventions have been performed, including but not limited to, dose reductions or withholding therapy secondary to symptoms and/or lab values, elimination of drug-drug interactions, increased blood pressure control, and supplementation for lab abnormalities.

Conclusions: These results illustrate the need for an established lab monitoring protocol for patients on oral oncologic agents and a designated provider to provide routine assessment of labs for appropriateness of therapy and address adherence concerns.

Publications
Topics
Page Number
S35
Sections
Abstract 51: 2017 AVAHO Meeting
Abstract 51: 2017 AVAHO Meeting

Purpose: The purpose of this evaluation was to assess current lab monitoring and medication adherence in patients on oral oncologic pharmacotherapy at the Milo C. Huempfner CBOC and implement a pharmacist-managed monitoring protocol.

Background: The realm of cancer therapy has changed significantly with the increased availability and use of oral oncologic agents. Oral agents offers patients a convenient, non-invasive option compared with intravenous therapy. In addition, oral agents offers flexibility in timing and location of administration. However, disadvantages of utilizing oral agents include reduced clinical supervision, loss to follow-up, and potentially decreased adherence. Furthermore, oral agents can be associated with significant drug-drug interactions and require lab monitoring to minimize toxicities and treatment lapses. Therefore, regular follow-up of patients on oral agents is crucial. Current practice at the Milo C. Huempfner CBOC does not include a defined monitoring protocol for patients who are on oral oncologic agents.

Methods: A list was generated of all veterans with a current prescription for an oral oncologic agent at the Milo C. Huempfner CBOC between April 2016 to April 2017. Forty-four patients were identified and 29 patients were included. Data was collected via retrospective chart review. Medication adherence and lab monitoring was determined by a refill and labs obtained every 30 days, respectively. Data is being collected to assess the impact of a pharmacist-managed monitoring protocol on medication and lab adherence and pharmacist interventions.

Results: There were 7 agents included in the study, and it was concluded that patients have good medication adherence (97.01%) but poor compliance with lab monitoring (61.92%). Since the implementation of the pharmacist-managed protocol, medication adherence and lab monitoring are 100%. In addition, various interventions have been performed, including but not limited to, dose reductions or withholding therapy secondary to symptoms and/or lab values, elimination of drug-drug interactions, increased blood pressure control, and supplementation for lab abnormalities.

Conclusions: These results illustrate the need for an established lab monitoring protocol for patients on oral oncologic agents and a designated provider to provide routine assessment of labs for appropriateness of therapy and address adherence concerns.

Purpose: The purpose of this evaluation was to assess current lab monitoring and medication adherence in patients on oral oncologic pharmacotherapy at the Milo C. Huempfner CBOC and implement a pharmacist-managed monitoring protocol.

Background: The realm of cancer therapy has changed significantly with the increased availability and use of oral oncologic agents. Oral agents offers patients a convenient, non-invasive option compared with intravenous therapy. In addition, oral agents offers flexibility in timing and location of administration. However, disadvantages of utilizing oral agents include reduced clinical supervision, loss to follow-up, and potentially decreased adherence. Furthermore, oral agents can be associated with significant drug-drug interactions and require lab monitoring to minimize toxicities and treatment lapses. Therefore, regular follow-up of patients on oral agents is crucial. Current practice at the Milo C. Huempfner CBOC does not include a defined monitoring protocol for patients who are on oral oncologic agents.

Methods: A list was generated of all veterans with a current prescription for an oral oncologic agent at the Milo C. Huempfner CBOC between April 2016 to April 2017. Forty-four patients were identified and 29 patients were included. Data was collected via retrospective chart review. Medication adherence and lab monitoring was determined by a refill and labs obtained every 30 days, respectively. Data is being collected to assess the impact of a pharmacist-managed monitoring protocol on medication and lab adherence and pharmacist interventions.

Results: There were 7 agents included in the study, and it was concluded that patients have good medication adherence (97.01%) but poor compliance with lab monitoring (61.92%). Since the implementation of the pharmacist-managed protocol, medication adherence and lab monitoring are 100%. In addition, various interventions have been performed, including but not limited to, dose reductions or withholding therapy secondary to symptoms and/or lab values, elimination of drug-drug interactions, increased blood pressure control, and supplementation for lab abnormalities.

Conclusions: These results illustrate the need for an established lab monitoring protocol for patients on oral oncologic agents and a designated provider to provide routine assessment of labs for appropriateness of therapy and address adherence concerns.

Page Number
S35
Page Number
S35
Publications
Publications
Topics
Article Type
Sections
Disallow All Ads
Content Gating
No Gating (article Unlocked/Free)
Alternative CME
Disqus Comments
Default

Modified Technique for Unipolar Allograft Ankle Replacement: Midterm Follow-up. A Case Report

Article Type
Changed
Thu, 09/19/2019 - 13:57
Display Headline
Modified Technique for Unipolar Allograft Ankle Replacement: Midterm Follow-up. A Case Report

Article PDF
Author and Disclosure Information

Albert W. Pearsall IV, MD, Sudhakar G. Madanagopal, MD, and Jesu Jacob, DO

Issue
The American Journal of Orthopedics - 40(4)
Publications
Topics
Page Number
E67-E70
Legacy Keywords
tibiotalar, arthritis, mosiacplasty, ankle, allograft, replacement, Modified Technique for Unipolar Allograft Ankle Replacement: Midterm Follow-up. A Case Report; Pearsall; Madanagopal; Jacob; The American Journal of Orthopedics, AJO
Sections
Author and Disclosure Information

Albert W. Pearsall IV, MD, Sudhakar G. Madanagopal, MD, and Jesu Jacob, DO

Author and Disclosure Information

Albert W. Pearsall IV, MD, Sudhakar G. Madanagopal, MD, and Jesu Jacob, DO

Article PDF
Article PDF

Issue
The American Journal of Orthopedics - 40(4)
Issue
The American Journal of Orthopedics - 40(4)
Page Number
E67-E70
Page Number
E67-E70
Publications
Publications
Topics
Article Type
Display Headline
Modified Technique for Unipolar Allograft Ankle Replacement: Midterm Follow-up. A Case Report
Display Headline
Modified Technique for Unipolar Allograft Ankle Replacement: Midterm Follow-up. A Case Report
Legacy Keywords
tibiotalar, arthritis, mosiacplasty, ankle, allograft, replacement, Modified Technique for Unipolar Allograft Ankle Replacement: Midterm Follow-up. A Case Report; Pearsall; Madanagopal; Jacob; The American Journal of Orthopedics, AJO
Legacy Keywords
tibiotalar, arthritis, mosiacplasty, ankle, allograft, replacement, Modified Technique for Unipolar Allograft Ankle Replacement: Midterm Follow-up. A Case Report; Pearsall; Madanagopal; Jacob; The American Journal of Orthopedics, AJO
Sections
Article Source

PURLs Copyright

Inside the Article

Article PDF Media