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Academic literature on the topic 'Oral Oncolytic Medications'
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Journal articles on the topic "Oral Oncolytic Medications"
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Tawfik, Bernard, Harmony Bowles, Zoneddy R. Dayao, Richard C. Lauer, and Janet Abernathy. "Pharmacist-driven oral oncolytic medication education and consent." Journal of Clinical Oncology 37, no. 27_suppl (September 20, 2019): 44. http://dx.doi.org/10.1200/jco.2019.37.27_suppl.44.
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44 Background: The number and type of oral oncolytic therapy in oncology is expanding rapidly. Oral oncolytics have serious side effect potential and patient education has been shown to reduce adverse events. Pharmacist driven interventions have been shown to safety and adherence. The University of New Mexico Comprehensive Cancer Center (UNM CCC) initiated and then improved upon a pharmacist driven patient education and consent process for oral oncolytic therapy. Methods: A pharmacist driven education and consent process was initiated at UNM CCC and monitored from August 2016 to October 2018. The intervention initially used a message generated by an order in the Electronic Medical Record (EMR) to alert the pharmacist of new oral oncolytic prescriptions. Initial uptake by providers was low so education regarding this order was presented to providers. Outpatient pharmacy staff were instructed not to release first fill oral oncolytic prescriptions without notifying the pharmacist educator. Lastly, hematology and oncology fellows notified the pharmacist educator of patients discharged directly from the hospital with a new oncolytic prescription. The metric measured was the percent of patients on oral oncolytic therapy who were educated and consented by the pharmacist for oral oncolytic medications filled at UNM CCC. Statistical analysis included run charts with 95% Confidence Intervals and t-tests with two tails, assuming unequal variation between groups and an alpha of 0.05. Results: The initial monthly education and consent rate was 17.9% followed by 45.5% the following month. This quickly grew to an average of 87.0% (95% CI 55.7-118.2) for the subsequent 15 months which achieved control. Additional changes were made as part of the PDSA cycle which increased the education rate to 95.7% (95% CI 84.4-107.1). These two periods were statistically significantly different (p = 0.0025). Conclusions: A pharmacist driven program for education and consent upon initiation of oral oncolytics is possible and can successfully educate the majority of patients. Future expansions of this program will include ensuring patient adherence and educating patients who fill oral oncolytics outside UNM CCC.
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Patel, Amita, Shannon Woerner, Tina Flocco, Rachel Carroll, and Ellen Shander. "Increasing compliance of an oral oncolytic program in a multi-location practice." Journal of Clinical Oncology 37, no. 27_suppl (September 20, 2019): 267. http://dx.doi.org/10.1200/jco.2019.37.27_suppl.267.
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267 Background: Over the past two decades the rise in number of oral oncolytics has significantly changed the landscape of cancer treatment. Although these medications offer patients the convenience of home administration, they pose different challenges. Two examples are adherence and education of associated toxicities. In an ongoing effort to provide quality cancer care, the Central Jersey Division of Regional Cancer Care Associates (CJD RCCA) has reconstructed its oral oncolytic program. Methods: In 2016 the CJD of RCCA developed an oral oncolytic program to educate patients on how to safely manage their medications. After the provider sent the prescription, a flowsheet is entered into the EMR, triggering the chemotherapy teaching session and appropriate follow up visits. During this visit patients are provided drug specific educational sheets which include lab monitoring, common adverse effects, and calendars to document adherence. Due to failure of entering flowsheets into the EMR, patients lost to scheduling while waiting for medication delivery, or patient refusal of teaching, compliance remained low. The program was modified to include running a daily report to identify all new oral oncolytic prescriptions. Schedulers are immediately calling patients to schedule a teaching session. A field in the EMR was created to document “patient refusal”. By making these improvements, CJD RCCA has increased compliance along with upholding quality care for patients receiving oral oncolytics. Results: Since re-structuring the program the RCCA CJD APNs have performed teaching on 124 of 172 (72%) patients from January to May of 2019. This is compared to only 79 of 144 (54%) in all of 2018. Of the patients identified in 2019 30 refused, 13 were completed by the physician, and 5 expired. This dramatic rise of 18% is largely due to running the daily oral oncolytic reports and entering the flowsheet into the EMR. Conclusions: Patient compliance has increased by identifying new patients and prompt enrollment into the program. It provides them the tools to safely navigate through treatment. At CJD RCCA, the oral oncolytic program is vital to ensuring positive clinical outcomes for these patients.
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Dye, Joseph T., Sharanya Murty, Irene Nsiah, Kenneth Kennedy, Tyler Whisman, and Karen Worley. "Refill patterns with oral oncolytic medications." Journal of Clinical Oncology 34, no. 15_suppl (May 20, 2016): e18216-e18216. http://dx.doi.org/10.1200/jco.2016.34.15_suppl.e18216.
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Mackler, Emily, Eve M. Segal, Benyam Muluneh, Kate Jeffers, and Jenna Carmichael. "2018 Hematology/Oncology Pharmacist Association Best Practices for the Management of Oral Oncolytic Therapy: Pharmacy Practice Standard." Journal of Oncology Practice 15, no. 4 (April 2019): e346-e355. http://dx.doi.org/10.1200/jop.18.00581.
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PURPOSE: The aim of the current work was to present a pharmacy practice standard from the Hematology/Oncology Pharmacy Association (HOPA) on the management of oral oncolytic therapy. METHODS: The HOPA Standards Committee organized a work group of oncology pharmacist specialists to create a pharmacy practice standard for the management of oral oncolytic therapy that describes the pharmacist’s role on the cancer care team, provides examples of practice tools and resources, summarizes current data related to outcomes, and discusses opportunities to enhance the care of patients with cancer who receive oral oncolytic therapy. We reviewed primary literature, including currently published oral oncolytic guidelines and HOPA’s Scope of Hematology/Oncology Pharmacy Practice. RESULTS: Management of oral oncolytic therapy was divided into the following primary areas: prescribing, education, dispensing and distribution, and monitoring and follow-up. Pharmacists’ roles were summarized in each area with a focus on interprofessional collaboration, communication, patient safety, and quality of patient care. Standards describe the best practices in each area ( Table 1 ). CONCLUSION: Multiple opportunities exist for pharmacists to enhance the care of patients with cancer who receive oral oncolytics through collaboration with oncology care team members. The role of the oncology pharmacist in the care of this patient population is critical given the complexities related to cost, tolerability, and safety of oral oncolytic medications; issues of access; and the monitoring and follow-up of patients receiving this therapy.
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Arrowsmith, Edward, Rachel L. Mitchell, Jack L. Taylor, Stephen Matthew Schleicher, Natalie R. Dickson, and Stacey McCullough. "Providing uninterrupted oral oncolytic therapies during the COVID-19 pandemic." Journal of Clinical Oncology 38, no. 29_suppl (October 10, 2020): 226. http://dx.doi.org/10.1200/jco.2020.38.29_suppl.226.
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226 Background: Uninterrupted utilization of oral oncolytics is critical to maximizing safety and efficacy of cancer treatment. The COVID-19 pandemic presented numerous challenges to delivering a continuous and safe supply of oral oncolytics to patients with cancer including potential loss of insurance coverage, patient lost income making copays more difficult, remote pharmacy staffing difficulties, and logistical challenges in safely distributing drug to cancer patients. Tennessee Oncology has an in-house Specialty Pharmacy that utilizes home delivery of oral oncolytics while coordinating care with providers during changing patient situations. Methods: We analyzed patients who received an oral oncolytic from our pharmacy in two periods: January-May 2019 and January-May 2020. We compared the aggregate patient copay amounts during these periods, the number of patients who utilized copay assistance or foundational financial support. For insights on continuation we also assessed the medication possession ratios (MPR, the sum of the day’s supply for all fills of a given drug in a particular period divided by the number of days in that period) during these time periods for five of our most commonly dispensed drugs. Results: The aggregate patient copay was similar between the two time periods. A 22% increase in the utilization of copay cards indicated patient’s insurance coverage was sustained. We also observed a 12% increase in the number of patients utilizing foundation support for prescriptions filled. MPRs for five commonly dispensed oral oncolytics were unchanged during COVID-19. Conclusions: Our in-house specialty pharmacy maintained delivery of oral oncolytics during the COVID-19 pandemic. Patient cost share was contained by our pharmacy staff proactively utilizing copay cards for all eligible patients and diligently securing foundational grant support. The pharmacy interventions allowed for affordability, uninterrupted pharmacy operations, and consistent medication supply. This led to continued medication adherence. MPR for the 5 top dispensed medications was consistent in a year-on-year comparison. [Table: see text]
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Mackler, Emily R., Teresa M. Salgado, Jane Alcyne Severson, Jamie Lindsay, Peter Batra, Laura Petersen, and Karen B. Farris. "Confidence in self-managing side effects from oral oncolytics among a sample of Michigan oncology practices." Journal of Clinical Oncology 34, no. 7_suppl (March 1, 2016): 68. http://dx.doi.org/10.1200/jco.2016.34.7_suppl.68.
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68 Background: The aim of this study was to assess patient confidence to self-manage common side effects of oral oncolytic agents among cancer patients whose providers participated in the Michigan Oncology Quality Consortium (MOQC). Methods: This was a cross-sectional study conducted between August and September 2015, enrolling a convenience sample of 125 patients currently taking oral oncolytics in 10 oncology practices who completed a brief online survey. Demographics, clinical information, health literacy (3 items) and Patient Activation Measure (PAM, 13 items) were assessed. The PAM instrument assesses patient self-reported knowledge, skills and confidence for self-management. Participants were also asked to rate on a scale 0-10 how confident they felt self-managing 3 common oral oncolytic side-effects: fatigue, nausea and diarrhea. Differences by age, gender, education level, health literacy, and PAM level were examined. Results: Respondents were 66.2 (SD, 13.6) years old and 57.7% were female. The mean length of oral oncolytic therapy was 12.9 (SD, 13.8) months and average number of medications was 5.9 (SD, 3.2). Approximately three-quarters of patients assessed had high levels of patient activation (41.5% level 3 and 32.5% level 4), with the remaining 26.0% having low involvement in their care (17.1% level 1 and 8.9% level 2). Confidence to manage fatigue was high for 79% of patients, moderate for 12.1% and low for 8.9%. Confidence to manage nausea and diarrhea was higher with 85.5% and 88.7% patients reporting high confidence, respectively, but 6.5% and 4.8% reporting low confidence to manage these two symptoms. When combining the confidence measures to manage each of the three symptoms, patients with higher health literacy (p = 0.001), higher PAM levels (p = 0.018) and older patients (p = 0.041) exhibited higher confidence at a statistically significant degree. Conclusions: Healthliteracy and PAM were associated with patient confidence to self-manage oral oncolytic side effects. Health literacy screening in clinical practice may be an efficient means to identify patients with low self-management confidence and determine needs of further education and support.
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Murdock, Joshua L., Marissa R. Duco, and David J. Reeves. "Tolerability of Highly Protein Bound Targeted Oral Oncolytic Drugs in Patients With Hypoalbuminemia: A Retrospective Analysis." Annals of Pharmacotherapy 55, no. 2 (July 16, 2020): 165–73. http://dx.doi.org/10.1177/1060028020942485.
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Background: Hypoalbuminemia is commonly observed in cancer patients. Given the pharmacokinetic interactions between serum proteins and protein bound medications, administration of highly protein bound targeted oral oncolytic drugs may result in elevated unbound drug levels and decreased tolerability in those with hypoalbuminemia. Objective: To describe the impact of hypoalbuminemia on oral oncolytic drug tolerability. Methods: A retrospective study was conducted of adult patients receiving treatment with targeted oral oncolytic drugs with ≥95% protein binding. The primary end point of this study was to compare time to discontinuation resulting from documented toxicity in those with and without hypoalbuminemia. Results: The study included 143 patients receiving 16 targeted oral oncolytic drugs (42% with hypoalbuminemia, 58% without hypoalbuminemia). Adverse events were common, with similar incidence among patients with and without hypoalbuminemia (73% vs 76%, respectively; P = 0.727). Median time to therapy discontinuation resulting from documented toxicity was significantly shorter in those with hypoalbuminemia (22 months vs not reached; P = 0.003). Cox regression demonstrated that hypoalbuminemia was the only significant risk factor for shorter time to discontinuation resulting from documented adverse effects (hazard ratio = 3.0; 95% CI = 1.15-8.0; P = 0.025). Conclusion and Relevance: This represents the first report of the impact of hypoalbuminemia on tolerability of highly protein bound oral oncolytic drugs, demonstrating that patients with hypoalbuminemia may be at increased risk for early discontinuation resulting from toxicity. Given the importance of maintaining dose intensity in patients receiving oncolytic therapy, albumin levels should be monitored throughout treatment and supportive care maximized in those developing hypoalbuminemia.
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Feinberg, BA, RA Burruss, V. Arikian, R. Jaster, K. Oleru, and T. Traurig. "Adherence Of Outpatient Cancer Patients To Oral Oncolytic Medications Provided By A Specialty Pharmacy." Value in Health 21 (May 2018): S35. http://dx.doi.org/10.1016/j.jval.2018.04.294.
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Burruss, Royce, Binita Bhusal, Kiona Oleru, Veronica Arikian, Ryan Jaster, Marc Stranz, and Justin Lindhorst. "Adherence of patients to oral oncolytic and neurologic specialty medications provided by a specialty pharmacy." Journal of Drug Assessment 8, sup1 (September 3, 2019): 10–11. http://dx.doi.org/10.1080/21556660.2019.1658288.
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Tapia, Christopher, Ann Andee Wang, Yasin Bhanji, Christopher Campbell, Daniel Larsen, Seema Ganatra, Derick Gross, Regina Michelle Stein, Claudia Tellez, and Shikha Jain. "Barriers in time to initiation of therapy for newly prescribed novel oral oncolytics." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): e18005-e18005. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e18005.
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e18005 Background: Novel oral oncolytics have been incorporated into standard of care for many malignancies. With increasing utility of these medications, accessibility issues have emerged. The purpose of this study is to examine the time-to-therapy initiation of novel oral oncolytics and to identify barriers that result in delays and access issues. Methods: A retrospective review of our electronic data warehouse was performed of adults newly prescribed a novel oral oncolytic for FDA approved indications from 04/01/16 to 12/31/16. Exclusion criteria: traditional chemotherapy or previous treatment with the same agent. Primary outcome: time from date prescribed to date filled. Record of pharmacy transfer, manufacturer assistance, and delays in treatment were also extracted. Kruskall-Wallis and Mann Whitney U tests of association were performed to identify whether pharmacy transfers or manufacturer assistance were associated with delays in time to treatment filled. Fisher’s Exact tests were performed to identify drug or insurance related associations with delays. Results: Of our interim analysis of 92 patients who met inclusion criteria, 9 (9.8%) were insured by Medicaid, 32 (34.8%) by Medicare, 51 (55.0%) by private insurance or other. The median time between date prescribed and date filled was 6 days (range 0-109 days). The most frequently prescribed drug was palbociclib (n = 22, 23.9%). 25 (27.2%) of patients had a pharmacy transfer prior to receiving their drug, 15 (16.3%) patients received manufacturer assistance, and 17 (19%) of patients’ records indicated a delay. Transfers, manufacturer assistance, and delays each had a statistically significant relation with time-to-fill (p < 0.05), though none were significantly associated with drug or insurance type. Time-to-fill was not significantly associated with a particular drug or insurance type. Conclusions: As the landscape of oncology changes, barriers to treatment will be discovered as new novel agents are approved. Our study shows that potential exists to prevent treatment delays and improve access to care. By studying the factors affecting time-to-treatment, quality improvement initiatives can be developed to better streamline the process.
Dissertations / Theses on the topic "Oral Oncolytic Medications"
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Voight, Michael, James Ketterer, and Kyle Kennedy. "Evaluation of a Specialty Pharmacy Counseling Program on Patient Outcomes for Oral Oncolytic Medications." The University of Arizona, 2017. http://hdl.handle.net/10150/624198.
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Class of 2017 AbstractObjectives: Our working hypothesis is that patients who opt in to pharmacist counseling will have a higher medication possession ratio and longer length on therapy than patients who opt out of pharmacist counseling. Methods: Using data extracted from patient’s charts we retrospectively calculated medication possession ratio and length on therapy in relation to the patient receiving or not receiving counseling. Results: The patients analyzed were receiving 8 specific oral oncolytic medications provided by Avella Specialty Pharmacy in 2015. There were no significant differences found in MPR values for any of the 8 oral oncolytic medications included in the study. Iressa (p=0.826), Lonsurf (p=0.392), Stivarga (p=0.838), Zydelig (p=0.633), Zykadia (p=0.077), Tagrisso (p=0.060), Imbruvica (p=0.263) and Tarceva (p=0.326). No statistically significant differences were found in LOT values for any of the 8 oral oncolytic medications included in the study. Iressa (p=0.885), Lonsurf (p=0.868), Stivarga (p=0.326), Zydelig (p=0.502), Zykadia (p=0.212), Tagrisso (p=0.089), Imbruvica (p=0.540), Tarceva (p=0.129). Conclusions: Pharmacist counseling does not appear to affect MPR or LOT for patients taking oral oncolytic medications. Further research is warranted targeting other chronic disease states with complex oral regimens where medication adherence has not already been established from prior therapy options and adequate disease state knowledge.