Oral cancer therapies include cytotoxic agents, targeted and/or biological therapies which are increasingly being used for cancer treatment. Oral cancer therapy carries the same risks in terms of potential for error and toxicities as cancer therapies administered by other routes.
While the oral route of administration is often preferred by patients, the self-administration of oral cancer therapies introduces additional risks of error and also the risk of non-adherence.
Oral cancer therapies are often complex to understand. Patients and/or caregivers may misinterpret instructions and inadvertently take an incorrect dose or continue therapy beyond that prescribed. The intermittent treatment that is characteristic of cancer chemotherapy may be difficult for some patients to understand. Fatal outcomes have been associated with patient misinterpretation of dosage instructions.
Oral cancer therapies may continue for weeks at a time without direct professional supervision and therefore medication, dose or scheduling errors are less likely to be detected.
Oral cancer therapies should be subject to the same standards for prescribing, verification, dispensing and administration as cancer therapies via other routes, with additional safeguards to support safe self-administration by patients and their caregivers in the home setting (Carrington, 2015; Carrington, 2013).
All healthcare professionals involved in prescribing, dispensing and administering oral cancer therapies need to be appropriately trained to assist patients and/or caregivers with issues pertaining to adherence, toxicity management and safety issues in the home setting (NHS National Patient Safety Agency UK, 2008; Taylor et al, 2006; Parsad and Ratain, 2007; Society of Hospital Pharmacists of Australia Committee of Specialty Practice in Cancer Services, 2007; Scottish Executive Health Department, 2005; Halfdanarson and Jatoi, 2010; Moore, 2010).
Online resources such as eviQ (Cancer Institute NSW) are available to assist community pharmacists on safety issues around oral therapy. EviQ education online provides a useful resource on oral antineoplastic therapy (Cancer Institute NSW).
Institutions should consider implementing adequate support and education programs to facilitate patient understanding of how to take medication, when to take medication, what to look out for in terms of potential side effects and when to report problems (Winkeljohn, 2010; Halfdanarson and Jatoi, 2010; Neuss et al, 2017).
(Carrington, 2015) ;(Carrington, 2013) ;(NHS National Patient Safety Agency UK, 2008) ;(Taylor et al, 2006) ;(Parsad and Ratain, 2007) ;(Society of Hospital Pharmacists of Australia Committee of Specialty Practice in Cancer Services, 2007) ;(Scottish Executive Health Department, 2005) ;(Halfdanarson and Jatoi, 2010) ;(Moore, 2010) ;(Cancer Institute NSW, 2016) ;(Winkeljohn, 2010) ;(Neuss et al, 2017)
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