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Improving the Safety of Oral Chemotherapy at an Academic Medical Center. J Oncol Pract 2016 Jan;12(1):e71-6 PMID: 26733627 PMCID: PMC4960462

Pubmed ID





PURPOSE: Over the last decade, the use of oral chemotherapy (OC) for the treatment of cancer has dramatically increased. Despite their route of administration, OCs pose many of the same risks as intravenous agents. In this quality improvement project, we sought to examine our current process for the prescription of OC at the Abramson Cancer Center of the University of Pennsylvania and to improve on its safety.

METHODS: A multidisciplinary team that included oncologists, advanced-practice providers, and pharmacists was formed to analyze the current state of our OC practice. Using Lean Six Sigma quality improvement tools, we identified a lack of pharmacist review of the OC prescription as an area for improvement. To address these deficiencies, we used our electronic medical system to route OC orders placed by treating providers to an oncology-specific outpatient pharmacist at the Abramson Cancer Center for review.

RESULTS: Over 7 months, 63 orders for OC were placed for 45 individual patients. Of the 63 orders, all were reviewed by pharmacists, and, as a result, 22 interventions were made (35%). Types of interventions included dosage adjustment (one of 22), identification of an interacting drug (nine of 22), and recommendations for additional drug monitoring (12 of 22).

CONCLUSION: OC poses many of the same risks as intravenous chemotherapy and should be prescribed and reviewed with the same oversight. At our institution, involvement of an oncology-trained pharmacist in the review of OC led to meaningful interventions in one third of the orders.

Author List

Shah NN, Casella E, Capozzi D, McGettigan S, Gangadhar TC, Schuchter L, Myers JS


Nirav N. Shah MD Assistant Professor in the Medicine department at Medical College of Wisconsin


2-s2.0-84958581892   4 Citations

MESH terms used to index this publication - Major topics in bold

Academic Medical Centers
Administration, Oral
Antineoplastic Agents
Antineoplastic Combined Chemotherapy Protocols
Drug Prescriptions
Education, Pharmacy
Nurse Practitioners
Quality Improvement
Quality of Health Care
Treatment Outcome
jenkins-FCD Prod-353 9ccd8489072cb19f5b9f808bb23ed672c582f41e