title: Safe practices and financial considerations in using oral chemotherapeutic agents.
abstract: OBJECTIVE
  Safe handling practices and financial concerns associated with oral chemotherapy in non-traditional settings are discussed.
  
  
  CONCLUSIONS
  Oral chemotherapy may pose a risk to patients because of a narrow therapeutic index, complex dosing regimen, dispensing by community pharmacists without prescription order review by an oncology pharmacist or nurse, or self-administration in the home or another nontraditional setting, where patient monitoring is infrequent. Errors in prescribing, dispensing, and administration and patient or caregiver misunderstandings are potential problems with the use of oral chemotherapy that need to be addressed when developing safe practices. Changes in Medicare pharmaceutical reimbursement rates and rules need to be monitored because they have the potential to affect patient care and outcomes. Patient assistance programs and advocacy groups can help alleviate financial concerns associated with oral chemotherapy.
  
  
  CONCLUSIONS
  Consensus guidelines specific to safe handling of oral chemotherapy in the home or other nontraditional setting need to be developed. Also, healthcare providers must understand reimbursement and provide direction to patients when patient assistance programs or advocacy groups can assist with the financial challenges of oral chemotherapy.
authors.affiliation: Dana-Farber Cancer Institute, Pharmacy Department, 44 Binney Street, Dana Building, Room DL294, Boston, MA 02115, USA. sylvia_bartel@dfci.harvard.edu
authors.forename: Sylvia B
authors.initials: SB
authors.lastname: Bartel
mesh_terms: D000284:Administration, Oral; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D004345:Drug Industry; D004348:Drug Labeling; D006699:Home Care Services; D006801:Humans; D007356:Insurance, Pharmaceutical Services; D008483:Medical Assistance; D008508:Medication Errors; D009369:Neoplasms / Q000188:drug therapy*; D016273:Occupational Exposure / Q000517:prevention & control; D010353:Patient Education as Topic; D012449:Safety; D012646:Self Administration / Q000009:adverse effects / Q000191:economics
chemical_list: D000970:Antineoplastic Agents