title: Identification of risks associated with the prescribing and dispensing of oral anticancer medicines in Ireland.
abstract: BACKGROUND
  Oral anticancer medicines (OAM) facilitate transfer of cancer care into the community, where safeguards developed in hospitals that control their prescribing, dispensing and administration may not exist.
  
  
  OBJECTIVE
  To determine if the systems of prescribing and dispensing OAM in Ireland facilitate clinical verification of the prescription, thereby ensuring treatment is tailored and appropriate for the patient.
  
  
  METHODS
  Randomly selected community pharmacies in Ireland and all Irish hospitals with cancer services.
  
  
  METHODS
  A questionnaire was sent to a random selection of Irish community pharmacists. A different questionnaire was sent to all Irish hospitals treating cancer patients. One hundred OAM prescriptions were retrospectively reviewed, to assess the information presented and the potential barriers to a community pharmacist performing a clinical verification of the prescription.
  
  
  METHODS
  Community pharmacist survey: problems experienced when dispensing OAM and risk factors identified with the current system. Hospital pharmacist survey: proportion of hospitals that clinically verify prescriptions for parenteral versus oral anticancer medicines and associated policies. OAM prescription review: proportion of OAM prescriptions that contained sufficient information for a community pharmacist to clinically verify the prescription and safely dispense the medication.
  
  
  RESULTS
  Sixty-four percent of community pharmacist respondents felt they did not have enough information available to them to safely dispense these prescriptions, and 74 % felt that patients are at risk with the current Irish system of prescribing and dispensing OAM. Irish hospitals do not have systems to ensure that all OAM prescriptions are clinically verified by a pharmacist. Seventeen different agents were prescribed on the prescriptions reviewed. The information provided to the community pharmacist would have allowed them to clinically verify 7 % of the OAM prescriptions.
  
  
  CONCLUSIONS
  Prescriptions for OAM reach the community pharmacist with little chance that they have been clinically verified in the hospital and the medicine reaches the patient with little chance that the community pharmacist has been able to clinically verify it. Healthcare risks are increased when inadequate information about patients and their medicines are available. Appropriate specialist practitioners should be provided nationally to clinically oversee each stage of the OAM use process.
authors.affiliation: Pharmacy Department, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland. l.hammond@st-vincents.ie
authors.forename: Lisa
authors.initials: L
authors.lastname: Hammond
authors.forename: Elaine
authors.initials: E
authors.lastname: Marsden
authors.forename: Niamh
authors.initials: N
authors.lastname: O'Hanlon
authors.forename: Fionnuala
authors.initials: F
authors.lastname: King
authors.forename: Martin Charles
authors.initials: MC
authors.lastname: Henman
authors.forename: Claire
authors.initials: C
authors.lastname: Keane
mesh_terms: D000284:Administration, Oral; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects* / Q000600:supply & distribution; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003157:Community Pharmacy Services; D032882:Comprehension; D004334:Drug Administration Schedule; D004347:Drug Interactions; D011307:Drug Prescriptions; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007494:Ireland; D008508:Medication Errors / Q000517:prevention & control*; D061214:Patient Safety; D010595:Pharmacists; D010607:Pharmacy Service, Hospital; D024382:Professional Role; D011787:Quality of Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014956:Writing
chemical_list: D000970:Antineoplastic Agents