title: Survey of oral chemotherapy safety and adherence practices of hospitals in Spain.
abstract: BACKGROUND
  Oral chemotherapy is increasingly used for cancer therapy but, without proper practices, creates safety and adherence issues. However, little is known on safety and adherence practices in wide clinical settings.
  
  
  OBJECTIVE
  To assess the implementation level of safety and adherence practices in oral chemotherapy in Spanish hospitals.
  
  
  METHODS
  All Pharmacy services from prescription, dispensation, patient education and monitoring hospitals that prescribe oral chemotherapy of Spain.
  
  
  METHODS
  Level of safety practices regarding oral chemotherapy prescription, dispensation, patient education and adherence.
  
  
  METHODS
  An 11 multiple-choice-item questionnaire made in consensus with GEDEFO (Spanish Group of Oncology Pharmacists) was sent to all pharmacy services from hospitals that prescribe oral chemotherapy. This questionnaire comprised prescription, dispensation, education and monitoring. We arbitrarily defined three levels of practices: no sufficient specific practices were reported (we termed this as 'level I'); performance of an initial visit with a pharmacist providing written patient educational materials and monitoring adherence (termed as 'level II'); and level II requirements plus electronic chemotherapy ordering system and extra safety practices (termed as 'level III').
  
  
  RESULTS
  Of the 169 targeted health-care settings, 86 (50.9 %) responded to the survey. The majority of responding hospitals were public, general, and teaching hospitals with more than 200 beds. Main discrepancies were in electronic prescription of oral chemotherapy and monitoring adherence. There were 32 hospitals (37.2 %) with level I of safety and adherence practices, 38 hospitals (44.2 %) accomplished level II, 16 (18.6 %) hospitals reached level III. No hospital variables were found to be correlated with each level of safety.
  
  
  CONCLUSIONS
  The majority of responding hospitals have safety and adherences practices for oral chemotherapy. However, the level of these practices varies. There are significant opportunities for improvement, particularly with regard to electronic prescription of oral chemotherapy and monitoring adherence.
authors.affiliation: Department of Pharmacy, Hospital Universitari del Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain, dconde@hospitaldelmar.cat.
authors.forename: David
authors.initials: D
authors.lastname: Conde-Estévez
authors.forename: Esther
authors.initials: E
authors.lastname: Salas
authors.forename: Joan
authors.initials: J
authors.lastname: Albanell
mesh_terms: D000284:Administration, Oral; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D019538:Health Care Surveys; D006761:Hospitals / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D055118:Medication Adherence; D010353:Patient Education as Topic / Q000379:methods / Q000706:statistics & numerical data; D010595:Pharmacists / Q000458:organization & administration* / Q000706:statistics & numerical data; D010607:Pharmacy Service, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data; D013030:Spain; D011795:Surveys and Questionnaires
chemical_list: D000970:Antineoplastic Agents