title: Impact of oncology pharmacist-managed oral anticancer therapy in patients with chronic myelogenous leukemia.
abstract: BACKGROUND
  Studies have identified non-adherence as one of the major contributing factors to treatment failure in chronic myelogenous leukemia (CML) patients receiving imatinib. Published literature has demonstrated a unique role of oncology pharmacists, as part of a multidisciplinary team, in contributing to overall positive outcomes for patients.
  
  
  OBJECTIVE
  To evaluate the impact of an oncology pharmacist-managed oral anticancer therapy program on oral medication adherence in CML patients versus usual care.
  
  
  METHODS
  Electronic refill history and medical records of patients diagnosed with CML treated with oral tyrosine kinase inhibitors (TKIs) managed by oncology pharmacists during a 6-year period, were retrospectively reviewed. Imatinib adherence rate, as the primary endpoint, was compared with the rate for those in the usual care group within the same organization. The secondary endpoints were descriptive to characterize pharmacist interventions for all TKIs.
  
  
  RESULTS
  A total of 56 patients including 45 who were treated with imatinib, were evaluated. The group managed by oncology pharmacists resulted in a higher percentage of imatinib adherence rate compared to usual care (88.6% vs 65.8%, p = 0.0046). A total of 3432 pharmacist encounters were reviewed, and 567 interventions of six categories including side effect monitoring/management (n = 95; 16.8%); drug interaction detection (n = 109; 19.2%); TKI dose adjustment (n = 82; 14.5%); laboratory monitoring (n = 200; 35.3%); non-CML related drug choice (n = 74; 13.1%); and copay assistance (n = 7; 1.2%), were documented. This resulted in a mean of 10.1 interventions per patient.
  
  
  CONCLUSIONS
  Our oncology pharmacist-managed oral anticancer therapy program significantly improved TKI adherence rates in CML patients. We attribute the success of our program to consistent follow-up by utilizing routine phone, and secure email follow-ups, that allowed our oncology pharmacists to build a close and trustworthy relationship with patients and families.
authors.affiliation: Hematology Oncology Infusion Clinic, Kaiser Permanente Health Plan, Antioch, CA, USA sin.h.lam@kp.org.
authors.forename: Masha Sh
authors.initials: MS
authors.lastname: Lam
authors.affiliation: Hematology Oncology Infusion Clinic, Kaiser Permanente Health Plan, Antioch, CA, USA.
authors.forename: Nathan
authors.initials: N
authors.lastname: Cheung
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000068877:Imatinib Mesylate / Q000008:administration & dosage; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000523:psychology*; D008297:Male; D008495:Medical Oncology / Q000379:methods; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D010595:Pharmacists; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D000068877:Imatinib Mesylate
keywords: Tyrosine kinase inhibitors; chronic myeloid leukemia; oncology pharmacist-managed oral anticancer therapy