title: Outcome Assessments and Cost Avoidance of an Oral Chemotherapy Management Clinic.
abstract: Increasing use of oral chemotherapy drugs increases the challenges for drug and patient management. An oral chemotherapy management clinic was developed to provide patients with oral chemotherapy management, concurrent medication (CM) education, and symptom management services. This evaluation aims to measure the need and effectiveness of this practice model due to scarce published data.
  
  
  
  This is a case series report of all patients referred to the oral chemotherapy management clinic. Data collected included patient demographics, depression scores, CMs, and types of intervention, including detection and management outcomes collected at baseline, 3-day, 7-day, and 3-month follow-ups. Persistence rate was monitored. Secondary analysis assessed potential cost avoidance.
  
  
  
  A total of 86 evaluated patients (32 men and 54 women, mean age of 63.4 years) did not show a high risk for medication nonadherence. The 3 most common cancer diagnoses were rectal, pancreatic, and breast, with capecitabine most prescribed. Patients had an average of 13.7 CMs. A total of 125 interventions (detection and management of adverse drug event detection, compliance, drug interactions, medication error, and symptom management) occurred in 201 visits, with more than 75% of interventions occurring within the first 14 days. A persistence rate was observed in 78% of 41 evaluable patients. The total estimated annual cost avoidance per 1.0 full time employee (FTE) was $125,761.93.
  
  
  
  This evaluation demonstrated the need for additional support for patients receiving oral chemotherapy within standard of care medical service. A comprehensive oral chemotherapy management referral service can optimize patient care delivery via early interventions for adverse drug events, drug interactions, and medication errors up to 3 months after initiation of treatment.
authors.affiliation: Chapman University School of Pharmacy, Orange, California
authors.forename: Siu-Fun
authors.initials: SF
authors.lastname: Wong
authors.affiliation: University of Washington, Pharmaceutical Outcomes Research and Policy Program, Seattle, Washington
authors.forename: Mark
authors.initials: M
authors.lastname: Bounthavong
authors.affiliation: University of California, Irvine Medical Center, Orange, California
authors.forename: Cham P
authors.initials: CP
authors.lastname: Nguyen
authors.affiliation: Veteran Affairs San Diego Healthcare System, San Diego, California
authors.forename: Timothy
authors.initials: T
authors.lastname: Chen
mesh_terms: D000284:Administration, Oral; D000554:Ambulatory Care Facilities / Q000191:economics / Q000706:statistics & numerical data*; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy*; D000069287:Capecitabine / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D017046:Cost Savings / Q000706:statistics & numerical data*; D003365:Costs and Cost Analysis / Q000706:statistics & numerical data; D004347:Drug Interactions; D064420:Drug-Related Side Effects and Adverse Reactions / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000706:statistics & numerical data; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010190:Pancreatic Neoplasms / Q000188:drug therapy*; D005791:Patient Care; D010349:Patient Compliance; D010353:Patient Education as Topic; D012004:Rectal Neoplasms / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents; D000069287:Capecitabine