HSPAL Resident M Health Fairview Minneapolis, Minnesota, United States
Poster Abstract: Oral chemotherapy (OC) medications are becoming a mainstay of treatment regimens for patients with cancer. With almost half of all FDA approved oncolytic and hematologic medications approved in the past 10 years being oral, the shift to oral oncology treatments will continue to happen. Digital health devices are a new way of providing care at the discretion of the patient while maintaining the clinical outcomes sought after by providers. Limited studies have been done to look at monitoring patients on oral oncolytic medications, and the studies that have been done are using only telephonic methods of monitoring.
At our clinic, we have a pharmacist OC monitoring team that collaborates with providers and nurses to monitor all patients that take an OC medication. The increasing complexity of medications/treatment plans and the growing population of patients on OC meds has led to various improvement and opportunities. The OC monitoring team currently completes a variety of assessments when monitoring patients but the time to complete these tasks can fluctuate and creates a variety of inefficiencies for pharmacists. During May-August 2022, a time trial was completed to locate our inefficient tasks.
In early 2022, talks began with Dosentrx regarding the use of their ReX device in our OC patient population. The ReX device stores the medication and dispenses the pill in the mouth of the patient. The ReX device asks scheduled questionnaires that have been designed by the OC monitoring team to assess common adverse effects and any serious side effects prior to the patient taking their scheduled dose. If the patient reports severe adverse effects or serious side effects, the pharmacy team will be notified immediately, and the pharmacist can complete a targeted assessment. The ability for the pharmacist to complete a targeted assessment will eliminate most tasks from the OC pharmacists. The OC pharmacist will record time spent monitoring patients and will be compared to our previous time trial. Any medication could be chosen but for the purpose of this study and we chose acalabrutinib (Calquence) because of our small patient population and that it is less burdensome to manage compared to other oral chemotherapy medications. Patients will only be offered the device after they have been prescribed Calquence and referred to the OC monitoring team to follow. We hope to empower our patients and the care that they receive from us while improving the efficiency and workflows of our pharmacy
References (must also be included in final poster): 1. Jacobs JM, et. al. Patient Experiences With Oral Chemotherapy: Adherence, Symptoms, and Quality of Life. J Natl Compr Canc Netw. 2019 Mar 1;17(3):221-228. doi: 10.6004/jnccn.2018.7098. https://ascopubs.org/doi/10.1200/OP.20.01108
2. Ajewole VB, et. al. Cancer Disparities and Black American Representation in Clinical Trials Leading to the Approval of Oral Chemotherapy Drugs in the United States Between 2009 and 2019. JCO Oncol Pract. 2021 May;17(5):e623-e628. doi: 10.1200/OP.20.01108. Erratum in: JCO Oncol Pract. 2021 Jul;17(7):459.
3. US Food and Drug Administration: Hematology/Oncology (Cancer) Approvals & Safety Notifications. https://www.fda.gov/drugs/resources-information-approved-drugs/hematologyoncology-cancer-approvals-safety-notifications
4. Trenfield SJ, et. al. Advancing pharmacy and healthcare with virtual digital technologies. Adv Drug Deliv Rev. 2022 Mar;182:114098. doi: 10.1016/j.addr.2021.114098. Epub 2022 Jan 5.https://www.mdpi.com/2226-4787/8/3/137
5. Crilly P, Kayyali R. A Systematic Review of Randomized Controlled Trials of Telehealth and Digital Technology Use by Community Pharmacists to Improve Public Health. Pharmacy (Basel). 2020 Aug 4;8(3):137. doi: 10.3390/pharmacy8030137.https://www.mdpi.com/1660-4601/19/1/532#B23-ijerph-19-00532
6. Parikh RB, et. al. Digital Health Applications in Oncology: An Opportunity to Seize. J Natl Cancer Inst. 2022 Oct 6;114(10):1338-1339. doi: 10.1093/jnci/djac108.
7. Park T, Muzumdar J, Kim H. Digital Health Interventions by Clinical Pharmacists: A Systematic Review. Int J Environ Res Public Health. 2022 Jan 4;19(1):532. doi: 10.3390/ijerph19010532.
