Improving oral chemotherapy adverse event reporting: Listening to pediatric oncology patients and parents.

Abstract

45 Background: Medication-related adverse events and near misses are underreported, particularly in the ambulatory setting. Our aim was to assess pediatric oncology parent and patient-reported oral chemotherapy errors and near misses. Methods: A survey of parent and patient-reported oral chemotherapy errors and near misses over the past month was developed and validated in a subgroup and administered to parents/patients at an academic pediatric hematology-oncology clinic. Parents and patients were included if the patient received any commercially available oral chemotherapy agent within the past month, dispensed by an onsite retail pharmacy, and agreed to participate. Results: Forty-eight of 69 parents and 11 of 17 patients responded (ten from the same household). Fifteen of 59 respondents (25%) reported at least one event, miss, or error (twelve (25%) parents and three (27%) patients). Of five events described by parents and patients of the same household, one was co-reported. Of the errors that occurred in the home, the most common were missed (n=5, 8%) and late (n=3, 5%) doses. Forty-six percent of respondents did not report events to the medical team. Two respondents perceived minor harm as a result of the event. Conclusions: Patients and parents are willing to share information about oral chemotherapy-related adverse events and near misses. Twenty-five percent of respondents noted an oral chemotherapy event, near miss, or error over the preceding month. Importantly, many of these events were unreported to care teams. Missed doses were the most common safety event, and interventions should target this need.[Table: see text]