Oral oncolytic education and adherence monitoring in poor, rural and minority patients.

Abstract

e19212 Background: Oral oncolytics therapy use has been exponentially growing over the last several years necessitating education and monitoring. Pharmacy driven interventions have been shown to increase side effects detection, mitigation and ensure adherence. The University of New Mexico Comprehensive Cancer Center (UNMCCC) treats a unique population composed of poor (poverty rate 19.7%), rural (22.6%) and minority (Native Americans and Hispanics constitute 10.4% and 48% of the population respectively). Methods: New patients starting oral oncolytics were enrolled from May 2019 to January 2020 with an initial 30-minute educational visit with a pharmacist. UNMCCC initiated a pharmacy driven process of tracking patients via phone calls to monitor compliance, early presence of adverse events and issues surrounding the administration of oral oncolytics. Phone calls were conducted monthly for three months and then spaced out depending on patient and drug characteristics. Late education occurred when the initial education was performed after the patient started chemotherapy. Late first follow-ups occurred when the follow-up date was greater thirty-eight days after the start of chemotherapy. Results: A total of 196 patients started on oral chemotherapy of which 70% (139) received education following prescription, 17% (35) received late education and 11% (22) missed education. Newly started actively monitored patients significantly increased to 196 patients by the ninth month of the program. A total of 296 follow ups calls were performed within the first three months, 41% (111) were considered late follow-up. The first, second and third call were missed in 18% (49), 14% (40) and 16% (45) of patients. Conclusions: The UNMCCC cares for poor, rural and minority based patients and was able to reach the majority of patients in a timely manner for education and adherence monitoring. Our efforts were significantly hampered by the increasing number of active patients needing monitoring as the program progressed which will require further resources including, a close collaboration between physicians and pharmacists to provide a service that was previously absent and process changes which we are addressing as our next steps.