Prescribing and safety issues of oral molecular therapies and chemotherapies in Australian haematology oncology practice.

Abstract

6149 Background: There is increasing use of oral therapies for the treatment of cancer, and although oral treatments have many benefits, the extent to which safe prescribing practices are employed is unknown. The aim was to determine the prescribing practices of oncologists and haematologists regarding oral molecular and chemotherapy medications across various practice settings in Australia. Methods: Ethics approval was obtained. A 19-question survey was developed, based, with permission, on that of Weingart et al (BMJ 2007); examining aspects of prescribing and supply of oral chemotherapy and molecular therapies. The survey was distributed electronically to all 203 medical oncologist and haematologist members of Medical Oncology Group of Australia (MOGA) and/or Clinical Oncology Society of Australia (COSA) in April 2008. Results: 84 surveys were returned (41% response rate). Ninety percent of respondents agreed that oral molecular medications should be prescribed and supplied using the same procedures as oral chemotherapy. 21%-45% of prescribers state that they prescribe the exact number of tablets/capsules required for each cycle for commonly used oral chemotherapies (capecitabine, temozolomide, vinorelbine, etoposide) and molecular therapies (gefitinib, imatinib, sunitinib, erlotinib). One third of respondents stated that they always assess a patient's adherence to oral chemotherapy and molecular therapies. In the past year, 43% of prescribers reported at least one medication error relating to oral chemotherapy and 15% relating to oral molecular therapies in the ambulatory setting. The vast majority of prescribers treating patients in the public setting have oral chemotherapy and molecular therapy prescriptions checked by an oncology pharmacist. Significantly fewer of these prescriptions are checked by an oncology pharmacist in private practice. Conclusions: There is significant variability in the prescribing of oral chemotherapy and molecular therapies among oncologist/haematologists which could contribute to potential for error. No significant financial relationships to disclose.