Background: The availability and use of oral oncolytic agents to treat malignancy is increasing. The use of oral agents to treat cancer introduces new complexities with regard to patient compliance, toxicity management, and cost containment. Veterans Affairs (VA) oncology clinics are uniquely equipped to manage oral chemotherapy processes because of direct access to health care records, pharmacy dispensing information, and oncology providers. A recent evaluation of a 14-day oral chemotherapy dispensing protocol at 1 VA facility demonstrated that patients had increased medication possession ratios and decreased cost associated with their care when compared to standard 30-day dispensing practices.
Methods: The Iowa City VA Health Care System Oncology Clinic (IC VAHCS) has developed a process to aid in tracking dispensed prescriptions, scheduling followup telephone calls, evaluating laboratory monitoring, and identification of future oncology appointments. A pharmacist has developed the ability to extract administrative from the VA Corporate Data Warehouse (CDW) for clinic operational use to support local processes. The management of oral oncolytic therapy is spearheaded by the local oncology clinical pharmacy specialist, in collaboration with oncologists and oncology nurse case managers.
The current practice at the IC VAHCS will be detailed to aid other VA oncology clinics in developing similar processes at their local site.
