Conference Coverage

Toward Improving the Delivery of Oral Anticancer Drugs in the VA: Work IN PROGRESS

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Purpose: An Innovation Network Spark award was received to develop “My Chemo Calendar,” a tool aimed at providing veterans with easy to understand critical information (eg drug name, schedule, side effects), to optimize the benefits of their oral anticancer drugs (OADs). Using a human-centered design approach, we are first obtaining insight from patients and providers on tools (including “my Chemo Calendar”) and strategies that may improve experiences with OADs.

Background: OADs often have complex dosing schedules, toxicity risk, and special handling precautions. Best tools and practices for ensuring safe and effective care for veterans who are prescribed OADs are not yet well established.

Methods: Surveys, focus groups, and semi-structured interviews are being conducted with patients and providers. Topics included: OAD education and knowledge, medication handling and adherence, and symptom management.

Data Analysis : Descriptive statistics will be used to summarize the survey data. Audio files from focus groups and semi-structured interviews will be transcribed and analyzed using NVivo.

Results: To date, data has been collected from two patients and eighteen oncology care providers. Both patients were ‘very satisfied’ with the information they received to successfully and safely take their OADs. They preferred to receive information from multiple sources (eg physician, internet, hand-outs). The majority of providers reported that they never/rarely/sometimes spoke about digesting an OAD with/without food, necessary diet modifications (e.g. no grapefruit), missed doses, medication storage temperatures, and refills. Most usually spoke about side effects, timing (eg morning), adverse effects, phone number to report side effects, and reporting concerning symptoms. Most were not/slightly/moderately confident that the patients were receiving all the necessary instructions to use the OAD properly. The oncology pharmacist was identified as the most appropriate oncology team member to provide patient education. Although, it was noted that it would be best for patients to receive information at various touch points from different team members. The concept of “My Chemo Calendar” was well received but how best to integrate it into care was unclear.

Implications: Data collection and analysis is still ongoing. This information will be used create and pilot new strategies and tools to improve experiences with OADs.

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