Is oral chemotherapy prescription safe for patients? A cross-sectional survey

Ann Oncol. 2014 Feb;25(2):500-4. doi: 10.1093/annonc/mdt553. Epub 2014 Jan 9.

Abstract

Background: Oral chemotherapies are increasingly prescribed. Yet wide variations in prescription practices and in monitoring of toxicity have been underlined despite existing guidelines. There is little recent information available as regard to these practices. We aimed to obtain exhaustive information on oral chemotherapy prescription practices and safety monitoring in French hospitals.

Methods: A cross-sectional multicentre survey was carried out to collect information on drug prescription, administration and surveillance: prescribing practices, coordination and monitoring of adherence, safety monitoring and side-effects occurrence prevention. Participants were a large sample of the French oncologists prescribing oral chemotherapy (20%).

Results: One hundred and fifty-seven oncologists from 112 hospitals (public, comprehensive cancer centres and private) replied (23.7% of cancer hospitals). The majority (56.1%) of the prescriptions were hand-written on a blank sheet. Eighty-four physicians (53.5%) included dose information and 36 (23%) declared having no monitoring procedures for adherence. Only 84 responders (54%) provided education material at first prescription of oral chemotherapy in way to limit avoidable side-effects. Sixty-one (39%) responders stated that they recalled at least one serious adverse event in the previous year declared in their centre.

Conclusions: In this 2012 study, the majority of prescribers followed no standards in prescription writing, safety monitoring and toxicity prevention. The implementation of the international recommendations for oral chemotherapy administration should be considered as a top priority-for both prescribers and health authorities-as regards to the dynamic of development of these molecules and their potential side-effects.

Keywords: education of patient; oral chemotherapy; patient adherence; prescription practices; safety monitoring; side-effects prevention.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Cancer Care Facilities
  • Cross-Sectional Studies
  • Drug Prescriptions / standards*
  • Humans
  • Medication Adherence
  • Neoplasms / drug therapy*
  • Patient Education as Topic
  • Practice Patterns, Physicians'
  • Prospective Studies
  • Quality Assurance, Health Care
  • Surveys and Questionnaires

Substances

  • Antineoplastic Agents