Department of Pharmacy, Hospital Universitari del Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain,
Int J Clin Pharm. 2013 Dec;35(6):1236-44. doi: 10.1007/s11096-013-9858-9. Epub 2013 Oct 16.
Oral chemotherapy is increasingly used for cancer therapy but, without proper practices, creates safety and adherence issues. However, little is known on safety and adherence practices in wide clinical settings.
To assess the implementation level of safety and adherence practices in oral chemotherapy in Spanish hospitals.
All Pharmacy services from prescription, dispensation, patient education and monitoring hospitals that prescribe oral chemotherapy of Spain.
Level of safety practices regarding oral chemotherapy prescription, dispensation, patient education and adherence.
An 11 multiple-choice-item questionnaire made in consensus with GEDEFO (Spanish Group of Oncology Pharmacists) was sent to all pharmacy services from hospitals that prescribe oral chemotherapy. This questionnaire comprised prescription, dispensation, education and monitoring. We arbitrarily defined three levels of practices: no sufficient specific practices were reported (we termed this as 'level I'); performance of an initial visit with a pharmacist providing written patient educational materials and monitoring adherence (termed as 'level II'); and level II requirements plus electronic chemotherapy ordering system and extra safety practices (termed as 'level III').
Of the 169 targeted health-care settings, 86 (50.9 %) responded to the survey. The majority of responding hospitals were public, general, and teaching hospitals with more than 200 beds. Main discrepancies were in electronic prescription of oral chemotherapy and monitoring adherence. There were 32 hospitals (37.2 %) with level I of safety and adherence practices, 38 hospitals (44.2 %) accomplished level II, 16 (18.6 %) hospitals reached level III. No hospital variables were found to be correlated with each level of safety.
The majority of responding hospitals have safety and adherences practices for oral chemotherapy. However, the level of these practices varies. There are significant opportunities for improvement, particularly with regard to electronic prescription of oral chemotherapy and monitoring adherence.
口服化疗在癌症治疗中应用日益广泛，但如果操作不当，会产生安全性和依从性问题。然而，在广泛的临床环境中，关于安全性和依从性实践的了解甚少。
评估西班牙医院口服化疗安全性和依从性实践的实施水平。
西班牙所有开具口服化疗处方、配药、患者教育和监测的药房服务。
口服化疗处方、配药、患者教育和依从性的安全性实践水平。
与 GEDEFO（西班牙肿瘤药师组）达成共识后，向所有开具口服化疗处方的医院药房服务部门发送了一份包含 11 个多项选择题的问卷。该问卷涵盖处方、配药、教育和监测。我们任意定义了三种实践水平：未报告足够具体的实践（我们称之为“水平 I”）；与药剂师进行初始访问，提供书面患者教育材料并监测依从性（称为“水平 II”）；以及水平 II 要求加上电子化疗医嘱系统和额外的安全实践（称为“水平 III”）。
在 169 个目标医疗保健机构中，有 86 个（50.9%）对调查做出了回应。回应调查的医院多数为公立、综合和教学医院，拥有超过 200 张床位。主要差异在于口服化疗的电子处方和依从性监测。有 32 家（37.2%）医院的安全性和依从性实践处于水平 I，38 家（44.2%）达到水平 II，16 家（18.6%）达到水平 III。未发现医院变量与每个安全级别相关。
大多数回应的医院都有口服化疗的安全性和依从性实践。然而，这些实践的水平存在差异。在电子处方开具和依从性监测方面，仍有很大的改进空间。
