Ahmad Noor, Simanovski Vicky, Hertz Sherrie, Klaric Goran, Kaizer Leonard, Krzyzanowska Monika K
Cancer Care Ontario, Toronto, ON, Canada.
Cancer Care Ontario, Toronto, ON, Canada
J Oncol Pharm Pract. 2015 Aug;21(4):249-57. doi: 10.1177/1078155214528830. Epub 2014 Apr 8.
The use of oral chemotherapy agents in cancer treatment is increasing. To better understand issues affecting the optimal use of these agents, Cancer Care Ontario conducted an environmental scan of current practices in Ontario related to prescribing, dispensing, patient education, and supporting regimen adherence.
A series of semi-structured interviews were conducted either by phone (11 regions) or via email (two regions) with Ontario's Regional Cancer Centres over a 3-month period in 2012. A questionnaire was pre-circulated to the regions to guide the discussions.
Responses were received from 13 of 14 regions. Considerable variation in practice was found. Of 13 responding regions, 12 (92%) lacked formal procedures or processes for the prescription of oral chemotherapy. Ten regions (77%) reported using either handwritten prescriptions or a mixture of methods with only three regions routinely using computerized order entry systems for oral chemotherapy prescribing. Oral chemotherapy was reported to be labeled as "chemotherapy" in 46% of the regions. Twenty-three percent indicated that they provide extensive patient education through a multi-disciplinary approach. A number of tools were used to encourage patient adherence in different regions. Patient education was identified as an area where more work could be done.
Results indicate a lack of formal policies and variable practices across all aspects of oral chemotherapy in many regions. However, some regions have developed and implemented successful initiatives. The results from this review are informing provincial priorities and being shared between regions to support collaborative learning.
口服化疗药物在癌症治疗中的使用正在增加。为了更好地理解影响这些药物最佳使用的问题，安大略癌症护理组织对安大略省目前在处方、配药、患者教育以及支持治疗方案依从性方面的做法进行了环境扫描。
2012年，在3个月的时间里，通过电话（11个地区）或电子邮件（2个地区）与安大略省的地区癌症中心进行了一系列半结构化访谈。一份问卷预先分发给各地区以指导讨论。
14个地区中有13个做出了回应。发现做法存在很大差异。在做出回应的13个地区中，12个（92%）缺乏口服化疗处方的正式程序或流程。10个地区（77%）报告使用手写处方或多种方法混合使用，只有3个地区常规使用计算机化医嘱录入系统进行口服化疗处方。据报告，46%的地区将口服化疗标记为“化疗”。23%表示他们通过多学科方法提供广泛的患者教育。不同地区使用了多种工具来鼓励患者依从。患者教育被确定为一个可以开展更多工作的领域。
结果表明，许多地区在口服化疗的各个方面都缺乏正式政策且做法不一。然而，一些地区已经制定并实施了成功的举措。本次审查的结果为省级优先事项提供了信息，并在各地区之间共享以支持协作学习。
