Usage Patterns of Oral Anticancer Medications in New South Wales: A Single-site Pilot

Authors

  • Bridgette Mackley Pharmacist
  • Claire Park
  • Glykeria Stavropoulou
  • Semun Galimam
  • Therése Kairuz

DOI:

https://doi.org/10.55136/apsj126

Keywords:

undergraduate research, pharmacy research, student-led journal, pharmacy, peer-reviewed , cancer, chemotheraphy, anticancer, oncology

Abstract

Background: Risk associated with oral anticancer medications (OAMs) is comparable to intravenous chemotherapy. Dosing is complex and usage patterns should be evaluated. OAMs for outpatients under the care of physicians at a hospital in New South Wales were dispensed from community pharmacies; only small quantities were supplied from the hospital.

Aim: To investigate the frequency of prescribing of OAMs in the outpatient setting at a teaching hospital.
Method: Five-years of data containing OAMs were extracted from a hospital database of prescriber notes using a customised search function. Cleaned records from a subset (01/01/2018 – 31/05/2018) were analysed for initiation of use. Cleaning identified ‘true positives’ (medications to initiate treatment) and ‘false positives’ (medications mentioned but not initiated). Of the 1,271 records, 629 were duplicates, 266 were ‘false positives’ and 376 were ‘true positives’. The proportion of ‘true positives’ (0.58; n=376/(376+266)) was applied to all records in the full dataset to estimate the OAMs prescribed over the five-year period.

Results: In the cleaned subset, 38 OAMs were prescribed in 376 records to 341 patients. Capecitabine, lenalidomide, cyclophosphamide and imatinib comprised 40% of OAMs. Most patients (77.7%) were aged >60 years. The estimated number of OAM records in the full dataset showed a linear increase over the five-year period.
Conclusion: The use of high-risk OAMs in the subset accounted for nearly half of the medications, and findings suggest an increase in the number of patients prescribed oral anticancer therapy at this hospital. There was an increasing trend in use of OAMs over the five-year period. Further research is required into quality care for cancer outpatients and the impact of policy on service delivery.

Keywords: Oral; Chemotherapy; Anticancer; Pharmacist; Australia

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Published

01.07.2022

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