RESUMO
Although there has been a significant increase in the availability and use of oral chemotherapeutic agents, the guidelines around their safe handling are still evolving. Although oral chemotherapy is associated with ease of administration, it has the same exposure risks to health care practitioners, patients, and their caregivers as intravenous formulations, and because it is administered in the home, to the families of patients. However, the general misconception appears to be that exposure risk is low and therefore oral chemotherapeutic agents present little risk and are safer to handle. In a series of three roundtable meetings, a team of international pharmacists from North America and Europe reviewed existing guidelines and identified gaps in recommendations that we believe are important for safe handling. The present article is a compilation of these gaps, especially applicable to manufacturers and distributors, storage and handling, and patient education regarding safe handling. These recommendations, on the basis of our experience and of best practices, provide an international perspective and can be adapted by institutions and practices for development of standardized procedures specific to their needs for the safe handling of oral chemotherapeutic agents.
RESUMO
OBJECTIVE: This study was conducted to define the task allocation in multiprofessional cancer medication management (MCMM) with a special focus on the role of the pharmacist as well as patient education and counseling. The acceptance of the proposed task allocation and the perceptions on multiprofessional teamwork were explored on a national level. METHODS: We held local focus group meetings (University of Bonn with collaboration partners) to identify MCMM tasks. With the Delphi technique the tasks were allocated to physicians, pharmacists and nurses. Professionals (members of the German Cancer Society) were approached nationwide via an online questionnaire to evaluate the acceptance of the MCMM model and explore their perceptions on multiprofessional teamwork. RESULTS: The MCMM model comprised 38 tasks including 11 on patient education and counseling. It was rated to be reasonable (79%) and feasible (68%). Barriers and benefits of multiprofessional teamwork stated were patient-, team-, therapy-, structure-, and resources-related. CONCLUSIONS: The MCMM model integrates the pharmacist with responsibilities in patient education and counseling as well as prevention of drug-related problems. The approach was generally appreciated nationwide by the professions. PRACTICE IMPLICATIONS: The proposed model can serve as a tool to trigger changes in cancer medication management.
