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Feasibility of personalising dispensing quantities to prevent waste of oral anticancer drugs

  • At: PPR 2022 (2022)
  • Type: Poster
  • By: SMALE, Elisabeth Marissa (Lisa-Marie) (Radboudumc)
  • Co-author(s): Elisabeth Marissa (Lisa-Marie) Smale, PhD Candidate, Radboud university medical center, Radboud Institute for Health Sciences, Department of Pharmacy, Netherlands
    J van Vlijmen, Pharmacist, Radboud university medical center, Radboud Institute for Molecular Life Sciences, Department of Pulmonary Diseases, Netherlands
    Hadewig Colen, Hospital pharmacist, Radboud university medical center, Radboud Institute for Health Sciences, Department of Medical Oncology, Netherlands
    Michel van den Heuvel, Professor, Sint Maartenskliniek, Department of Pharmacy, Netherlands
    Ingrid Desar, Medical Oncologist
    Bart van den Bemt, Professor
    Charlotte Bekker, Senior Researcher
  • Abstract:

    BACKGROUND
    Personalising oral anticancer drug (OAD) quantities dispensed to patients could prevent medication waste, avoiding its economic loss and contributing to sustainability.

    AIM
    Evaluating feasibility of a personalised dispensing program to prevent OAD waste.

    METHODS
    Personalising dispensing quantities was implemented as standard care for adult patients starting OAD treatment at Radboudumc. Fifty patients were followed for six months in a feasibility study conform Bowen's framework between December 2021 and December 2022. A) Demand was determined by frequency and economic value of OAD waste. B) Implementation was measured by reach (percentage eligible patients included) and protocol fidelity (percentage dispensings that followed protocol). C) Acceptability was assessed with a survey among patients and pharmacy technicians requesting satisfaction rate on a scale of 0 - 10 and agreement with Theoretical Framework Acceptability domains on a 5-point Likert scale. D) Practicality was based on costs for additional activities. E) Effect was determined by waste reduction and net cost-savings versus standard care (one-month and one package supply). Descriptive statistics were used.

    RESULTS
    Participants’ median age was 67 (IQR 58-71) years and 76% was male. Reach and protocol fidelity were respectively 89% and 91%. Satisfaction was high: patients scored on average 9 out of 10 (SD±1), and pharmacy technicians 7 out of 10 (SD±2). All acceptability domains were agreed on (median ranking ≥4). Total program costs were €4,036 related to patient counselling, additional dispensings and home delivery services. OAD waste was reduced by 24% - 35%, corresponding to net cost-savings between €5,133 and €11,053 when compared with one-month and one package supply.

    CONCLUSION
    Personalised dispensing appears feasible for preventing waste of OADs in terms of demand, implementation, acceptability, practicality and effect.

Last update 4 October 2019

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