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Implications for medication safety and adherence in dermato-oncology: The AMBORA care program for oral antitumor
Lisa Cuba1,2,3,4,5, Frank Dörje1,3,4,6, Rafaela Kramer3,4,7
1Pharmacy Department, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Background And Objectives:
Dermatological oral antitumor therapeutics (OAT) are often interaction-prone and used in complex regimens. The pharmacological/pharmaceutical care program of the randomized AMBORA trial significantly improved medication safety with various OAT; however, dermato-oncological patients were not included. It was subsequently implemented into clinical routine, including dermato-oncology. We aimed to analyze medication errors and adherence in patients treated with any dermatological OAT.
Patients And Methods:
Medication errors were characterized, for example, according to their cause (PCNE V9.1). Adherence was assessed using the Medication Event Monitoring System (MEMS® Button) and the MARS-D questionnaire. Primary outcomes were the percentage of resolved OAT-involving errors and Dosing Adherence (DA); proportion of days with correct OAT intake) over 12 weeks.
Results:
In 92 patients (81.5% melanoma), we detected 1.6 medication errors per patient and 61.6% involved the OAT. Thereof, 89.2% were resolved. Of 52 patients participating in the additional adherence monitoring, 48 were evaluable and reached a median DA of 95.0% and MARS-D score of 25/25. DA was higher in once- vs. twice-daily regimens (p = 0.0127).
Conclusions:
The interprofessional AMBORA care program in dermato-oncology was associated with the resolution of a large proportion of medication errors and high adherence. Evidence-based medication management and patient counseling by clinical pharmacologists/pharmacists optimizes medication safety in dermato-oncological practice.
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