Introduction: The Portland VAMC is a tertiary referral center covering all of Oregon and parts of southern Washington. Many patients have to travel great distances to receive their oncology care. We developed a clinic run by pharmacists and nurse practitioners for patients receiving oral antitumor drugs using telephone calls to evaluate adverse effects (AEs), improve compliance, and decrease costs.
Purpose: To improve patient care relating to AEs and compliance and to decrease costs in patients receiving oral antitumor drugs.
Methods: The clinic sees patients at initiation of an oral agent for treating malignancies to discuss the program and follow-up telephone calls. Drug counseling is offered at this time. Depending on monitoring parameters, routine telephone calls help evaluate AEs and remind patients of upcoming appointments. Refills are also arranged. After physician buy-in for the program was obtained, a template for consulting the clinic was added to the electronic charting system. Note titles and encounter codes were also developed. A shared care management tool is used to remind clinic staff of follow-up needs.
Results: The program is currently piloting 5 drugs–sorafenib, sunitinib, everolimus, dasatinib, and vemurafenib–with plans to expand the list of drugs. During the piloting period, the clinic will examine possible problems and alter the program as needed prior to expansion.
Conclusions: A telephone clinic can potentially improve the quality of care for cancer patients receiving oral antitumor agents.
