Improving Oral Oncolytic Patient Self-Management

J Oncol Pract. 2016 Sep;12(9):e864-9. doi: 10.1200/JOP.2016.011304. Epub 2016 Aug 16.


Purpose: Managing patients who are taking oral oncolytics is challenging because of the changing paradigm from frequent supervision during intravenous therapy to periodic observation with oral administration of drugs. We joined the Michigan Oncology Quality Consortium (MOQC) Oral Oncolytics Collaborative in 2013 to identify opportunities for improvement in this area.

Methods: We completed MOQC's baseline self-assessment and performed an audit of medical records for 25 patients prescribed an oral oncolytic from May 2011 to July 2013. We implemented the following MOQC resources: a tracking system for patients taking oral oncolytics, patient education with drug-specific self-care guidelines, use of a modified Edmonton Symptom Assessment Scale, and a medication adherence questionnaire to be used on scheduled follow-up calls and return visits. We modified our workflow to include a standard teaching session and consistent follow-up phone calls. We conducted a retrospective postimplementation medical records audit from August 2013 to September 2014.

Results: Baseline self-assessment revealed lack of start date documentation and lack of consistent follow-up. A baseline medical records audit showed that 48% of patients discontinued their medication without consulting their physician, and start date documentation was available for only 52% of patients. After participating in the quality initiative, 100% of patients sampled had a documented start date, and no patients discontinued their drug on their own. Seventeen percent had a dose reduction as a result of toxicity, as directed by the physician.

Conclusion: The introduction of new office procedures to easily identify all patients receiving oral therapy and improvement in patients' ability to manage symptoms at home with the use of self-care guidelines contributed to an improvement in managing patients who are taking oral oncolytics.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Agents / therapeutic use
  • Humans
  • Medication Adherence / statistics & numerical data*
  • Neoplasms / drug therapy*
  • Patient Education as Topic
  • Self Care / statistics & numerical data*


  • Antineoplastic Agents