In this era of polypharmacy—where individuals with multiple conditions take multiple medications—the route to safer, more effective care may lie with how a patient answers this question: What are you taking and how are you taking it?
As one New York area hospital found, this was especially true with outpatients at its cancer care clinic where the rising use of oral anti-cancer drugs could lead to more life-threatening complications related to drug interactions or incorrect use.
The idea of reviewing a patient's medications—finding out what they are using, when they are using them, and how they are using them—of course, is not new. The "brown bag" patient safety campaign, which has been around for years, encourages patients to bring their medications and other medical products to check-ups or pharmacy visits so providers can review their dosage and use.
But as times change, treatments and medications are changing as well. What once may have seemed like "a good idea" may be evolving into something that is a critical aspect of a patient's care. This is what sparked an initiative for outpatients at the Montefiore-Einstein Center for Cancer Care.
"Many of our patients have other co-morbid conditions such as diabetes or a heart condition," says Pragna Patel, PharmD, RPh, who is an oncology investigational pharmacy manager at Montefiore. She, along with Una Hopkins, BSN, MSN, FNP BC, a nurse practitioner with the medical oncology department at Montefiore, created the Medication Therapy Management program.
Their goal was to help cancer patients safely take their oral chemotherapy—along with other prescription medications they need for other conditions—to help avoid what could be adverse interactions or life threatening errors. The idea was to create a personalized plan to support safe and effective use and storage of their prescriptions.
The goal is to assist patients to get a better understanding of their medications—including prescribed and over the counter, along with vitamins or herbal supplements they use, according to Patel.
During their treatment, the cancer center patients are referred to the Medication Therapy Management program by the physicians and nurses for a visit with both Patel and Hopkins. During a 30- to 45-minute session, the clinical team discusses possible side effects associated with the potent anti-cancer drugs. They also will look at possible allergies or adverse reactions the patients may experience or possible drug drug or drug food interactions.