Steven D'Amato Outlines Strategies for Improving Adherence to Oral Oncolytics

Information technology and an integrated clinical team can help improve medication adherence for patients receiving oral oncolytics, said Steven D’Amato, RPh, BSPharm, executive director of New England Cancer Specialists.

How are you using information technology to improve medication adherence?

We need to use some IT to enhance the ability of our clinicians to enhance adherence in the patients receiving oral oncolytics. So, there are many ways we can use information technology to help enhance adherence. With the smartphone technology that we have today, many companies are developing applications that can be used via smartphone that can be integrated in an electronic health record (EHR) in an effort to connect to patients in real time to help educate them about the medications they are receiving and also about when they should receive them. And, also, to report toxicities they may be experiencing while taking oral oncolytics.

So, I believe that smartphone technology and other smart technology will develop over time and give us multiple tools to help our patients learn more about their medications, how important their schedules are, to monitor their toxicity in real time so that clinicians can intervene, prevent unneeded, or excessive toxicities, from developing and make the appropriate dose adjustments or clinical recommendations as needed in real time.

What strategies have you used to improve adherence for oral oncolytics?

To improve adherence, I believe you really need to have an integrated clinical team that works with patients receiving their oral oncolytics therapy. In our practice we have 2 pharmacists and a lead technician that work every day to help educate our patients on the therapies they are receiving. And we’ve incorporated an adherence program into our practice that helps with that. To do that, we’ve integrated some technology into our EHR or we’ve created some fields in our EHR to help drive communication with patients and to ensure that we’re documenting the follow ups that we have with patients in an effort to enhance their adherence to oral therapy.

Where have you seen the biggest challenges and opportunities for improvement in the Oncology Care Model?

We’re an OCM practice and I think one of the challenges that CMS would even acknowledge is how to track oral oncolytics accurately and to reimburse the practices accurately for the oral therapies that they dispense or that another provider may dispense that they’re accountable for.

We have put things into our practice to help track the oral oncolytics and I think that’s a combination of things that we use in our systems. Not only do we use our electronic health record, we also use our practice management system and our dispensing system, in an integrated fashion to track those patients who are on oral oncolytic therapy. With the EHR we’ve really created oral regimens for all of the oral agents, they have regimens built into the EHR where there are multiple triggers. And a lot of this is based on [Quality Oncology Practice Initiative from the American Society of Clinical Oncology] requirements for the delivery of oral oncolytics. But this also ties into OCM requirements and how we track patients on oral oncolytics and how we communicate with them and document the experiences they are having with oral oncolytics. It’s really multi-faceted: we use the EHR, we use our practice management system, and we use our pharmacy dispensing system.