Team medical care for oral anticancer agents induced adverse events

Background: The oral anticancer agents TS-1 and Capecitabine,frequently used to treat cancers such as of the gastrointestinal tract,present medical staff with administering difficulties due to nausea-like adverse events;pharmacokinetic characteristics of slow increase in blood concentration lead to emergence in the latter half of treatment. In forming a multidisciplinary team with strengthened understanding of oral anticancer agent therapy-induced adverse events, we organized a system to either prevent or to promptly respond to any adverse event occurrence.Method: After forming the team, a diary-like investigation sheet (Treatment Diary) was created. The target subjects were patients on 3-week regimen cycles: 2 weeks of daily administering either TS-1 or Capecitabine, followed by 1 week of drug withdrawal. Once the patient-subjects were determined, Oncology Pharmacy Specialists explained how to record entries in the Treatment Diary, and Cancer Chemotherapy Nursing Certified Nurses conducted self-care support counselling. For periodic health consultations, nurses conducted assessments using templates based on STAS-J [Support Team Assessment Schedule -Japanese]. Additionally, our system enables requests for medical fee explanations from Medical Social Workers and for intraoral checks from Dental Hygienists, on a per need basis. Clinical research of these approaches is currently ongoing.Results and considerations: A multidisciplinary system approach interconnects proper use, adverse event-early stage response, and smooth coordination between departments. Oncology Pharmacy Specialists and Certified Nurses jointly assessed costs applicable to “Cancer Patient Guidance Administration Fees”, a new public means for medical fee remuneration established following ministry revisions. Treatment Diary entry-recording by the actual patient, with the involvement of many supporting medical staff, appears to be related to improved treatment adherence. Background: The oral anticancer agents TS-1 and Capecitabine,frequently used to treat cancers such as of the gastrointestinal tract,present medical staff with administering difficulties due to nausea-like adverse events;pharmacokinetic characteristics of slow increase in blood concentration lead to emergence in the latter half of treatment. In forming a multidisciplinary team with strengthened understanding of oral anticancer agent therapy-induced adverse events, we organized a system to either prevent or to promptly respond to any adverse event occurrence. Method: After forming the team, a diary-like investigation sheet (Treatment Diary) was created. The target subjects were patients on 3-week regimen cycles: 2 weeks of daily administering either TS-1 or Capecitabine, followed by 1 week of drug withdrawal. Once the patient-subjects were determined, Oncology Pharmacy Specialists explained how to record entries in the Treatment Diary, and Cancer Chemotherapy Nursing Certified Nurses conducted self-care support counselling. For periodic health consultations, nurses conducted assessments using templates based on STAS-J [Support Team Assessment Schedule -Japanese]. Additionally, our system enables requests for medical fee explanations from Medical Social Workers and for intraoral checks from Dental Hygienists, on a per need basis. Clinical research of these approaches is currently ongoing. Results and considerations: A multidisciplinary system approach interconnects proper use, adverse event-early stage response, and smooth coordination between departments. Oncology Pharmacy Specialists and Certified Nurses jointly assessed costs applicable to “Cancer Patient Guidance Administration Fees”, a new public means for medical fee remuneration established following ministry revisions. Treatment Diary entry-recording by the actual patient, with the involvement of many supporting medical staff, appears to be related to improved treatment adherence.