Cancer therapy is experiencing a shift in drug delivery from systemic chemotherapy to more targeted oral medications. Health systems are developing multidisciplinary teams that collaborate with an oncology clinical pharmacist to provide patient education as well as dispense and perform an extensive review of the use of oral antineoplastic treatments from initiation throughout the duration of treatment. The VA CARES program is one such initiative that provides medication management services to veterans via a telemedicine clinic. The primary goals for the VA CARES program include safety (number and type of pharmacist interventions), cost-savings or cost avoidance, and patient satisfaction.
Veterans are automatically enrolled in the program when they are prescribed oral antineoplastic treatments that are to be dispensed by Veterans Affairs (VA). The program enrolled 108 veterans with 27 cancer types and 35 different oral treatments from 3 VA medical facilities from January 2020 to January 2021. Improved safety, effectiveness, and/or cost benefit resulted from 501 telemedicine visits and 129 interventions. Oncology clinical pharmacist interventions most commonly included detection and/or prevention of drug–drug interactions (n = 57) and adverse events (n = 29), drug not indicated (n = 15), alternative therapy suggested (n = 15), and limited-quantity dispensed (n = 7). Program patient satisfaction surveys indicate veterans were highly satisfied with the services received.
Telemedicine in an oncology setting and pharmacist-led management of medication is achievable and provides clinical and economic benefits with high patient satisfaction. The VA CARES program can serve as a model for remotely delivering highly coordinated care to patients with cancer receiving oral antineoplastic treatments.
Source: Healy R, Passey D, Pinnell D, et al. Veterans on anticancer medications in rural and community environment support (VA CARES) program: a pharmacist-led telemedicine medication management program for veterans receiving oral antineoplastic therapies through the MISSION Act. American Society of Clinical Oncology Virtual Meeting; June 4-8, 2021. Abstract 1545.