This is a non-randomized prospective pilot intervention study to assess the feasibility of a onetime pharmacist-led video consultation for medication review and patient education among patients initiating an oral anti-cancer drug. In addition, investigator will evaluate reductions in polypharmacy, potential DDIs, and patient self-efficacy by comparing these variables for each patient before and after the video consultation.
In this study, the investigator will be evaluating a 30-minute pharmacist-led video consultation to provide education about patients new oral anti-cancer drug (OACD) and help identify and manage potential drug-drug interactions alongside your oncologist. While OACDs offer both clinical benefits and added convenience when compared to traditional intravenous chemotherapy, they also present a number of potential challenges. One critical challenge involves the increased risk of taking multiple oral medications daily. Patients taking multiple medications can result in harmful effects due to unexpected drug interactions, as well as patient confusion regarding when to take specific medications. Given the relatively recent rise in available OACDs, little is known about the extent of this issue
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
PREVENTION
Masking
NONE
Enrollment
44
During the video visit, a pharmacist will speak with the patient about potential drug-drug interactions between the patient's cancer treatment and the other medications on the list, make recommendations about medication management (which will also be directly communicated to the oncologist), provide education about the patient's new OACD, and answer any questions. The virtual consultation will last about 30 minutes via an electronic device.
Columbia University Medical Center
New York, New York, United States
Proportion of subjects enrolled that complete the 30 minutes consultation and assessments
To determine feasibility of a one-time pharmacist-led video consultation among advanced cancer patients initiating oral anti-cancer drugs. Feasibility will be defined as significant evidence that 50% of enrolled patients will complete all components of the study.
Time frame: 30 minutes
Rate of absorption interaction
Based on the pre-consultation medication reconciliation, we will assess the characteristics (absorption interaction) of medication list inaccuracies identified by medication reconciliation among study participants.
Time frame: Baseline
Average of QTc prolongation
Based on the pre-consultation medication reconciliation, we will assess the characteristics ( QTc prolongation) of medication list inaccuracies identified by medication reconciliation among study participants.
Time frame: Baseline
Mean of medication list inaccuracies among study participants prior to the consultation
Based on the pre-consultation medication reconciliation, we will assess the mean number of medication list inaccuracies identified by medication reconciliation among study participants.
Time frame: Baseline
Change in assess factors associated with OACD-related potential drug-drug interactions and medication inaccuracies
We will assess patient-level factors associated with OACD-related potential DDIs and medication inaccuracies, such as age, race/ethnicity, socioeconomic status, cancer diagnosis, number of medications, and number of comorbidities.
Time frame: Within 30 days of the consultation
Number of medication changes recommended
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The number of medication changes recommended to address polypharmacy and/or DDIs
Time frame: Within 30 days of the consultation
Change in the proportion of patients with a mitigated DDI
The proportion of patients with a mitigated DDI, defined as a change in one involved medication within 30 days of the consultation
Time frame: Within 30 days of the consultation
Change in proportion of patients with a reduction in total number of medications and/or supplements
The proportion of patients with a reduction in total number of medications and/or supplements within 30 days of the consultation
Time frame: Within 30 days of the consultation
Change in Medication Regimen Complexity Index (MRCI) before and after the consultation
The change in medication list complexity using the Medication Regimen Complexity Index (MRCI) within 30 days of the consultation
Time frame: within 30 days of the consultation
Mean Score to Medication Self-Efficacy Scale (MASES) to assess patient confidence and competence regarding OACD administration before and after the consultation
The change in patient confidence and competence regarding OACD administration using a modified version of the Medication Adherence Self-Efficacy Scale (MASES-R) before and after the consultation
Time frame: Within 30 days of the consultation
Change in mean score on the Satisfaction with Information about Medications Scale (SIMS) before and after the consultation
Patient reported outcomes as measured by the Satisfaction with Information about Medications Scale (SIMS)
Time frame: Within 30 days of the consultation
Change in mean score on the Acceptability of Intervention Measure (AIM) before and after the consultation
Patient reported outcomes as measured by the Acceptability of Intervention Measure (AIM)
Time frame: Within 30 days of the consultation
Change in mean score on the Intervention Appropriateness Measure (IAM) before and after the consultation
Patient reported outcomes as measured by the Intervention Appropriateness Measure (IAM)
Time frame: Within 30 days of the consultation
Change in mean score on the Feasibility of Intervention Measure (FIM) before and after the consultation
Patient reported outcomes as measured by the Feasibility of Intervention Measure (FIM)
Time frame: Within 30 days of the consultation