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Traditionally, chemotherapy is carried out in a hospital setting. However, oral chemotherapy is now increasingly being dispensed in the community and taken by patients at home. To improve patient safety and treatment effectiveness, clear, and preferably documented, communication is required between patients, oncologists, general practitioners and pharmacists.

General practitioners can improve the safety of community-based chemotherapy by:

  • Discussing the treatment plan with the patient, pharmacist and oncologist
  • Being aware of all medicines the patient is taking, including over-the-counter or complementary and alternative medicines and assessing the risk of interactions with the chemotherapy regimen
  • Ensuring that the patient has been provided with clear written instructions, including start and stop dates for each chemotherapy cycle
  • Providing support to the patient throughout treatment and regularly monitoring them for adverse effects, particularly those requiring immediate referral to secondary care

Pharmacists need to recognise when they receive a prescription for a cytotoxic medicine, and have additional safety procedures in place, e.g. confirming medicines dispensed match those on the treatment protocol, checking any calculations based on the patient’s body surface area are correct, checking that quantities for chemotherapy cycles are appropriate, and including the start and stop dates for cycles of treatment on prescription labels. Pharmacists should verify at dispensing that patients understand their treatment protocol.

For further information, see: “Improving the safety of community-based chemotherapy”, BPJ 71 (Oct, 2015).