Introduction: Oral anti-cancer therapies (OACT) are increasingly emerging as a mainstream modality in delivering anti-cancer regimens. This transition could impact the dynamics of clinical pharmacy service delivery by shifting education and monitoring responsibilities to pharmacists. The extent to which pharmacists in cancer care centres are able to fulfil such responsibilities remains undetermined.

Aim: To explore the management of OACT and assess whether a more universal dispensing and monitoring guideline is needed to optimise patient care.
Method: Face to face, multiple-choice surveys were conducted with pharmacists at cancer care centres in northern Sydney and the Central Coast. The questions addressed 4 key areas; the extent of adherence to guidelines, the impact of the availability of necessary resources and/or skilled staff, the variances in management between cytotoxic and non-cytotoxic OACT and pharmacists’ opinions on current practice.

Results: Pharmacists from seven cancer care centres took part in the survey; three were affiliated with public hospitals and four were private. The consistency of clinical service varied depending on clinic size and designated pharmacy staffing, with 80% of centres dispensing, on average, 50-100 OACT per month. All pharmacists interviewed acknowledged that patients on OACT should be as vigorously monitored as those receiving parenteral therapy. Merely 29% of centres reported following a dispensing guideline for OACT and only 43% were routinely fulfilling all monitoring criteria, for both cytotoxic and non-cytotoxic OACT. Although 85% noted patient compliance issues, 30% of centres were still dispensing more than one cycle of therapy at a time.

Conclusion: The results demonstrated large disparities in clinical practice, highlighting a need for a more universal guideline and a standardised accreditation process. Although this project focused on management of OACT within cancer centres, any develpments should consider the greater pharmacy community to ensure consistency in patient care.