Improving the quality of oral chemotherapy services using home care

There has been a plethora of oral chemotherapeutic agents introduced over recent years. For hospital pharmacies this has meant unprecedented activity. At the same time there is pressure to meet waiting time targets and to improve patient experience. The Cancer Centre had already used homecare services for trastuzumab (Herceptin) so it seemed reasonable to apply this to selected oral agents. A formal tender resulted in a contract award for homecare. The service has been running successfully for 3 years with imatinib in chronic myeloid leukaemia and in gastro-intestinal stromal tumour patients. Patients are informed about the homecare supply service in clinic by the nurse or pharmacist, with most patients opting for the service rather than a wait in pharmacy for their prescription. The drug is then delivered by post to the patient's home. We plan to extend the service in the coming months to include a second oral agent, erlotinib for the treatment of non small cell lung cancer. As well as avoiding a patient wait in pharmacy, provision through a homecare company offers a more cost effective way for the Trust to deliver an oral chemotherapy service. By reducing the number of patients arriving in pharmacy for prescriptions, it facilitates the achievement of outpatient waiting time targets and improves the overall patient experience.