Highlighting Operational Challenges in the AML Treatment Landscape

An operational challenge relating to the timely receipt of oral medications may impact dose adherence for patients who are taking therapeutics from home, according to Zahra Mahmoudjafari, PharmD, MBA, BCOP, FHOPA, Clinical Pharmacy Manager in the Division of Hematologic Malignancies and Cellular Therapeutics at the University of Kansas Health System.

Mahmoudjafari discussed challenges that have emerged in the treatment of patients with acute myeloid leukemia (AML) in an interview with CancerNetwork®. She initially highlighted an operational challenge wherein patients are incapable of adhering to a dosing schedule outlined by providers due to outside factors, such as insurance disputes or shipment delays, which may negatively impact outcomes for patients receiving oral chemotherapy for this disease. However, she noted that once oral medication is received, providers can better monitor treatment adherence and tolerability.

Furthermore, she stressed the importance of a 2-way model of communication, whereby patients are encouraged to relay concerns regarding adverse effects to providers. In this sense, providers may be better informed to mitigate the impact of an emergent toxicity and provide a patient with some recovery time before continuing full drug dosing.

Transcript:

One of the challenges when you have oral medications is that, while it is somewhat more convenient for patients to take at home, there are additional challenges as it relates to adherence, as well as being able to ensure the patient receives their medication in a timely manner. It often can be held up with some concerns with insurance, if you will, or shipment from a specialty pharmacy. There are some operational challenges that come with having oral chemotherapy. Now, once a patient does receive it, you tend to be on a better track. The patients can take their medications in the comfort of their home, and we have systems in place to check in on adherence and how they are tolerating it.

Other challenges that we have then are making sure that we are checking in frequently with our patients and ensuring that they are not experiencing any unexpected [adverse] effects, and making sure that they know that 2-way communication is extremely important; that they are not expected to handle the adverse events that are occurring [alone]. We want to ensure that they have a pathway to reach us if they have any questions or are experiencing any [adverse] effects that require a dose modification or a hold in treatment for a bit of time to allow them to rest.