Current situation for medication process and pharmacovigilance in The Netherlands: A comparison between cytostatic and non-cytostatic agents

Abstract

Aim To describe the current situation regarding the medication order entry system and pharmacovigilance for cytostatic and non-cytostatic agents in The Netherlands. Method An electronic questionnaire, consisting of multiple choice questions, was sent to hospital pharmacists to compare general and specific information about cytostatic agents and non-cytostatic agents. A quality index (QI) was established as the gold standard to measure the quality of the medication process phases in the participating hospitals. Results For cytostatic agents, 17% of the hospitals used an electronic medication order entry system and in 71% of these hospitals physicians entered the medication. For non-cytostatic agents, 38% of the hospitals used an electronic medication order entry system and in 52% physicians entered the medication. For cytostatic agents, pharmacovigilance for interactions was carried out automatically in 12% of the hospitals compared with 62% for non-cytostatic agents. Pharmacovigilance for cytostatic agents was performed by physicians in 26% of cases compared with 2% for non-cytostatic agents. When comparing the QI for participating hospitals, the mean score was 47.2% (95% CI 44.6% to 49.9%). In general, 22 hospitals (39.3%) scored ≥50%. Concluding statement Pharmacovigilance for interactions and contraindications is not routinely performed for cytostatic agents, while for non-cytostatic agents this is a routine procedure. Keeping in mind the high toxicity and narrow therapeutic range of cytostatic agents, there is still much work to be done to achieve the same pharmacovigilance level and quality that currently exists for non-cytostatic agents.