Implications for medication safety and adherence in dermato-oncology: The AMBORA care program for oral antitumor therapeutics

Abstract

Background and Objectives: Dermatological oral antitumor therapeutics (OAT) are often interaction-prone and used in complex regimens. The pharmacological/pharmaceutical care program of the randomized AMBORA trial significantly improved medication safety with various OAT; however, dermato-oncological patients were not included. It was subsequently implemented into clinical routine, including dermato-oncology. We aimed to analyze medication errors and adherence in patients treated with any dermatological OAT. Patients and Methods: Medication errors were characterized, for example, according to their cause (PCNE V9.1). Adherence was assessed using the Medication Event Monitoring System (MEMS® Button) and the MARS-D questionnaire. Primary outcomes were the percentage of resolved OAT-involving errors and Dosing Adherence (DA); proportion of days with correct OAT intake) over 12 weeks. Results: In 92 patients (81.5% melanoma), we detected 1.6 medication errors per patient and 61.6% involved the OAT. Thereof, 89.2% were resolved. Of 52 patients participating in the additional adherence monitoring, 48 were evaluable and reached a median DA of 95.0% and MARS-D score of 25/25. DA was higher in once- vs. twice-daily regimens (p = 0.0127). Conclusions: The interprofessional AMBORA care program in dermato-oncology was associated with the resolution of a large proportion of medication errors and high adherence. Evidence-based medication management and patient counseling by clinical pharmacologists/pharmacists optimizes medication safety in dermato-oncological practice.