Implementation of an electronic early treatment assessment and monitoring questionnaire for oral anticancer medication.

Abstract

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Purpose: To evaluate the implementation of an electronic early treatment assessment and monitoring (eTEAM) questionnaire within the electronic health record (EHR) patient portal designed to identify early adverse effects to oral anticancer therapy requiring pharmacist intervention.

Methods: This quality improvement analysis used the 5 dimensions of the RE-AIM implementation science framework to assess use of an innovative eTEAM questionnaire sent to patients 7 to 14 days after initial counseling on oral anticancer therapy. RE-AIM outcomes included the following: reach and adoption: the number of eTEAM questionnaires sent and the number of eTEAM responses received; effectiveness: the number of pharmacist interventions resulting from the eTEAM questionnaire; implementation: pharmacist responses to a postimplementation survey and semistructured individual interviews; maintenance: responses from postimplementation semistructured individual interviews with pharmacists. Results are reported descriptively.

Results: Of the 182 patients sent an eTEAM questionnaire, 47% (n = 85) responded. Pharmacists performed 29 interventions in 25 responding patients, most often due to adverse effects (n = 25) or adherence (n = 4). Most pharmacists agreed that the eTEAM questionnaire was appealing and feasible to use and that its use positively impacted their practice and patient care. Pharmacists recommended that the eTEAM questionnaire be improved by standardizing documentation of patients' actual oral anticancer medication start date in a discrete field.

Conclusion: The eTEAM questionnaire was positively received by patients, and pharmacists were supportive of its continued use based on feasibility and impact on practice. The eTEAM questionnaire effectively identified opportunities for pharmacist intervention in patients starting oral anticancer medications.