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Medication Management

  • Toni Choueiri, MD, with medications

    At Dana-Farber, multidisciplinary teams involving clinicians and pharmacists ensure that the medications used are appropriate for each individual patient. As medication errors are the most common source of medical injury, and a special hazard in cancer care, we have several processes in place to help prevent these errors.

  • Several robust electronic systems and tools help our clinical staff with decision support when ordering medications. These systems include:

    1. Computerized order entry system
    2. Standardized chemotherapy order templates
    3. Electronic medical record
    4. Bar-code scanning used in medication preparation
    5. "Smart" infusion pumps with error reduction software that can program and calculate dose and delivery rates
    6. Guardrails that direct accurate infusion of medications
    7. Medication reconciliation in which the patient and provider review the list of medications the patient is taking, at every visit.

    Our goal is to prevent medication errors before they reach the patient. To achieve this aim we have a strong culture of reporting, in which staff members share medication order or administration mistakes known as "near-misses." The purpose of these reports is to reveal any areas of vulnerability and solve the problem before harm comes to a patient.

    Oral Chemotherapy

    With the increasing use of oral chemotherapy agents, challenges in its prescribing, dispensing, administration, and compliance are evident.

    We take a proactive approach to ensure that patients taking oral chemotherapy receive education and monitoring. A specialized oncology pharmacist educates patients regarding the expected side effects of therapy, how to manage these, and when to contact the provider for follow-up. A program nurse calls the patient 72 hours later to assess toxicities and adherence, re-enforce drug information, and answer any additional questions that may have arisen. All information is documented in the medical record to ensure that all members of the patient team are informed.

    Learn more about  oral chemotherapy and tools to assist patients with the management of their medications.