Cancer Program Guidelines - Association of Community Cancer ...

4. Educating patients and ensuring they understand
what medication will be continued, what will be
discontinued, what the new plan includes, and
why they are receiving the therapy
5. Contacting other providers who provide care
before, after, or concurrently to ensure they also
reconcile the patients’ total therapy needs
6. Ensuring thorough documentation in the patient
medical record.
Guideline IV
Appropriate drug-related education will be provided to
patients and staff.
Rationale
It is important to incorporate new scientific discoveries and
standards into practice as soon as possible, by educating
patients and members of the multidisciplinary team. Training
new staff and retraining established staff on a regular basis
are important. Specific areas of focus include pharmacology,
pharmacokinetics, pharmacodynamics, drug compatibility,
drug administration, drug therapy interactions in patients
taking multiple therapeutic agents, adverse effects of
medication, medication outcomes, and taking comprehensive
medication histories.
Characteristics
A. Staff should follow The Joint Commission Medication
Reconciliation requirements to ensure a complete medication
history upon admission, that the patients understand
their therapy plan and their therapy, and that medication
is reviewed between each site of care. Patients
should understand their medication prior to discharge,
and the medication records should be available to other
practitioners providing care to the patients.
1. Patients should understand their medication
sufficiently to participate in therapy decisions.
2. Patients should understand the importance of
compliance, how to monitor for therapy effectiveness
or adverse effects, and the appropriate
course of action.
B. Current and appropriate drug information and other
related compendia are available for all members of the
institution/practice.
C. Regular education is provided to other members of the
healthcare team in a timely manner.
1. Therapy updates from the literature or institutional
committees, such as the Pharmacy and
Therapeutics Committee
2. Results of institutional decisions, studies, and
evaluations.
3. FDA-related information such as new drug
approval, changes in indications, warnings,
recalls, or discontinuation of availability.
4. Pharmacy Services should participate in
multidisciplinary rounds, committees, and
conferences.
Guideline V
Pharmacy Services should contribute to the financial and
legal requirements associated with the patient’s therapy.
Rationale
A complete and accurate patient bill is important to ensure
reimbursement. Pharmacy systems should be designed to
ensure that required billing information is complete and
accurate in the patient record. All required records should be
complete and meet legal requirements for required information
and confidentiality (HIPAA). Pharmacy Services can
also contribute to the development of budgets, influence
effective cost management, and perform cost/outcome
analysis of therapy.
Characteristics
A. The drug therapy indication is appropriate for the patient
diagnosis and is documented during the ordering process.
B. References are provided for drugs being used outside of
indications that have already been approved by payers.
C. Appropriate billing codes and dosing increments are
used as determined by the payer.
D. Systems are in place to identify and enroll patients into
“manufacturer patient assistance programs” and other
charitable programs when appropriate.
E. Pharmacy Services will assist with developing budgets
related to the procurement and provision of drug therapy.
F. All pharmacy and medication records should meet all
legal standards including, but not limited to, HIPAA.
G. Pharmacy Services will assist with assessing patient outcomes
and developing cost-based analysis of outcomes.
16 Chapter 4 Clinical Management and Supportive Care Services ACCC Cancer Program Guidelines