Community pharmacists' knowledge of and attitudes toward oral chemotherapy

OBJECTIVE

To assess community pharmacists' attitude toward and knowledge of oral chemotherapy (OC) in terms of drug indications, general dosing principles, drug interactions, adverse effects, and special handling precautions.

DESIGN

Descriptive, nonexperimental, cross-sectional survey.

SETTING

Colorado, Kansas, and the southeastern United States in May and June 2005.

PARTICIPANTS

1,080 pharmacists in four divisions of a large community pharmacy chain.

INTERVENTIONS

Web-based survey.

MAIN OUTCOME MEASURES

Pharmacist knowledge of and attitude toward OC.

RESULTS

243 surveys were returned (response rate 22.5%). Overall, pharmacists answered 49.7% of knowledge questions correctly. Pharmacists were most knowledgeable about general dosing principles (69%) and least knowledgeable about adverse effects (45%) and special handling (25%) of OC. Higher scores were seen for pharmacists who dispensed a greater number of OC prescriptions. Percentages of correct responses did not vary based on years of experience or number of OC continuing pharmacy education (CPE) programs attended. On a Likert-type scale of 1 (low) to 5 (high), the average comfort in dispensing OC was 2.4. On average, pharmacists indicated that knowing about OC was important to their practice (3.7) and expressed interest in participating in additional CPE programs on OC (4.2). Of respondents, 94.7% indicated that their pharmacy did not have a counting tray devoted to cytotoxic drugs.

CONCLUSION

This survey identified several areas in which pharmacists' knowledge of OC could be enhanced. Handling of OC is an area of important need, given the low number of pharmacists reporting separate counting trays for cytotoxic drugs.

Pilot study: fluvoxamine treatment for depression and anxiety disorders in children and adolescents with cancer

OBJECTIVE

To evaluate the safety, tolerability, and benefit of fluvoxamine for the treatment of major depressive disorder or anxiety disorders in children and adolescents with cancer.

METHOD

The study was conducted from 2001 to 2004 at a pediatric hematology-oncology center. Fifteen children and adolescents with cancer were treated with fluvoxamine 100 mg/day in an open prospective 8-week trial. Safety and tolerability were evaluated at baseline and at weeks 4 and 8 by blood tests and the Side Effects Checklist. Clinical benefit was assessed with the Clinical Global Impressions-Improvement, the Children's Depression Rating Scale-Revised, and the Pediatric Anxiety Rating Scale.

RESULTS

Fluvoxamine was well tolerated by all subjects. Psychiatric symptoms improved significantly.

CONCLUSIONS

In this open trial, fluvoxamine appeared to be well tolerated and was associated with a promising reduction in the depression and anxiety symptoms of pediatric patients with cancer.