[Safety management of intravenous cancer chemotherapy and oral premedication drugs].

The administration of oral premedication drugs (OPDs) is increased before intravenous cancer chemotherapy to prevent adverse events such as hypersensitivity or nausea and vomiting. As intravenous chemotherapy regimens and OPDs are ordered separately in the electronic medical record system, the prescription or administration of OPDs may be missed. To overcome this problem, we developed a combination regimen ordering (CRO) system, in which OPDs were included in the intravenous chemotherapy regimen enabling simultaneous ordering. This system used the electronic medical record system HAPPY ACTIS by TOSHIBA Medical Information Systems Co. in our hospital. OPDs were prepared in an envelope labeled with a bar code to identify the patient, which was then used by the nursing staff to administer the medication. Between August 2011 and January 2014, CRO systems were used in 66 regimens for the treatment of the following cancers: 21 lung cancers, 14 breast cancers, 9 hematologic malignancies, 7 genitourinary cancers, 6 gastrointestinal cancers, 5 gynecological cancers, 3 head and neck cancers, and 1 dermatological malignancy. The OPDs administered were diphenhydramine, loxoprofen, chlorpheniramine, aprepitant, and ramosetron. Although we were unable to check OPDs in the oral drug administration histories, no errors in the administration of OPDs have been reported after the adoption of the CRO system. Therefore, our CRO system improved the safety and quality of patient care for cancer chemotherapy.