# Implications for medication safety and adherence in dermato‐oncology: The AMBORA care program for oral antitumor therapeutics

## TL;DR

The AMBORA care program improves medication safety and adherence for patients in dermato-oncology using oral antitumor drugs.

## Contribution

Implementation of the AMBORA program in dermato-oncology, showing high error resolution and adherence rates.

## Key findings

- 1.6 medication errors per patient were detected, with 89.2% resolved.
- Patients achieved a median dosing adherence of 95.0% over 12 weeks.
- Once-daily regimens showed higher adherence than twice-daily ones.

## Abstract

Dermatological oral antitumor therapeutics (OAT) are often interaction‐prone and used in complex regimens. The pharmacological/pharmaceutical care program of the randomized AMBORA trial significantly improved medication safety with various OAT; however, dermato‐oncological patients were not included. It was subsequently implemented into clinical routine, including dermato‐oncology. We aimed to analyze medication errors and adherence in patients treated with any dermatological OAT.

Medication errors were characterized, for example, according to their cause (PCNE V9.1). Adherence was assessed using the Medication Event Monitoring System (MEMS® Button) and the MARS‐D questionnaire. Primary outcomes were the percentage of resolved OAT‐involving errors and Dosing Adherence (DA); proportion of days with correct OAT intake) over 12 weeks.

In 92 patients (81.5% melanoma), we detected 1.6 medication errors per patient and 61.6% involved the OAT. Thereof, 89.2% were resolved. Of 52 patients participating in the additional adherence monitoring, 48 were evaluable and reached a median DA of 95.0% and MARS‐D score of 25/25. DA was higher in once‐ vs. twice‐daily regimens (p = 0.0127).

The interprofessional AMBORA care program in dermato‐oncology was associated with the resolution of a large proportion of medication errors and high adherence. Evidence‐based medication management and patient counseling by clinical pharmacologists/pharmacists optimizes medication safety in dermato‐oncological practice.