Real-world management of oral anticancer therapies: opportunities and gaps within a regional multidisciplinary oncology network.

ABSTRACT Background: The increasing use of oral anticancer therapies has shifted much of cancer treatment into the home environment, intensifying the need to implement procedures that ensure treatment adherence, safe medication use, timely pharmacovigilance reporting, and coordinated multidisciplinary care. Aim: To assess organizational and clinical-pharmacological approaches to oral anticancer treatment management across Veneto centers, delineating the current state and identifying opportunities for improvement. Methods: A regional cross-sectional assessment was conducted using a multidisciplinary validated web-based questionnaire developed in collaboration with the Regional Coordination for Oncological Activities. The survey explored eight domains relevant to the organizational and clinical-pharmacological management of oral anticancer therapies and was administered to oncology, hematology, and hospital pharmacy units. Descriptive analyses summarized adherence to requirements and recurrent themes from open-ended responses. Results: Fourteen centers participated. Overall, a high level of procedural formalization emerged in the management of oral anticancer therapies. Medication reconciliation was implemented in 57% of centers using heterogeneous tools, while pharmacological counseling was widespread but inconsistently structured. Despite broad adoption of electronic medical records (93% of centers), the use of digital health tools to support care continuity remained limited, with telemedicine or telepharmacy services implemented or under implementation in six centers. All centers had procedures for Adverse Drug Reaction reporting; however, active pharmacovigilance and patient-engagement activities were inconsistently developed. Therapeutic drug monitoring was not implemented in any center, and error-prevention procedures were formalized in 79%, although gaps persisted in risk-management tools and remote digital monitoring. Governance of high-cost drugs was supported by horizon scanning and, when required because of packaging-related issues, enhanced attention to deblistering activities. Conclusions: The assessment revealed variability in workflows and heterogeneous tools, partly driven by limited enabling technologies and workforce constraints. Technical standards and shared models are needed to optimize therapy reconciliation and counseling, support care coordination through digital health tools—particularly for home-managed treatment—and enhance monitoring, safety, and adherence.