September 13, 2023
Benyam Muluneh, Pharm.D. ‘10, assistant professor in the Division of Pharmacotherapy and Experimental Therapeutics at the UNC Eshelman School of Pharmacy is starting a new project focused on optimizing the delivery of cancer care for North Carolinian patients taking orally administered chemotherapy drugs.
With the support of a $1 million National Cancer Institute grant, Muluneh’s end goal for the project, which will be piloted in urban community and rural cancer centers, is to better understand the barriers patients face in being able to start and then stay on their oral anticancer drugs, which will lead to a patient-centered intervention that addresses those barriers.
“I am excited about seeing how we can meaningfully support cancer patients in North Carolina to get the best outcomes from their treatments by organizing and designing their care around clinical, financial, psychosocial, educational domains. I am especially looking forward to speaking with our rural patient population so we can identify and address their unique challenges,” he said. “Once patients can be connected with the support they need most through tailored services, they are more likely to get the optimal benefit from their treatments, ideally feeling better and living longer.”
According to the proposal, cancer treatment is increasingly moving away from the infusion clinic and into the patient’s home given the rapid rise in the approval of orally administered chemotherapy drugs by the Food and Drug Administration.
Although these drugs are convenient for patients, it also presents a challenge since these drugs have a unique set of side effects and can be very costly—about $150,000 a year. Also, patients sometimes face psychosocial distress leading to forgetting to take their medications.
The proposal points out that with all of these distinct factors, medication adherence rates, or how likely a patient will follow its health provider’s recommendation, are quite low. Much of the data suggests that for these medications to be successful the medication adherence rate should be around 90%, whereas some studies show it’s currently as low as 16%.
Through this research, Muluneh plans to design a multidisciplinary program to support patients on these drugs, which will likely include proactive check-ins, side-effect management and addressing financial and psychosocial barriers, paving the way for more patients to receive oral chemotherapy drugs.
Muluneh also plans to pilot this project at the UNC Medical Center, Rex Oncology in the Triangle area and McCreary Cancer Center in Lenoir, North Carolina.