Table 1.
Items | Additional Notes | |
---|---|---|
1 | Height | Confirm measurement date (if there is an institution-specific rule, e.g., within the last several months, confirm whether the measurement is performed within that period) |
2 | Weight | |
3 | Body surface | |
4 | Indications | Confirm cancer types for preventing an off-label regimen use |
5 | Regimens | Confirm the main purpose of a regimen (neoadjuvant therapy, adjuvant therapy, life-prolonging treatment, or palliative therapy) |
6 | Treatment date | Confirm treatment date |
7 | Dosage | Confirm cumulative dose if the upper limit of the total dose is set for a drug |
8 | Infusion rate | Special caution should be exercised for a drug with a different infusion rate between the initial treatment and second and subsequent treatment courses |
9 | Duration | Confirm whether an anticancer drug exceeds the upper limit of the dosing duration |
10 | Dose interval | Confirm the reason why a rest period is shorter than the specified period |
11 | Premedication | Confirm whether all premeditations described in the package inserts are prescribed according to anticancer drugs |
12 | Latest treatment history | Confirm whether a regimen is performed on a patient to prevent a regimen error (e.g., the use of a previous treatment regimen for the initial treatment) |
13 | Laboratory test | Confirm examination date (if there is an institution-specific rule, e.g., within the last several months, confirm whether the examination is performed within that period) |
14 | Urinalysis | |
15 | Allergy history | Confirm whether a drug used in a regimen can be administered safely by checking a patient’s allergy history |
16 | Medical history | Confirm whether a drug used in a regimen can be administered safely by checking the side effects of the drug and a patient’s medical history |
17 | Concomitant drug | Confirm whether a drug used in a regimen can be administered safely by checking a patient’s concomitant drugs (drug interaction, duplicate medication, and contraindications for co-administration) |
18 | Oral anticancer drug | Confirm days on therapy, dosage, and dose interval in a regimen that concomitantly uses an oral anticancer drug |
19 | History of hepatitis B virus | Confirm examination date (if there is an institution-specific rule, e.g., within the last several months, confirm whether the examination is performed within that period) Confirm whether HBV-DNA levels are measured within 1–3 months (periods vary depending on each anticancer drug) if a patient tested positive for HBs antibodies or HBc antibodies |