Viele Carol S
University of California San Francisco Medical Center, San Francisco, CA 94044, USA.
Am J Health Syst Pharm. 2007 May 1;64(9 Suppl 5):S25-32. doi: 10.2146/ajhp070037.
[corrected] Management of the side effect profiles of the new oral cancer chemotherapeutic agents differs from those of traditional oral chemotherapy and hormonal therapy. The healthcare practitioner's role in counseling and managing these toxicities as well as methods for assessing and promoting adherence is reviewed.
Many side effects from traditional oral cancer chemotherapeutic agents are the result of their effects on healthy cells as well as cancer cells. The side effects from the novel targeted therapies differ from those of traditional chemotherapy. Managing side effects and patient self-administration in non-traditional settings without supervision may affect patient adherence, especially with the newer agents. Social and psychological factors also can affect adherence. Various methods are available to assess adherence, including obtaining prescription refill histories and performing pill counts. Counseling patients, asking patients to keep a diary of doses and side effects, and following up with patients at clinic visits or through telephone contact are all methods that promote adherence. Patient education should address the proper dose, frequency, timing with respect to food and other medications, what to do if a dose is missed, side effects to anticipate, and what to do if side effects occur.
Healthcare practitioners play an important role in educating patients regarding potential side effects to oral chemotherapy and assessing and promoting adherence to the treatment regimen.
[已修正]新型口服癌症化疗药物的副作用管理与传统口服化疗和激素治疗不同。本文综述了医疗保健从业者在咨询和管理这些毒性方面的作用,以及评估和促进依从性的方法。
传统口服癌症化疗药物的许多副作用是其对健康细胞和癌细胞产生作用的结果。新型靶向治疗的副作用与传统化疗不同。在无监督的非传统环境中管理副作用和患者自我给药可能会影响患者的依从性,尤其是使用新型药物时。社会和心理因素也会影响依从性。有多种方法可用于评估依从性,包括获取处方 refill 历史记录和进行药丸计数。为患者提供咨询、要求患者记录剂量和副作用日记,以及在门诊就诊时或通过电话联系对患者进行随访,都是促进依从性的方法。患者教育应涉及正确的剂量、频率、与食物及其他药物相关的服用时间、漏服一剂时该怎么做、预期的副作用以及出现副作用时该怎么做。
医疗保健从业者在教育患者了解口服化疗的潜在副作用以及评估和促进对治疗方案的依从性方面发挥着重要作用。