Imamura Makio, Ogawa Daisuke, Takatori Toshikazu, Yamaguchi Maiko, Takata Tomoyuki, Hada Tomonori, Ota Yoshiaki, Uehara Takashi
Department of Clinical Support, Kurashiki Medical Center.
Department of Medicinal Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University.
Biol Pharm Bull. 2017;40(11):1956-1962. doi: 10.1248/bpb.b17-00501.
Specialist oncology pharmacists are being trained in Japan to assist cancer treatment teams. These specialized pharmacists address patients' physical and mental problems in pharmacist-managed cancer care clinics, actively participate in formulating treatment policies, and are beneficial in offering qualitative improvements to patient services and team medical care. However, the effect of outpatient treatment by oncology pharmacists on therapeutic outcomes and medical costs is still unknown. A retroactive comparative analysis of the treatment details and clinical course was conducted among three groups of patients: patients who underwent adjuvant chemotherapy managed by a gynecologic oncologist only (S arm), patients managed by a non-oncologist (general practice gynecologist) only (NS arm), and patients managed by both a non-oncologist and a specialist oncology pharmacist (NS+Ph arm). The medical cost per course was significantly lower for patients in the NS+Ph arm than for those in the other two arms. Surprisingly, the outpatient treatment rate in the NS+Ph arm was overwhelmingly high. The involvement of an oncology pharmacist did not make a significant difference in therapeutic outcomes such as recurrence rate and survival. The participation of oncology pharmacists in the management of cancer patients undergoing chemotherapy enables safe outpatient treatment and also reduces medical costs.
日本正在培训肿瘤专科药剂师以协助癌症治疗团队。这些专科药剂师在药剂师管理的癌症护理诊所中解决患者的身心问题，积极参与制定治疗政策，并且有助于提高患者服务和团队医疗护理的质量。然而，肿瘤药剂师的门诊治疗对治疗效果和医疗成本的影响仍然未知。对三组患者的治疗细节和临床过程进行了回顾性比较分析：仅由妇科肿瘤学家进行辅助化疗的患者（S组）、仅由非肿瘤学家（普通妇科医生）管理的患者（NS组）以及由非肿瘤学家和肿瘤专科药剂师共同管理的患者（NS+Ph组）。NS+Ph组患者每疗程的医疗成本显著低于其他两组。令人惊讶的是，NS+Ph组的门诊治疗率极高。肿瘤药剂师的参与在复发率和生存率等治疗效果方面没有显著差异。肿瘤药剂师参与化疗癌症患者的管理能够实现安全的门诊治疗，同时还能降低医疗成本。
