Bayraktar-Ekincioglu A, Kucuk E
Department of Clinical Pharmacy, Faculty of Pharmacy, Hacettepe University, 06100, Sihhiye, Ankara, Turkey.
Int J Clin Pharm. 2018 Apr;40(2):386-393. doi: 10.1007/s11096-018-0590-3. Epub 2018 Jan 20.
Background There is a growing interest in the use of targeted and immunotherapies in oncology. However, the assessment of side effects can be different due to interpretation of patients' health status by healthcare professionals in oncology outpatient clinics. Objective To demonstrate the differences in the assessments of side effects conducted independently by a clinical pharmacist and nurses in patients who receive targeted therapies at an oncology outpatient clinic. Setting The study was conducted at the University Oncology Hospital in an outpatient clinic from October 2015 to March 2016. Method Patients receiving ipilimumab, nivolumab, pembrolizumab, bevacizumab, panitumumab or cetuximab during study period were included. The assessment of side effects was conducted by a pharmacist and nurse independently using the NCI-CTCAE version-2. Main outcome measure To compare the severity assessments of side effects between a clinical pharmacist and nurses in an outpatient clinic. Results During the study, 204 visits for 43 patients with a total of 5508 side effect assessments were recorded where 1137 (20.64%) assessments were graded differently. Out of 1137 assessments, 473 of them were graded higher by a clinical pharmacist whereas 664 were graded higher by nurses. Statistically significant differences were detected in the assessment of vomiting, taste changes, sense changes, alopecia, fatigue, mood changes, anxiety, hearing impairment, and allergic reactions. Conclusion An assessment of side effects by healthcare providers in patients with cancer may be challenging due to an increased workload in clinics and undistinguishable symptoms of side effects and cancer itself. Therefore, a new care model which increases an interprofessional communication may improve pharmaceutical care in oncology outpatient clinics.
肿瘤学中靶向治疗和免疫治疗的应用越来越受到关注。然而，由于肿瘤门诊医护人员对患者健康状况的解读不同，副作用的评估可能会有所差异。目的：展示临床药剂师和护士在肿瘤门诊对接受靶向治疗的患者独立进行副作用评估时的差异。环境：该研究于2015年10月至2016年3月在大学肿瘤医院的门诊进行。方法：纳入研究期间接受伊匹木单抗、纳武单抗、帕博利珠单抗、贝伐单抗、帕尼单抗或西妥昔单抗治疗的患者。药剂师和护士使用NCI-CTCAE第2版独立进行副作用评估。主要观察指标：比较门诊临床药剂师和护士对副作用严重程度的评估。结果：研究期间，记录了43例患者的204次就诊，共进行了5508次副作用评估，其中1137次（20.64%）评估分级不同。在1137次评估中，临床药剂师将473次评估分级更高，而护士将664次评估分级更高。在呕吐、味觉改变、感觉改变、脱发、疲劳、情绪改变、焦虑、听力障碍和过敏反应的评估中检测到统计学显著差异。结论：由于诊所工作量增加以及副作用和癌症本身症状难以区分，医护人员对癌症患者副作用的评估可能具有挑战性。因此，一种增加跨专业沟通的新护理模式可能会改善肿瘤门诊的药学护理。
