Conliffe Brette, Figg Lindsay, Moffett Padmini, Lauterwasser Leslie, Parsons Laura Beth
University of Louisville Hospital, Louisville, USA.
J Oncol Pharm Pract. 2019 Jun;25(4):777-786. doi: 10.1177/1078155217753889. Epub 2018 Jan 29.
In recent years, there has been a changing paradigm in the management of oncologic disease states from the use of intravenous therapies, requiring a visit to the infusion center or hospitalization, to new therapies that can be administered orally. Several publications have evaluated the role pharmacists may play in the initial prescribing of oral chemotherapy, however the impact of a formalized pharmacist follow-up program has not been well defined. This study evaluates the impact of a pilot pharmacist-run oral antineoplastic monitoring program.
This retrospective cohort analysis evaluated patients prescribed an oral antineoplastic in the genitourinary oncology clinic at an academic medical center between 1 July 2014 and 15 March 2017. Patients enrolled in the program were compared to a historical control group. The primary objective was adherence to pre-defined standards for monitoring. Secondary objectives include persistence on therapy, need to seek medical care, analysis of pharmacist interventions, patient satisfaction, and financial impact for the on-site retail pharmacy.
In total, 33 patients were evaluated (11 cases, 22 controls). Average adherence to monitoring recommendations was significantly higher in the case group compared to controls (89% vs. 61%; p = 0.008). In total, 67 interventions were made by the clinical pharmacist with an average of 6 per patient.
This study shows that formalized pharmacist follow-up programs can improve patients' adherence with antineoplastic monitoring standards. Additionally, pharmacists made clinically significant interventions and had high patient satisfaction, providing justification for expansion into other disease states.
近年来，肿瘤疾病的管理模式发生了变化，从需要前往输液中心或住院接受的静脉治疗，转变为可口服的新疗法。已有多篇出版物评估了药剂师在口服化疗初始处方中可能发挥的作用，然而，正式的药剂师随访计划的影响尚未得到明确界定。本研究评估了一项由药剂师主导的口服抗肿瘤监测试点计划的影响。
这项回顾性队列分析评估了2014年7月1日至2017年3月15日期间在一所学术医疗中心的泌尿生殖肿瘤诊所开具口服抗肿瘤药物的患者。将参与该计划的患者与一个历史对照组进行比较。主要目标是遵守预先定义的监测标准。次要目标包括治疗持续性、寻求医疗护理的需求、药剂师干预分析、患者满意度以及对现场零售药房的财务影响。
总共评估了33例患者（11例病例，22例对照）。病例组对监测建议的平均依从性显著高于对照组（89%对61%；p = 0.008）。临床药剂师总共进行了67次干预，平均每位患者6次。
本研究表明，正式的药剂师随访计划可以提高患者对抗肿瘤监测标准的依从性。此外，药剂师进行了具有临床意义的干预，患者满意度较高，为将该计划扩展到其他疾病状态提供了依据。
