Kucuk Esra, Bayraktar-Ekincioglu Aygin, Erman Mustafa, Kilickap Saadettin
Department of Clinical Pharmacy, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey.
Department of Medical Oncology, Hacettepe University, Hacettepe Cancer Institute, Ankara, Turkey.
J Oncol Pharm Pract. 2020 Apr;26(3):595-602. doi: 10.1177/1078155219861679. Epub 2019 Jul 25.
Some studies in the literature describe drug-related problems in patients with cancer, although few studies focused on patients receiving targeted chemotherapy and/or immunotherapy. To identify the incidence of drug-related problems in patients receiving targeted chemotherapy and/or immunotherapy, and demonstrate the impact of a clinical pharmacist in an outpatient oncology care setting.
Prospective study was conducted in a hospital outpatient oncology clinic between October 2015 and March 2016. Patients greater than 18 years old receiving cetuximab, nivolumab, ipilimumab, or pembrolizumab were included in the study and monitored over a three-month period by a clinical pharmacist. Drug-related problems were analyzed using the Pharmaceutical Care Network Europe classification system. The main outcome measures were the frequency and causes of drug-related problems and the degree of resolution achieved through the involvement of a clinical pharmacist.
A total of 54 patients (mean age: 57 ± 12 years) were included. There were 105 drug-related problems and 159 associated causes. Among the planned interventions (n = 149), 92 interventions were at the patient-level with 88 (96%) being accepted by the doctors. This resulted in 68 (65%) drug-related problems being completely resolved and 9 (8.6%) being partially resolved. The most common drug-related problem identified was "adverse drug event" (n = 38, 36%). Of the 105 drug-related problems, 63 (60%) related to targeted chemotherapy and/or immunotherapy with 34 (54%) classified as an "adverse drug event."
Adverse drug events were the most common drug-related problems in patients with cancer. The involvement of a clinical pharmacist improved the identification of drug-related problems and helped optimize treatment outcomes in patients receiving targeted chemotherapy/immunotherapy.
文献中的一些研究描述了癌症患者的药物相关问题，尽管很少有研究关注接受靶向化疗和/或免疫治疗的患者。为了确定接受靶向化疗和/或免疫治疗患者的药物相关问题发生率，并证明临床药师在门诊肿瘤护理环境中的作用。
2015年10月至2016年3月在一家医院门诊肿瘤诊所进行前瞻性研究。纳入年龄大于18岁、接受西妥昔单抗、纳武单抗、伊匹单抗或派姆单抗治疗的患者，并由临床药师在三个月内进行监测。使用欧洲药物治疗护理网络分类系统分析药物相关问题。主要观察指标为药物相关问题的频率和原因，以及通过临床药师参与实现的解决程度。
共纳入54例患者（平均年龄：57±12岁）。有105个药物相关问题和159个相关原因。在计划的干预措施（n = 149）中，92项干预措施是针对患者层面的，其中88项（96%）被医生接受。这导致68个（65%）药物相关问题得到完全解决，9个（8.6%）得到部分解决。最常见的药物相关问题是“药物不良事件”（n = 38，36%）。在105个药物相关问题中，63个（60%）与靶向化疗和/或免疫治疗相关，其中34个（54%）被归类为“药物不良事件”。
药物不良事件是癌症患者中最常见的药物相关问题。临床药师的参与改善了药物相关问题的识别，并有助于优化接受靶向化疗/免疫治疗患者的治疗结果。
