Herledan Chloé, Baudouin Amandine, Larbre Virginie, Gahbiche Anas, Dufay Edith, Alquier Isabelle, Ranchon Florence, Rioufol Catherine
Unité de Pharmacie Clinique Oncologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, 165 Chemin du Grand Revoyet, Pierre-Bénite, France.
EMR3738, Université de Lyon, Lyon, France.
Support Care Cancer. 2020 Aug;28(8):3557-3569. doi: 10.1007/s00520-020-05400-5. Epub 2020 Mar 18.
Medication reconciliation can reduce drug-related iatrogenesis by facilitating exhaustive information transmission at care transition points. Given the vulnerability of cancer patients to adverse drug events, medication reconciliation could provide a significant clinical benefit in cancer care. This review aims to synthesize existing evidence on medication reconciliation in cancer patients.
A comprehensive search was performed in the PubMed/Medline, Scopus, and Web of Science databases, associating the keywords "medication reconciliation" and "cancer" or "oncology."
Fourteen studies met the selection criteria. Various medication reconciliation practices were reported: performed at admission or discharge, for hospitalized or ambulatory patients treated with oral or parenteral anticancer drugs. In one randomized controlled trial, medication reconciliation decreased clinically significant medication errors by 26%. Although most studies were non-comparative, they highlighted that medication reconciliation led to identification of discrepancies and other drug-related problems in up to 88% and 94.7% of patients, respectively. The impact on post-discharge healthcare utilization remains under-evaluated and mostly inconclusive, despite a trend toward reduction. No comparative economic evaluations were available but one study estimated the benefit:cost ratio of medication reconciliation to be 2.31:1, suggesting its benefits largely outweigh its costs. Several studies also underlined the extended pharmacist time required for the intervention, highlighting the need for further cost analysis.
Medication reconciliation can reduce adverse drug events in cancer patients. More robust and economic evaluations are still required to support its development in everyday practice.
用药核对可通过在护理转接点促进详尽的信息传递来减少与药物相关的医源性疾病。鉴于癌症患者易发生药物不良事件，用药核对在癌症护理中可能带来显著的临床益处。本综述旨在综合现有关于癌症患者用药核对的证据。
在PubMed/Medline、Scopus和Web of Science数据库中进行全面检索，关联关键词“用药核对”和“癌症”或“肿瘤学”。
14项研究符合入选标准。报告了各种用药核对实践：在入院或出院时进行，针对接受口服或胃肠外抗癌药物治疗的住院或门诊患者。在一项随机对照试验中，用药核对使具有临床意义的用药错误减少了26%。尽管大多数研究为非对比性研究，但它们强调用药核对分别在高达88%和94.7%的患者中发现了差异和其他与药物相关的问题。尽管有减少的趋势，但对出院后医疗保健利用的影响仍评估不足且大多无定论。没有可用的对比性经济评估，但一项研究估计用药核对的效益成本比为2.31:1，表明其益处远大于成本。几项研究还强调了干预所需的药剂师额外时间，突出了进一步进行成本分析的必要性。
用药核对可减少癌症患者的药物不良事件。仍需要更有力和经济的评估来支持其在日常实践中的发展。
