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对接受癌症化疗的胸部癌症住院患者发生不良事件时临床药师干预措施的评估。

Evaluation of clinical pharmacist interventions for adverse events in hospitalized patients with thoracic cancer receiving cancer chemotherapy.

作者信息

Iihara Hirotoshi, Hirose Chiemi, Funaguchi Norihiko, Endo Junki, Ito Fumitaka, Yanase Komei, Kaito Daizo, Ohno Yasushi, Suzuki Akio

机构信息

Department of Pharmacy, Gifu University Hospital, Gifu 501-1194, Japan.

Laboratory of Pharmacy Practice and Social Science, Gifu Pharmaceutical University, Gifu 501-1196, Japan.

出版信息

Mol Clin Oncol. 2021 Jun;14(6):116. doi: 10.3892/mco.2021.2278. Epub 2021 Apr 8.

Abstract

Due to the increasing complexity of cancer chemotherapy and its associated supportive care, the role of clinical pharmacists in cancer chemotherapy is becoming increasingly more important. The present study evaluated the clinical interventions of a single pharmacist on the adverse events in hospitalized patients with thoracic cancer receiving cancer chemotherapy. A single-center, retrospective study was conducted at the 614-bed, tertiary care Gifu University Hospital. Hospitalized patients with thoracic cancer who received cancer chemotherapy in the respiratory medicine ward between April 2013 and May 2014 were enrolled. One of the two clinical pharmacists in charge was based in the respiratory medicine ward and implemented pharmaceutical care for the patients, including management of adverse events. Patient data were recorded in the electronic medical chart and retrospectively analyzed. A total of 445 patients with thoracic cancer received cancer chemotherapy in the respiratory medicine ward. A total of 152 interventions (101 patients) were performed by the clinical pharmacist prior to the administration of cancer chemotherapy, half of which comprised the addition of drugs to prevent adverse events. A total of 190 patients (39.4%) experienced grade ≥2 non-hematological or grade ≥3 hematological adverse events associated with cancer chemotherapy, and 223 medical interventions for relief of adverse events lowered the incidence of grade ≥2 non-hematological or grade ≥3 hematological adverse events to 17.8%. Of these, 45.3 and 7.5% of medical interventions for non-hematological and hematological adverse events, respectively, were implemented based on the pharmacist's recommendations. These findings revealed the marked contribution of a single clinical pharmacist in the respiratory medicine ward to the prevention and relief of adverse events in hospitalized patients with thoracic cancer receiving cancer chemotherapy.

摘要

由于癌症化疗及其相关支持治疗日益复杂,临床药师在癌症化疗中的作用变得越来越重要。本研究评估了一名药师对接受癌症化疗的住院胸段癌患者不良事件的临床干预。在拥有614张床位的三级医疗岐阜大学医院进行了一项单中心回顾性研究。纳入了2013年4月至2014年5月期间在呼吸内科病房接受癌症化疗的住院胸段癌患者。两名负责的临床药师中有一名驻在呼吸内科病房,为患者提供药学服务,包括不良事件管理。患者数据记录在电子病历中并进行回顾性分析。共有445例胸段癌患者在呼吸内科病房接受了癌症化疗。临床药师在癌症化疗给药前共进行了152次干预(涉及101例患者),其中一半是添加预防不良事件的药物。共有190例患者(39.4%)发生了与癌症化疗相关的≥2级非血液学或≥3级血液学不良事件,223次缓解不良事件的医疗干预使≥2级非血液学或≥3级血液学不良事件的发生率降至17.8%。其中,分别有45.3%和7.5%的非血液学和血液学不良事件的医疗干预是根据药师的建议实施的。这些发现表明,呼吸内科病房的一名临床药师对接受癌症化疗的住院胸段癌患者不良事件的预防和缓解做出了显著贡献。

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