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综合药物评估改善合并症癌症患者药物使用的可行性。

Feasibility of a comprehensive medication review to improve medication use for patients with cancer and comorbid conditions.

机构信息

Michigan Oncology Quality Consortium (MOQC) and Michigan Institute for Care Management and Transformation (MICMT), 4251 Plymouth Road Arbor Lakes, Building 3, Floor 3, Ann Arbor, MI, 48105, USA.

Johns Hopkins Department of Pharmacy, Baltimore, MD, USA.

出版信息

Support Care Cancer. 2022 Dec;30(12):10111-10116. doi: 10.1007/s00520-022-07413-8. Epub 2022 Oct 20.

Abstract

PURPOSE

A focus on oral medications for patients receiving care from both oncologists and primary care providers elicits an opportunity for improvement in patient outcomes. The purpose of this pilot study was to explore the feasibility and appropriateness of a comprehensive medication review (CMR) by a primary care pharmacist in a population of patients with cancer and chronic conditions.

METHODS

Adult patients who received both cancer and primary care at Michigan Medicine, received active systemic cancer treatment, and had a comorbid condition of diabetes, hypertension, chronic heart failure, depression, and/or anxiety were eligible to receive a CMR by the primary care clinical pharmacist. Data collected included number eligible for the CMR (feasibility), patient demographics, medication-related problems (MRPs) and medication interventions (appropriate), number of patients requiring follow-up with the clinical pharmacist or physician, and pre/post-intervention changes in A1c and BP, as applicable.

RESULTS

Of the 96 patients that met inclusion criteria, 55 patients (57%) received a CMR. Pharmacists provided 66 instances of patient education and identified 22 medication-related problems (MRPs) in 15 (27%) of patients. After CMRs were completed, 22 patients (40%) were referred to primary care pharmacists or physician providers for ongoing care.

CONCLUSION

A CMR was feasible and appropriate for patients with chronic conditions receiving treatment for cancer.

摘要

目的

关注同时接受肿瘤学家和初级保健提供者护理的患者的口服药物,为改善患者结局提供了机会。本试点研究的目的是探索在癌症和慢性病患者群体中,由初级保健药剂师进行全面药物审查(CMR)的可行性和适宜性。

方法

在密歇根医学中心接受癌症和初级保健治疗、接受积极的全身癌症治疗且患有糖尿病、高血压、慢性心力衰竭、抑郁和/或焦虑等合并症的成年患者有资格接受初级保健临床药剂师的 CMR。收集的数据包括有资格进行 CMR 的患者人数(可行性)、患者人口统计学特征、药物相关问题(MRP)和药物干预(适当性)、需要临床药剂师或医生随访的患者人数,以及适当时 A1c 和 BP 的干预前后变化。

结果

在符合纳入标准的 96 名患者中,有 55 名(57%)患者接受了 CMR。药剂师提供了 66 次患者教育,并在 15 名(27%)患者中发现了 22 个药物相关问题(MRP)。CMR 完成后,22 名(40%)患者被转介给初级保健药剂师或医生提供者进行持续治疗。

结论

CMR 对于接受癌症治疗的慢性病患者是可行且适宜的。

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