Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France.
Université Lyon 1- EA 3738, CICLY Centre Pour l'Innovation en Cancérologie de Lyon, 69921, Lyon, Oullins Cedex, France.
J Cancer Res Clin Oncol. 2023 Aug;149(10):7905-7924. doi: 10.1007/s00432-023-04630-4. Epub 2023 Feb 28.
Clinical pharmacy can reduce drug-related iatrogenesis by improving the management of adverse effects of drugs, limiting drug-drug interactions, and improving patient adherence. Given the vulnerability of cancer patients and the toxicity of injectable anticancer drugs, clinical pharmacy service (CPS) could provide a significant clinical benefit in cancer care. This review aims to synthesize existing evidence on clinical pharmacy's impact on patients treated with intravenous anticancer drugs.
A comprehensive search was performed in the PubMed/Medline database from January 2000 to December 2021, associating the keywords: clinical pharmacy, pharmaceutical care, pharmacist, oncology, and chemotherapy. To be eligible for inclusion, studies have to report clinical pharmaceutical services for patients treated with intravenous chemotherapy with a clinical and/or economic impact.
Forty-one studies met the selection criteria. Various CPS were reported: medication reconciliation, medication review, and pharmaceutical interview with patient. There was a lack of randomized study (n = 3; 7.3%). In one randomized controlled trial, pharmaceutical intervention significantly improved quality of life of patients receiving pharmaceutical care during injectable anticancer drugs courses. Economical results appear to show positive impact of clinical pharmacy with cost savings reported from 3112.87$ to 249 844€. Although most studies were non-comparative, they highlighted that clinical pharmacy tend to limit chemotherapy side effects and drug-related problems, improve quality of life and satisfaction of patients and healthcare professional, and a positive economic impact.
Clinical pharmacy can reduce adverse drug events in cancer patients. More robust and economic evaluations are still required to support its development in everyday practice.
临床药学可以通过改善药物不良反应的管理、限制药物相互作用和提高患者的依从性来减少与药物相关的医源性疾病。鉴于癌症患者的脆弱性和注射用抗癌药物的毒性，临床药学服务（CPS）可以为癌症护理提供重要的临床效益。本综述旨在综合现有证据，评估静脉用抗癌药物治疗患者中临床药学的影响。
在 2000 年 1 月至 2021 年 12 月期间，对 PubMed/Medline 数据库进行全面检索，使用关键词：临床药学、药学服务、药剂师、肿瘤学和化疗。为了符合纳入标准，研究必须报告静脉化疗患者的临床药学服务，具有临床和/或经济影响。
有 41 项研究符合选择标准。报告了各种 CPS：药物重整、药物审查和与患者的药物访谈。缺乏随机研究（n=3；7.3%）。在一项随机对照试验中，药物干预显著改善了接受注射用抗癌药物期间接受药物护理的患者的生活质量。经济学结果似乎显示了临床药学的积极影响，节省的成本从 3112.87 美元到 249844 欧元不等。尽管大多数研究是非比较性的，但它们强调了临床药学倾向于限制化疗副作用和与药物相关的问题，改善患者和医疗保健专业人员的生活质量和满意度，并产生积极的经济影响。
临床药学可以减少癌症患者的药物不良事件。仍需要更强大和经济的评估来支持其在日常实践中的发展。
