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加强老年病学家、肿瘤学家和药剂师之间的合作,以优化老年癌症患者的药物治疗:SOFOG-SFPO 的立场文件。

Enhancing collaboration between geriatricians, oncologists, and pharmacists to optimize medication therapy in older adults with cancer: A position paper from SOFOG-SFPO.

机构信息

Société Française de Pharmacie Oncologique (SFPO), France; Department of Pharmacy, Lyon Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, France and EA 3738 CICLY, Lyon 1 University, Oullins, France.

Société Française de Pharmacie Oncologique (SFPO), France; Department of Pharmacy, Lille University Hospital, Lille, France.

出版信息

Crit Rev Oncol Hematol. 2023 Oct;190:104117. doi: 10.1016/j.critrevonc.2023.104117. Epub 2023 Sep 1.

Abstract

Optimizing anticancer treatment and medication therapy in older patients with cancer requires a multidisciplinary approach, with a strong collaboration between geriatricians, oncologists and pharmacists. While all patients can benefit, some clinical situations seem to be high-priority. Careful attention should be given to patients with cardiovascular comorbidities and/or diabetes, which are prone to decompensate during anticancer treatment and often involve multiple medications. Another great concern is the risk of falls, closely related to polypharmacy, hence the need for a comprehensive medication review. Managing the pharmacological treatment of depression is also challenging and require shared expertise. Finally, pharmacists can prove valuable in situations of adherence difficulties or use of complementary medicines. Collaborative practice should begin at initiation of anticancer treatment and continue throughout the care pathway, as continuous reassessment is essential. Although the integration of pharmacists in multidisciplinary teams is often challenged by funding, collaborative should still be strongly encouraged.

摘要

优化老年癌症患者的抗癌治疗和药物治疗需要多学科方法,老年病学家、肿瘤学家和药剂师之间需要密切合作。虽然所有患者都可能受益,但某些临床情况似乎更为优先。应特别关注有心血管合并症和/或糖尿病的患者,这些患者在抗癌治疗期间容易出现失代偿,并且经常涉及多种药物治疗。另一个令人关注的问题是跌倒的风险,这与多种药物治疗密切相关,因此需要进行全面的药物审查。管理抑郁症的药物治疗也具有挑战性,需要共享专业知识。最后,药剂师在药物依从性困难或使用补充药物的情况下可能会非常有帮助。协作实践应在开始抗癌治疗时开始,并贯穿整个护理途径,因为持续评估至关重要。尽管药剂师加入多学科团队通常受到资金的限制,但仍应强烈鼓励协作。

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