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管理癌症和慢性病患者的药物治疗:是时候让初级保健药师与肿瘤药师展开合作了。

Managing medications for patients with cancer and chronic conditions: It's time for collaboration between primary care and oncology pharmacists.

作者信息

Davidson Arielle, Ismail Mohamad, Gatwood Justin, Farley Joel, Mackler Emily, Thompson Amy, Farris Karen

机构信息

Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, MI, USA.

US Health Economics and Outcomes Research, Vaccines, GSK, Philadelphia, PA, USA.

出版信息

J Oncol Pharm Pract. 2025 Jan;31(1):151-159. doi: 10.1177/10781552241279303. Epub 2024 Aug 30.

Abstract

OBJECTIVE

To provide a rationale for a collaborative care model involving oncology and primary care pharmacists to improve the coordination of care of medications for cancer patients with multiple chronic conditions.

DATA SOURCES

A review of selected literature and the authors' own research was used. Studies illustrating the gaps in care for medications and pharmacists' roles in oncology and primary care settings from PubMed were reviewed.

DATA SUMMARY

There has been a substantial increase in the development and utilization of oral anticancer agents (OAAs). Although OAAs offer convenience and flexibility, they also introduce challenges related to medication adherence, monitoring, and managing side effects. Up to 17.5% of patients experience moderate to severe symptoms from OAAs and about 30% report less than excellent medication adherence. Further, studies showed that 30% to 53% of adult cancer patients have at least one chronic condition that complicates their treatment plan due to the need for medications, increasing the risk of drug interactions, side effects, and non-adherence. The Primary Care Oncology Model (PCOM) incorporates both primary care and oncology pharmacists with comprehensive medication review and patient-reported outcome measure, respectively, to enhance medication appropriateness and effectiveness, and improve overall patient experience.

CONCLUSION

Implementing PCOM may improve the medication management of patients taking OAAs for active cancer treatment and chronic medications for their multiple chronic conditions. This collaborative approach can transform patient care by leveraging the expertise of both primary care and oncology pharmacists.

摘要

目的

为一种涉及肿瘤学和初级保健药剂师的协作护理模式提供理论依据,以改善对患有多种慢性病的癌症患者用药护理的协调。

数据来源

采用对选定文献和作者自身研究的综述。对来自PubMed的说明用药护理差距以及药剂师在肿瘤学和初级保健环境中作用的研究进行了综述。

数据总结

口服抗癌药(OAA)的研发和使用大幅增加。虽然OAA提供了便利和灵活性,但它们也带来了与用药依从性、监测和副作用管理相关的挑战。高达17.5%的患者因OAA出现中度至重度症状,约30%的患者报告用药依从性不佳。此外,研究表明,30%至53%的成年癌症患者至少有一种慢性病,由于需要用药,这使他们的治疗计划复杂化,增加了药物相互作用、副作用和不依从的风险。初级保健肿瘤学模式(PCOM)分别将初级保健和肿瘤学药剂师纳入全面用药审查和患者报告的结局指标,以提高用药的合理性和有效性,并改善患者的整体体验。

结论

实施PCOM可能会改善正在接受OAA进行积极癌症治疗以及因多种慢性病而服用慢性药物的患者的用药管理。这种协作方法可以通过利用初级保健和肿瘤学药剂师的专业知识来改变患者护理。

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