In recent years a paradigm shift towards a patient-focused rather than a disease-focused approach occurred in many health care systems. The pharmacy profession experienced an accordant development. The traditional drug-oriented services expanded towards patient-oriented services. In oncology, pharmacists established central services for compounding of cytotoxic drugs and offered therapeutic drug monitoring for critical substances. Pharmaceutical care concepts are now being introduced to optimize individual drug therapy. Pharmaceutical care aims at improving safety and therapeutic outcomes and consequently, the patient's quality of life. These objectives imply a close relationship to supportive care. To achieve this, a multidisciplinary approach seems to be beneficial.

PurposeIndividualized patient care may help reduce the incidence of adverse drug events in systemic cancer therapy. This study was conducted to explore the feasibility and potential of additional pharmaceutical care for breast and ovarian cancer patients.MethodsThe study was designed as a prospective, multicentered cohort study with a control group. Ninety-eight breast or ovarian cancer patients were recruited from outpatient oncology clinics and primary care oncologists: initially into the control group receiving standard care and after implementation of pharmaceutical care into the intervention group consisting of additional patient counseling on the management of treatment-associated adverse events and optimization of supportive medication. Primary outcome was the complete response to the antiemetic prophylaxis. Secondary endpoints were the severity of nausea, frequency of emesis, health-related quality of life, and patient satisfaction with information on cancer treatment education.ResultsForty-eight patients were included in the control group and 50 in the intervention group. Of the patients, 35.4% in the control group and 76.0% in the intervention group (p < 0.001) had a complete response to the antiemetic prophylaxis. The severity of acute and delayed nausea was not reduced. The global health scale and two symptom scales (nausea and vomiting, appetite loss) of the EORTC QLQ-C30 questionnaire were positively affected by pharmaceutical care. Patient satisfaction with information was significantly higher in the intervention group.ConclusionsPatients with breast and ovarian cancer seem to benefit from pharmaceutical care, as suggested by improved patient-reported outcomes such as emetic episodes, quality of life, and patient satisfaction after implementation.Electronic supplementary materialThe online version of this article (doi:10.1007/s00520-012-1385-z) contains supplementary material, which is available to authorized users.

The version of the questionnaire with a total of 14 items seems to be suitable for measuring patient satisfaction with information. Additional research is needed to further verify the validity of the instrument. The questionnaire may help pharmaceutical-care providers to develop needs-based information strategies. The assessment of patient satisfaction can contribute to the outcome evaluation of pharmaceutical care. The fact that pharmacists are not yet being recognised by most patients as a source of information should support an intensified and more active offer of care by the pharmacist.

Aim of the review To review the consequences of drug-related problems (DRP) in systemic cancer therapy and identify specific contributions of the pharmacist to minimise treatment-associated risks. Method Searches in PubMed, Embase and the Cochrane Library were conducted. Bibliographies of retrieved articles were examined for additional references. Only papers in English between 1980 and 2007 were included. Results In systemic cancer therapy there is an enormous potential for DRP due to the high toxicity and the complexity of most therapeutic regimens. The most frequently reported DRP can be classified into adverse effects, drug-drug interactions, medication errors, and non-adherence. Pharmacists have enhanced efforts to assure quality and safety in systemic cancer therapy together with other health care providers. In consequence, oncology pharmacy has evolved as a novel specialist discipline. The endeavour to merge and coordinate individual activities and services of the pharmacist has led to pharmaceutical care concepts which aim at offering novel solutions to the various DRP. Conclusion Pharmaceutical care for cancer patients should be developed within research projects and integrated into disease management programs in order to ensure broad implementation.

ObjectivesClinical pharmacy services in German hospitals appear to be underdeveloped compared with other European countries. However, recent developments have increased the interest in expanding these services. Detailed data about the current state of clinical pharmacy services in Germany are lacking. This survey establishes the current level of pharmacy services in Germany and the barriers to implementation.MethodsAn online survey conducted in 2017 was distributed to directors of all 389 German hospital pharmacies. The survey contained 26 questions addressing hospital and pharmacy characteristics, clinical pharmacy services provided, the number of clinical pharmacists and the frequency as well as the quality assurance of these services.ResultsThere were 133 responses (34%). Of these, 84 (63%) pharmacies provided some form of clinical pharmacy services. Based on the 389 contacted pharmacies, a clinical pharmacy service is available in at least 22% of hospital pharmacies in Germany. On average there are 2.4 full-time equivalent (FTE) clinical pharmacists per hospital employed, although there is a wide variation in numbers (0.3–22 FTE) and service provision between hospitals. Clinical pharmacy services are generally provided on a daily or weekly basis, with a principal focus on general surgery, critical care and general medicine wards.ConclusionsThis is the first survey providing a detailed picture of clinical pharmacy services in Germany. There is wide variation in clinical service provision among hospitals, with some hospitals having developed a comprehensive range of clinical services. Compared with other countries, particularly the UK where the focus has shifted to provision of 7-day clinical services, the gap in clinical pharmacy services remains large. The focus should be turned to refining clinical pharmacy services in hospital admissions and discharge planning while also improving Health IT, the opportunities for specialisation and aligning education in accordance with the EAHP common training framework.