Implementation of a pharmaceutical care programme for patients receiving new molecular-targeted agents in a clinical trial unit

Abstract

A pharmaceutical care programme was implemented at our hospital in early 2013. The main objectives were to analyse and describe the pharmaceutical interventions made, to calculate adherence, interventions and to evaluate patient satisfaction with the care programme. We performed a single-centre descriptive and prospective intervention in cancer patients who received oral chemotherapy as part of a clinical trial in 2013. Eighty-three patients were included. Median age was 58 years (range, 31-80) and 42 patients (50.6%) were men. We recorded 23 interventions, 13 of which were associated with drug interactions. The mean percentage of adherence was 98.9%. The interview with the pharmacist was considered to be very important by 84.6% of the respondents. A total of 92.3% said that they would like to speak to the pharmacist at subsequent visits. The doubts detected during the visits enable us to conclude that the information patients receive with respect to their study medication is usually incomplete. An integrated pharmaceutical care programme for cancer patients participating in clinical trials with oral cytostatic drugs was successful in terms of adherence and patient satisfaction and makes it possible to guarantee the safety and effectiveness of treatment on an individual basis.

Use of Telepharmacy To Support Patients Using Oral Antineoplastic Agents: A Pilot Study

“…It is worth noting that, as important as technical knowledge, the pharmacist also should study the desirable clinical skills to perform patient care, such as active listening, individualization, and empowerment, among others. The medication adherence rates described in the literature are diverse, varying according to the methods for measurement and the analyzed oral antineoplastic agent [1], [2], [7], [10], [23], [24]. The results obtained in this study of low adherence to Bicalutamide and Exemestane are compatible with the work of Marques and Pierin (2008).…”

“…Like other reports [2], [24], the results show a high number of drugs in addition to oral antineoplastic agents, most of them for the treatment of comorbidities. Polypharmacy is associated with lower adherence, especially in chronic treatments [1] and oral antineoplastic treatments [2]. Although it was not possible to demonstrate the relationship between low adherence and polypharmacy in the present study statistically, this may have been one of the critical points for adherence to drug therapy.…”

“…Interestingly, it was possible to observe that, on some occasions, the patient's report over the phone did not correspond to the answers to the survey, reinforcing that the self-report cannot be interpreted literally or as the only source of information. However, even so, it is a method that has been used [1], [2], [7]. On the other hand, although Hematology/Oncology Pharmacist Association points out that dispensing indicators can be helpful tools to identify non-adherence [25], it must be remembered that such indicators are predictors of persistence and not of adherence properly said [17].…”

“…Data from literature suggest that the rates of oral antineoplastic adherence vary from 16 to 100%, depending on the medication and the method used for analysis [1], [9], [10]. It is noteworthy that failure to adhere to the treatment can have serious consequences, such as lack of therapeutic e cacy, toxicity, and higher costs resulting from the increased use of the health system, including more rates visits to care units and prolongation of hospital stay [10], [11].…”

Drug interactions with oral antineoplastic drugs: The role of the pharmacist

“…The main disadvantages are as follows: (a) the severity of the consequences of poor adherence, in terms of both extra doses and missed doses; (b) increased possibility of interactions with other drugs, alternative therapies, and food (Chan, Tan, Wong, Yap, & Ko, ); and (c) poorer control of prescription, dispensing, and administration (Goodin et al, ; Ruddy, Mayer, & Partridge, ). All these facts make indispensable the safety in the prescription, validation, and administration of OAD (Goodin et al, ; Riu et al, ).…”