Introduction of Pharmaceutical Care and its Effects in Outpatients with Cancer Chemotherapy

Abstract

In recent years, cancer chemotherapy has been shifted from inpatients to outpatients. In outpatient cancer chemotherapy, patients manage side effects by themselves. Therefore, it is very important that pharmacists provide information of side effects to patients. In Shiga University of Medical Science Hospital, pharmaceutical care to all outpatients by pharmacists was started from October 2010. However, starting the service incurred some problems. One of them was understaffing. When we constructed a novel original outpatient chemotherapy system, the manpower shortage problem was dispelled. Throughout this service, various symptoms caused by chemotherapy were more significantly improved in intervention cases than in non-intervention cases. A medication leaflet was used when providing medical information for pharmaceutical care. It was also expected to provide information to medical facilities outside the hospital. We consider that the medical leaflet may contribute to promoting collaboration between hospital and community pharmacies.

Pharmacist-managed clinics for patient education and counseling in Japan: current status and future perspectives

“…At present, various PMCs are in operation at hospital pharmacies in Japan [ 42 - 50 ] (Table 1 ). For example, we now operate 7 PMCs at Nagoya University Hospital, such as for anticoagulation therapy, asthma/chronic obstructive pulmonary disease (COPD), donepezil outpatient consultation service (DOCS), palliative care, chronic kidney disease, molecular-targeted drugs, and continuous ambulatory peritoneal dialysis.…”

“…As a distinct feature of PMCs in Japan, the number of PMCs for cancer chemotherapy has rapidly increased in parallel with a paradigm shift of the treatment from inpatients to outpatients [ 45 - 50 ]. Of note, PMCs for cancer chemotherapy have been approved as a new medical service in hospitals in 2014, and are covered by the universal coverage in Japan, if certified oncology pharmacists, in agreement with physicians, conduct patient education and counseling about cancer chemotherapy with the consent of patients.…”

“…Furthermore, clinical pharmacists are expected to participate actively in cancer chemotherapy with pharmaceutical knowledge and skills to enhance patient understanding and adherence to the regimens and to secure the safety of treatment. Accordingly, the number of PMCs for cancer chemotherapy has rapidly increased in parallel with a paradigm shift of treatment from an inpatient to an outpatient basis [ 45 - 50 ].…”

“…In this study, a majority of patients (44/50, 88%) who had had some anxiety about chemotherapy reported that their anxiety levels were reduced by the counseling in the PMC [ 49 ]. The outcome analysis of pharmaceutical care in outpatients who had received cancer chemotherapy at Shiga University of Medical Science Hospital indicated that the rate of amelioration of symptoms associated with chemotherapy was significantly higher (94/145 cases, 65%) when a pharmacist’s suggestions about the prescription were adopted by the physician than the rate when the suggestions were not adopted (6/17 cases, 35%) [ 50 ]. These results support the clinical significance of PMCs for cancer chemotherapy, while the cost-effectiveness of this clinical practice by pharmacists should be demonstrated in future studies.…”

A Retrospective Study of the Effects of Oncology Pharmacist Participation in Treatment on Therapeutic Outcomes and Medical Costs

“…1,2) Several studies on the effectiveness of pharmacist's activities in the field of cancer chemotherapy have been reported in Japan. [1][2][3][4][5][6][7][8] However, no study has yet addressed the effect of collaboration between oncology pharmacists and physicians on therapeutic outcomes and medical costs in Japan. 9) In this study, we compared patients undergoing chemotherapy for cancer who were managed by physicians alone with those managed in collaboration with oncology pharmacists.…”