Usefulness of a pharmacist outpatient service for S-1 adjuvant chemotherapy in patients with gastric cancer

Abstract

Abstract. S-1 adjuvant chemotherapy is an outpatient treatment for gastric cancer. To evaluate the role of the pharmacist outpatient service in increasing medication adherence and reducing adverse events associated with S-1, the present study retrospectively analyzed prescription recommendations from pharmacists to physicians and the persistence rate of S-1 adjuvant chemotherapy use in patients with gastric cancer. A total of 40 subjects who utilized the pharmacist outpatient service between November 2014 and March 2016 comprised the pharmacist group; and 94 patients who underwent S-1 adjuvant chemotherapy for gastric cancer between September 2012 and October 2014, but not as pharmacist outpatients, comprised the control group. Data on the prescription recommendations, persistence rate of S-1 adjuvant chemotherapy for 1 year and relative dose intensity were collected. The number of interventions and consultations for the pharmacist outpatient group were 40 and 644, respectively. Prescription recommendations regarding dosage, drug administration interval, and supportive therapy were provided in 62, 15 and 132 cases, respectively. The prescription proposal acceptance rate was 92.5%. The persistence rate of S-1 adjuvant chemotherapy for 1 year was significantly higher in the pharmacist group (82.5%) compared with the control group (39.4%; P<0.0001). The discontinuation rate due to adverse events was significantly lower in the pharmacist group (7.5%) compared with the control group (31.9%; P= 0.0015). In subjects who completed S-1 adjuvant chemotherapy, the relative dose intensities in the control and pharmacist groups were 82.9 and 84.7%, respectively. In conclusion, the continued pharmaceutical intervention ensured a high persistence rate of S-1 adjuvant chemotherapy.

Evaluation of pharmaceutical intervention in direct-acting antiviral agents for hepatitis C virus infected patients in an ambulatory setting: a retrospective analysis

“…We established an ambulatory care pharmacy practice for HCV-infected outpatients receiving IFN-free DAA therapy in September 2014, when we started therapy with DAAs in Kobe City Medical Center General Hospital. The purposes of establishing this practice were to provide information to physicians for appropriate prescriptions and to patients for the resolution of unclear points, to minimize the potential influence of drug-drug and drug-food interactions, to prevent adverse drug events, to enhance the patients’ adherence, and to maximize the effectiveness of IFN-free DAA therapy through patient education and counseling on DAA treatments [ 10 , 11 ]. The DAA therapy includes daclatasvir tablets and asunaprevir capsules (DCV + ASV), sofosbuvir/ledipasvir combination tablets (SOF/LDV), ombitasvir/paritaprevir/ritonavir combination tablets (OBV/PTV/r), and elbasvir tablets and grazoprevir tablets (EBR + GZR) for HCV genotype 1-infected patients and sofosbuvir tablets and ribavirin tablets or capsules (SOF + RBV), and OBV/PTV/r tablets and ribavirin capsules (OBV/PTV/r + RBV) for HCV genotype 2-infected patients.…”

An increase in the neutrophil-to-lymphocyte ratio during adjuvant chemotherapy indicates a poor prognosis in patients with stage II or III gastric cancer

“…In view of the RDI, some studies have demonstrated that insufficient RDI of chemotherapy was related to a poor prognosis in some malignancies such as breast, ovarian, colon, and pancreatic cancers [27–30]. In GC, two studies suggested that a decreased RDI of S-1 will lessen the efficacy of S-1 adjuvant chemotherapy for GC and may lead to a poor prognosis [31, 32]. Our present study included only patients with stage II or III GC who received sufficient adjuvant chemotherapy with S-1 after surgery and excluded patients with very advanced metastatic disease.…”

The impact of pharmacist‐led strategies implemented to reduce errors related to cancer therapies: a systematic review

“…There were nine studies that met our inclusion criteria with a total of 3496 participants (Table 1). 4,9,14,[24][25][26][27][28][29] The studies included 945 females and 1108 males, with one study of 1443 patients not reporting on the breakdown of these patients. The included studies had a weighted mean (SD) age of 60.8 (11.4).…”

“…In total, five studies followed a pre-and post-intervention design, 4,9,26,27,29 one study was a cohort study, 24 one study was a single arm historical cohort study 25 and two were randomised controlled trials. 14,28 All studies completed the initial pharmacist intervention face-to-face.…”

“…In three studies, usual care was defined as the care before pharmacist monitoring with no further elaboration. 24,26,29 Usual care in two studies included the primary specialist physician and other healthcare providers, with one also including ad hoc pharmacy consultations if requested by the patient. 25,27 A further study defined usual care as the provision of information and education by a nurse.…”