Evaluation of oral chemotherapeutic drug therapy managed jointly by oncologists and pharmacists

Abstract

Objective: To assess the need for medication therapy management(MTM) from an oncologist/pharmacist joint clinic for patients who self-administer oral chemotherapeutic drugs and to identify intervention programs for pharmacists. Methods: Eighty-three patients who received oral chemotherapy drugs and received medication therapy management(MTM) were assessed by follow-up for three months. Pharmacists reviewed drug indications, use and dosage, oral and written medication education, evaluation of drug interactions, management of adverse drug reactions, medication errors and compliance, improvement and resolution of adverse drug reactions, avoidance of medication errors, and correction of medication compliance. Results: There were 226 follow-up visits and 164 interventions. The management of adverse drug reactions was the most important intervention. There were 655 adverse drug reactions, of which 104 were addressed by intervention and 80 were alleviated or resolved. Eighteen drug interactions were identified, 11 of which were serious drug-drug interactions. Seven medication errors were corrected. Twenty-seven items of medication compliance were managed. Conclusions： Patients who were receiving oral chemotherapy drugs within the standard of care needed additional support, and the medication therapy management(MTM) by pharmacists in the combined oncologist-pharmacist outpatient model could partly meet this need. Early medication therapy management(MTM) interventions may reduce the severity of adverse events, and late medication therapy management(MTM) interventions suggest the need for long-term follow-up management. Further analysis of the cost savings and cost avoidance of pharmacist intervention is necessary to justify the implementation of joint oncologist and pharmacist clinics.