Impact of a medication therapy management service offered to patients in treatment of breast cancer

Abstract

Cancer has high morbidity and mortality rates related to medication use and produce a costly impact in health care. Thus, patients require constant monitoring and proper coordination of care between different professionals. This study aimed to evaluate the impact generated by a Medication Therapy Management service (MTM) offered to patients with breast cancer in use of polypharmacy. Observational, exploratory, descriptive and retrospective study of a MTM service that included 93 patients. Sociodemographic and clinical data related to pharmacotherapy and the processes associated with the systematization of the service were collected and analyzed. Patients were followed-up by the MTM service on average for 18 months (±4.31) and 185 drug-related problems (DRP) were identified, an average of two DRP per patient. Of these DRP, 48.11% were resolved and 49.73% were in the resolution process. The most common DRP were in the categories of Indication (37.84%), followed by Safety (23.78%). The safety category showed the highest resolution rate (59.09%). The study revealed an increased risk of DRP for patients with three or more comorbidities and using 5 or more medications. The process of systematization of a MTM service in oncology was associated with positive outcomes.

Evaluation of process indicators of a medication review service between pharmacists and physicians

“…In this study, the results obtained after the CMRS implementation were similar to those in other studies: most of the DRPs cases were identified and often resolved in the first comprehensive medication management consultation . The probability of identifying DRPs increased as more pharmaceutical consultations were performed.…”

“…Apart from comorbidities, patients' DRPs type and complexity may have an impact on DRPs resolution, and thus must also be considered . Regarding type, studies have pointed out the need for additional drug therapy as the most frequent DRPs among patients cared at a clinical pharmacy service . In the present study, the DRPs of need for drug therapy could be solved with greater ease and brevity owing to the collaborative work among physicians and pharmacists of the CMRS.…”

“…This may be used as a factor to determine an optimum number of consultations for patients with similar characteristics to this study. Thus, continuity of service is critical, as DRPs can occur at any time during treatment . Consecutive pharmaceutical consultations may elucidate the nature of the clinical circumstances that generate DRPs, and these may be related to the drug, patient, prescriber, pharmacist, or health care system …”

Experiência Subjetiva com Medicamentos de Pacientes convivendo com o Câncer de Mama: um Fotovoz

“…Para isso, o profissional avalia se todos os medicamentos utilizados pelo paciente são indicados, efetivos e seguros, para então fomentar sua adesão aos respectivos produtos farmacêuticos. Ao seguir essas etapas, o farmacêutico determina se o paciente apresenta algum PRM, elabora planos de cuidado para solucioná-lo, em colaboração com o paciente e equipe de saúde, e, posteriormente, avalia os resultados das suas recomendações 6,[11][12][13]16 .…”

“…O tratamento com hormônio já tem impacto positivo bem documentado, pois propicia uma sobrevida global e sobrevida livre de progressão da doença de 15 a 20 anos 3 . No entanto, as pacientes estão susceptíveis a problemas relacionados ao uso de medicamentos (PRM) que podem comprometer a efetividade do tratamento e oferecer riscos à sua saúde, levando à morbimortalidade relacionada à farmacoterapia 4,5,6 . Esse é um problema social de grande magnitude e que requer atenção permanente 6 .…”