Investigation into the Establishment of Indicators for Pharmaceutical Intervention in Cancer Pharmacotherapy

Abstract

The present study was conducted to establish pharmaceutical intervention guidelines to enable hospital pharmacists to provide optimal pharmacotherapy to cancer patients. Many patients who use oral anticancer agents showed favorable drug compliance but insu‹cient drug adherence. It was demonstrated that in order to improve drug adherence, it is important to conduct interventions tailored to the patients' conditions so as to encourage interest in their medications, as well as to gain their understanding on the necessity and the side eŠects of their medications. In adjuvant chemotherapy with tegafur/gimeracil/oteracil potassium (S-1) following surgery for stomach cancer, a serum albumin value ＜3.5 g/ dL and a creatinine clearance value ＜80 mL/min were found to signiˆcantly aŠect S-1 dose reduction or termination of the S-1 intake due to side eŠects. Furthermore, patients for whom treatment was discontinued or dosage was reduced demonstrated a large reduction in body mass index. When adding insulin to an at-home high-calorie infusion, the insulin retention rate decreased when the number of grams of sugar level per 1 g of sodium bisulˆte in the infusion (G/g) was  364.6, whereas the insulin retention rate did not decrease when G/g was  466.0. Ourˆndings in the present study can serve as highly useful guidelines when pharmacists working in clinical settings conduct pharmaceutical interventions in pharmacotherapy for cancer.

Needs of chemotherapy regimen checks procedure: from the survey on chemotherapy regimen checks performed by pharmacists in hospitals other than designated cancer hospitals in Japan

“…In the 2014 revisions, the term cancer patient counseling fees was changed to cancer patient instruction fees so that pharmacists can charge fees for explaining the side effects of antineoplastic agents. For example, Demachi et al [2] reported that the presence of a pharmacist during the physician's examination in outpatient care increased safety in chemotherapy and another study comparing patients administered S-1, the combination of tegafur, gimeracil, and oteracil potassium, for gastric cancer with and without pharmacists’ interventions reported that pharmacists’ intervention of adjuvant chemotherapy for gastric cancer of chemotherapy regimen increased the rate of patients who completed the treatment from 39.4% to 91.7% [3] …”

“…For example, Demachi et al [2] reported that the presence of a pharmacist during the physician's examination in outpatient care increased safety in chemotherapy and another study comparing patients administered S-1, the combination of tegafur, gimeracil, and oteracil potassium, for gastric cancer with and without pharmacists' interventions reported that pharmacists' intervention of adjuvant chemotherapy for gastric cancer of chemotherapy regimen increased the rate of patients who completed the treatment from 39.4% to 91.7%. [3] The major conventional roles of Japanese pharmacists in cancer care have comprised dispensing and preparation of anticancer drugs. However, as the number of patients who undergo chemotherapy increases, occasions requiring pharmacists to perform regimen checks of physicians' prescription orders increases so that patients can undergo safe and effective chemotherapy.…”