Role of Pharmaceutical Outpatient Clinic in Cancer Patients and Evaluation

Introduction When rapid feedback to physicians must be provided, e.g. monitoring therapy with the oral anticoagulant warfarin or providing therapeutic support for patients undergoing cancer chemotherapy, the involvement of pharmacists is required for outpatients. We launched a pharmacist outpatient service for patients with cancer taking oral anti-cancer agents. We evaluated the role and usefulness of the pharmacist outpatient service for these patients undergoing oral monotherapy with anti-cancer agents. Methods Data regarding prescription recommendations were collected from the drug management guidance records of 154 patients who consulted the pharmacist outpatient service between July 2013 and September 2015. In addition, the rates of prescription recommendation adherence were calculated. Between April and August 2015, a self-reported questionnaire was administered to 47 patients undergoing therapy with oral anti-cancer agents who were visiting the pharmacist outpatient service at the Ogaki Municipal Hospital (Ogaki, Japan). Results Prescription recommendations were given to 235 cases. The total rate of adherence to the prescription recommendations was 94.9% (223/235 cases). The majority of prescription recommendations regarding supportive care were those for moisturizing agents (20.9%), analgesics (20.9%), steroid ointments (12.7%), and antihypertensive agents (10.8%). When continued guidance was provided, significant changes were observed for survey items 3 (knowing the side effects of the medication), 8 (worrying about side effects), and 12 (interest in prescribed medicine) ( p = 0.0049, p < 0.0001, and p = 0.0164, respectively). Conclusion Our study showed that continued pharmaceutical intervention resulted in a deeper understanding of the medications' side effects, and it reduced anxiety levels in patients undergoing monotherapy with oral anti-cancer agents.

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“…1 Many community pharmacists are required to provide medication instructions. When rapid feedback to physicians must be provided, e.g.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the role and usefulness of a pharmacist outpatient service for patients undergoing monotherapy with oral anti-cancer agents

Kimura

Iwai

et al. 2016

J Oncol Pharm Pract

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“…10 Some studies have reported outpatient pharmacy services in which pharmacists limit their services to patients in private rooms. 11,12 However, the benefits of outpatient services in which clinical pharmacists collaborate with oncologists at outpatient clinics for cancer chemotherapy have not been reported in Japan.…”

Section: Introductionmentioning

confidence: 99%

Impact of pharmacy collaborating services in an outpatient clinic on improving adverse drug reactions in outpatient cancer chemotherapy

Suzuki

Kamata

et al. 2018

J Oncol Pharm Pract

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Background Collaboration between pharmacists, doctors, and nurses in outpatient treatment is beneficial; however, such services are limited in Japan due to the lack of a healthcare reimbursement fee for outpatient pharmacy services at outpatient clinic. Objective We evaluated the impact of a service in which clinical pharmacists collaborated with an oncologist at an outpatient clinic in the treatment of adverse drug reactions in outpatient cancer chemotherapy. Methods We performed a retrospective cohort study using patients' medical records and treatment diaries. Subjects were patients who received outpatient chemotherapy via a clinical pharmacist collaboration service provided by six outpatient pharmacists and an oncologist at an outpatient clinic between June and August 2016. Results During the study period, the total number of outpatient services was 2508, with 2055 (81%) related to chemotherapy. The six outpatient pharmacists provided interventions to 498 of the 2055 cases (24%). Of the 498 interventions, 103 (20%), in addition to oncologist's prescription, were suggested treatments for adverse drug reactions due to cancer chemotherapy. Oncologists approved a total of 82 prescription suggestions from pharmacists (79%) to 63 patients. Fifty-seven percent ( n = 47) of the adverse drug reactions were improved following the pharmacists' suggested prescriptions. Conclusions This is the first study to clarify the benefits of outpatient pharmacy services in which pharmacists collaborate with oncologists at an outpatient clinic for the management of adverse drug reactions in cancer patients in Japan.

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“…A recent assessment of a PMC for cancer chemotherapy at the International University of Health and Welfare Mita Hospital indicated that the respective degrees of understanding of drugs, treatment schedule, and the side effects and their prevention were significantly improved by consultation in the PMC compared with those without PMC consultation. 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 ].…”

Section: Reviewmentioning

confidence: 99%

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

Yamada

Nabeshima

2015

J Pharm Health Care Sci

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To improve the adherence to and knowledge about pharmacotherapy in outpatients and to maximize the efficacy and minimize the adverse drug events, the first pharmacist-managed clinic (PMC) in Japan was established for anticoagulation therapy at Nagoya University Hospital in 2000. Since then, various PMCs such as for asthma/chronic obstructive pulmonary disease, Alzheimer’s disease, hypercholesterolemia, chronic hepatitis C, cancer chemotherapy, palliative care, chronic kidney disease, and continuous ambulatory peritoneal dialysis have been established and expanded to many hospitals in Japan. Accumulating evidences suggest that PMCs have some beneficial effects on patients’ adherence to and knowledge about their pharmacotherapy as well as the clinical outcome, besides being cost-effective. Notably, PMCs for cancer chemotherapy have been approved as a new medical service in hospitals in 2014, which is covered by the universal health coverage in Japan. In this review article, the current status of PMCs for patient education and counseling in Japan and their impact on pharmaceutical care and management are critically reviewed. Furthermore, future perspectives on PMCs are discussed.

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Role of Pharmaceutical Outpatient Clinic in Cancer Patients and Evaluation

Cited by 17 publications

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Evaluation of the role and usefulness of a pharmacist outpatient service for patients undergoing monotherapy with oral anti-cancer agents

Evaluation of the role and usefulness of a pharmacist outpatient service for patients undergoing monotherapy with oral anti-cancer agents

Impact of pharmacy collaborating services in an outpatient clinic on improving adverse drug reactions in outpatient cancer chemotherapy

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

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