CP-163 Onco-haematological outpatients treated with oral antineoplastic agents: pharmacist interventions

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Abstract

Background

Currently, oral antineoplastic agents (OAA) represent approximately 40% of all chemotherapy agents. Thus, onco-haematological outpatients have acquired more autonomy and responsibility since OAA require self-administration at home. Hospital pharmacists are the last health professionals in touch with patients and should detect problems related to these drugs (DRP).

Purpose

To assess pharmacist interventions performed in outpatients treated with OAA in a tertiary hospital.

Material and methods

All patients who started treatment with OAA between January and September 2016 in the outpatient pharmacy were included. Pharmacist interventions took place during the pharmacist interview at the beginning of the treatment. Other variables were: demographics, ECOG, type of tumour, OAA and concurrent medication. These data were collected from medical records and also directly from patients at the pharmacist interview. Severity of DRP was classified as minor, moderate or serious.

Results

170 patients (mean age 67.3 years, 64.7% men) were included. 7.9% of patients had ECOG >1. Prostate cancer (18.8%), renal cancer (17.0%), liver cancer (12.4%) and multiple myeloma (11.2%) were the most prevalent tumours. The most frequent OAA were: sorafenib (11.8%), everolimus (10.6%), abiraterone (10.0%) and lenalidomide (9.4%). 84 pharmacist interventions were performed in 62 different patients (90.5% oncological and 9.5% haematological patients). Interventions were classified as follows: 46.4% interactions (66.7% drug interactions and 33.3% herb interactions), mainly with omeprazole (35.9%), green tea (10.3%) and statins (7.7%); 17.9% reinforcement of health education (management of side effects and improvement in healthy lifestyle); 10.7% correcting inappropriate drug administration; 7.1% reinforcement of adherence; 7.1% dose modification; and 10.7% others. The OAA with more DRP (DRP/patient) were: pazopanib 1.1, sunitinib 1.0, enzalutamide 0.8, erlotinib 0.8, gefitinib 0.5, everolimus 0.4 and axitinib 0.4. Severity of DRP was: 41.7% minor, 38.1% moderate and 20.2% serious.

Conclusion

Pharmacist interventions and follow-up have detected DRP and improved the treatment of onco-haematological outpatients. The most frequent interventions consisted of identifying drug and herb interactions and improving the management of side effects.

Conclusion

No conflict of interest

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