[Examination of the usefulness of the pharmacists' outpatient clinic for treatment with oral molecule-targeting drugs].

ABSTRACT

BACKGROUND: In the author's hospital, pharmacists' outpatient clinics were initiated in April 2010, and the department of breast surgery there has provided guidance on oral anti-cancer medication, but with difficulty in adopting proposals for supportive therapy made after the doctor's consultation on the same day. Under such circumstances, this study examined methods for conducting interviews with patients before the doctor's consultation in cases where oral molecular-targeted drugs are necessary. OBJECTIVE: To promote next-generation skill-mix team medicine in order to improve the continuity of treatment and optimize therapeutic effects. METHODS: Patients being treated with oral molecular-targeted drugs in Hitachi General Hospital were studied. INTERVENTION Outcomes were assessed through medication-monitoring reports, while conducting a questionnaire regarding duties of pharmacists coordinating molecular-targeted drugs. RESULTS: Within the study period, 245/259(94. 6%)of proposals for prescriptions were adopted in 95 patients, among which 212/245(86. 5%) proposed supportive therapy. Improvement in conditions was observed in all patients treated with supportive therapy. The mean duration of sorafenib administration among 19 patients before and after the pharmacist's intervention was 66±20. 3 and 102±30. 8 days, respectively. The main reason for the need of pharmacists coordinating molecular-targeted drugs was security among all patients; "support for adverse event management"among all doctors; and "proposals for prescription" among all nurses. DISCUSSION: The mean duration of sorafenib administration prolonged by the pharmacist's intervention and consequent reduction in side effects may have directly improved the continuity of treatment. Furthermore, when reflecting on each prescription, the pharmacist's expertise may have facilitated pharmacological intervention. In the future, it may also be necessary to promote pharmacist-led consultations supporting patients' informed choice of drugs.