Implementation of pharmaceutical care service to elderly cancer patients in a tertiary care hospital in South India

• Published in: Journal of oncology pharmacy practice Vol. 29; no. 8; pp. 1836 - 1843
• Main Authors: Fariya, Shaik, Mary Martin Daniel, Priya Jovita, Raj, John Stephen, Sureshkumar, Kaoshik, Suthakar, Monisha, Muhasaparur Ganesan, Rajanandh
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-12-2023; Sage Publications Ltd
• Subjects: Cancer; Chemotherapy; Drug interaction; Patient education; Patients; Pharmaceuticals; Pharmacists; Platinum compounds; Vomiting; MOATT© – MASCC teaching tool; cancer; pharmaceutical care; Geriatric population
• ISSN: 1078-1552; 1477-092X
• DOI: 10.1177/10781552221143065

Purpose
The goal of this study is to identify drug-related problems (DRPs) for elderly cancer patients receiving chemotherapy by implementing pharmaceutical care services.
Methods
In this interventional study, patients were followed after each cycle till 12 weeks. The MOATT-MASCC teaching tool was used to educate patients about their therapy. The outcome measures included the occurrences of any DRPs such as inappropriate medication dose, dosage form, route of administration, therapeutic duplication, failure of the patient to adhere to the medication regimen, adverse drug reactions (ADRs), and drug–drug interactions (DDIs) and to resolve it.
Results
On 186 patients, there were 38% ADRs, 16% DDIs, 6% non-adherence to therapy, 4% medical conditions for which no medication was prescribed, and 1% therapeutic duplication and transcribing error was identified. A total of 226 ADRs were documented. Nausea and vomiting were the most frequently occurring ADRs (24%) and platinum compounds caused the highest number of ADRs. Assessments of causality showed that the majority of cases are ‘probable’ (50%). In evaluating the severity of ADRs, 53% of ADRs were ‘moderate’ and 51% of ADRs were ‘probably’ preventable. Upon assessing the DDIs, 35% of the prescriptions had ‘monitor therapy’. All of the DRPs, that were identified were notified to the treating oncologists and resolved without any disagreement.
Conclusions
Pharmaceutical care is essential for elderly cancer patients. Oncologists and pharmacists should work together to identify and manage DRPs as well as educate patients about their disease. This will help in improved patient care and a better therapeutic outcome.