Drug-related problems with targeted/immunotherapies at an oncology outpatient clinic

J Oncol Pharm Pract. 2020 Apr;26(3):595-602. doi: 10.1177/1078155219861679. Epub 2019 Jul 25.

Abstract

Background: Some studies in the literature describe drug-related problems in patients with cancer, although few studies focused on patients receiving targeted chemotherapy and/or immunotherapy. To identify the incidence of drug-related problems in patients receiving targeted chemotherapy and/or immunotherapy, and demonstrate the impact of a clinical pharmacist in an outpatient oncology care setting.

Methods: Prospective study was conducted in a hospital outpatient oncology clinic between October 2015 and March 2016. Patients greater than 18 years old receiving cetuximab, nivolumab, ipilimumab, or pembrolizumab were included in the study and monitored over a three-month period by a clinical pharmacist. Drug-related problems were analyzed using the Pharmaceutical Care Network Europe classification system. The main outcome measures were the frequency and causes of drug-related problems and the degree of resolution achieved through the involvement of a clinical pharmacist.

Results: A total of 54 patients (mean age: 57 ± 12 years) were included. There were 105 drug-related problems and 159 associated causes. Among the planned interventions (n = 149), 92 interventions were at the patient-level with 88 (96%) being accepted by the doctors. This resulted in 68 (65%) drug-related problems being completely resolved and 9 (8.6%) being partially resolved. The most common drug-related problem identified was "adverse drug event" (n = 38, 36%). Of the 105 drug-related problems, 63 (60%) related to targeted chemotherapy and/or immunotherapy with 34 (54%) classified as an "adverse drug event."

Conclusion: Adverse drug events were the most common drug-related problems in patients with cancer. The involvement of a clinical pharmacist improved the identification of drug-related problems and helped optimize treatment outcomes in patients receiving targeted chemotherapy/immunotherapy.

Keywords: Drug-related problems; chemotherapy; clinical pharmacist; oncology; pharmaceutical care.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / adverse effects*
  • Drug-Related Side Effects and Adverse Reactions / epidemiology
  • Female
  • Humans
  • Immunotherapy / adverse effects*
  • Male
  • Middle Aged
  • Molecular Targeted Therapy / adverse effects*
  • Neoplasms / drug therapy*
  • Outpatient Clinics, Hospital
  • Prospective Studies

Substances

  • Antineoplastic Agents