[Hospital - community pharmacy coordination for the dispensing of oral antineoplastic drugs: An observational study in the French county of the Aveyron]

Oral anticancer medicine interventions: A cross-sectional study in French community pharmacies

IntroductionThe increasing number of oral anticancer medicines (OAMs) dispensed in community pharmacies and the associated challenges (misuse, management of side effects) give the community pharmacist (CP) a major role in the pharmacotherapeutic management of cancer patients. In France, as a response to these challenges, cancer outpatients can schedule a meeting with their CP to ensure the safe and effective use of OAMs. The objectives of this study were to evaluate the perspectives of these interventions regarding their implementation and the opinion of French CPs.MethodsA declarative survey and semi-structured interviews were conducted with CPs that dispensed at least one OAM between January 2021 and March 2022. The study was conducted between April and August 2022.ResultsEighty-five CPs completed the survey. Of these pharmacists, 21% (n = 18) had already performed OAM interventions and 91% (n = 61) wanted to implement them. Lack of time, knowledge and training were the main barriers to implementation. No correlations were identified between the characteristics of community pharmacies and the likelihood of implementing OAM interventions.ConclusionsConsidering that CPs seem willing to implement them and the favourable context in France, this observational study highlights the potential of OAM interventions to improve the management of cancer patients. Though further studies are required to better evaluate the implementation and the potential effects of these interventions, OAM interventions could be relevant strategies in other healthcare systems to secure the management of cancer patients through the involvement of the CP.

[Patients treated with anticancer drugs: Practices and expectations of community pharmacists]

INTRODUCTION

The evolution of pharmacotherapeutic management of cancer patients makes essential the role of the community pharmacist through its management conducted in community pharmacy as well as its relationships with the hospital and primary care professionals. The objective of this work is to study this pharmacotherapeutic management, for all routes of administration considered.

METHODS

This observational study is based on a questionnaire and semi-structured interviews conducted with community pharmacists in contact with the Unité médicale ambulatoire de cancérologie (UMAC) of the University Hospital of Dijon.

RESULTS

The main objective of community pharmacists is to ensure that patients understand and comply with their treatment. Twenty-one percent of them have already implemented oral anticancer drug interviews. Sixty-five percent have partial information about the injectable treatments administered to their patients while only 3 % have complete knowledge. Sixty-nine percent of community pharmacists are satisfied with the documents sent by the UMAC (summary of drug treatments, pharmaceutical report, individualized pharmaceutical plan). However, the lack of information from hospital structures generally represents one of the main difficulties in the management of cancer patients by community pharmacists and coordination with other professionals.

DISCUSSION

The information and training of community pharmacists represent possible improvements for a better care and coordination between healthcare professionals. Some emerging practices, such as the implementation of oral anticancer drug interviews in community pharmacies and the participation of community pharmacists in primary care coordination organizations, also represent opportunities to strengthen their role in the management of cancer patients.

Survey of community and hospital pharmacist involvement in outpatient chemotherapy using Japanese health information data

In this study, information on injectable anticancer drug use and additional fee for enhanced collaboration (AEC) and additional fee for specific drug management guidance 2 (ASD2) claims from the NDB Open Data Japan (NODJ) dataset and the number of patients with cancer according to sex and age from the National Cancer Registry (NCR) dataset were integrated and evaluated to determine the current status and challenges in pharmacist interventions for patients receiving cancer treatment. The NODJ data, including receipt data billed from 2020 to 2021, were obtained from the Ministry of Health, Labour and Welfare website. The use of injectable anticancer drugs decreased relative to the number of cancer patients aged ≥ 75 years compared to those aged < 75 years. Regarding injectable anticancer drug use, the number of AEC claims was similar between men and women, but the number of ASD2 claims was lower in men than in women. The number of times community pharmacists claimed their ASD2 was approximately 5% of the number of times hospital pharmacists claimed their AEC. This study revealed that several patients did not receive sufficient guidance from community pharmacists compared to hospital pharmacists, suggesting a potential insufficiency in the collaboration between the two groups.

[Oral anticancer drug: Feedback from six years of tripartite consultations in a hospital center]

INTRODUCTION

Tripartite consultations with a coordination between hospital and community care givers were implemented within hospital center for patients who start an oral anticancer regimen.

METHODS

Six years after the implementation, we wanted to assess this patient's pathway and describe how adjustments were necessary over the time.

RESULTS

A total of 961 patients received tripartite consultations. The medication review process revealed that nearly half of patients had polypharmacy (≥5 drugs/day). A pharmaceutical intervention was formulated in 45 % of cases and they were all accepted. For 33 % of patients, a drug interaction was identified and required for 21 % of them, discontinuation of one drug of their personal treatment. Coordination with general practitioner and community pharmacists were achieved for all patients. 390 patients benefitted from nursing telephone follow-up which represents approximately 20 calls per day to assess tolerance and compliance with treatments. Over time, organisational adjustments were necessary to adapt to the increase in activity. The scheduling of consultations has been improved thanks to the creation of a shared agenda and consultation reports have been expanded. Finally, an hospital functional unit was created to facilitate the financial valuation of this activity.

DISCUSSION

The feedback collected from the teams showed a real desire to perpetuate this activity even if it would seem that an improvement in human resources is still relevant as well as a better optimisation of the coordination between all the participants.