Journal
JOURNAL OF ONCOLOGY PHARMACY PRACTICE
Volume 25, Issue 1, Pages 130-139Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/1078155218783814
Keywords
Radiotherapy; ambulatory care; pharmacy; medication safety; medicine use optimisation
Categories
Funding
- Western and Central Melbourne Integrated Cancer Service (WCMICS) - Australian Department of Health
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Background Patients receiving anticancer therapies are frequently prescribed complex and high-risk medication regimens, which at times can result in medication misadventures. The objective of this review was to assess the effect of outpatient clinical pharmacy services on medication-related outcomes in patients receiving anticancer therapies, including patients undergoing radiotherapy. Methods A systematic review of original publications indexed in EMBASE, MEDLINE and Cochrane Library from June 2007 to June 2017. Eligible studies evaluated outpatient pharmacy clinic services for cancer patients and reported at least one medication-related quantitative outcome measure. Two authors independently reviewed full-text articles for inclusion, then extracted data and performed quality and risk of bias assessments. Results Of 908 identified publications, 13 met predefined eligibility criteria; 1 randomised control trial, 2 controlled cohort studies and 10 uncontrolled before-after studies. Many excluded studies described outpatient pharmacy services but lacked medication-related outcomes. All included studies had informative practice model designs, with interventions for drug-related problems including drug dose optimisation (n = 8), reduced drug interaction (n = 6) and adverse drug reaction reporting (n = 3). Most studies (n = 11) reported on symptom improvement, commonly nausea (n = 7) and pain (n = 5). Of four studies in radiotherapy cohorts, pharmacist involvement was associated with improved symptoms, satisfaction and wellbeing scores. Conclusion Few studies have objectively assessed outpatient pharmacy cancer services, even fewer in the radiotherapy settings. Although the results support these services, significant heterogeneity and bias in the study designs prohibit robust conclusions and further controlled trials are required.
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