The Pharmacist’s Role in Drug-Related Problem Management at a Cancer Clinic in a Tertiary Care Hospital

Abstract

Background: Pharmacists have a crucial role in providing pharmaceutical care to cancer patients, working alongside the multidisciplinary professional team to ensure that patients receive the safest and most efficient therapy available.

Objective: This study aims to analyze the types of drug-related problems (DRPs), their causes, the role of pharmacists in their resolution, the rate of physician acceptance of these recommendations by pharmacists, and their clinical significance.

Methods: A retrospective study was conducted. Data from electronic databases of patients receiving anti-cancer drugs at the radiotherapy building at Khon Kaen Hospital from May 1, 2022, to April 30, 2023, were included. Data on patient demographics, types of drug problems, pharmacists' interventions, and physician acceptance rates with clinical significance were collected. All data were analyzed with descriptive statistics and presented as frequency, percentage, mean, and standard deviation.

Results: A total of 590 patients who reported at least one episode of a drug-related problem (DRP) were included in the study. A total of 909 DRPs were reported. The primary type of DRPs was safety-related (96.6%), mainly concerning adverse effects from drug mechanisms of action (82.2%). Common adverse effects included neuropathy (17.7%), hand-foot syndrome (15.1%), and neutropenia (8.4%). Pharmacists provided medication counseling to 80.5% of patients and collaborated with physicians to resolve adverse effects in 15.2% of cases. There were 1.8% of cases that did not achieve the intended treatment efficacy level, attributed to lower drug intake, medication omissions, and inadequate instructions or prescription information. Overall, pharmacists provided instructions and changed labels in cooperation with physicians, and 94.7% of these interventions were accepted, resulting in the prevention of chemotherapy toxicity to organs (79.6%).

Conclusion: Pharmacists play a crucial role in monitoring, preventing, and resolving adverse effects caused by chemotherapy. Providing information, reviewing drug lists, and giving recommendations on chemotherapy are thus essential roles of pharmacists in helping patients receive effective and safe drug therapy.