2011 年 37 巻 5 号 p. 317-321
In a retrospective study, pharmacists attended medical interviews and examinations conducted by a doctor and carried out follow-up interviews by telephone, to lessen the risk factors for hand-foot skin reactions (HFSR) caused by sorafenib in advanced hepatocellular carcinoma patients and improve treatment adherence for the drug. The study was conducted to assess the effectiveness of pharmacist intervention. The medical records and risk assessment sheets of 48 hepatocellular carcinoma patients who received sorafenib from June 2009 to May 2010 were reviewed.
There were 45 male and 3 female patients, with a median age of 70.5 (range 37-83) yrs. The Eastern Cooperative Oncology Group performance status was 0, 1 and 2 in 37, 10 and 1 patients, respectively. The incidence of HFSR was 73%(35/48), and the maximum grade of HFSR was 0, 1, 2 and 3 in 13, 7, 23 and 5 patients, respectively. The mean number of risk factors for HFSR was significantly reduced after pharmacist intervention as compared with that before (3.5 ± 2.1 vs. 1.4 ± 1.3, p<0.001). Non-adherence to sorafenib was observed in 17 patients (35%), but treatment adherence improved for all of these patients after pharmacist intervention.
Therefore, pharmacist intervention mitigated risk factors for HFSR and resolved the problem of non-adherence to treatment in patients with advanced hepatocellular carcinoma.