Survey to Demonstrate the Effectiveness of Protocol-based Adverse Reaction Management by Pharmacotherapy for Oral Anticancer Drugs

- A Cooperative Study between Nagasaki University Hospital and Community Pharmacists Belonging to the Nagasaki Pharmaceutical Association

Abstract

In this practical research, we assessed the effectiveness of “Protocol-based Pharmacotherapy Management” (PBPM) by community pharmacists and the Nagasaki University Hospital with the cooperation of the Nagasaki Pharmaceutical Association and Nagasaki City Pharmaceutical Association. This study was implemented from July 1 to December 15, 2018. We targeted outpatients prescribed anticancer drugs (the combination drug tegafur/gimeracil/oteracil (S-1) or capecitabine) from Nagasaki University Hospital. Community pharmacists confirmed the presence of adverse reactions in patients by follow-up phone calls throughout the medication period or drug withdrawal period, and reported patients’ situation to their attending doctors according to the protocol. Telephone support by community pharmacists was provided to 17 and seven patients for S-1 and capecitabine, respectively. The number of telephone support times was 45 (2.9 times per patient) and 20 (2.7 times per patient) for S-1 and capecitabine, respectively. There were several instances of adverse skin reaction and whole-body weariness, and hand-foot syndrome was confirmed with a particularly high frequency. Community pharmacists followed compliance with recommended methods of skin care and the usage of prescribed medications. The telephone support for patients included “extension of the drug withdrawal period for S-1” and “reduction of the dosage of capecitabine”, which contributed to the safe discontinuation of drug treatment. This report is a valuable study that indicates PBPM between community pharmacists, hospital pharmacists and medical doctors through cooperation between key hospitals and regional pharmaceutical associations effectively achieved seamless medical cooperation.