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Hospital pharmacist interventions for the management of oral mucositis in patients with head and neck cancer receiving chemoradiotherapy: a multicenter, prospective cohort study

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Abstract

Purpose

Oral mucositis is a severe adverse event in patients with head and neck cancer (HNC) receiving chemotherapy and radiotherapy that may cause the termination of cancer treatment. In this study, we aimed to reveal the benefits of pharmacist interventions in oral health care for patients with HNC receiving concurrent chemoradiotherapy (CCRT).

Methods

We conducted a multicenter, prospective cohort study on 173 patients from September 2019 to August 2022. We evaluated the association between the occurrence of oral mucositis during CCRT and various factors in the absence or presence of direct medication instructions from hospital pharmacists.

Results

Sixty-eight patients received medication instructions from pharmacists (the pharmacist intervention group), whereas 105 patients did not receive instructions (the control group). Logistic regression analysis showed that grade 2 (Gr 2) oral mucositis was significantly lower in patients receiving pharmacist interventions than in patients in the control group (adjusted odds ratio [aOR], 0.42; 95% confidence interval [CI], 0.18–0.96; P = 0.04). The time to onset of Gr 2 oral mucositis was significantly longer in the pharmacist intervention group than in the control group (hazard ratio, 0.53; 95% CI, 0.29–0.97; P = 0.04).

Conclusion

Direct intervention, especially when provided by hospital pharmacists, can have a real effect in supporting patients with HNC experiencing severe side effects of treatments. Moreover, the integration of pharmacists into the oral healthcare team is becoming even more essential to reduce the severity of side effects.

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Data availability

Data used in this study are not publicly available.

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Acknowledgements

We wish to thank Mamoru Tanaka, Hiroaki Yamaguchi, and Mayumi Kaise for organizing the data collection and caring for the study subjects.

Author information

Authors and Affiliations

  1. Division of Hospital Pharmacy, Niigata University Medical and Dental Hospital, Niigata, Japan

    Kensuke Yoshida, Naoto Hoshino, Naoto Suzuki & Akira Toyama

  2. Department of Clinical Pharmacy, College of Pharmaceutical Sciences, Matsuyama University, Matsuyama, Japan

    Shinichi Watanabe

  3. Division of Biostatistics, Center for Clinical Research, National Center for Child Health and Development, Tokyo, Japan

    Kyongsun Pak

  4. Division of Pharmacy, Ehime University Hospital, Toon, Japan

    Noriaki Hidaka & Masaki Nakai

  5. Department of Pharmacy, Yamagata University Hospital, Yamagata, Japan

    Noboru Konno & Chinami Ando

  6. Department of Pharmacy, Uonuma Kikan Hospital, Minamiuonuma, Japan

    Tsuyoshi Yabuki

  7. Division of Oral Radiology, Niigata University Medical and Dental Hospital, Niigata, Japan

    Kouji Katsura

  8. Division of Oral and Maxillofacial Surgery, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan

    Kei Tomihara

Authors
  1. Kensuke Yoshida
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  2. Shinichi Watanabe
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  3. Naoto Hoshino
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  4. Kyongsun Pak
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  5. Noriaki Hidaka
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  6. Noboru Konno
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  7. Masaki Nakai
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  8. Chinami Ando
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  9. Tsuyoshi Yabuki
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  10. Naoto Suzuki
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  11. Kouji Katsura
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  12. Kei Tomihara
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  13. Akira Toyama
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Contributions

All authors meet the ICMJE authorship criteria. All authors contributed to the study’s conception and design. Data collection was performed by Shinichi Watanabe, Naoto Hoshino, Noriaki Hidaka, Noboru Konno, Masaki Nakai, Chinami Ando, Tsuyoshi Yabuki, and Naoto Suzuki. Analysis was performed by Kyongsun Pak. Kouji Katsura provided e-learning. Kei Tomihara and Akira Toyama developed the trial design. The first draft of the manuscript was written by Kensuke Yoshida, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kensuke Yoshida.

Ethics declarations

Ethics approval

This study was approved by the Research Ethics Committee of Niigata University (approval number: 2021–0269).

Consent to participate

Informed consent was obtained from all individual participants included in the study by opt-out.

Competing interests

The authors declare no competing interests.

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Yoshida, K., Watanabe, S., Hoshino, N. et al. Hospital pharmacist interventions for the management of oral mucositis in patients with head and neck cancer receiving chemoradiotherapy: a multicenter, prospective cohort study. Support Care Cancer 31, 316 (2023). https://doi.org/10.1007/s00520-023-07784-6

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