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Impact of clinical pharmacist-based parenteral nutrition service for bone marrow transplantation patients: a randomized clinical trial

Supportive Care in Cancer volume 21, pages 3441–3448 (2013)Cite this article

An Erratum to this article was published on 21 September 2013

Abstract

Purpose

Parenteral nutrition (PN) is a well-documented supportive care which maintains the nutritional status of patients. Clinical pharmacists are often involved in providing PN services; however, few studies have investigated the effect of a clinical pharmacy-based PN service in resource-limited settings.

Methods

We designed a randomized clinical trial to compare the clinical pharmacist-based PN service (intervention group) with the conventional method (control group) for adult patients undergoing hematopoietic stem cell transplantation in Shariati Hospital, Tehran, Iran (2011–2012). In the intervention group, the clinical pharmacists implemented standard guidelines of nutrition support. The conventional method was a routine nutrition support protocol which was pursued for all patients in the bone marrow transplantation wards. Main study outcomes included nutritional status (weight, albumin, total protein, pre-albumin, and nitrogen balance), length of hospital stay, time to engraftment, rate of graft versus host disease, and mortality rate. Patients were followed for 3 months.

Results

Fifty-nine patients were randomly allocated to a study group. The overall intake (oral and parenteral) in the control group was significantly lower than standard daily needed calories (P < 0.01). Patients in the intervention group received fewer days of PN (10.7 ± 4.2 vs. 18.4 ± 5.5 days, P < 0.01). All nutritional outcomes were either preserved or improved in the intervention group while the nutritional status in the control group was deteriorated (P values < 0.01). Length of hospital stay was significantly shorter in the intervention group (P < 0.01). Regarding PN complications, hyperglycemia was observed more frequently in the intervention group (34.5 %, P = 0.01). Two patients in the control group expired due to graft versus host disease at the 3-month follow-up.

Conclusion

A clinical pharmacist-based nutrition support service significantly improved nutritional status and clinical outcomes in comparison with the suboptimal conventional method. Future studies should assess the cost effectiveness of clinical pharmacists’ PN services.

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Acknowledgment

We express our gratitude to the staff of Bone Marrow Transplantation wards and Pharmaceutical Care Department of Shariati Hospital.

Conflicts of interest

We have no conflicts of interest to declare. The study was carried out as part of the doctoral thesis of the first author. We have full control of all primary data and we agree to allow the journal to review the data if requested.

Author information

Affiliations

  1. Department of Clinical Pharmacy, Faculty of Pharmacy, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran

    Maryam Mousavi

  2. Clinical Pharmacy Department, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran

    Alireza Hayatshahi & Mohammadreza Javadi

  3. Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran

    Amir Sarayani

  4. Clinical Pharmacy Department, Faculty of Pharmacy, and Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, 4th floor, No 92, Karimkhan Zand Ave., Hafte Tir Sq, Tehran, Iran

    Molouk Hadjibabaie & Kheirollah Gholami

  5. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Hassan Torkamandi

  6. Hematology-oncology and Stem cell Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Ardeshir Ghavamzadeh

Authors
  1. Maryam Mousavi
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  2. Alireza Hayatshahi
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  3. Amir Sarayani
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  4. Molouk Hadjibabaie
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  5. Mohammadreza Javadi
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  6. Hassan Torkamandi
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  7. Kheirollah Gholami
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  8. Ardeshir Ghavamzadeh
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Corresponding author

Correspondence to Molouk Hadjibabaie.

Additional information

Trial Registration ID: IRCT201203041030N9

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Mousavi, M., Hayatshahi, A., Sarayani, A. et al. Impact of clinical pharmacist-based parenteral nutrition service for bone marrow transplantation patients: a randomized clinical trial. Support Care Cancer 21, 3441–3448 (2013). https://doi.org/10.1007/s00520-013-1920-6

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  • DOI: https://doi.org/10.1007/s00520-013-1920-6

Keywords

  • Parenteral nutrition
  • Clinical pharmacist
  • Bone marrow transplantation
  • Nutrition status
  • Clinical outcome
  • Randomized clinical trial
  • Iran