Abstract
Introduction
Nausea, vomiting, constipation, and diarrhea are common cancer and cancer therapy adverse effects. Pharmacists are uniquely positioned to optimize patient symptom control and minimize excess use of hospital resources, such as emergency department visits.
Methods
Michigan Medicine oncology clinical pharmacists have been independently providing patient symptom management through a collaborative drug therapy management (CDTM) program which established guidelines for management of gastrointestinal toxicities (nausea, vomiting, diarrhea, and/or constipation) secondary to a patient’s cancer diagnosis or treatment of the cancer. Patients were referred to the pharmacist by the treating oncologist or hematologist.
Results
From June 2019 to May 2020, there were a total of 62 patient referrals. Ten of the 62 referrals did not meet the CDTM inclusion criteria, resulting in 52 patients who were managed by the pharmacists. The total number of individual pharmacist visits was 136, with a median of 2.2 (range, 0–11) visits per patient referred. A total of 169 categorized pharmacist interventions were captured. Most interventions (100/169, 59.2%) were related to nausea/vomiting. Diarrhea-related and constipation-related interventions accounted for 10 (5.9%) and 13 (7.7%) of the total interventions, respectively. Most patients (36/52, 69.2%) had a reduction in the severity of their referral diagnosis symptom(s) based on Common Terminology Criteria for Adverse Events grading.
Conclusion
The Michigan Medicine Pharmacist CDTM program allowed pharmacists to independently manage gastrointestinal toxicities of patients with cancer and improved patient symptom severity. The CDTM program has the opportunity to improve quality of care.
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All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by M.H. and J.R. The first draft of the manuscript was written by M.H. and J.R., and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Ethical approval was waived by institutional IRB in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.
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Homan, M.J., Reid, J.H., Nachar, V.R. et al. Implementation and outcomes of a pharmacist-led collaborative drug therapy management program for oncology symptom management. Support Care Cancer 29, 6505–6510 (2021). https://doi.org/10.1007/s00520-021-06239-0
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DOI: https://doi.org/10.1007/s00520-021-06239-0