The role of pharmaceutical care in care pathways for cancer patients

Keywords

pharmaceutical care - pathway - cancer patients

Introduction: Medication Therapy Management (MTM) is a service designed to optimize therapeutic outcomes through improved medication use and to reduce the risk of adverse events. It acknowledges the essential role of pharmacists in improving clinical outcomes and decreasing healthcare costs.

Objectives: To describe pharmaceutical care practice in a patient-centered service for breast cancer patients by implementing medication therapy management (MTM) to prevent and resolve drug therapy problems. Methods. An experience report was developed to explore the implementation and initial results of a pharmaceutical care service in a Brazilian private clinic for outpatients with cancer.

Results: A pharmacist was assigned to conduct an initial assessment of patients starting a new chemotherapy protocol, aiming to collect data on all medications, herbs, supplements, and alternative products used by the patient. The objective in this context is to understand the prescriptions, how each is being administered, and if subjective perceptions of the individual may influence its use. An established method, Pharmacotherapy Workup (PW) is used to comprehensively review each drug in use, determining its indication, effectiveness, safety, and convenience. These parameters should be systematically analyzed in this order. A problem detected in any of those areas is classified as a drug therapy problem (DTP), which implies a personalized intervention. Adherence is monitored with qualitative and quantitative tools, including self-report, Morisky-Green test, and counting tablets/pills for oral antineoplastics in each new dispensing. All patients in one of the institution's care pathways were screened for eligibility. A validated score to measure DTP risk is applied to prioritize appointments and indicate a minimal follow-up period. Patients who scored above 9 points or presented a clinical situation that demanded a pharmacist's follow-up were included. Between January and July 2024, 209 patients were screened with an initial assessment. 121 interventions targeting a drug were proposed, and 97 were successfully implemented and effective (80,02%). Major causes of pharmaceutical interventions were lack of prescription for prophylactic drugs, dose adjustments, and low rates of patient adherence.

Conclusion: Pharmaceutical care practice can be useful in addressing and resolving DTPs to improve clinical outcomes and reduce adverse events, considering patients’ medication experiences.

Corresponding author: Carolina Martins Vieira (e-mail: [e-mail]).

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
06 May 2025