A telephone follow-up management model for oral outpatient chemotherapy featuring concerted interventions by hospital and community pharmacists, and physicians

Abstract

Abstract Purpose Despite the critical importance of patients’ recognition and self-management of adverse drug effects (ADEs) in oral outpatient chemotherapy, continuous care and patient education in this field have not been fully explored in Japan. We conducted a prospective pilot study to examine the feasibility of a management model for oral outpatient chemotherapy. Methods The inclusion criterion was patients treated with S-1 alone or in combination with other agents. In the management model, patients underwent consultation with a hospital oncology pharmacist after a checkup with their physician, and were followed up by a community pharmacist on the telephone at least once a week until their next hospital visit. Both pharmacists focused on drug-related problems (e.g., obstacles to adherence, early ADEs), provided counseling, and informed the physician of any ADEs. The primary outcome was feasibility of the management model. The secondary outcomes were medication adherence, ADEs, and patient satisfaction. Results Among 23 eligible patients, 20 (with colorectal, pancreatic, or biliary cancer) agreed to participate. Of these, 14 were treated with S-1 monotherapy and 6 with S-1, irinotecan, and bevacizumab (SIRB) or S-1, oxaliplatin, and bevacizumab (SOX/BV). The completion rate of telephone follow-up was 100%. Mean adherence was 99.5% (range: 95.5–100.0). Community pharmacists identified 16 ADE cases during the treatment period. In a satisfaction questionnaire, 17/17 patients indicated that the hospital pharmacist consultation was useful, and 15/17 viewed the telephone follow-up as helpful. Conclusions Our new management model featuring concerted interventions enables continuous management for safe and effective oral outpatient chemotherapy.