Impact of oncology pharmacist services on humanistic outcome in patients with breast cancer.

Abstract

This study aims to investigate the change in quality adjusted life-years (QALYs) after providing oncology pharmacist services to assess its impact on humanistic outcome. It was a prospective, single-centered study conducted for a period of two years at Bharat cancer Hospital and Nirali memorial radiation center, Surat. Patients were recruited into the control group (CG) and the intervention group (IG). The oncology pharmacist services (OPS) were provided only to the IG. The humanistic outcome was measured by incorporating the EQ-5D-5L instrument to calculate quality-adjusted life-years (QALYs) in both the groups. Patients have been provided with the EQ-5D-5L questionnaire at the pre-determined intervals i.e. before the commencement of chemotherapy and then after every chemotherapy cycle till the completion of treatment. The analysis was carried out using descriptive analysis (frequency distribution for categorical variables and measures of central tendency (median and average) and dispersion (std. deviation) for quantitative variables). A total of 230 patients were screened and from them 105 patients were recruited, out of which 54 patients were in CG and 51 patients in IG. AC regimen followed by weekly paclitaxel was prescribed in majority of the patients (CG: 59.3%; IG: 60.8%) followed by AC-TRA and AC regimen alone. The majority of patients in the CG were facing improper administration of pre-medication (83.3%), lack of knowledge regarding chemo-mixing, counselling in nursing staff (66.7%) and a sub-therapeutic dose of anti-emetics (37%). The baseline QALY at the inception of chemotherapy was 0.040 and 0.014 in CG and IG, respectively. After the completion of the 6 chemotherapy cycle, the QALY was found to be 0.042 and 0.043 in CG and IG, respectively. The study has demonstrated that the improvisation in QALY after provision of oncology pharmacist services reflect the positive impact of oncology pharmacist on humanistic outcomes. The study also provided the opportunity to identify the thrust area where more clinical pharmacy exposure is needed in order to improve patient care.