P28.01 The Clinical Pharmacist as a Member of a Multidisciplinary Team for Lung Cancer Patients Assistance

Abstract

The recent finds related to molecular biology have been modifying treatment scenarios for lung cancer patients. Along with better understanding of different genetic changes and signalling pathways, new drugs have been developed for that kind of cancer treatment. Due to broad type of clinic protocols and oncological drug combinations, the participation of clinic pharmacists working as a multiprofessional team member has increased. In this article we will describe the caregiving model developed for patient treatment by a specialized clinical pharmacist. This article aims to provide a real case of a multiprofessional team that have been acting in specialized pharmaceutical patient monitoring. All patients were diagnosed with lung cancer and treated between november of 2018 and July of 2020, in a private oncologic clinic in the city of Rio de Janeiro, Brazil. We developed a pharmacist assistance model for lung cancer patients in order to improve its experience, safety and quality of life during all treatment scope (figure 1). 273 patients and 23 types of different oncological drugs were identified for lung cancer treatment, with 4 different types of pharmaceutical classes: 40% oral target-therapy; 30% conventional chemotherapy; 22% immunotherapy and 8% intravenous target-therapy. All patients were conducted by a previous clinical pharmacist query before begginning of treatment. Were evaluated: degree of treatment understanding of patient and caregiver; distress levels through assessment “thermometer”; identification and registration of allergies; smoking; social habits; comorbidities and drug reconciliation. Each patient received an individualized care plan, education material with guidance for drug administration and packaging of oncological medicines for home use, telephone follow-up to assess adherence and schedule of laboratory tests. Of the patients consulted by the clinical pharmacist, 67% needed pharmaceutical intervention, being referred for assessment of nutrition, psychologist or reassessment by the oncologist. 97% of pharmaceutical interventions were accepted by the multidisciplinary team. All identified drug toxicities were recorded and no patient abandoned treatment. With new oncological drugs for lung cancer treatment available on the market, it has been necessary a better understanding of protocols and monitoring plans for intravenous administration or for oral administration. The clinical pharmacist is a key factor for correct patient monitoring for each different types of protocols, by helping reduce drug interactions risks, toxicity identification and developing better treatment adherence. For this method of assistance to succeed, the presence of the pharmacist is fundamental on the “tumor board” and its inclusion as a member of multidisciplinary team.