Pharmaceutical Care for Cancer Outpatients

Abstract

In recent years, the number of oral anticancer agents (OACA), protein kinase inhibitors (PKI or “nibs”), in particular, has sharply increased. In the near future, the rise is likely to continue. OACA are used in the treatment of both common cancer types and a wide variety of less commonly occurring cancers and hematological malignancies. Due to the spreading use of OACA in cancer treatment pharmacists (and staff) of outpatient pharmacies are becoming more closely involved in the disease’s main treatment and directly interact with predominantly older cancer patients and other caregivers. Providing pharmaceutical care for cancer outpatients requires specific knowledge of cancer (drug) therapy, pharmacogenomics, contraindications, interactions of OACA with other drugs and food, side effects, and their management and patient education.Within the framework of a multidisciplinary team effort, the pharmacist dispensing OACA must assess the suitability of its use for the patient and address eventual problems that the treatment entails, notably with respect to supportive and current medication for chronic diseases. The pharmacist is also responsible for adequate patient counseling. Adherence to OACA treatment and effects brought about by OACA and co-medication require careful monitoring of the patient and his/her use of medication. Close collaboration with other healthcare providers, both in the case of prescribing OACA and co-medication and with respect to events occurring during the course of treatment as the result of disease progression, side effects or incorrect medication use, is the most appropriate way to resolve eventual problems and adequately adjust treatment. In the present chapter, the various steps of the pharmaceutical care process, conditions for its successful completion and the role of the pharmacist in it, are lined out and the main topics that have to be addressed during this process including the detection and management of drug interactions, the reporting and management of side effects, (non-) adherence and adherence supportive care, and last but not least, patient counseling are discussed. The basic approach is that pharmacists are partners of (primary care) physicians as they collaborate on a wide variety of care activities including the optimization of treatment, medication reconciliation, patient education, and medication safety.