Effectiveness of pharmacist-managed oncology ambulatory care for patients with non–small cell lung cancer in Taiwan

 

Ding-Cheng Liu, School of Pharmacy, College of Pharmacy, Taipei Medical University
Chuan-Lun Hung, School of Pharmacy, College of Pharmacy, Taipei Medical University
Yi-Wen Chen, Department of Pharmacy, Wan Fang Hospital, Taipei Medical University
Li-Na Kuo, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan; Department of Pharmacy, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
Yen-Chun Hsin, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan; Department of Pharmacy, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
Chun-Nan Kuo, School of Pharmacy, College of Pharmacy, Taipei Medical University; Department of Pharmacy, Wan Fang Hospital, Taipei Medical UniversityFollow

Keywords

Ambulatory care, Non-small cell lung cancer, Oncology pharmacist, Oral oncolytic therapy

Abstract

Non-small cell lung cancer (NSCLC) is commonly treated with tyrosine kinase inhibitors (TKIs). However, adverseevents from such treatment can lead to treatment discontinuation and additional medical expenditures. Ambulatory carefrom oncology pharmacists in patient education and symptom management can benefit patients with NSCLC. In thisstudy, we evaluated the effectiveness of an oncology pharmacy service at a medical center in Taiwan. We retrospectivelyenrolled 137 patients with NSCLC who initiated treatment with afatinib, gefitinib, or erlotinib between January 2017 andDecember 2021; 40 of them utilized the oncology pharmacy service (intervention group), and the remaining 97 did not(nonintervention group). To determine the effectiveness of the oncology pharmacy service, we analyzed the followingoutcomes: adverse event rates, number of hospital visits (unexpected outpatient department visits, emergency depart-ment visits, and hospitalization), and medical expenditure. The intervention group had significantly more skin-relatedadverse events (acneiform rash: 75% vs. 49%; mucositis: 40% vs. 21%; dermatitis: 30% vs. 9%; and paronychia: 85% vs.28%) but significantly fewer monthly emergency department visits (0.04 vs. 0.17) and unexpected outpatient departmentvisits (0.15 vs. 0.34). The intervention group also had significantly lower expenditure for emergency department visits(NT$166.4 vs. NT$734.8) and nonsignificantly lower expenditure for outpatient department visits. Our findings indicatethe value of pharmacist-managed ambulatory oncology care. Although this service did not reduce the incidence rates ofadverse events, it reduced the number of unplanned outpatient and emergency department visits and reduced the emergency department expenditure of patients with NSCLC receiving TKIs.

Recommended Citation

Liu, Ding-Cheng; Hung, Chuan-Lun; Chen, Yi-Wen; Kuo, Li-Na; Hsin, Yen-Chun; and Kuo, Chun-Nan (2024) "Effectiveness of pharmacist-managed oncology ambulatory care for patients with non–small cell lung cancer in Taiwan," Journal of Food and Drug Analysis: Vol. 32 : Iss. 4 , Article 13.
Available at: https://doi.org/10.38212/2224-6614.3528

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