I. Kenis PharmD, L-M Kinnaer PhD, PharmD, T. Van Nieuwenhuyse PharmD, V. Foulon PhD, PharmD
Over the last decades, the development and use of oral anticancer drugs has increased substantially. Although oral anticancer drugs are associated with numerous advantages, they also entail important challenges for patients and for healthcare professionals. In contrast to intravenous chemotherapy and immunotherapy, the administration of oral anticancer drugs takes place at the patients’ home. This implies a greater autonomy and responsibility for patients in their own care. To achieve an adequate level of self-management in patients and to provide effective self-management support by health care professionals, an interdisciplinary approach is crucial. However, the (potential) contribution of hospital pharmacists and community pharmacists to support adequate patient self-management in oncology, has not been described in policy documents (EPAAC, ESMO, ASCO, BeNCP) and is rather unknown for most health care professionals and patients. Therefore, this review aims to summarise the evidence on the role of the pharmacist, both in the hospital and in primary care, in the care process for patients treated with oral anticancer drugs and to discuss future opportunities for the evolvement of this role.
Different approaches and interventions, led by a hospital pharmacist, have been described and tested to improve quality and safety of the care for patients treated with oral anticancer drugs. Several of these interventions resulted in significant improvements in adherence, safety and other patient outcomes, which shows the added value of the involvement of a hospital pharmacist in the care for patients treated with oral anticancer drugs. However, the impact of interventions performed by a community pharmacist on outcomes in patients treated with oral anticancer drugs remains unclear.
Based on the evidence in literature, this article further describes the potential roles of the hospital pharmacist and community pharmacist in the total care process for patients treated with oral anticancer drugs. This ranges from checking doses and regimens and evaluation of potential drug interactions over dispensing and patient counselling to assessment and management of toxicity and adherence. Based on what we found in literature, we can conclude that involvement of both the hospital and the community pharmacist seems crucial to obtain an adequately individualised treatment and monitoring plan, with respect to comorbidities and concomitant medication.