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통원치료센터 단기항암요법 환자의 부작용 양상 및 약사의 중재활동 효과

Adverse Drug Reaction Profile in Patients with Cancer Chemotherapy and Pharmacist's Intervention in the Ambulatory Care Unit

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초록

Adverse drug reactions (ADRs) to cancer chemotherapy are common, and it can lead to noncompliance or even discontinuation of the therapy. The purpose of this study was to assess the suspected ADR profiles of cancer chemotherapy, and to evaluate the pharmacist’s intervention in a tertiary care hospital. A retrospective, observational review of electronic medical records and pharmacist records were performed in a single department of an ambulatory oncology care unit. The collected dataset was analyzed for ADR profiles, dosage regimens, demographic profiles, causality, severity and pharmacist's intervention. Patients were included (n=157, 17-80 Y, median age 58 Y, male/female(2/1)) if they were prescribed cancer chemotherapy, and have had an intervention by the pharmacist, between July 2009 and June 2010. The most common ADRs were neutropenia (95.4%), thrombocytopenia (81.8%), nausea (84.1%), anorexia (84.1), constipation (52/3%), hand-foot syndrome (50%), neuropathy (50%), stomatitis (47.7%), diarrhea (27.3%), hiccups (20.5%) by XP (capecitabibe/Cisplatin) regimen; neutropenia (46.3%), thrombocytopenia (41.9%), nausea (54.8%). anorexia (38.7%), constipation (50%), myalgia (75.8%), neuropathy (9.7%), diarrhea (12.9%) by TC (Paclitaxel/Carboplatin) regimens; and neutropenia (73.6%), thrombocytopenia (41.5%), nausea (39.6%), anorexia (13%), constipation (24.5%), myalgia (3.8%), neuropathy (73.6%), stomatitis (35.2%), and diarrhea (13.2%) by R-CHOP (Rituximab/Cyclophosphamide/Doxorubicin/Vincristine/Prednisolone) regimen. ADRs commonly occur in chemotherapy patients and the pharmacist’s intervention was helpful. Improvement rates by the pharmacist's intervention were 80.8% (hiccup), 32.8% (constipation), 32% (myalgia), 19.6% (anorexia), 16.3% (nausea), 7.7% (neuropathy) and 6.4% (stomatitis). In conclusion, this indicates the need for rigid ADR monitoring in chemotherapy patients to ensure safety of the drug therapy.

Abstract

Adverse drug reactions (ADRs) to cancer chemotherapy are common, and it can lead to noncompliance or even discontinuation of the therapy. The purpose of this study was to assess the suspected ADR profiles of cancer chemotherapy, and to evaluate the pharmacist’s intervention in a tertiary care hospital. A retrospective, observational review of electronic medical records and pharmacist records were performed in a single department of an ambulatory oncology care unit. The collected dataset was analyzed for ADR profiles, dosage regimens, demographic profiles, causality, severity and pharmacist's intervention. Patients were included (n=157, 17-80 Y, median age 58 Y, male/female(2/1)) if they were prescribed cancer chemotherapy, and have had an intervention by the pharmacist, between July 2009 and June 2010. The most common ADRs were neutropenia (95.4%), thrombocytopenia (81.8%), nausea (84.1%), anorexia (84.1), constipation (52/3%), hand-foot syndrome (50%), neuropathy (50%), stomatitis (47.7%), diarrhea (27.3%), hiccups (20.5%) by XP (capecitabibe/Cisplatin) regimen; neutropenia (46.3%), thrombocytopenia (41.9%), nausea (54.8%). anorexia (38.7%), constipation (50%), myalgia (75.8%), neuropathy (9.7%), diarrhea (12.9%) by TC (Paclitaxel/Carboplatin) regimens; and neutropenia (73.6%), thrombocytopenia (41.5%), nausea (39.6%), anorexia (13%), constipation (24.5%), myalgia (3.8%), neuropathy (73.6%), stomatitis (35.2%), and diarrhea (13.2%) by R-CHOP (Rituximab/Cyclophosphamide/Doxorubicin/Vincristine/Prednisolone) regimen. ADRs commonly occur in chemotherapy patients and the pharmacist’s intervention was helpful. Improvement rates by the pharmacist's intervention were 80.8% (hiccup), 32.8% (constipation), 32% (myalgia), 19.6% (anorexia), 16.3% (nausea), 7.7% (neuropathy) and 6.4% (stomatitis). In conclusion, this indicates the need for rigid ADR monitoring in chemotherapy patients to ensure safety of the drug therapy.

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