药师主导干预对成人肿瘤门诊患者的影响
药剂师主导的药物重整、咨询和随访对成人肿瘤门诊患者用药依从性、用药错误和药物相关住院率的影响
Background and Rationale: Cancer patients receiving outpatient therapy often manage complex medication regimens that include anticancer agents, supportive care medications, and treatments for chronic comorbidities. This polypharmacy greatly increases the risk of medication discrepancies, potential drug-drug interactions, and unintentional errors. Moreover, because most oncology care is delivered in outpatient settings, patients are primarily responsible for self-administering their medications, making adherence a key determinant of treatment success and patient safety (Lindenmeyer et al., 2022; Alshehri et al., 2024). Medication errors and poor adherence among oncology patients are widely recognized global concerns. Research indicates that nearly half of cancer patients experience at least one medication discrepancy during transitions of care, and nonadherence to oral anticancer therapies can exceed 40%. Such issues can result in reduced treatment efficacy, increased toxicity, avoidable hospitalizations, higher healthcare costs, and poorer quality of life (Weingart et al., 2018; Wu et al., 2020; Patel et al., 2021). Pharmacists, as essential members of the multidisciplinary oncology team, are uniquely positioned to address these medication-related challenges. Their pharmacotherapy expertise and patient-education roles enable them to detect discrepancies, optimize medication use, and enhance patient understanding of treatment regimens. Evidence from various healthcare settings shows that pharmacist-led interventions such as medication reconciliation, individualized counseling, and structured follow-up can improve medication safety and adherence (de Clercq et al., 2021; Boeni et al., 2022). Despite strong evidence supporting each of these interventions individually, few studies have examined the combined effect of pharmacist-led reconciliation, counseling, and follow-up in outpatient oncology practice. Adult cancer patients face additional challenges, including complex dosing schedules, emotional distress, and financial burdens, all of which can impair medication adherence. An integrated pharmacist led program may create a continuous safety net that detects medication discrepancies early, reinforces correct use, and sustains adherence throughout treatment (Gellad et al., 2022; ISPOR Report, 2023). Therefore, this study aims to evaluate the impact of a comprehensive pharmacist-led program encompassing medication reconciliation, individualized counseling, and systematic follow-up on enhancing medication adherence and reducing medication errors among adult outpatient cancer patients. Demonstrating the effectiveness of this integrated care model may provide strong evidence to support the routine inclusion of pharmacists in outpatient oncology services to improve patient outcomes and medication safety (Alshehri et al., 2024; Boeni et al., 2022).
Study Hypothesis: Adult oncology outpatients are frequently prescribed complex medication regimens upon leaving the hospital. Therefore, this study aims to evaluate whether a comprehensive pharmacist-led outpatient program improves medication adherence and reduces medication errors among this population.
研究概览
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
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Dr
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Cairo、Dr、埃及、11829
- Badr University in Cairo
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Cairo、Dr、埃及、11829
- National Cancer Institute, Cairo University
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
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• Adult medical oncology outpatient at NCI, Cairo University with different diagnoses.
- Receiving ≥5 medication
Exclusion criteria:
- Cognitive impairment,
- Palliative care
- Language barriers
学习计划
研究是如何设计的?
设计细节
- 主要用途:支持治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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有源比较器:PH-LED
Pharmacist led intervention |
Medication Reconciliation, Counseling and Follow-Up |
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有源比较器:ST- CARE
Standard care |
Counselling
其他名称:
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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medication adherence
大体时间:at baseline and after ONE MONTH
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• To measure medication adherence score in both groups using the Morisky (MMAS-8) scale at baseline and after one month to assess improvement in adherence after the pharmacist-led intervention compared to usual care where 8 = High adherence, 6 to <8 = Medium adherence ,<6 = Low adherence |
at baseline and after ONE MONTH
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Detection of medication errors
大体时间:Number of medication errors within ONE MONTH from baseline
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• To identify and detect the number of medication errors in both groups |
Number of medication errors within ONE MONTH from baseline
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合作者和调查者
出版物和有用的链接
一般刊物
- References: Alshehri, M., Althumairi, A., Alharbi, K., & Alharbi, F. (2024). The impact of pharmacist-led medication reconciliation on patient safety outcomes: A systematic review. International Journal of Medical Toxicology and Legal Medicine, 27(2), 87-95. Boeni, F., Spinatsch, M., Suter, K., Hersberger, K. E., & Arnet, I. (2022). Effectiveness of pharmacist-led counseling on medication adherence in cancer outpatients: A systematic review and meta-analysis. Journal of Oncology Pharmacy Practice, 28(5), 1123-1134. de Clercq, L., Van Camp, Y., De Winter, S., & Simoens, S. (2021). Pharmacist-led medication review and reconciliation in oncology: A scoping review. International Journal of Clinical Pharmacy, 43(4), 929-940. Gellad, W. F., Zhao, X., Thorpe, C. T., & Donohue, J. M. (2022). Pharmacist interventions to improve medication use and safety in oncology outpatients. BMC Health Services Research, 22(1), 1147. Hasen G, Negeso B. Patients Satisfaction with Pharmaceutical Care and Associated Factors in the Southwestern Ethiopia. Patient Prefer Adherence. 2021 Sep 21;15:2155-2163. doi: 10.2147/PPA.S332489. PMID: 34584408; PMCID: PMC8464365 ISPOR Report. (2023). Pharmacist-led interventions to improve medication adherence in cancer patients: A systematic review. Value in Health, 26(Suppl 1), S123-S131. Joy AM, UP N, Chand S, Shetty JK, George SM, Chacko CS, Joel JJ. Role of clinical pharmacist in the medication adherence behaviour of cancer patients: An interventional study. Le Pharmacien Hospitalier et Clinicien. 2021; 56:291-297. Lindenmeyer, A., Oliveira, T., Santos, R., & Mendes, E. (2022). Medication discrepancies among oncology patients: The importance of pharmacist involvement. Journal of Hospital Pharmacy Services, 9(3), 55-63. Patel, J., Wong, A., & Clark, C. (2021). Medication errors and patient outcomes in ambulatory oncology. American Journal of Health-System Pharmacy, 78(14), 1275-1282. Weingart, S. N., Brown, E., Bach, P. B., Engelhardt, K. E., Johnson, S
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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