4CPS-288 Clinical pharmacist’s impact in improving the safety of therapies for patients using oral anticancer agents: a prospective single centre study

Abstract

Background and importance Oral anticancer agents (OAA) are frequently used in oncology practice. Drug interactions involving OAA are of great concern as they can cause an altered safety or efficacy profile for cancer treatments. Aim and objectives To estimate the prevalence of potential drug interactions in cancer patients to justify the implementation of preventive actions to optimise the effectiveness and efficiency of cancer management, in a context where the relevance of care is a public health issue. Material and methods Data on drugs used for comorbidities, OAA, over-the-counter (OTC) drugs and herbal supplements were collected through a structured interview with the patient, a review of medical records and a call to the dispensing pharmacist. Potential drug interactions involving OAA were detected during the primary prescribing process using the databases Lexicomp and Micromedex. Results 51 patients were included in the study. The median age of patients was 70 years. We identified 26 potentially clinically significant interactions (PCSI) in 24 patients (47%). Of the PCSI detected, 17.4% were assessed by both sources as major interactions and 8.7% as moderate interactions. The OAA that interacted the most were anagrelide (19.2%), capecitabine (15.4%) and lenalidomide (11.5%). PCSI involving OAA appeared in the following therapeutic classes: PPI 26.9%, herbal therapy 11.5% and antiplatelet–anticoagulants 11.5%. We observed that 30.8% of PCSI resulted in an altered efficacy profile of the OAA. Conclusion and relevance Analysis of PCSI in cancer patients allows the description of the use of OAA and thus how to optimise monitoring of the correct use of these drugs. The clinical pharmacist can improve drug safety by notifying hospital and frontline healthcare staff of PCSI to reduce drug therapy problems and optimise drug therapy for these patients. References and/or acknowledgements Ranchon F, Bouret C, Charpiat B, et al. Securisation de l’emploi des chimiotherapies anticancereuses administrables par voie orale. Le Pharmacien Hospitalier 2009;44:36–44. Banna GL, Collova E, Gebbia V, et al. Anticancer oral therapy: Emerging related issues. Cancer Treatment Reviews 2010;36:595–605. Conflict of interest No conflict of interest