2 型糖尿病癌症患者药物相关问题的检测和管理初步指南:肿瘤药剂师的实用资源。

IF 3.4 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Supportive Care in Cancer Pub Date : 2024-11-14 DOI:10.1007/s00520-024-09014-z
Chloé Gossery, Justine Clarenne, Sara Barraud, Mathias Brugel, Mathieu Boulin, Claire Carlier, Marine Perrier, Damien Botsen, Dominique Hettler, Lukshe Kanagaratnam, Céline Mongaret, Olivier Bouché, Florian Slimano
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引用次数: 0

摘要

目的:2 型糖尿病(T2DM)在癌症患者中的发病率很高。在药物审查过程中,临床药师可以发现并处理与药物相关的问题(DRP),以优化药物治疗,但有必要对药师干预措施(PI)进行标准化,尤其是针对与 T2DM 相关的 DRP。本研究旨在描述接受抗癌治疗(AT)的 T2DM 癌症患者的药物相关问题,并提出管理 T2DM 相关药物相关问题的初步指南:本研究在一家肿瘤门诊医院进行,该医院的临床药学团队通过对接受抗癌治疗的癌症患者进行PI来进行药物回顾,以检测和管理DRP。研究提取了2015年11月23日至2019年11月23日的所有数据,并收集和分析了人口统计学、临床、肿瘤学和生物学数据。根据这些结果和文献综述,组成了一个工作组(2 名药剂师和 1 名糖尿病专家),提出了第一套临床药剂师初步指南,然后由肿瘤专家和药剂师组成的专家小组采用德尔菲法对其进行了审查:共有 161 名 T2DM 癌症患者参与了研究(占所有接受筛查癌症患者的 19.7%)。总体而言,发现了 152 例 DRP(平均 1.67 例/患者)(49.3%为药物相互作用),临床药师执行了 152 例 PI,主要是药物监测(48.0 例)和停药(25.7%)。具体而言,与 T2DM 相关的药物不良反应有 24 例(包括 29.2% 的药物相互作用)。其中 24 例 DRP 与 T2DM 状态直接相关。五项拟议指南在修订后达成共识,并增加了第六项:我们假设,初步指南应能更好地发现与 T2DM 直接相关的 DRP。现在应在临床实践中评估初步指南的实施情况。
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Preliminary guidelines for the detection and management of drug-related problems in cancer patients with type 2 diabetes mellitus: a practical resource for oncology pharmacists.

Purpose: The prevalence of type 2 diabetes mellitus (T2DM) in cancer patients is high. During the medication review process, clinical pharmacists could detect and manage drug-related problems (DRP) to optimize pharmacotherapy but there is a need to standardize pharmacists' interventions (PI) especially for T2DM-related DRP. The present study aims to describe DRP in cancer patients with T2DM undergoing anticancer treatment (AT) and to propose related preliminary guidelines to manage T2DM-related DRP.

Methods: The study was conducted in one oncology outpatient hospital where a clinical pharmacy team performs medication reviews to detect and manage DRP by performing PI in cancer patients undergoing AT. All the data from November 23rd, 2015 to November 23rd, 2019 were extracted and demographic, clinical, oncological, and biological data were collected and analyzed. Based on these results and a literature review, a working group (2 pharmacists and one diabetologist) was constituted to propose a first set of preliminary guidelines clinical pharmacists that were then reviewed using the Delphi method by an expert panel of oncologists and pharmacists.

Results: A total of 161 T2DM cancer patients were included in the study (19.7% of all cancer patients screened). Overall, 152 DRP (mean 1.67/patient) were detected (49.3% drug interaction) and 152 PI were performed by clinical pharmacists, mainly drug monitoring (48.0) and drug discontinuation (25.7%). Specifically, there was 24 T2DM-related DRP (including 29.2% drug interactions). Twenty-four DRPs were directly related to T2DM status. The five proposed guidelines reached a consensus after revisions and a sixth has been added.

Conclusion: DRPs were frequent among cancer patients with T2DM and we hypothesize that the preliminary guidelines should improve the detection of DRPs directly related to T2DM. The implementation of the preliminary guidelines should now be assessed in clinical practice.

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来源期刊
Supportive Care in Cancer
Supportive Care in Cancer 医学-康复医学
CiteScore
5.70
自引率
9.70%
发文量
751
审稿时长
3 months
期刊介绍: Supportive Care in Cancer provides members of the Multinational Association of Supportive Care in Cancer (MASCC) and all other interested individuals, groups and institutions with the most recent scientific and social information on all aspects of supportive care in cancer patients. It covers primarily medical, technical and surgical topics concerning supportive therapy and care which may supplement or substitute basic cancer treatment at all stages of the disease. Nursing, rehabilitative, psychosocial and spiritual issues of support are also included.
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