Skip to main content
Top
Published in: Supportive Care in Cancer 5/2013

01-05-2013 | Original Article

The impact of medication therapy management in older oncology patients

Authors: Ting Ting Yeoh, Phebe Si, Lita Chew

Published in: Supportive Care in Cancer | Issue 5/2013

Login to get access

Abstract

Purpose

This project aimed to identify common drug-related problems (DRP) among elderly cancer patients, to determine the effectiveness of medication therapy management (MTM) service in resolving DRP, to determine the clinical significance of pharmacist interventions, and to determine patients’ satisfaction level of MTM service.

Method

Elderly cancer patients (age ≥65) who were at least on one chronic medication would be eligible for the MTM service. Any DRP that was detected would be recorded and steps to resolve it were taken. Pre- and post-service patient satisfaction surveys (PSS) were conducted before and after MTM. All interventions performed by MTM pharmacists were subjected to independent evaluation by a panel of three judges.

Results

One hundred eighteen patients received at least one session of MTM. We identified and attempted to resolve 361 DRPs, and the most common DRPs were drug interactions (117 cases, 32.4 %), adverse effects (114 cases, 31.6 %), and non-adherence (48 cases, 13.3 %). Forty-four interventions were performed by pharmacists and forty cases (91 %) were accepted by physicians. Almost two third of these interventions were deemed significant (or higher) by the judges. Seventy-two patients completed PSS. There was statistically significant improvement in patients’ satisfaction level after the service was provided.

Conclusion

MTM is an important platform in identifying and managing DRPs. Patients are generally satisfied with MTM services.
Literature
3.
go back to reference Oliveira DR, Brummel AR, Miller DB (2007) Medication therapy management: 10 years of experience in a large integrated health care system. J Manag Care Pharm 16(3):185–195 Oliveira DR, Brummel AR, Miller DB (2007) Medication therapy management: 10 years of experience in a large integrated health care system. J Manag Care Pharm 16(3):185–195
4.
go back to reference Welch E, Delate T, Chester EA, Stubbings T (2009) Assessment of the impact of medication therapy management delivered to home-based Medicare beneficiaries. Ann Pharmacother 43:603–610PubMedCrossRef Welch E, Delate T, Chester EA, Stubbings T (2009) Assessment of the impact of medication therapy management delivered to home-based Medicare beneficiaries. Ann Pharmacother 43:603–610PubMedCrossRef
6.
go back to reference Smith BD, Smith GL, Hortobagyi GN, Buchholz TA (2009) Future of cancer incidence in the United States: burdens upon an aging, changing nation. J Clin Oncol 27(17):2758–2765PubMedCrossRef Smith BD, Smith GL, Hortobagyi GN, Buchholz TA (2009) Future of cancer incidence in the United States: burdens upon an aging, changing nation. J Clin Oncol 27(17):2758–2765PubMedCrossRef
9.
go back to reference Hajjar ER, Cafiero AC, Hanlon JT (2007) Polypharmacy in elderly patients. Am J Geriatr Pharmacother 5(4):345–351PubMedCrossRef Hajjar ER, Cafiero AC, Hanlon JT (2007) Polypharmacy in elderly patients. Am J Geriatr Pharmacother 5(4):345–351PubMedCrossRef
10.
go back to reference Terret C (2005) Geriatric oncology—a challenge for the future. Eur Oncol Rev 24–26 Terret C (2005) Geriatric oncology—a challenge for the future. Eur Oncol Rev 24–26
11.
go back to reference Wedding U, Pientka L, Hoffken K (2007) Quality of life in elderly patients with cancer: a short review. Eur J Cancer 43:2203PubMedCrossRef Wedding U, Pientka L, Hoffken K (2007) Quality of life in elderly patients with cancer: a short review. Eur J Cancer 43:2203PubMedCrossRef
13.
go back to reference Extermann M, Hurria A (2007) Comprehensive geriatric assessment for older patients with cancer. J Clin Oncol 25(14):1824–1831PubMedCrossRef Extermann M, Hurria A (2007) Comprehensive geriatric assessment for older patients with cancer. J Clin Oncol 25(14):1824–1831PubMedCrossRef
14.
go back to reference Poon D (2008) Challenges in the practice of geriatric oncology in a national comprehensive cancer centre in Asia. Asia-Pac Oncol Haematol 1:67–68 Poon D (2008) Challenges in the practice of geriatric oncology in a national comprehensive cancer centre in Asia. Asia-Pac Oncol Haematol 1:67–68
15.
go back to reference American Society of Hospital Pharmacists (1993) ASHP statement on pharmaceutical care. Am J Hosp Pharm 50:1720–1723 American Society of Hospital Pharmacists (1993) ASHP statement on pharmaceutical care. Am J Hosp Pharm 50:1720–1723
16.
go back to reference Hanlon JT, Lindblad CIL, Hajjar ER, McCarthy TC (2003) Update on drug-related problems in the elderly. Am J Geriatr Pharmacother 1(1):38–43PubMedCrossRef Hanlon JT, Lindblad CIL, Hajjar ER, McCarthy TC (2003) Update on drug-related problems in the elderly. Am J Geriatr Pharmacother 1(1):38–43PubMedCrossRef
17.
go back to reference Goldberg RM, Tabah-Fisch I, Bleiberg H et al (2006) Pooled analysis of safety and efficacy of oxaliplatin plus fluorouracil/leucovorin administered bimonthly in elderly cancer patients with colorectal cancer. J Clin Oncol 24(25):4085–4091PubMedCrossRef Goldberg RM, Tabah-Fisch I, Bleiberg H et al (2006) Pooled analysis of safety and efficacy of oxaliplatin plus fluorouracil/leucovorin administered bimonthly in elderly cancer patients with colorectal cancer. J Clin Oncol 24(25):4085–4091PubMedCrossRef
18.
go back to reference Litchman SM, Hollis D, Antonius A et al (2006) Prospective evaluation of the relationship of patient age and paclitaxel clinical pharmacology: cancer and leukemia group B (CALGB 9762). J Clin Oncol 24(12):1846–1851CrossRef Litchman SM, Hollis D, Antonius A et al (2006) Prospective evaluation of the relationship of patient age and paclitaxel clinical pharmacology: cancer and leukemia group B (CALGB 9762). J Clin Oncol 24(12):1846–1851CrossRef
19.
go back to reference Wedding U, Honecker F, Bokemeyer C, Pientka L, Hoffken K (2007) Tolerance to chemotherapy in elderly patients with cancer. Cancer Control 14(1):44–56PubMed Wedding U, Honecker F, Bokemeyer C, Pientka L, Hoffken K (2007) Tolerance to chemotherapy in elderly patients with cancer. Cancer Control 14(1):44–56PubMed
20.
go back to reference Litchman SM, Buchholtz M, Marino J et al (1992) Use of cisplatin for elderly patients. Age Ageing 21:202–204CrossRef Litchman SM, Buchholtz M, Marino J et al (1992) Use of cisplatin for elderly patients. Age Ageing 21:202–204CrossRef
21.
go back to reference Smorenburg CH, ten Tije AJ, Bontenbal M et al (2003) Altered clearance of unbound paclitaxel in elderly patients with metastatic breast cancer. Eur J Cancer 39:196–202PubMedCrossRef Smorenburg CH, ten Tije AJ, Bontenbal M et al (2003) Altered clearance of unbound paclitaxel in elderly patients with metastatic breast cancer. Eur J Cancer 39:196–202PubMedCrossRef
22.
go back to reference Albert J, Ten T, Verweij J, Carducci MA et al (2005) Prospective evaluation of the pharmacokinetics and toxicity profile of docetaxel in the elderly. J Clin Oncol 23(6):1070–1077CrossRef Albert J, Ten T, Verweij J, Carducci MA et al (2005) Prospective evaluation of the pharmacokinetics and toxicity profile of docetaxel in the elderly. J Clin Oncol 23(6):1070–1077CrossRef
23.
go back to reference Hurria A, Togawa K, Mohile SG et al (2011) Predicting chemotherapy toxicity in older adults with cancer: a prospective multicenter study. J Clin Oncol 29(25):3457–3465PubMedCrossRef Hurria A, Togawa K, Mohile SG et al (2011) Predicting chemotherapy toxicity in older adults with cancer: a prospective multicenter study. J Clin Oncol 29(25):3457–3465PubMedCrossRef
24.
go back to reference Extermann M, Boler I, Reich R et al (2010) The Chemotherapy Risk Assessment Scale for High-age patients (CRASH) score: design and validation. J Clin Oncol 28:15s, suppl; abstract 9000 Extermann M, Boler I, Reich R et al (2010) The Chemotherapy Risk Assessment Scale for High-age patients (CRASH) score: design and validation. J Clin Oncol 28:15s, suppl; abstract 9000
25.
go back to reference Rhoads M, Thai A (2003) Physician acceptance rate of pharmacist recommendations to reduce use of potentially inappropriate medications in the assisted living setting. Consult Pharm 18(3):241–247PubMed Rhoads M, Thai A (2003) Physician acceptance rate of pharmacist recommendations to reduce use of potentially inappropriate medications in the assisted living setting. Consult Pharm 18(3):241–247PubMed
26.
go back to reference Von Muenster SJ, Carter BL, Weber CA, Ernst ME, Milchak JL, Steffensmeier JJ, Xu Y (2008) Description of pharmacist interventions during physician–pharmacist co-management of hypertension. Pharm World Sci 30(1):128–135CrossRef Von Muenster SJ, Carter BL, Weber CA, Ernst ME, Milchak JL, Steffensmeier JJ, Xu Y (2008) Description of pharmacist interventions during physician–pharmacist co-management of hypertension. Pharm World Sci 30(1):128–135CrossRef
27.
go back to reference Doucette WR, McDonough RP, Klepser D, McCarthy R (2005) Comprehensive medication therapy management: identifying and resolving drug-related issues in a community pharmacy. Clin Ther 27(7):1104–1111PubMedCrossRef Doucette WR, McDonough RP, Klepser D, McCarthy R (2005) Comprehensive medication therapy management: identifying and resolving drug-related issues in a community pharmacy. Clin Ther 27(7):1104–1111PubMedCrossRef
28.
go back to reference McCollum M, Nuffer W, Ellis SL, Turner CJ (2009) Physician acceptance of pharmacotherapy recommendations made by pharmacy students in a rural pharmacy-based diabetes care and education clinic. Am J Pharm Educ 73(2):24PubMedCrossRef McCollum M, Nuffer W, Ellis SL, Turner CJ (2009) Physician acceptance of pharmacotherapy recommendations made by pharmacy students in a rural pharmacy-based diabetes care and education clinic. Am J Pharm Educ 73(2):24PubMedCrossRef
29.
go back to reference Lundquist LM, Moye PM (2009) Resident physicians’ acceptance of pharmacy students’ pharmacotherapy recommendations during an ambulatory care advanced pharmacy practice experience. Am J Pharm Educ 73(8):145PubMedCrossRef Lundquist LM, Moye PM (2009) Resident physicians’ acceptance of pharmacy students’ pharmacotherapy recommendations during an ambulatory care advanced pharmacy practice experience. Am J Pharm Educ 73(8):145PubMedCrossRef
30.
go back to reference Wilson S, Wahler R, Brown J, Doloresco F, Monte SV (2011) Impact of pharmacist intervention on clinical outcomes in the palliative care setting. Am J Hosp Palliat Med 28(5):316–320CrossRef Wilson S, Wahler R, Brown J, Doloresco F, Monte SV (2011) Impact of pharmacist intervention on clinical outcomes in the palliative care setting. Am J Hosp Palliat Med 28(5):316–320CrossRef
31.
go back to reference Chumney EC, Robinson LC (2006) The effects of pharmacist interventions on patients with polypharmacy. Pharm Pract 4(3):103–109 Chumney EC, Robinson LC (2006) The effects of pharmacist interventions on patients with polypharmacy. Pharm Pract 4(3):103–109
32.
go back to reference Shah S, Dowell J, Greene S et al (2006) Evaluation of clinical pharmacy services in a haematology/oncology outpatient setting. Ann Pharmacother 40:1527–1533PubMedCrossRef Shah S, Dowell J, Greene S et al (2006) Evaluation of clinical pharmacy services in a haematology/oncology outpatient setting. Ann Pharmacother 40:1527–1533PubMedCrossRef
33.
go back to reference Kjeldsen LJ, Jensen TB, Jensen JJ et al (2011) Physicians’ evaluation of clinical pharmacy revealed increased focus on quality improvement and cost savings. Dan Med Bull 58(5):A4261PubMed Kjeldsen LJ, Jensen TB, Jensen JJ et al (2011) Physicians’ evaluation of clinical pharmacy revealed increased focus on quality improvement and cost savings. Dan Med Bull 58(5):A4261PubMed
34.
go back to reference Alsoud NA, El-Hamamsy M, Zawahry HA, Al-Azizi M (2010) Effects of clinical pharmacist interventions on clinical outcomes in oncology patients. Res J Med Med Sci 5(2):133–141 Alsoud NA, El-Hamamsy M, Zawahry HA, Al-Azizi M (2010) Effects of clinical pharmacist interventions on clinical outcomes in oncology patients. Res J Med Med Sci 5(2):133–141
35.
go back to reference Ganachari MS, Mahendra Kumar BJ, Shashikala CW, Fibin M (2010) Assessment of drug therapy interventions by clinical pharmacist in a tertiary care hospital. Indian J Pharm Pract 3(3):22–28 Ganachari MS, Mahendra Kumar BJ, Shashikala CW, Fibin M (2010) Assessment of drug therapy interventions by clinical pharmacist in a tertiary care hospital. Indian J Pharm Pract 3(3):22–28
36.
go back to reference Knez L, Laaksonen R, Duggan C et al (2010) Evaluation of clinical interventions made by pharmacists in chemotherapy preparation. Radiol Oncol 44(4):249–256PubMedCrossRef Knez L, Laaksonen R, Duggan C et al (2010) Evaluation of clinical interventions made by pharmacists in chemotherapy preparation. Radiol Oncol 44(4):249–256PubMedCrossRef
37.
go back to reference Barnett MJ, Frank J, Wehring H et al (2009) Analysis of pharmacist provided medication therapy management (MTM) services in community pharmacies over 7 years. J Manag Care Pharm 15(1):18–31PubMed Barnett MJ, Frank J, Wehring H et al (2009) Analysis of pharmacist provided medication therapy management (MTM) services in community pharmacies over 7 years. J Manag Care Pharm 15(1):18–31PubMed
38.
go back to reference McMahan R (2008) Operationalizing MTM through the use of health information technology. J Manag Care Pharm 14(2 Suppl):S18–S21PubMed McMahan R (2008) Operationalizing MTM through the use of health information technology. J Manag Care Pharm 14(2 Suppl):S18–S21PubMed
Metadata
Title
The impact of medication therapy management in older oncology patients
Authors
Ting Ting Yeoh
Phebe Si
Lita Chew
Publication date
01-05-2013
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 5/2013
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-012-1661-y

Other articles of this Issue 5/2013

Supportive Care in Cancer 5/2013 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine