Annales pharmaceutiques francaises · 2026
Pharmacist-led multidisciplinary care and its clinical impact on haematology patients receiving intravenous immuno-chemotherapy.
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Cerfon Marie-Anne, Herledan Chloé, Albert Mélanie, Baudouin Amandine, Sesques Pierre, Kimbidima Reine, Golfier Camille, Ghesquieres Hervé, Rioufol Catherine, Ranchon Florence
Аннотация
INTRODUCTION: Diffuse large B-cell lymphoma and follicular lymphoma are treated with immuno-chemotherapy (R-CHOP or G-CHOP), which can cause significant toxicities. This study assessed clinical impact of pharmaceutical interventions (PIs) in a multidisciplinary city-hospital follow-up of patients receiving intravenous immuno-chemotherapy.
METHODS: A prospective study was conducted from December 2021 to March 2022 at a French university hospital. A clinical pharmacist provided pharmaceutical care to patients receiving their first cycle of R-CHOP or G-CHOP, including medication reconciliation, patient education, and follow-up interviews. Drug-related problems (DRPs) and PIs were analyzed using the CLEO tool. Patient knowledge of adverse drug reactions (ADRs) and health literacy (FCCHL) were assessed.
RESULTS: Thirty-eight patients were included (mean age 64.6±14.6 years, 71.1% men), with 84.2% receiving first-line treatment, primarily R-CHOP (71.1%). Polypharmacy increased significantly from 36.8% before cycle 1 to 100% by cycle 2 (P<0.05). A total of 187 PIs were generated with 94.8% acceptance rate. The most frequent DRPs involved digestive tract medications, nervous and musculoskeletal system medications, and systemic anti-infectives. Complementary and alternative medicines (CAMs) were used by 13% of patients. Clinical impact assessment showed that 16.2 and 22.2% of PIs were rated as major by haematologists and pharmacists, respectively, with one intervention rated as life-threatening. All CAM-related PIs had moderate clinical impact. Patient knowledge scores improved significantly after pharmacist intervention (P<0.05) and were maintained throughout chemotherapy cycles.
CONCLUSION: Pharmacist integration into multidisciplinary care significantly improved DRP identification and management, with high PI acceptance rates and sustained improvement in patient knowledge, enhancing treatment safety and patient education.
METHODS: A prospective study was conducted from December 2021 to March 2022 at a French university hospital. A clinical pharmacist provided pharmaceutical care to patients receiving their first cycle of R-CHOP or G-CHOP, including medication reconciliation, patient education, and follow-up interviews. Drug-related problems (DRPs) and PIs were analyzed using the CLEO tool. Patient knowledge of adverse drug reactions (ADRs) and health literacy (FCCHL) were assessed.
RESULTS: Thirty-eight patients were included (mean age 64.6±14.6 years, 71.1% men), with 84.2% receiving first-line treatment, primarily R-CHOP (71.1%). Polypharmacy increased significantly from 36.8% before cycle 1 to 100% by cycle 2 (P<0.05). A total of 187 PIs were generated with 94.8% acceptance rate. The most frequent DRPs involved digestive tract medications, nervous and musculoskeletal system medications, and systemic anti-infectives. Complementary and alternative medicines (CAMs) were used by 13% of patients. Clinical impact assessment showed that 16.2 and 22.2% of PIs were rated as major by haematologists and pharmacists, respectively, with one intervention rated as life-threatening. All CAM-related PIs had moderate clinical impact. Patient knowledge scores improved significantly after pharmacist intervention (P<0.05) and were maintained throughout chemotherapy cycles.
CONCLUSION: Pharmacist integration into multidisciplinary care significantly improved DRP identification and management, with high PI acceptance rates and sustained improvement in patient knowledge, enhancing treatment safety and patient education.