1. Patient’s experiences of anticancer therapy and opportunities for community pharmacists to support patients with cancer.
Fiona MacLean1, Alexander Mullen2, Richard Lowrie1 and Anne Boyter2 1NHS Greater Glasgow & Clyde; 2University of Strathclyde
Introduction
Cancer treatments are mostly given in an out-patient or day case unit. Patients spend the interval between treatments at home without specialist support. Toxicity from systemic anticancer therapy (SACT) can occur late and patients must be supported to manage toxicity between cycles. But do we know how patients cope at home and what additional medicines they buy or are prescribed?
Innovative models of care might involve community pharmacists. To scope this, an investigation of patient’s experiences between SACT cycles was needed to understand how patients cope and what they do if they need help and support.
Results
Patient reported toxicity and problems with medicines between SACT cycles and the sources of advice used were identified (Charts 2 and 3).
Medicines purchased between cycles included cough medicines, analgesics, laxatives, mouth products and dyspepsia medicines.
Medicines prescribed between cycles included the above and antibiotics, sertraline, ramipril and multiple skin products.
All patients agreed that their hospital clinical information could be shared with and used by community pharmacists.
75% attended the same community pharmacy
37% said that a community pharmacist could offer support during SACT
Patients were asked what would you like a community pharmacist to do to help support you during cancer treatment? Their replies included:
Chart 2: Toxicity & problems between SACT cycles
Chart 3: Advice provider
Aim
To understand for a population of patients receiving SACT:
What - if any- toxicity is experienced between cycles
Who patients seek advice from
Do patients need medicines between SACT cycles
Is there a role for community pharmacists in supporting patients who are receiving SACT
Method
A questionnaire was given to adults patients attending the New Victoria Hospital (Glasgow) for SACT for breast, lung, urology or haemato-oncology cancers.
Convenience sampling was used.
Data collection took place between November May 2015
Data were analysed using Excel®
Results
112 questionnaires were issued and 68 were returned (60.7%). Patients could enter their name and date of birth or remain anonymous.
The age range was years.
All patients had received at least one cycle of SACT.
A variety of regimens were used to treat a number of tumour types (Chart 1).
“Management of side effects
Prescribe for diarrhoea/constipation
Just advice if required
To know you have cancer & having chemo
A professional to phone or visit
To be aware of the drugs I take and offer advice about how other drugs will affect me”
Chart 1: Breakdown of tumour types
Conclusion
Suitably trained community pharmacists are ideally placed to support safe and effective self management of common, non-complex SACT toxicity
Hospital teams should seek out ways of sharing patient information with colleagues in primary care
Hospital teams should educate patients to seek advice from their community pharmacist for non-complex toxicity management
Acknowledgements
Thanks to all the patients who completed the questionnaire.