Abstract
Introduction
Optimizing medication use is a major issue in older patients with cancer and pharmacists
are increasingly involved in their multidisciplinary care. The implementation of pharmaceutical
care interventions must be supported by impact evaluations to enable their development
and funding. This systematic review aims to synthesize evidence on the impact of pharmaceutical
care interventions in older patients with cancer.
Materials and Methods
A comprehensive search was performed in the PubMed/Medline, Embase, and Web of Science
databases, for articles reporting evaluations of pharmaceutical care interventions
for patients with cancer aged 65 years or older.
Results
Eleven studies met the selection criteria. Most pharmacists were part of multidisciplinary
geriatric oncology teams. Whether in outpatient or inpatient settings, interventions
had common components, including patient interview, medication reconciliation, and
comprehensive medication review to assess drug-related problems (DRPs). DRPs were
identified in 95% of patients with 1.7 to 3 DRPs on average. Pharmacist recommendations
resulted in a 20–40% reduction in the total number of DRPs and a 20–25% decrease in
the prevalence of DRP. Prevalence of potentially inappropriate or omitted medications
and their subsequent deprescribing or addition varied greatly between studies, notably
depending on detection tools used. Clinical impact was insufficiently evaluated. Only
one study reported a reduction of anticancer treatment toxicities following a joint
pharmaceutical and geriatric assessment. A single economic evaluation calculated a
potential net benefit of $3,864.23 per patient resulting from the intervention.
Discussion
These encouraging results must be confirmed by more robust evaluations to support
the involvement of pharmacists in multidisciplinary care of older patients with cancer.
Keywords
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Article info
Publication history
Published online: February 20, 2023
Accepted:
February 9,
2023
Received in revised form:
November 22,
2022
Received:
August 2,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Elsevier Ltd. All rights reserved.
