Hospital-pharmacy cooperation for patients treated with S-1 based chemotherapy.

Author(s)：

Chisato Yamada ¹, Chihoko Takahata ¹, Michiko Miyatani ¹, Makiko Kobara¹, Kanae Tozaki ¹, Mituyo Nisio ¹, Akimitsu Maeda ², Minekazu Murayama ³, Azusa Komori ³, Takashi Ura ³

Affiliation(s)：

¹Dept. of Nursing,Aichi Cancer Center Hospital, ²Dept. of Pharmacy, Aichi Cancer Center Hospital, ³Dept. of Clinical Oncology, Aichi Cancer Center Hospital

Background: Some reports were available that the direct admission is common in outpatients treated with S-1 based chemotherapy. We started hospital-pharmacy cooperation (HPC) for enhancing patient adherence to S-1 based chemotherapy and decreasing the development of serious adverse events (SAEs) since January 2012. The objective of this study was to investigate the association between HPC and the development of SAEs.
Methods: Contents of HPC were the following: (1) Usage of S-1 notebook; (2) Medication counseling using S-1 notebook at the pharmacy out of the hospital; (3) Holding the meeting of HPC; (4) Nurse phone support on AEs; (5) Prescription drug of supportive care before chemotherapy. Gastrointestinal cancer patients treated with S-1 based chemotherapy were retrospectively analyzed from January 2011 to December 2012. Cancer site, chemotherapy regimen, supportive care, nurse phone support, adverse events including SAEs, and the direct admission were evaluated.
Results: A cohort of 368 patients before HPC and 363 patients after HPC. Cancer site were gastric cancer 195/184; colorectal cancer 65/56; bile duct cancer 24/26; pancreas cancer 84/97 (before/after HPC, respectively). Chemotherapy regimen were S-1 alone 228/230; S-1+CDDP 83/82; S-1+IRI 16/10; S-1+L-OHP 25/15; S-1+GEM 12/17; other 4/9 (before/after HPC, respectively). Cancer site and chemotherapy regimen of the study patients were similar between before and after HPC. Prescription drugs of supportive care before chemotherapy were antiemetic 127/159; antidiarrhoic 94/134; antibiotic 93/107 (before/after HPC, respectively). The number of nurse phone support was 3/12 (before/after HPC, respectively). The direct admission was significantly decrease in patients after HPC in comparison with that in patients before HPC (p=0.001). The reasons of direct admission were diarrhea 10/2; nausea 3/1; anorexia 16/4; fever 6/2 (before/after HPC, respectively).
Conclusion: Our study demonstrated that HPC may be useful for reduction of SAEs in gastrointestinal cancer patients treated with S-1 based chemotherapy.