内容紹介
Medical Assistance Based on Interviews Conducted before Physician Examination by a Pharmacist for Outpatients with Thyroid Cancer Treated with Lenvatinib
Summary
In municipal hospitals, there are few cases of thyroid cancer for which the multi-kinase inhibitor lenvatinib is used. Moreover, there are very few reports of lenvatinib use. We examined interventions related to the use of lenvatinib made at the pharmaceutical outpatient clinic in our facility. Seven patients received lenvatinib. The prescription proposals from the pharmacist(45 cases)provided advice on dosage(15.6%), discontinuation of medication(11.1%), supportive care(64.4%), and other advice(9.0%). The prescription acceptance rate was 84.4%. Among the prescription proposals of supportive care, there were suggestions regarding blood pressure(26.7%), diarrhea(8.9%), nausea(8.9%), and oral hemorrhage(6.7%). Some patients also experienced side effects, such as abnormalities in equilibrioception and visual field defects; however, the relationship between such abnormalities and lenvatinib is unclear. In addition, we asked physicians to confirm if the outpatient pharmacists contributed to the examination process. We believe that lenvatinib administration can be continued safely with pharmaceutical outpatient clinic support for patients, even in municipal hospitals.
要旨
市中病院では,マルチキナーゼ阻害薬であるレンバチニブが適応となる甲状腺癌の患者数は少なく,十分な使用報告がされているとはいえない。そこで,当院における薬剤師による医師の診察前面談(以下,薬剤師外来)による介入について検討した。レンバチニブ服用患者7名のうち薬剤師による処方提案回数は45回で,内訳としては用量15.6%,休薬11.1%,支持療法64.4%,その他9.0%であり,処方提案採択率は84.4%であった。支持療法の主な処方提案内容として,高血圧26.7%,下痢8.9%,嘔気8.9%,口腔内出血6.7%があった。レンバチニブとの因果関係は不明であるが,平衡感覚異常や視野障害などの副作用も経験した。また,医師にもアンケートを実施し,薬剤師外来が診察に貢献できていることが確認できた。以上,レンバチニブは一般病院においても薬剤師外来にて患者支援を行うことにより,QOLを維持しながら安全な治療を継続できると考える。
目次
Summary
In municipal hospitals, there are few cases of thyroid cancer for which the multi-kinase inhibitor lenvatinib is used. Moreover, there are very few reports of lenvatinib use. We examined interventions related to the use of lenvatinib made at the pharmaceutical outpatient clinic in our facility. Seven patients received lenvatinib. The prescription proposals from the pharmacist(45 cases)provided advice on dosage(15.6%), discontinuation of medication(11.1%), supportive care(64.4%), and other advice(9.0%). The prescription acceptance rate was 84.4%. Among the prescription proposals of supportive care, there were suggestions regarding blood pressure(26.7%), diarrhea(8.9%), nausea(8.9%), and oral hemorrhage(6.7%). Some patients also experienced side effects, such as abnormalities in equilibrioception and visual field defects; however, the relationship between such abnormalities and lenvatinib is unclear. In addition, we asked physicians to confirm if the outpatient pharmacists contributed to the examination process. We believe that lenvatinib administration can be continued safely with pharmaceutical outpatient clinic support for patients, even in municipal hospitals.
要旨
市中病院では,マルチキナーゼ阻害薬であるレンバチニブが適応となる甲状腺癌の患者数は少なく,十分な使用報告がされているとはいえない。そこで,当院における薬剤師による医師の診察前面談(以下,薬剤師外来)による介入について検討した。レンバチニブ服用患者7名のうち薬剤師による処方提案回数は45回で,内訳としては用量15.6%,休薬11.1%,支持療法64.4%,その他9.0%であり,処方提案採択率は84.4%であった。支持療法の主な処方提案内容として,高血圧26.7%,下痢8.9%,嘔気8.9%,口腔内出血6.7%があった。レンバチニブとの因果関係は不明であるが,平衡感覚異常や視野障害などの副作用も経験した。また,医師にもアンケートを実施し,薬剤師外来が診察に貢献できていることが確認できた。以上,レンバチニブは一般病院においても薬剤師外来にて患者支援を行うことにより,QOLを維持しながら安全な治療を継続できると考える。