Article Text
Abstract
Background and Importance The figure of the pharmacist was incorporated into the Multidisciplinary Committee Uro-Oncological Pathology (MCUP): Oncology, Radiation Oncology, Urology, Pathological Anatomy, Nuclear Medicine, Radiology), for the evaluation of patients with locally advanced or metastatic prostate cancer (PC), participating in the selection of the most appropriate treatment (effectiveness, safety, efficiency, comorbidities and interactions) and appropriateness of prescription (financing criteria of Ministry of Health and Multidisciplinary Commission Rational Use of Medicines).
Aim and Objectives To describe the integration of the pharmacist in the MCUP, participating in the selection of treatment, adequacy of the prescription and concomitant medication. Degree of acceptance (GA) of the recommendations.
Material and Methods Observational, retrospective study of patients with prostate cancer reviewed at MCUP between January 2022 and June 2023.
Variables collected from electronic medical record Diraya®: age, functional status (ECOG), Gleason, comorbidities, diagnosis, previous treatment, proposed treatment at MCUP, home medication and allergies.
Interactions with Micromedex®, Cancer Drug Interactions, drug labels and patient interview were verified.
Registration of medication in the outpatient dispensing programme (Athos Prisma®,) or Farmis Oncofarm.®
Continuous variables were expressed as median [(Interquartile Range (IQR)].
Results 69 treatments were reevaluated. 72 years (IQR:66–78). Median of associated comorbidities: 4 (IQR: 2.75–5) among them:
Arterial hypertension (n=60), dyslipidaemia (n=35), cardiovascular disease (n=30) and diabetes mellitus (n=29). Median number of medications prescribed: 8.5 (IQR:5–10.25;
527 medications were reviewed, 85 interactions detected. Selection of best treatment according to comorbidities/interactions (n=20, GA:85%) and modification/monitoring of concomitant medication (n=65, GA:87%).
Previous treatment androgen deprivation therapy (n=45), radiotherapy (n=39), radical prostatectomy (n=36), chemotherapy (n=16), new antiandrogens (n=14).
The following requests to start treatment were evaluated and agreed upon: 10 requests to start apalutamide [(nine metastatic hormone-sensitive (mHSPC), one non-metastatic castration-resistant (CRPC0)], 13 abiraterone (nine metastatic castration-resistant (mCRPC), four mCSPC), 14 enzalutamide (12 mCRPC, two CRPC), nine docetaxel (six mCRPC, three mCPHS), seven darolutamide (CPHSM0), 12 abiraterone in combination with docetaxel (CPHSM new high-risk diagnosis, off-label use), four cabazitaxel (mCRPC).
Conclusion and Relevance The integration of the pharmacist into MCUP for assessment of PC treatment improves the quality of care, guaranteeing patient safety, compliance with protocols, individualisation of therapy, improving access to drugs, favouring the innovation and the sustainability of the health system. Degree of acceptance of recommendations was high.
References and/or Acknowledgements Thanks MCUP
Conflict of Interest No conflict of interest.