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EPICC study: evaluation of pharmaceutical intervention in cancer care
Author(s) -
Vantard N.,
Ranchon F.,
Schwiertz V.,
Gourc C.,
Gauthier N.,
Guedat M.G.,
He S.,
Kiouris E.,
Alloux C.,
You B.,
Souquet P.J.,
Freyer G.,
Salles G.,
TrilletLenoir V.,
Rioufol C.
Publication year - 2015
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/jcpt.12242
Subject(s) - pharmaceutical care , medicine , drug , medical prescription , adverse effect , pharmacy , pharmacist , psychological intervention , cancer , clinical pharmacy , intensive care medicine , pharmacology , family medicine , nursing
Summary What is known and objectives In cancer care, clinical pharmacists contribute to improving prevention and management of drug‐related problems ( DRP s). The 3‐year EPICC study (Evaluation of Pharmaceutical Intervention in Cancer Care) aimed to collect and analyse pharmaceutical interventions ( PI s) in oncology. Methods The free online version of the French Society of Clinical Pharmacy ( SFPC ) coding system, ACT ‐ IP , was used, supplemented by a standardized dedicated cancer‐care decision tree. Results A total of 29 589 medication orders (77 004 anticancer drug preparations) were analysed. Eight hundred and ninety‐four PI s were recorded. ACT ‐ IP identified 54·1% of DRP s as concerning over‐ or underdosage. The standardized dedicated cancer‐care decision tree identified the three principal causes of dosage problems: 50·2% due to miscalculation, 20% to omission of dose adjustment and 12% to poor choice of antineoplastic regimen. About 13·8% of DRP s were adverse effects and 3·9% were drug–drug interactions. The decision tree showed that 22% of adverse events could be circumvented by a switch within the same drug family and 72% of drug–drug interactions would have led to increased neoplastic toxicity. Discussion Pharmaceutical analysis of prescription forms contributes to medication safety in cancer care, and the present dedicated decision tree highlights additional information about DRP s and PI s. The DRP rate (3% of prescriptions) was consistent with the literature. The pharmacist has a role to play in optimizing the management of patients with cancer in terms of dose adjustment, drug toxicity management, improvement of administration and drug–drug interactions. What is new and conclusion This study, highlighting PI s in cancer care, is the first of this scale in terms of number of prescriptions analysed (nearly 30 000). Results demonstrated the specificity of DRP s and PI s for patients with cancer and the value of a dedicated coding system in cancer care.