- 医療薬学 (ISSN:1346342X)
- vol.44, no.6, pp.280-287, 2018-06-10 (Released:2019-06-10)
A pharmacist outpatient service for patients receiving monotherapy with oral anticancer drugs aims to improve safety and medication continuation through pre-examination interviews. We assess medication adherence and monitor chemotherapy-induced adverse events by referring to patientsʼ complaints of symptoms and their medical diaries. In addition, “unused prescribed medicines” can also be a useful information resource. However, unused medicines are becoming a large-scale problem in Japan, thus leading to lower therapeutic effects and higher healthcare costs. In this study, we interviewed 270 patients (cumulative total: 1,385, monthly average: 153.9) from January 1 to October 31, 2017. Adjusted numbers of unused anticancer drugs were 96 and those of unused medicines for supportive care were 420, including moisturizing creams and steroidal ointments (23.1%), antidiarrheal drugs (18.1%), and antiemetic drugs (8.1%). We calculated the reduction in healthcare costs as JPY 5,045,585.5 (monthly average: JPY 560,621) for all unused medicines and as JPY 4,699,791.6 (monthly average: JPY 522,199) for only unused anticancer drugs. Anticancer drugs went unused because of chemotherapy-induced adverse events (grade 1: 37.3%, grade 2: 60.8%, grade 3: 2.0%) and failure to take them as prescribed. However, the chemotherapy discontinuation rate caused by adverse events was only 6.8% through our continuous interventions. Chemotherapy with oral anticancer drugs needed to be discontinued appropriately in cases of developing grade≧2 adverse events; therefore, unused medicines exist. This pharmacist outpatient service can also lead to major reductions in healthcare costs through management of unused medicines.