Hospital pharmacist interventions for the management of oral mucositis in patients with head and neck cancer receiving chemoradiotherapy: a multicenter, prospective cohort study.

Autor: Yoshida K; Division of Hospital Pharmacy, Niigata University Medical and Dental Hospital, Niigata, Japan. kensukeyoshi.pd9@nuh.niigata-u.ac.jp., Watanabe S; Department of Clinical Pharmacy, College of Pharmaceutical Sciences, Matsuyama University, Matsuyama, Japan., Hoshino N; Division of Hospital Pharmacy, Niigata University Medical and Dental Hospital, Niigata, Japan., Pak K; Division of Biostatistics, Center for Clinical Research, National Center for Child Health and Development, Tokyo, Japan., Hidaka N; Division of Pharmacy, Ehime University Hospital, Toon, Japan., Konno N; Department of Pharmacy, Yamagata University Hospital, Yamagata, Japan., Nakai M; Division of Pharmacy, Ehime University Hospital, Toon, Japan., Ando C; Department of Pharmacy, Yamagata University Hospital, Yamagata, Japan., Yabuki T; Department of Pharmacy, Uonuma Kikan Hospital, Minamiuonuma, Japan., Suzuki N; Division of Hospital Pharmacy, Niigata University Medical and Dental Hospital, Niigata, Japan., Katsura K; Division of Oral Radiology, Niigata University Medical and Dental Hospital, Niigata, Japan., Tomihara K; Division of Oral and Maxillofacial Surgery, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan., Toyama A; Division of Hospital Pharmacy, Niigata University Medical and Dental Hospital, Niigata, Japan.
Jazyk: angličtina
Zdroj: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [Support Care Cancer] 2023 May 03; Vol. 31 (5), pp. 316. Date of Electronic Publication: 2023 May 03.
DOI: 10.1007/s00520-023-07784-6
Abstrakt: Purpose: Oral mucositis is a severe adverse event in patients with head and neck cancer (HNC) receiving chemotherapy and radiotherapy that may cause the termination of cancer treatment. In this study, we aimed to reveal the benefits of pharmacist interventions in oral health care for patients with HNC receiving concurrent chemoradiotherapy (CCRT).
Methods: We conducted a multicenter, prospective cohort study on 173 patients from September 2019 to August 2022. We evaluated the association between the occurrence of oral mucositis during CCRT and various factors in the absence or presence of direct medication instructions from hospital pharmacists.
Results: Sixty-eight patients received medication instructions from pharmacists (the pharmacist intervention group), whereas 105 patients did not receive instructions (the control group). Logistic regression analysis showed that grade 2 (Gr 2) oral mucositis was significantly lower in patients receiving pharmacist interventions than in patients in the control group (adjusted odds ratio [aOR], 0.42; 95% confidence interval [CI], 0.18-0.96; P = 0.04). The time to onset of Gr 2 oral mucositis was significantly longer in the pharmacist intervention group than in the control group (hazard ratio, 0.53; 95% CI, 0.29-0.97; P = 0.04).
Conclusion: Direct intervention, especially when provided by hospital pharmacists, can have a real effect in supporting patients with HNC experiencing severe side effects of treatments. Moreover, the integration of pharmacists into the oral healthcare team is becoming even more essential to reduce the severity of side effects.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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