The rise of oral therapies in the management of cancers has considerably changed the patient care path. If the oral route is preferred by patients because it offers a better quality of life, it is not without impact for patients and the health professionals involved in their management in their care. Indeed, the use of the oral route shifts part of the responsibility for monitoring treatment towards the patient, thereby leading to compliance problems, drug interactions and the management of adverse effects.These risks can cause complications or compromise the effectiveness of treatment, and generate additional costs for the investigator's health system. The study proposes to involve Healthcare Facilities Pharmacist and the Dispensary Pharmacist with all other health professionals.First, the hospital pharmacist will operate before the initiation of an oral route to perform a clinical pharmaceutical analysis of drug prescriptions. Then after the primary prescription and finally during a follow-up consultation 3 months after the initiation of treatment. The hypothesis of the study is that the coordinated intervention of the hospital pharmacist and of the dispensary pharmacist would improve the tolerance of oral treatments by reducing the number of serious adverse effects found, as well as improve the, quality of life, patient and professional satisfaction
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
396
The coordinated experimental pharmaceutical path consists of 7 pharmaceutical interviews or consultations. One initial pharmaceutical consultation with the hospital pharmacist. Five follow-up pharmaceutical interviews with the dispensary pharmacist. One follow-up pharmaceutical consultation with hospital pharmacist. Each pharmaceutical interview or consultation will result in the drafting of a pharmaceutical report to be sent to the other participating health professionals. At each pharmaceutical consultation or interview, the pharmacists requested perform a clinical pharmaceutical analysis of drug prescriptions; Evaluate the patient's understanding; Detect adherence problems, Identify drug related problems; Alert the oncologist and / or the attending physician.
Institut de Cancérologie de l'Ouest
Angers, France
RECRUITINGCHU
Angers, France
RECRUITINGCh Cholet
Cholet, France
RECRUITINGCHD Vendée
La Roche-sur-Yon, France
RECRUITINGCh Le Mans
Le Mans, France
RECRUITINGChu Nantes
Nantes, France
RECRUITINGInstitut de Cancérologie de l'Ouest
Saint-Herblain, France
RECRUITINGImpact of the coordinated pharmaceutical path on the tolerance of oral therapies against cancer.
The impact on tolerance will be measured by the proportion of patients with at least one grade 3 or 4 adverse event occurring / confirmed, linked to oral therapy, and confirmed by the oncologist.
Time frame: 6 months from the treatment initiation
Impact of the coordinated pharmaceutical path on the number of grade 3 and 4 adverse events detected linked to oral therapy
The impact will be measured by the number of grade 3 and 4 adverse events occurring / confirmed, linked to oral therapy, and confirmed by the oncologist.
Time frame: 6 months from the treatment initiation
Impact of the coordinated pharmaceutical path on unplanned hospitalizations related to the oral therapy
Number of unplanned hospitalizations related to the oral therapy and confirmed by the oncologist.
Time frame: 6 months from the treatment initiation
Impact of the coordinated pharmaceutical path on the drug related problems.
Number and nature of potential and confirmed drug related problemS detected by pharmacists
Time frame: 6 months from the treatment initiation
Detection of concerted treatment modifications between oncologist and pharmacist related to oral therapy
Number of treatment modifications related to oral therapy, necessary before starting treatment and during oral therapy and confirmed by the oncologist during follow-up consultations
Time frame: 6 months from the treatment initiation
Impact of the coordinated pharmaceutical path on quality of life: EORTC QLQ-C30 questionnaire
Quality of life for patients will be evaluated by a questionnaire before and after starting oral therapy according to the The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire
Time frame: Inclusion ; 1 month ; 3 months and 6 months from the treatment initiation
Impact of the coordinated pharmaceutical path on adherence to the oral therapy
Adherence to the oral therapy measured with the Girerd questionnaire wich is composed of 6 questions with an expected answer yes or no. A "yes" answer is worth 1, "No" answer is worth 0. The maximum score obtained is 6; the minimum score is 0. Final Score\> 2: low compliance ; Final score = 1 or 2: average compliance ; Final score = 0: good compliance.
Time frame: 1 month ; 3 months and 6 months from the treatment initiation
Satisfaction of patients related to the coordinated pharmaceutical path: questionnaire
Satisfaction of patients will be evaluated by a series of questions related to oral therapy. The patient responds if he strongly disagrees; rather disagree; somewhat agree ; Totally agree. An overall score is also required between 1 and 10; 1 is very bad; 10 is perfect
Time frame: 6 months from the treatment initiation
Assessment of the link between hospital and city
Evaluation of the link will be performed by a questionnaire to be completed by the oncologist and pharmacists. Each responds if he strongly disagrees; rather disagree; somewhat agree ; Totally agree
Time frame: Through study completion, an average of 42 months
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