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Pharmaceutical care and the cancer patient

University of California, Division of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco, California

Reginald King, PharmD

Hahnemann Medical Center, Philadelphia, Pennsylvania

Purpose. The primary objective of this paper is to discuss pharmaceutical care of the oncology patient in the context of recent recommendations made by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and recent changes in Health Care Reform.

Data Sources. We reviewed the literature through a MEDLINE search from 1985 to 1995. We searched the following terms: pharmaceutical care, cancer, patient, and pharmacist. We restricted the search to the English language. We also have incor porated several of our practice guidelines as examples of tools that can be used in the implementation of pharmaceutical care. We also focused on areas that the JCAHO guidelines specify as important pharma ceutical care issues in the cancer patient.

Data Extraction. Within the framework of drug prescribing, drug administration, drug monitoring, and patient education, we have provided interven tions that may potentially improve outcomes in can cer patients.

Data Synthesis. The advent of managed care will require that the pharmacist be more involved in the care and management of the cancer patient. This activity will necessitate that the pharmacist document the impact of interventions on patient outcomes. Although tumor response and survival are classic outcomes that are assessed in the cancer patient, other outcome indicators may be used to evaluate interventions made by the pharmacist.

Conclusions. This review offers strategies for implementing pharmaceutical care in the cancer pa tient. Because we did not present study results on patient outcomes, it is unknown which of these proposed pharmacist interventions are important fac tors in the implementation of pharmaceutical care in this patient population. Although pharmaceutical care is the new paradigm in pharmacy practice, we must perform prospective studies to determine its value to the cancer community.

Key Words: Pharmaceutical care • cancer; patient • pharmacist.

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