Incorporating tumour markers within a pharmaceutical care plan

Abstract

The availability of tumour markers in managing oncology patients contributes to developing personalised pharmacotherapy. The aim of this research was to develop a personalised pharmaceutical approach through the design and implementation of a pharmaceutical care plan (PCP) incorporating tumour markers for patients suffering from ovarian, pancreatic or prostate cancer. Guidelines, recommendations and standards of care for the management of ovarian, pancreatic and prostate cancer were reviewed. The classification systems for drug therapy problems developed and validated by Cipolle et al. (2004)1 and the Pharmaceutical Care Network Europe version 6.22 were considered. These classifications were used in the development of a newly designed PCP template, which presented specific pharmaceutical oncology care requirements and trending of tumour marker results. The developed PCP, which was implemented at Sir Anthony Mamo Oncology Centre consists of two sections. The first section records patient’s details, carer’s details, diagnosis, past medical history, previous cancer treatments, current medications including non-oncologic therapy, chemotherapy cycles prescribed, relevant laboratory investigations and tumour marker results. The second section of the PCP categorises individualised pharmaceutical care issues (PCIs) identified. The pharmacist’s actions are documented in this section. A total of 67 patients (35 male, 32 female) were enrolled in this study. The mean age was 65 ± 10.4 years. The range was 26 to 83 years. Forty-five patients had a family history of cancer while 22 did not. Patients suffering from ovarian, pancreatic and prostate cancer were 19, 27 and 21 respectively. A total of 238 PCIs were identified, ranging from 2 to 5 PCIs per patient. The most common PCIs identified were classified as counselling needs (65), adverse drug reactions (65) and additional medication needs (47). There was statistical correlation (p < 0.05) between age and cancer type and between pre- and post-treatment tumour marker results. The developed individualised PCP was developed as a helpful tool for the clinical pharmacist who can update patient pharmaceutical care records according to the PCIs identified whilst at the same time taking into consideration relevant tumour marker trends as well as other laboratory investigations.