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Role of the Pharmacist in Detection of Drug Interactions Before Antitumor Treatment Initiation

Completed
Conditions
Neoplasm
Registration Number
NCT04142567
Lead Sponsor
Assistance Publique - Hôpitaux de Paris
Brief Summary

The purpose of this observational study is to evaluate the benefits of a pharmacist integration in an oncology ambulatory center, to prevent drug related problems (in particular drug drug interactions) at antitumor treatment initiation.

The hypothesis of this work is that a drug drug interaction will be observed in 30% of cancer patients and will have a major clinical impact in 1% of the cases. The primary endpoint is the prevalence of pharmacist interventions among patients who are going to receive an oral targeted therapy or cancer chemotherapy or immunotherapy

Detailed Description

The purpose of this observational study is to evaluate the benefits of a pharmacist integration in an oncology ambulatory center, to prevent drug related problems (in particular drug drug interactions) at antitumor treatment initiation.

The hypothesis of this work is that a drug drug interaction will be observed in 30% of cancer patients and will have a major clinical impact in 1% of the cases.

The primary endpoint is the prevalence of pharmacist interventions among cancer patients who are going to receive an oral targeted therapy (140 patients) or cancer chemotherapy or immunotherapy (300 patients).

Pharmacist interventions will be classified according to the SFPC (société française de pharmacie Clinique) classification.

The secondary endpoints are

* The detection of drug drug interactions with theriaque software, Micromedex software and DDI predictor tool.

* The clinical gradation by an independent expert comity of the clinical impact of avoided drug drug interaction. The expert comity will grade avoided clinical consequences in 3 levels (minor, moderate or major),

* The Economic evaluation of pharmacist intervention: Cost of the project to evaluate drug drug interaction and benefits after evaluation of avoided clinical consequences

* The Adherence evaluation of patients treated with oral cancer targeted therapy (Therefore, only patients under oral targeted therapy will be evaluated at Day0, Day15 ,Day 30 and Month 6 to determine adherence.)

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
440
Inclusion Criteria
  • legal age patients
  • Affiliated to social security or with another insurance system
  • with a solid tumor
  • who are going to receive an antitumor treatment (chemotherapy, immunotherapy or oral targeted therapy)
Exclusion Criteria
  • pregnant women
  • minor patient

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Prevalence of Pharmacist interventionup to 1 week from date of inclusion

Percentage of patients whom antitumora treatment or usual treatment has been changed by the pharmacist intervention

Secondary Outcome Measures
NameTimeMethod
Detection of Drug -drug interactionsup to 1 week from date of inclusion

Number of drug drug interactions detected

Potential cost of the avoided clinical consequencesOne year

Treatment cost of avoided clinical consequences , balanced with the probability of occurrence

Adherence evaluation with oral cancer targeted therapy by pill count6 months after oral therapy initiation

Pill counts will be used to calculate the percent of total prescribed dose taken to prescribed during the 90-day period

Adherence evaluation with oral cancer targeted therapy by therapeutic drug monitoringday 15, 30 and 6 months after oral therapy initiation

Patients with plasma drug concentration below the 10th percentile will be classified as nonadherent patients

Clinical gradation of drug drug interactionsOne year

Gradation by an independent experts comity of the clinical impact of prevented drug drug interaction

Cost of the pharmacist intervention by avoided clinical consequenceOne year

Cost evaluation of pharmacist for analysis and medication review with patient by avoided interaction

Adherence evaluation with oral cancer targeted therapy by the 6 item-Girerd Scaleday 15, 30 and 6 months after oral therapy initiation

Patients with a Girerd score greater than or equal to 3 will be classified as nonadherent patients

Trial Locations

Locations (1)

APHP -Cochin Hospital and Georges Pompidou European Hospital

🇫🇷

Paris, France

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