(CSPOT03) Implementation of Clinical Pharmacist’s Services in Patients Receiving Oral Oncolytics and its Effects on Medication Adherence and Quality of Life: A Hospital-Based Prospective Interventional Study

Background: Oral chemotherapy has gained popularity due to its convenience and potential to improve the quality of life (QoL) for cancer patients. However, ensuring medication adherence remains a significant challenge, as non-adherence can have a negative impact on treatment efficacy and patient outcomes. Addressing this issue is crucial to optimize the benefits of oral oncolytics and enhance patients' overall well-being.

Objectives: To implement clinical pharmacist services and evaluate their impact on medication adherence and QoL in patients receiving oral oncolytics.

Methods: A prospective interventional cohort study was conducted at Dr. Bhubaneswar Barooah Cancer Institute (BBCI) from August 2022 to April 2023. The study included patients aged 18 years and above receiving oral chemotherapy. The intervention group received personalized medication counseling and educational materials, while the control group received standard care. Medication adherence was assessed using the Morisky Medication Adherence Scale (MMAS-8), and QoL was evaluated using the EQ-5D-5L and EORTC QLQ-C30 questionnaires

Results: A total of 202 participants were randomly assigned to either the intervention or control group. The intervention group demonstrated a significantly higher change in medication adherence compared to the control group (0.66±0.09, p< 0.01). Furthermore, the intervention had a positive and significant effect on specific aspects of functioning and QoL. The intervention group showed improvements in overall role functioning (0.06±0.02, p=0.03), cognitive functioning (0.08±0.03, p=0.01), and social functioning (0.12±0.03, p< 0.01), along with a decrease in overall pain (-0.06±0.05, p=0.03) compared to the control group.
The analysis of self-reported questionnaires revealed important findings regarding non-adherence factors in both the intervention and control groups. The primary factors contributing to non-adherence were consistently associated with feelings of depression or being overwhelmed (98.0%), perceiving the treatment as complex (94.0%), and facing challenges in reaching the hospital easily (51.0%).

Conclusions: Pharmacist-led interventions have demonstrated the potential to improve medication adherence and health outcomes among various patient populations. Personalized medication counseling aimed to address adherence barriers and enhance patient understanding. This study provides valuable insights into the impact of pharmacist interventions on medication adherence and QoL in cancer patients receiving oral chemotherapy.