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Oral cancer drugs: care provided in community pharmacies

Community pharmacists in France can offer, and claim payment for, structured pharmaceutical care for the growing number of patients taking oral cancer drugs.

Community pharmacists in France have been authorised since September 2020 to offer structured pharmaceutical care for adults receiving oral cancer drugs, and to bill the national health insurance system for providing this service. The main objectives of this scheme are to help reduce the risk of adverse effects and foster treatment adherence. If the patient consents, the pharmacist and patient formalise the arrangement by completing a registration form on the national health insurance website.

During the first interview, the pharmacist obtains general information about the patient (lifestyle, any over-the-counter health products used, etc.) and assesses whether the patient understands their treatment, while informing them about how to take it.

The second interview focuses on any adverse effects experienced and any treatment-related difficulties the patient is encountering in their day-to-day life. When adverse effects occur, the pharmacist informs the hospital doctor who prescribed the treatment or the patient’s usual GP, and refers the patient for appropriate care.

The third interview is to review the patient’s treatment adherence and identify anything that is preventing them from taking the prescribed doses, such as having too many tablets to take, adverse effects or a fear of them, or forgetting doses, so that strategies can be devised to improve adherence.

One or two interviews are scheduled the following years, depending on the cancer drugs prescribed, to discuss adverse effects and adherence.

The availability of oral cancer drugs in the community requires more self-management on the part of patients, who are left to their own devices more than they would be if treated in hospital. This pharmaceutical care scheme, involving coordinated hospital and community care, is probably a useful aid to self-management.

©Prescrire 1 June 2021

Source: "Oral cancer drugs: community pharmacists in France provide billable, structured care" Prescrire International 2021; 30 (227): 162-164. Subscribers only.

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