If this care process is not formalized, the hospital pharmacy will carry out a pharmaceutical consultation whose management and scope are tailor-made. It is assumed that oncology skills come from experience gained and/or specific training (e.g. university degree in oncology pharmacy, master class, etc.). The pharmaceutical consultation is the subject of a personalized pharmaceutical strategy, which is added to the patient`s file and is made available to the various stakeholders in the care. The SFPO recommends that this location be as close as possible to the location of confidential ambulatory care (consultation and/or day clinic) and/or hospitalization in the same room. An area belonging to the hospital pharmacy is also an option. The hospital pharmacy defines the selection criteria for the implementation and use of the convocation of the pharmaceutical consultation. The pharmaceutical consultation takes place in a specially designed and equipped area (e.g. a consultation room). The SFPO recommends drafting a procedure that formalizes the typical way of a pharmaceutical consultation. Before proceeding with the pharmaceutical consultation, it is of utmost importance to have access to as much information as possible on clinical aspects (e.g. cancer history, comorbidities, nutritional modalities, etc.), therapeutic aspects (e.g.
the latest list of treatments administered), the patient (e.g. lifestyle, dependence, etc.) and his care. The initial pharmaceutical consultation shall include at least: experts; Peer review; pharmaceutical counselling; Recommendations At the end of the pharmaceutical consultation, the patient receives written information (e.g. advice, time of medication, follow-up of the registration booklet, etc.). [29] Oncology pharmaceutical consultations are intended for patients treated with oral therapies including hormone therapy, anticancer cytostatics and targeted therapy drugs. In the multidisciplinary treatment of a patient, the pharmacist specializing in oncology must perform pharmaceutical consultations, which include at least the realization of the drug matching and its analysis. A follow-up pharmaceutical consultation lasts about 20 minutes. It can be replaced by a telephone or remote (e.g. webcast) interview by a pharmacist. [32] As required, a follow-up pharmacy consultation includes: establishment and scope take into account medical support, resources allocated (e.g., number of employees in the pharmaceutical sector), drug tolerability profile, complexity of administration modalities (sequential dosing regimen, etc.) and patient profile. Treatment analysis should be planned in several phases: active search for information about the patient`s medications, combined with drug evaluation; perform a drug comparison with an associated pharmaceutical analysis; information about the prescribing physician; and the patient with traceability in his personalized health plan.
The active search for information on the treatment or its modification is based on consultation of the drug file, the follow-up of dispensing by the community pharmacy, a targeted interview with the patient and the prescription that generates the dispensation. [30,31] The objectives of pharmaceutical consultations in oncology are as follows: The pharmaceutical consultation action is recorded, measured, monitored and added to the progress report of the pharmacy and the hospital. Fourteen directives were issued and instruments were proposed for the hospital pharmacist community. Although the initial pharmaceutical consultation should preferably take place face-to-face with the patient in order to maintain a relationship of trust, a pharmaceutical consultation can be conducted by telephone or remotely by digital means (e.g. web). Pharmaceutical oncology consultation is part of the multidisciplinary treatment process. The pharmacist in charge of the pharmaceutical consultation participates in the coordination of the pharmaceutical functioning of the community – the hospital. The flow of information should be multidisciplinary, secure and interactive.
Different “non-exhaustive” criteria are proposed here, without being classified in any order. The pharmaceutical consultation must be carried out on the basis of the organizational constraints specific to each center. The implementation of a drug comparison and the development of a personalized drug strategy are among the main objectives of a pharmaceutical consultation in oncology. Multidisciplinarity is defined by the involvement of an oncology specialist, a hospital pharmacist specializing in oncology and other health professionals in the hospital and/or community sector. While some oral therapies must be dispensed from the hospital pharmacy for outpatients, the dispensing process is an opportunity to conduct pharmaceutical consultations. The use of special status and innovative medicines (e.g. hospital early access programme, clinical trials, etc.) may be a reason for the pharmaceutical consultation process within the hospital pharmacy. In the event of an unusual tolerability profile, an identified interaction (without possible substitution), a stoma or a situation that may be considered relevant by the pharmacist performing the pharmaceutical consultation, plasma levels with therapeutic pharmacovigilance should be provided as an option for the physician. [36–38] These guidelines only concern pharmaceutical consultations and their relationship to pharmaceutical interviews. Therapeutic patient education (TPE) is not covered by these guidelines. For this reason, PAHO recommends selected pharmaceutical consultations (e.g., to get a clear picture of the patient`s profile, type of medication, initial prescription, etc.).
Since 2012, pharmaceutical interviews have been one of the new obligations of pharmacists in France. The implementation modalities are defined (e.g. Processing, duration, frequency and content). [14] In oncology, conducting pharmaceutical interviews is complicated by the variety of oral therapies available and the low frequency of their administration. To assist pharmacist oncologists, PAHO offers various tools (Supplemental Digital Content 1, templates for the initial links.lww.com/EJOP/A0 pharmaceutical consultation; Additional digital content 2, for subsequent pharmaceutical consultation, links.lww.com/EJOP/A1; Complementary digital content 3 for the initial pharmacy consultation report, links.lww.com/EJOP/A2; Additional digital content 4 for the follow-up pharmacy consultation report, links.lww.com/EJOP/A3; and additional digital content 5, for the report to be used by the pharmacist and treating physician links.lww.com/EJOP/A4). Pharmaceutical consultations are part of the multidisciplinary community/hospital treatment of patients treated orally associated with hospital and community health professionals and in particular the dispensing pharmacist. [11–13] It is preferable that a pharmaceutical analysis be carried out for all treatments before the introduction of a therapeutic agent. The practice of pharmaceutical counselling could be heterogeneous between regions and/or hospital structures and required a common organisational basis.