摘要
目的:评价全程化药学服务在免疫检查点抑制剂(ICIs)治疗晚期非小细胞肺癌(NSCLC)中的应用效果。方法:采用前瞻性随机对照研究方法,选取南通大学附属肿瘤医院肿瘤科收治的80例晚期一线NSCLC患者为研究对象,随机分为2组:对照组40例,接受临床医生常规治疗及临床药师常规指导;干预组40例,在对照组的治疗基础上联合临床药师全程化药学服务干预。观察并比较2组临床疗效、超说明书用药评价、生活质量评分、不良反应发生率、患者满意度及依从性。结果:治疗后客观缓解率(ORR)、疾病控制率(DCR)观察组略高于对照组(12.5%vs.10.0%,80.0%vs.70.0%),差异无统计学意义(P>0.05);ICIs超说明书用药发生率观察组小于对照组(37.5%vs.60.0%),(P<0.05);根据Micromedex Thomson分级系统评价,ICIs用药有效性等级2组差异无统计学意义(P>0.05),ICIs用药推荐等级与证据等级观察组高于对照组(P<0.05);治疗后2组生活质量评分(QOL-C30)观察组高于对照组(P<0.05);免疫相关不良反应(irAEs)总发生率观察组低于对照组(37.5%vs.47.5%),差异无统计学意义(P>0.05),其中1级irAEs发生率观察组高于对照组(P<0.05),2级irAEs发生率观察组低于对照组(P<0.05);治疗后患者满意度及依从性评分观察组高于对照组(P<0.05)。结论:全程化药学服务应用于ICIs治疗晚期NSCLC可以提高合理用药水平、提高患者生活质量、降低药物不良反应发生率、提高患者满意度及依从性,在临床药师为ICIs临床使用提供药学服务过程中发挥积极的作用。
OBJECTIVE To evaluate the effect of integrated pharmaceutical care in the treatment of advanced NSCLC with immune checkpoint inhibitors(ICIs).METHODS Totally 80 patients were randomly divided into two groups.The 40 patients in the control group received the treatment by clinicians and pharmacists,and the 40 patients in the intervention group were combined with the integrated pharmaceutical care.The clinical efficacy,off-label medication evaluation,quality of life score,incidence of adverse reactions,patient satisfaction and compliance were observed.RESULTS The ORR and DCR of the intervention group were slightly higher than those of the control group(12.5%vs.10.0%,80.0%vs.70.0%,P>0.05).The overall incidence of off-label medication in the intervention group was lower(37.5%vs.60.0%,P<0.05).According to the Micromedex Thomson grading system,there was no significant difference in the effectiveness level between the two groups(P>0.05).The recommendation level and evidence level of the intervention group were higher(P<0.05);the QOL score was higher(P<0.05),the total incidence of irAEs was lower(P>0.05),the incidence of grade 1 irAEs was higher(P<0.05),and the incidence of grade 2 irAEs was lower(P<0.05)in the intervention group.CONCLUSION The application of integrated pharmaceutical care in the treatment with ICIs can improve the level of rational drug use and the quality of life of patients,reduce the incidence of irAEs,and improve patient satisfaction and compliance as well.Integrated pharmaceutical care can play an active role in pharmaceutical services for the rational use of ICIs.
作者
缪华媛
顾海娟
朱冬梅
韩黎黎
顾翩翩
倪美鑫
MIAO Hua-yuan;GU Hai-juan;ZHU Dong-mei;HAN Li-li;GU Pian-pian;NI Mei-xin(Department of Pharmacy,Affiliated Tumor Hospital of Nantong University,Jiangsu Nantong 226001,China)
出处
《中国医院药学杂志》
CAS
北大核心
2023年第9期1008-1012,共5页
Chinese Journal of Hospital Pharmacy
基金
白求恩公益基金会“白求恩·求索-药学科研能力建设”科研项目(编号:B-19-H-20200622)
江苏省药学会恒瑞药学服务专项科研项目(编号:H2020051)。
关键词
全程化药学服务
临床药师
免疫检查点抑制剂
非小细胞肺癌
前瞻性研究
integrated pharmaceutical care
clinical pharmacist
immune checkpoint inhibitors(ICIs)
non small-cell lung cancer(NSCLC)
prospective study
