Pharmacist Counseling Drives Patient Preference in Breast Cancer Treatment

Researchers in Japan are beginning to construct patient-centered counseling techniques for breast cancer by evaluating patient preference.

Pharmacist counseling may influence patient preferences in breast cancer therapy. Researchers Kawaguchia et al, in association with the Pharmaceutical Society of Japan, investigated optimal methods of counseling based on patient preferences and published results in the journal J-STAGE.¹

Researchers surveyed a total of 280 patients with breast cancer, and recorded patients’ preferences with regard to pharmacist counseling before initiation of chemotherapy. Patients reported a desire to interact with a pharmacist who had a friendly and attentive attitude providing individualized information.¹

Before initiation of chemotherapy, patients have many therapeutic options. To help reduce confusion and decisional conflict, patients may benefit from pharmacist counseling. More than three-fourths of patients in this study expressed interest in getting a pharmacist's input about treatment before initiating chemotherapy treatment, and the majority of patients involved in the survey (87.7%) have already benefitted from pharmacist counseling.¹

Previous research from the same group in Japan found that pharmacists helped patients make decisions about chemotherapy treatment. On a 16-item questionnaire assessing levels of decisional conflict, patients who spoke to a pharmacist before initiating chemotherapy were significantly less conflicted about the chosen chemotherapeutic regimen on all 5 scales evaluated on the decisional conflict questionnaire (P <.001).²

An abundance of evidence supports the value of pharmacists in improving patient adherence to medication regimens. However, most of these interventions have been limited to chronic disease states such as diabetes and hypertension.^3-6

In the United States, the American Society of Health-System Pharmacists has studied the role of specialist pharmacists in 26 cancer centers across the United States. In these institutions, 96% reported that pharmacists provide drug therapy management services.

The majority (80%) of institutions have implemented automated dispensing and order entry technology to enable pharmacists to interact directly with patients. Many institutions are deploying pharmacists in direct patient care roles.⁷

As more oral anticancer treatments become available, the importance of counseling may extend more frequently to rarer and more specialized disease states—expanding the role of the pharmacist to areas that involve more direct interaction with patients.

References:

• Kawaguchi T, Azuma K, Yamaguchi T, et al. Preferences for pharmacist counselling in patients with breast cancer: a discrete choice experiment. Biol Pharm Bull. 2014.
• Kawaguchi T, Azuma K, Yamaguchi T, et al. Development and validation of the Japanese version of the Decisional Conflict Scale to investigate the value of pharmacists' information: a before and after study. BMC Med Inform Decis Mak. 2013;13:50.
• Stewart K, George J, Mc Namara KP, et al. A multifaceted pharmacist intervention to improve antihypertensive adherence: a cluster-randomized, controlled trial (HAPPy trial). J Clin Pharm Ther.2014;39(5):527-534.
• Lau R, Stewart K, McNamara KP, et al. Evaluation of a community pharmacy-based intervention for improving patient adherence to antihypertensives: a randomised controlled trial. BMC Health Serv Res.2010;10:34.
• Svarstad BL, Kotchen JM, Shireman TI, et al. The Team Education and Adherence Monitoring (TEAM) trial: pharmacy interventions to improve hypertension control in blacks. Circ Cardiovasc Qual Outcomes. 2009;2(3):264-271.
• Carter BL, Foppe van Mil JW. Comparative effectiveness research: evaluating pharmacist interventions and strategies to improve medication adherence. Am J Hypertens. 2010;23(9):949-955.
• Smith MB, Gumpper KF, Riebandt G, Handel EM. Implementation of the Pharmacy Practice Model Initiative within comprehensive cancer centers. Am J Health Syst Pharm. 2014;71(19):1647-1660.