Effects of consultations and interventions in a pharmacist-led outpatient clinic on duration of treatment and adverse events with osimertinib.

Abstract

PurposeOsimertinib, which is a key treatment for patients with epidermal growth factor receptor gene mutation-positive non-small cell lung cancer (EGFR mt NSCLC), causes intractable adverse events for some patients. The objective of this study was to assess the impact of pharmacist consultation in a pharmacist-led outpatient clinic (PLOC) and the effectiveness of pharmacist interventions on osimertinib treatment.Patients and MethodsThis observational cohort study included patients who started osimertinib for EGFR mt NSCLC at Aichi Medical University Hospital between April 2018 and December 2021. The duration of treatment and occurrence of adverse events were compared according to whether they consulted a PLOC pharmacist, and whether they received pharmacist intervention. This study was approved by the ethical review board of the university (approval no. 2019-203).ResultsThe median duration of treatment was significantly longer for the patients who consulted with the PLOC pharmacist than for those who did not (561 vs 203 days, hazard ratio 0.40, p < 0.001). The median duration of treatment was significantly longer for patients who received pharmacist intervention than for those who did not. (774 vs 237 days, hazard ratio 0.39, p < 0.001). The discontinuation rate was significantly lower in patients who consulted a PLOC pharmacist than for those who did not (73% vs 97%, p = 0.008). However, the rates and reason for osimertinib discontinuation or dose reduction did not differ between groups.ConclusionPLOC consultation and intervention for the treatment of adverse events might have led to extending the duration of osimertinib treatment.