Role of pharmacists in adherence in oncology patients

Figures & data

Figure 1. PRISMA diagram of the scoping review process.

Table 1. List of articles included in the scoping literature review.

Authors	Objectives
Hansen EA, et al. (2016) [15]	The patient and physician satisfaction survey demonstrated the value of the CDTM (collaborative drug therapy management) pharmacists, and respondents were supportive of the program.
Djebbari F et al. (2018) [16]	To evaluate the role of pharmacists in dosing strategies
Birand N et al. (2019) [17]	The aim was to assess the impact of counselling by an oncology pharmacist on patients’ medication adherence and beliefs.
Defoe KD et al. (2019) [18]	To describe key activities performed by a newly deployed clinical pharmacist in an outpatient pediatric haematology, oncology and transplant clinic. To demonstrate how the utilization of the pharmacist evolved in key activities.
Mackler E et al. (2019) [19]	To create a pharmacy practice standard for the management of oral oncolytic therapy that describes the pharmacist’s role on the cancer care team, examples of practice tools and resources
Holle LM et al. (2020) [20]	Oncology pharmacists are an integral part of the cancer care team; their value has been documented in several studies and is highlighted in this Issue.
Crul M and Oosterh P (2020) [21]	We incorporated two pharmacists in the palliative team, one hospital pharmacist and one pharmacist who was trained as a community pharmacist. The objective of our study was to evaluate their contribution to the palliative team.
Anisty Maria Joy et al. (2021) [22]	The main objective of this study was to counsel the patients and to assess their impact on medication-taking behaviour among cancer patients visiting the outpatient department.
Pirolli AV et al. (2022) [23]	The present study aimed to know the perception of patients who live with breast cancer and who do AHT about the educational performance of the clinical pharmacist.
Ghiggia A et al. (2021) [24]	To evaluate the efficacy of a reinforcement message administered by a hospital pharmacist on adherence, through a randomized study involving patients undergoing oral chemotherapy
Oliveira CS et al. (2021) [25]	To evaluate, synthesize and critically present the available evidence on the impact of the Clinical Pharmacy in the treatment of patients with haematological cancer.
Neuner J et al. (2022) [26]	We developed a pilot single-site study of patients with evidence of early nonadherence to AET (adjuvant endocrine treatment) to assess the feasibility of a novel, clinical pharmacist-led intervention targeting symptom and medication management.
Novosadova M et al. (2023) [27]	To evaluate the importance of a clinical pharmacist in the palliative care team.

Table 2. Results from demographic characteristics of patients from a pharmacist’ perspective.

Indicator	Number of respondents (%)
Age group
40–65	15 (58%)
>65	11 (42%)
Gender
Male	2 (7%)
Female	3 (11 %)
Equal distribution of gender among patients	21 (82 %)
The patient’s residence depends on the hospital location
Sofia	5 (19%)
Another big regional city	1 (4%)
Irrespective of the regional city	1 (4%)
Small village	19 (73%)

Table 3. Results from the questionnaire regarding the factors and opportunities to influence adherence according to hospital pharmacists.

Factors affecting therapy adherence
Questions	Number of responses (%)
When dispensing medicines to oncology patients, do you have the option for patient consultation?
Yes, always	10 (38%)
Yes, sometimes	11 (42%)
No, I do not have this opportunity	5 (19%)
According to your observations, are patients sufficiently informed about the daily dose and how to take the medicines?
Yes, always	12 (46%)
Yes, sometimes	11 (42%)
No	3 (12%)
Do you discuss with patients the regular intake of medication and the need for adherence to therapy?
Yes, always	12 (46%)
Yes, sometimes	9 (34%)
No, I do not have this opportunity	5 (20%)
Which factors did patients share as the main reasons for lower adherence to therapy? (more than one option could be stated)
Manifestation of an adverse drug reaction	21 (79%)
Distrust in the ongoing therapy	5 (2%)
Do not want to share with the hospital pharmacy	1 (4%)
Missed daily dose	1 (4%)
In which age group of patients do you observe a higher rate of adherence to therapy?
<40	3 (12%)
40–65	11 (42%)
>65	6 (23%)
I cannot determine	6 (23%)
According to your observations, are male or female patients more likely to adhere to therapy to a higher degree?
Male	2 (7%)
Female	7 (28%)
Gender has no significant influence on the degree of adherence to therapy	17 (65%)
Opportunities to influence adherence to therapy
What do you think might encourage patients to take medicines as prescribed? (more than one option could be stated)
Presence of response to therapy	17 (67%)
Discussions with the oncologist or pharmacist	17 (67%)
Monitoring the patient’s therapy response	1 (4%)
All of the above	1 (4%)
Do you discuss questions regarding patients’ adherence with the oncologist?
Yes, always	7 (29%)
Yes, sometimes	12 (42%)
No, I don’t have that opportunity	6 (25%)
N/A	1 (4%)
Do you use digital approaches or apps to communicate with patients and assess their adherence to therapy?
Yes	6 (23%)
No	20 (77%)

Hansen EA, Pietkiewicz JM, Blum BL. Evaluation of the feasibility and utility of a pharmacist-centered collaborative drug therapy management program for oncology-based symptom management. J Pharm Pract. 2016;29(3):206–211. doi: 10.1177/0897190014557626.

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Djebbari F, Stoner N, Lavender VT. A systematic review of non-standard dosing of oral anticancer therapies. BMC Cancer. 2018;18(1):1154. doi: 10.1186/s12885-018-5066-2.

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Birand N, Boşnak AS, Diker Ö, et al. The role of the pharmacist in improving medication beliefs and adherence in cancer patients. J Oncol Pharm Pract. 2019;25(8):1916–1926. doi: 10.1177/1078155219831377.

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Defoe KD, Jupp J, Leslie T. Integration of clinical pharmacists into an ambulatory, pediatric hematology/oncology/transplant clinic. J Oncol Pharm Pract. 2019;25(3):607–612. doi: 10.1177/1078155217752534.

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Mackler E, Segal EM, Muluneh B, et al. 2018 Hematology/oncology pharmacist association best practices for the management of oral oncolytic therapy: pharmacy practice standard. J Oncol Pract. 2019;15(4):e346–e355. doi: 10.1200/JOP.18.00581.

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Holle LM, Segal EM, Jeffers KD. The expanding role of the oncology pharmacist. Pharmacy (Basel). 2020;8(3):130. doi: 10.3390/pharmacy8030130.

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Crul M, Oosterhof P. The oncology pharmacist as part of the palliative treatment team. Int J Pharm Pract. 2020;28(1):92–96. doi: 10.1111/ijpp.12583.

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Joy AM, Nandakumar UP, Sharad C, et al. Role of clinical pharmacist in the medication adherence behaviour of cancer patients: an interventional study. Pharm Hosp Clin. 2021;56(3):291–297. doi: 10.1016/j.phclin.2021.05.002.

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Pirolli AV, Brusamarello T, Everton SS, et al. The role of the clinical pharmacist in guiding adjuvant hormonal therapy in patients with breast cancer. J Oncol Pharm Pract. 2022;28(6):1368–1374. doi: 10.1177/10781552211029361.

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Ghiggia A, Bianco A, Castelli L, et al. Adherence to oral chemotherapy: evidence from a randomised clinical trial. Eur J Cancer Care (Engl). 2021;30(1):e13336. doi: 10.1111/ecc.13336.

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Oliveira CS, Silva MP, Miranda Í, et al. Impact of clinical pharmacy in oncology and hematologycenters: a systematic review. J Oncol Pharm Pract. 2021;27(3):679–692. doi: 10.1177/1078155220976801.

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Neuner J, Weil E, Fergestrom N, et al. Feasibility of a pharmacist-led symptom monitoring and management intervention to improve breast cancer endocrine therapy adherence. J Am Pharm Assoc (2003). 2022;62(4):1321–1328.e3. doi: 10.1016/j.japh.2022.03.001.

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Novosadova M, Filip S, Molnarova V, et al. Clinical pharmacist in oncology palliative medicine: drug compliance and patient adherence. BMJ Support Palliat Care. 2023;13(e3):e1308–e1317. doi: 10.1136/spcare-2023-004212.

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Data availability statement

The data that support the findings reported in this study are available from the corresponding author [MD] upon reasonable request.