Hospital pharmacist interventions for the management of oral mucositis in patients with head and neck cancer receiving chemoradiotherapy: a multicenter, prospective cohort study

• Published in: Supportive care in cancer 2023-05, Vol.31 (5), p.316-316, Article 316
• Main Authors: Yoshida, Kensuke, Watanabe, Shinichi, Hoshino, Naoto, Pak, Kyongsun, Hidaka, Noriaki, Konno, Noboru, Nakai, Masaki, Ando, Chinami, Yabuki, Tsuyoshi, Suzuki, Naoto, Katsura, Kouji, Tomihara, Kei, Toyama, Akira
• Format: Article
• Language: English
• Subjects: Analysis; Cancer; Cancer patients; Cancer therapies; Chemoradiotherapy - adverse effects; Chemotherapy; Cohort analysis; Head & neck cancer; Head and neck cancer; Head and Neck Neoplasms - drug therapy; Head and Neck Neoplasms - radiotherapy; Health aspects; Hospitals; Humans; Intervention; Medicine; Medicine & Public Health; Mucositis; Nursing; Nursing Research; Oncology; Oncology, Experimental; Pain Medicine; Pharmacists; Prospective Studies; Radiation therapy; Rehabilitation Medicine; Stomatitis; Stomatitis - drug therapy; Stomatitis - etiology
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-023-07784-6

Purpose Oral mucositis is a severe adverse event in patients with head and neck cancer (HNC) receiving chemotherapy and radiotherapy that may cause the termination of cancer treatment. In this study, we aimed to reveal the benefits of pharmacist interventions in oral health care for patients with HNC receiving concurrent chemoradiotherapy (CCRT). Methods We conducted a multicenter, prospective cohort study on 173 patients from September 2019 to August 2022. We evaluated the association between the occurrence of oral mucositis during CCRT and various factors in the absence or presence of direct medication instructions from hospital pharmacists. Results Sixty-eight patients received medication instructions from pharmacists (the pharmacist intervention group), whereas 105 patients did not receive instructions (the control group). Logistic regression analysis showed that grade 2 (Gr 2) oral mucositis was significantly lower in patients receiving pharmacist interventions than in patients in the control group (adjusted odds ratio [aOR], 0.42; 95% confidence interval [CI], 0.18–0.96; P  = 0.04). The time to onset of Gr 2 oral mucositis was significantly longer in the pharmacist intervention group than in the control group (hazard ratio, 0.53; 95% CI, 0.29–0.97; P  = 0.04). Conclusion Direct intervention, especially when provided by hospital pharmacists, can have a real effect in supporting patients with HNC experiencing severe side effects of treatments. Moreover, the integration of pharmacists into the oral healthcare team is becoming even more essential to reduce the severity of side effects.