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Reporting and Monitoring of Radiation Related Adverse Events by Clinical Pharmacists in Cancer Patients: A Pilot Study

Author(s): Himanshu Patel*, Acsah Annie Paul, Rajesh Hadia, Baharul Islam and Parthasarathi Gurumurthy*

Objectives: This study was conducted to investigate the role of clinical pharmacists in radiation related adverse events detection and monitoring in cancer patients. Methods: This was a prospective interventional study conducted at private academic oncology care setting for a period of six months. Patients on radiation therapy or chemo-radiation therapy were enrolled and followed by clinical pharmacists on daily basis to identify adverse event(s) if any. Upon identification, adverse events were discussed with concerned radiation oncologists for authentication and graded as per defined by Radiation Therapy Oncology Group (RTOG). Enrolled patients were also followed to ensure if they were provided adequate supportive care. Results: A total of 226 radiation related adverse events (RRAEs) were reported from 254 patients followed during the study period. Among the study subjects, majority of them received chemo-radiation (n=126, 56%) than radiotherapy (n=100, 44%) alone. The most common reported events were fatigue (n=39, 17.2%) followed by mucositis (n=29, 12.8%), pain (n=23, 10.17%), diarrhoea (n=23, 10.17%), gastritis (n=22, 9.7%), proctalgia (n=20, 8.8%) and vomiting (n=18, 7.9%). Among the study patients who developed adverse events, majority (n=126, 56%) of them received a combination of chemotherapy and radiation therapy and 100 (44%) of 226 patients received radiotherapy alone. Weekly cisplatin monotherapy was the most common chemotherapy prescribed concurrently to radiotherapy. Clinical pharmacists intervened to initiate adequate supportive care for 32% (n=72) patients. Conclusions: Clinical pharmacists may contribute for identifying radiation related toxicities in cancer patients. Team work of clinical pharmacists with radiation oncologists can improve the radiation safety reporting and can ensure required medical and supportive care to manage RRAEs.

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