IMPROVING THE PATIENT’S EXPERIENCE WITH CAPECITABINE
Reshenthie Govender1, Kin-Ngai Soo1, Dr Sun Myint2
1. Pharmacy Department, Clatterbridge Centre for Oncology NHS Foundation
Trust, Wirral
2. Consultant Clinical Oncologist, Clatterbridge Centre for Oncology NHS
Foundation Trust, Wirral
Introduction
Capecitabine is a convenient alternative to intravenous 5-fluorouracil for
chemo-radiation treatment of rectal cancer patients. Patients on Capecitabine
require greater support and education to minimise toxicities. The National
Patient Safety Agency has highlighted the unmanaged risks associated with
oral chemotherapy1.
Aim
To reduce waiting times and travel of patients, a one stop multidisciplinary
clinic visit is provided on their first day of chemo-radiotherapy.
To improve the patient’s understanding of treatment, the pharmacist provides
counselling and education concerning the unlicensed dose of Capecitabine
(825mg/m2 b.d. on days receiving radiotherapy), together with a Capecitabine
Patient Diary that was locally developed in conjunction with the manufacturer.
Methods
Within a designated clinical area, patients are reviewed sequentially by the
Consultant, Specialist Colorectal Nurse and Pharmacist before being escorted
to the Radiotherapy Department. The Pharmacist spends 30 minutes with
each patient in a dedicated clinic room, offering the second check on blood
results, dispensing the Capecitabine with counselling and written information
(including the Patient Diary). The Pharmacist follows a Capecitabine
counselling procedure document to ensure uniformity of the information
given2. Easier access to the prescriber and patient notes facilitates
Pharmacist’s interventions if required. Any patient monitoring issues are
communicated with the Colorectal Specialist Nurse or Consultant for followup.
Results
43 patients (mean age 63.5 years; 31 males) with adjuvant /neo-adjuvant
colorectal cancer completed the pathway in the first seven months. All but two
were Capecitabine naïve. Pharmacist made 2 significant interventions
(treatment was affected) and 8 minor interventions (no change to treatment).
Patient review on subsequent visits confirmed better understanding and
improved retention of facts.
Conclusion
Patients benefit from access to a dedicated clinic that is targeted to their
needs. Oncology pharmacists have a pivotal role to play in such a service.
References
1. Risk of incorrect dosing of oral anti-cancer medicines. NPSA Rapid
Response Report. NPSA/2008/RRR001 issued on 22 January 2008
2. Roche Products Ltd. Summary of Product Characteristics, Capecitabine.
Accessed on-line October 2007. www.medicines.org.uk
1. Abstract Title
IMPROVING THE PATIENT’S EXPERIENCE WITH CAPECITABINE
2. Authors
Reshenthie Govender, Kin-Ngai Soo, Dr Sun Myint
3. Name
Reshenthie Govender
4. Postal Address
Pharmacy Department
Clatterbridge Centre for Oncology NHS Foundation Trust
Clatterbridge road
Bebington
Wirral
CH63 4JY
5. Telephone
0151 - 3341155 Ext 4194
6. Fax
0151 - 4827767
7. Email address
Reshenthie.Govender@ccotrust.nhs.uk