药师在胃肠间质瘤多学科诊疗团队中的作用

• 作 者: 周毅 吴星烨 李娟 程伟 李小松 沈依帆 张军
• 机 构: 重庆医科大学附属第一医院药学部,重庆400016;重庆医科大学附属第一医院胃肠外科,重庆400016;重庆医科大学附属第一医院临床分子医学检测中心,重庆400016
• 出 处: 中国药学（英文版）
• 发表日期: 2021年7期
• 关键词: Pharmacist Imatinib Multidisciplinary team Gastrointestinal stromal tumor Trough

多学科诊疗手段有利于胃肠道间质瘤的治疗.然而,药师很少被纳入胃肠间质瘤的多学科诊疗团队中.本回顾性研究旨在评估药师在胃肠道间质瘤多学科诊疗团队中的临床和经济价值.药师建立了高效液相色谱法向胃肠道间质瘤患者提供血药浓度监测服务;此外,药师也前往胃肠道间质瘤门诊进行患者教育和提供药学服务,并收集数据进行分析.240名胃肠间质瘤患者接受了药师提供的服务,有25.42％的患者的谷浓度小于1100 ng/mL.121名患者完成了肿瘤分子诊断检测,主要基因型为KIT 11外显子突变、野生型和KIT9外显子突变.13名谷浓度小于1100 ng/mL的胃肠道间质瘤患者被证实依从性较低并得到纠正.13名胃肠道间质瘤患者因不耐受不良反应而降低剂量,通过监测血药浓度和降低剂量,每日服药成本也能够降低.“,”The multidisciplinary approach is beneficial to the treatment of gastrointestinal stromal tumors (GISTs).However,pharmacists are seldom incorporated into a multidisciplinary team (MDT) of GIST.In the present study,we evaluated the clinical and economic benefits of a pharmacist in an MDT of GIST.This was a retrospective study that included 240 GIST patients receiving imatinib therapy.The GIST MDT pharmacist developed and validated an HPLC method to monitor the trough concentrations of imatinib in GIST patients.Besides,the pharmacist also provided patient education and pharmaceutical care services and collected the data for analysis.The 240 GIST patients received the services provided by the pharmacist.The trough concentrations in 25.42％ of the 240 patients were less than 1100 ng/mL.The main genotypes of 12l in the 240 patients were KIT exon ll mutations,wild type,and KIT exon 9 mutations.Moreover,13 GIST patients with trough concentrations less than 1100 ng/mL were confirmed to have low compliance.The adverse reactions were primarily mild and tolerable,except that 13 GIST patients were adjusted to lower doses because of the intolerable adverse reactions.The daily cost could be lowered by monitoring the trough concentrations and dose reductions.Collectively,a pharmacist included in a GIST MDT could increase the compliance of Chinese GIST patients to imatinib therapy and improve the efficacy,safety,and economy of imatinib therapy.