Publication: Kolon kanseri hastalarında farmasötik bakım gereksinimlerinin belirlenmesi
Abstract
1. ÖZET Amaç: Çalışmamızın amacı, kolon kanseri hastalarında farmasötik bakım gereksinimlerinin belirlenip çözümlenmesi ve GAS6 proteininin kolon kanseri ile olası ilişkisinin değerlendirilmesidir. Gereç ve Yöntem: Çalışmaya kolon kanseri tanısı yeni konmuş olan 70 hasta ve kontrol grubunda yer alan 53 sağlıklı gönüllü dahil edilmiştir. Kemoterapi tedavisi alan 36 hasta, 3 kür süresince takip edilmiş ve her hasta için farmasötik bakım planları hazırlanmıştır. Aynı hastaların ilk kür öncesi ve 3 kür sonrası yaşam kaliteleri değerlendirilmiştir. Kolon kanseri hastalarının kemoterapi öncesi ve 3 kür sonrası; cerrahi öncesi ve 1 ay sonrası; kontrol hastalarının ise 1 kere GAS6 plazma düzeyleri ölçülmüştür. Bulgular: Çalışmaya katılan kemoterapi hastalarında, 3. kürde ilaç kaynaklı problemler (İKP) 1. küre göre azalmıştır (Sırasıyla %63,9, %75; n=36; p>0,05). Hastalara, 3 kür süresince klinik onkoloji eczacısı tarafından 147 öneri yapılmış, bu önerilerin %98'i (n=144) uygulanmıştır. Hastaların uyguladıkları önerilerin %91,7'sinde (n=132) İKP çözülmüş, %8,3'ünde (n=12) ise çözülememiş ve ileri tetkikler için hastalar doktora yönlendirilmiştir. Hastaların anemi, diyare ve nörotoksisite ile ilişkili olarak yaşam kalitelerinin azaldığı tespit edilmiştir (p<0,05). Kolon kanseri hastalarında GAS6 plazma düzeyleri kontrol hastalarına göre daha düşük bulunmuş, (p<0,05), cerrahi ve kemoterapi tedavileri sonrası ise yükselmiştir (p<0,05). Kanser belirteçlerinden CA19-9 ile GAS6 plazma düzeylerinin tedavi öncesi ve sonrasındaki değerlerinin farkları arasında anlamlı pozitif bir korelasyon bulunmuştur (Spearman’s r = 0,596; p<0,05). Sonuçlar: Klinik onkoloji eczacısının farmasötik bakım uygulayarak; İKP'nin belirlenmesi ve çözümlenmesinde önemli bir rolü olduğu gösterilmiştir. Ayrıca GAS6 proteinin kolon kanserinin tanı ve prognozunda kullanılabilecek bir belirteç olduğu gösterilmiş olup, bu konuyla ilgili daha fazla araştırma yapılması gerektiği sonucuna ulaşılmıştır. Anahtar sözcükler: Kolon kanseri, onkoloji eczacısı, farmasötik bakım, yaşam kalitesi, GAS 2.
Objectives: The aim of this study is to determine and solve the pharmaceutical care needs of colon cancer patients and to evaluate the relation between GAS6 protein levels and colon cancer. Method: 70 patients newly diagnosed with colon cancer and 53 healthy volunteer as control group were included in the study. 36 chemotherapy patients were followed during 3 courses of treatment and pharmaceutical care plans were developed for each patient. Quality of life of patients were evaluated before and after the 3 courses of chemotherapy. Plasma GAS6 levels were measured before and after 3 courses of chemotherapy; before and 1 month after the surgery for colon cancer patients and anytime for once for control group. Results: Drug releated problems in chemotherapy patients were decreased in the 3. course as compared to 1. course (63,9%, 75% respectively; n=36; p>0.05). 147 recommendations were given to patients by clinical oncology pharmacist and 98% (n=144) of them were performed by patients. Drug releated problems were solved in 91,7% (n=132) of recommendations, for unsolved problems 8,3% (n=12) the patients were referred to doctor for further investigations. Quality of life related to anemia, diarrhea and neurotoxicity was decreased (p<0,05). GAS6 plasma levels were lower in colon cancer patients compared to control group (p<0,05). After chemotherapy and surgical treatments GAS6 plasma levels were elevated (p<0,05). A positive correlation was found between pre and post treatment differences of CA19-9, a cancer marker, and GAS6 levels (Spearman’s r = 0,596; p<0,05). Conclusions: The pharmaceutical care performed by the clinical oncology pharmacist was shown to have an important role in the identification and resolving of drug related problems. Also GAS6 protein was shown to may have a potential role in diagnosis and follow up of prognosis in colon cancer but further studies are needed to confirm these results. Key Words: Colon cancer, oncology pharmacist, pharmaceutical care, quality of life, GAS6 prote
Objectives: The aim of this study is to determine and solve the pharmaceutical care needs of colon cancer patients and to evaluate the relation between GAS6 protein levels and colon cancer. Method: 70 patients newly diagnosed with colon cancer and 53 healthy volunteer as control group were included in the study. 36 chemotherapy patients were followed during 3 courses of treatment and pharmaceutical care plans were developed for each patient. Quality of life of patients were evaluated before and after the 3 courses of chemotherapy. Plasma GAS6 levels were measured before and after 3 courses of chemotherapy; before and 1 month after the surgery for colon cancer patients and anytime for once for control group. Results: Drug releated problems in chemotherapy patients were decreased in the 3. course as compared to 1. course (63,9%, 75% respectively; n=36; p>0.05). 147 recommendations were given to patients by clinical oncology pharmacist and 98% (n=144) of them were performed by patients. Drug releated problems were solved in 91,7% (n=132) of recommendations, for unsolved problems 8,3% (n=12) the patients were referred to doctor for further investigations. Quality of life related to anemia, diarrhea and neurotoxicity was decreased (p<0,05). GAS6 plasma levels were lower in colon cancer patients compared to control group (p<0,05). After chemotherapy and surgical treatments GAS6 plasma levels were elevated (p<0,05). A positive correlation was found between pre and post treatment differences of CA19-9, a cancer marker, and GAS6 levels (Spearman’s r = 0,596; p<0,05). Conclusions: The pharmaceutical care performed by the clinical oncology pharmacist was shown to have an important role in the identification and resolving of drug related problems. Also GAS6 protein was shown to may have a potential role in diagnosis and follow up of prognosis in colon cancer but further studies are needed to confirm these results. Key Words: Colon cancer, oncology pharmacist, pharmaceutical care, quality of life, GAS6 prote