title: The impact of medication therapy management in older oncology patients.
abstract: OBJECTIVE
  This project aimed to identify common drug-related problems (DRP) among elderly cancer patients, to determine the effectiveness of medication therapy management (MTM) service in resolving DRP, to determine the clinical significance of pharmacist interventions, and to determine patients' satisfaction level of MTM service.
  
  
  METHODS
  Elderly cancer patients (age ≥65) who were at least on one chronic medication would be eligible for the MTM service. Any DRP that was detected would be recorded and steps to resolve it were taken. Pre- and post-service patient satisfaction surveys (PSS) were conducted before and after MTM. All interventions performed by MTM pharmacists were subjected to independent evaluation by a panel of three judges.
  
  
  RESULTS
  One hundred eighteen patients received at least one session of MTM. We identified and attempted to resolve 361 DRPs, and the most common DRPs were drug interactions (117 cases, 32.4 %), adverse effects (114 cases, 31.6 %), and non-adherence (48 cases, 13.3 %). Forty-four interventions were performed by pharmacists and forty cases (91 %) were accepted by physicians. Almost two third of these interventions were deemed significant (or higher) by the judges. Seventy-two patients completed PSS. There was statistically significant improvement in patients' satisfaction level after the service was provided.
  
  
  CONCLUSIONS
  MTM is an important platform in identifying and managing DRPs. Patients are generally satisfied with MTM services.
authors.affiliation: Pharmacy Department, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610, Singapore. yeoh.ting.ting@nccs.com.sg
authors.forename: Ting Ting
authors.initials: TT
authors.lastname: Yeoh
authors.forename: Phebe
authors.initials: P
authors.lastname: Si
authors.forename: Lita
authors.initials: L
authors.lastname: Chew
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D054539:Medication Therapy Management / Q000458:organization & administration*; D009369:Neoplasms / Q000188:drug therapy*; D017060:Patient Satisfaction; D010593:Pharmaceutical Services / Q000458:organization & administration; D010595:Pharmacists / Q000458:organization & administration*; D024382:Professional Role; D011446:Prospective Studies