[Clinical pharmacy actions in adjuvant hormonal therapy for early breast cancer: A qualitative study of needs]

Oral adjuvant hormone therapy for early breast cancer, despite its proven importance in terms of survival and prevention of recurrence, does not fall within the scope of clinical pharmacy programs set up for oral anticancer drugs, even though issues of therapeutic adherence have been clearly identified. The aim of our study was to explore the perception of healthcare professionals regarding the prescription and dispensing of this hormone therapy, in order to identify the risks for these patients and determine the clinical pharmacy actions that could address these risks.

A prospective qualitative study was carried out by means of semi-structured interviews with doctors at a university hospital involved in the care of these patients, and with pharmacists and technicians involved in their outpatient follow-up. The interviews were analyzed using an inductive approach.

Ten interviews were conducted. Analysis of the interviews with doctors revealed that poor adherence to treatment, frequently linked to adverse effects, remains a major concern. For the majority of professionals interviewed, a pharmaceutical interview could limit this lack of adherence. All professionals consider that a city-hospital link is essential, but obstacles persist, such as lack of time and the multitude of interlocutors involved.

The introduction of hormone therapy could be accompanied by a multi-professional approach, including clinical pharmacy activities for patients identified as being at risk of adverse effects or non-compliance. Day hospitalization, financed by the gradation of care system, could meet this need.