Role of pharmacists in providing information on cancer genome medicine and patient decision making: Open-label...

Cancer genome medicine grounded in genetic alterations is advancing worldwide, with comprehensive genome profiling (CGP) now routinely implemented in Japan. Although the role of pharmacists in cancer genome medicine remains unclear, they may serve as trusted sources of CGP-related information, potentially enhancing patient health literacy and supporting informed decision making. This study evaluated whether pharmacists providing CGP information earlier than the completion of standard therapy affects patient decision making. Using treatment intent as a stratification factor, participants were randomly allocated 1:1 to nonintervention or intervention groups, in which pharmacists delivered only standard medication counseling as in usual practice or additionally provided structured information regarding CGP, respectively. The primary endpoint was the proportion of patients demonstrating reduced Decisional Conflict Scale (DCS) scores before and after pharmacist interviews, 2-6 weeks follow-up interval. Secondary endpoint analysis explored factors associated with patient decision making. Data from 180 patients were included in the final analysis. The proportion of patients with decreased DCS scores did not differ significantly between the intervention and non-intervention groups (49.4% vs. 41.9%; p = 0.31). However, while decisional conflict regarding treatment selection increased in both groups, the amplitude of this increase was significantly lower in the pharmacist intervention group, with mean DCS scores rising by only 1.98 ± 16.5 compared to 3.61 ± 17.3 in the non-intervention group (p = 0.0261). In conclusion, although early pharmacist-led information provision did not change the overall proportion of improved patients, it successfully limited the rise of decisional conflict amplitude. These findings demonstrate that pharmacists can play an active, valuable role in supporting patients for cancer genome medicine-related patient decisions.