Multiprofessional Medication Management (MuMM) Intervention Aiming at Enhancing the Tolerability of Cancer Chemotherapy: A Randomized Feasibility Trial

Abstract Background: A newly developed multiprofessional medication management (MuMM) intervention in an oncologic outpatient care setting was evaluated for its feasibility to enhance the tolerability of cancer-directed therapy. The intervention consisted of a basic care module for medication review including drug-drug interaction checks, and four supplementary modules for the management of common adverse events, specifically nausea/vomiting, mucositis, fatigue, and pain.Methods: A single-centre, unblinded, randomized two-arm trial was conducted in the oncologic outpatient ward of a municipal hospital in Bonn, Germany, with an associated community pharmacy. Feasibility of the intervention was assessed by analyzing the application of supplementary modules and semi-structured interviews with the participating health care providers. Symptom burden was assessed as primary outcome by the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE). Furthermore, health-related quality of life and patient satisfaction with received information were analyzed.Results: 51 patients were randomized either to a control group receiving standard care (25 patients) or the intervention group receiving MuMM (26 patients). The results indicate that the MuMM intervention delivered by physicians, pharmacists, and nurses is needed and feasible, but hampered by several barriers concerning cooperation and communication within the multiprofessional health care team. The intervention did not affect symptom burden, quality of life, and patient satisfaction.Conclusion: The degree of implementation of the MuMM intervention was apparently not high enough to show a preliminary efficacy signal. Nevertheless, our study provides a starting point and methodological framework for future trials aiming at enhancing the tolerability of cancer-directed therapy.TRIAL REGISTRATION NUMBERDRKS00010128 at the German Clinical Trials Register (DRKS) Date of registration: March 7th, 2016 (retrospectively registered)