Adverse effect monitoring: opportunity for patient care and pharmacy practice.

OBJECTIVES: To present an adverse effect monitoring tool with theoretical, practical, and data-supported explanation and justification for use in pharmacy practice for the purpose of building patient-pharmacist partnerships and improving medication-management outcomes. DESIGN: Randomized pretest-posttest experimental design. SETTING: Ambulatory patients in three multidisciplinary cancer clinics. PATIENTS: 74 patients who were beginning chemotherapy. INTERVENTIONS: A calendar for daily adverse drug event tracking by ambulatory patients was adapted from The WriteTrack: Personal Health Tracker and provided to those assigned to the intervention group, who were asked to record symptoms and possible adverse drug events during their first two chemotherapy cycles. Patient reports of self-monitoring activities were gathered through posttests (n = 74) and semistructured interviews (n = 7). MAIN OUTCOME MEASURES: Self-reported use and perceived usefulness of the tool. RESULTS: A total of 88.4% of the experimental group (38 of 43 individuals) reported using the monitoring tool to keep written track of adverse effects, while 38.7% of the control group (12 of 31 individuals) reported keeping some form of written record of their experiences. A total of 65.8% of those in the intervention group found patterns in their adverse effects, 47.4% indicated they took the calendar to the clinic to help them recall events, and 26.3% reported using the calendar at the clinic to show their health care team what was happening. Experimental group subjects most often shared the adverse effect monitoring information with nurses alone (23.7%). Patients using the diary indicated that it had a high degree of utility and value and that they would use it again and recommend it to other patients with cancer. CONCLUSION: A system for adverse effect monitoring by patients in the context of cancer drug management was acceptable and useful, and pharmacists could incorporate this tool into their daily practice with minimal effort, time, and expense. Patients' self-documented symptoms and adverse effects can be valuable data when used to help tailor medication regimens to improve clinical status while satisfying patients' personal priorities.