Purpose: The present study was conducted to elucidate the gap in awareness of experience of care management and the actual work of being responsible for this field by spotlighting on the attributes of of case managers and who are in charge of care management of terminal cancer patients at home.
Methods: Anonymous individual style questionnaire investigation was conducted against a target of 443 care managers.
Results: 70.3% had experience being in charge of terminal cancer patients and there was a significant difference in that this was found in those of more than 5 years of experience and among those of full timer status. As for experience in regard to those with or without experience being in charge by basic type of job, there was not much significant difference.
As for awareness regarding being in charge of terminal cancer patients, those who felt “I want to avoid it”, remained in 25% and found more in non-fulltimers (P<0.05). As for those who thought that “health care providers are more suited to be in charge”, this was found in 70% of health care providers and 40% in welfare related individuls (P<0.05) and a significant difference was noted. As for awareness of “should not depend on specific profession and should be done fairly among professions and which was found in 80% of those who have less than 5 years among care support specialist profession and hence compared to those with more than 5 years, it was many, and a significant gap was found. Regarding need of education and training about care management of terminal cancer patients, 95% agreed there is.
Conclusion: Approximately 70% of all had experience with terminal cancer patients and particularly, among those with over 5 years as care support specialist, it became clear that full timers were in charge. However, about awareness of being in charge of care management, it became clear that there was an positive attitude toward who takes in charge without being restricting to specific individuals and not selecting by number of years of experince as care managers nor by basic job types. Therefore, it can be concluded that opportunity for education and training about care management of terminal cancer patients and consolidating education environment for self training is important.

Objective: In patients with specific backgrounds, comprehensive identification of health problems and proactive pharmacist intervention are crucial to providing safe and effective medical care. However, there are insufficient reports on chemotherapy regimen selection and supportive care management in patients taking immunosuppressants. In this study, to circumvent adverse events, pharmacists intervened with a patient administering tacrolimus (TAC) using known information, focusing on multiple factors attributable to the patient in addition to drug interactions.Methods: The patient was a male in their 70s who received palliative chemotherapy for gastric cancer during their dermatomyositis treatment with TAC. Pharmaceutical support for cancer chemotherapy was provided using the following four procedures: (1) Patient information was collected from interviews and electronic medical records to identify patient-specific problems; (2) Basic pharmacological information was collected from tertiary sources, focusing on the interaction between TAC and aprepitant (APR). Furthermore, clinical reports were collected, and the pharmacokinetic drug interaction significance classification system was used for quantitative predictions; (3) The information obtained in steps 1) and 2) was evaluated, and comprehensive proposals linked to the patient information were presented; (4) Adverse events, TAC blood level, and patient outcomes were monitored after treatment initiation.Results: A chemotherapy regimen consisting of S-1/oxaliplatin therapy without APR was selected. The adverse effects were controllable, and the treatment was completed without many adverse events. Meanwhile, TAC adherence was unaffected by cancer chemotherapy, and the TAC blood concentration or dose ratios were controlled within the same range as previously reported.Conclusion: In cancer chemotherapy, for cases with limited evidence or information, comprehensive pharmaceutical support was provided using known patient information, considering multiple patient factors. This report is beneficial as an example of supportive care management by a pharmacist and contributes to providing optimal service in cases with specific backgrounds.