The Effect of Pharmacist-led Education and Counseling on Medication Adherence and Quality of Life in Breast Cancer Patients: A Literature Review
Article Sidebar
Main Article Content
Page: 3039-3047
Abstract
Pharmacist-led interventions, particularly through education and counselling, play an essential role in supporting treatment adherence and improving the quality of life of breast cancer patients. This article aims to review the influence of pharmacist interventions—such as medication counseling, side effect management, and adherence monitoring—on patient understanding, psychological aspects, and quality-of-life indicators. Results from various experimental studies and randomized controlled trials suggest that structured pharmacist interventions can improve patient understanding, reduce anxiety, and support adherence to long-term therapies such as tamoxifen and chemotherapy. Improvements were also observed in various domains of quality of life, including physical, emotional, and social functioning. However, some studies show inconsistent results, especially in terms of statistical differences in changes in quality of life, which may be due to factors such as sample size, duration of intervention, or other variables, including family support and disease prognosis. Overall, the involvement of pharmacists is an integral part of oncology care, serving as both an educator and a long-term therapy companion.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
References
WHO. Cancer Today. 2024. https://doi.org/10.17226/18700. DOI: https://doi.org/10.17226/18700
Prastowo AD. Pengaruh Konseling Terhadap Tingkat Pemahaman Penyakit Dan Efek Samping Obat Kemoterapi Pada Pasien Kanker Payudara di Unit Kemoterapi Salah Satu Rumah Sakit Di Kota Malang. Sainsbertek Jurnal Ilmiah Sains & Teknologi 2021;1:36–41. https://doi.org/10.33479/sb.v1i2.95.
Puspitasari AW, Kristina SA, Farrukh MJ. The association among adherence, self-efficacy, and health-related quality of life in cancer patients with oral chemotherapy in Indonesia. Pharmacy Practice 2025;23:1–8. https://doi.org/10.18549/PharmPract.2025.1.3107. DOI: https://doi.org/10.18549/PharmPract.2025.1.3107
Tanaka K, Tachi T, Hori A, Osawa T, Nagaya K, Makino T, et al. Cost utility analysis of pharmacist counseling care for breast cancer chemotherapy outpatients. Die Pharmazie 2019;74:439–42. https://doi.org/10.1691/ph.2019.9327.
Tanaka K, Hori A, Tachi T, Osawa T, Nagaya K, Makino T, et al. Impact of pharmacist counseling on reducing instances of adverse events that can affect the quality of life of chemotherapy outpatients with breast Cancer. Journal of Pharmaceutical Health Care and Sciences 2018;4:1–14. https://doi.org/10.1186/s40780-018-0105-3. DOI: https://doi.org/10.1186/s40780-018-0105-3
Prastowo AD. Pengaruh Konseling Terhadap Tingkat Pemahaman Penyakit Dan Efek Samping Obat Kemoterapi Pada Pasien Kanker Payudara Di Unit Kemoterapi Salah Satu Rumah Sakit Di Kota Malang. Sainsbertek Jurnal Ilmiah Sains & Teknologi 2021;1:36–41. https://doi.org/10.33479/sb.v1i2.95. DOI: https://doi.org/10.33479/sb.v1i2.95
Sabaté E. Adherence to Long-term Therapies: Evidence for Action. Geneva: World Health Organization; 2003.
Lam WY, Fresco P. Medication Adherence Measures: An Overview. BioMed Research International 2015;2015. https://doi.org/10.1155/2015/217047. DOI: https://doi.org/10.1155/2015/217047
M. Agung Rahmadi, Helsa Nasution, Luthfiah Mawar, Milna Sari. Pengaruh Kecemasan Terhadap Kepatuhan Pengobatan Kanker Payudara. Jurnal Medika Nusantara 2024;2:325–50. https://doi.org/10.59680/medika.v2i3.1354. DOI: https://doi.org/10.59680/medika.v2i3.1354
Rinder P, Marcille T, Sinel-Boucher P, Cals-Maurette M, Kanoun D, Levy C, et al. Dynamic Projection of Medication Nonpersistence and Nonadherence Among Patients With Early Breast Cancer. JAMA Network Open 2024;7:E2411909. https://doi.org/10.1001/jamanetworkopen.2024.11909. DOI: https://doi.org/10.1001/jamanetworkopen.2024.11909
Brett J, Boulton M, Fenlon D, Hulbert-Williams NJ, Walter FM, Donnelly P, et al. Adjuvant endocrine therapy after breast cancer: A qualitative study of factors associated with adherence. Patient Preference and Adherence 2018;12:291–300. https://doi.org/10.2147/PPA.S145784. DOI: https://doi.org/10.2147/PPA.S145784
Zhao F, Ren D, Shen G, Ahmad R, Dong L, Du F, et al. Toxicity of extended adjuvant endocrine with aromatase inhibitors in patients with postmenopausal breast cancer: A Systemtic review and Meta-analysis. Critical Reviews in Oncology/Hematology 2020;156:103114. https://doi.org/10.1016/j.critrevonc.2020.103114. DOI: https://doi.org/10.1016/j.critrevonc.2020.103114
de Heer SE, Tromp VNMF, Westerman MJ, Konings I, Beckeringh JJ, Boons CL, et al. Patient experiences and views on pharmaceutical care during adjuvant endocrine Therapy for breast cancer: a qualitatice study. Eur J Cancer Care 2022;31. DOI: https://doi.org/10.1111/ecc.13749
Faroughi F, Fathnezhad-Kazemi A, Sarbakhsh P. Factors affecting quality of life in women with breast cancer: a path analysis. BMC Women’s Health 2023;23:1–9. https://doi.org/10.1186/s12905-023-02755-9.
Faroughi F, Fathnezhad-Kazemi A, Sarbakhsh P. Factors affecting quality of life in women with breast cancer: a path analysis. BMC Women’s Health 2023;23:1–9. https://doi.org/10.1186/s12905-023-02755-9. DOI: https://doi.org/10.1186/s12905-023-02755-9
Devi MK, Fong KCK. Spiritual Experiences of Women with Breast Cancer in Singapore: A Qualitative Study. Asia-Pacific Journal of Oncology Nursing 2019;6:145–50. https://doi.org/10.4103/apjon.apjon_77_18. DOI: https://doi.org/10.4103/apjon.apjon_77_18
Brandão ML, Fritsch TZ, Toebe TRP, Rabin EG. Association between spirituality and quality of life of women with breast cancer undergoing radiotherapy. Revista Da Escola de Enfermagem 2021;55:1–6. https://doi.org/10.1590/1980-220X-REEUSP-2020-0476. DOI: https://doi.org/10.1590/1980-220x-reeusp-2020-0476
Karsten MM, Roehle R, Albers S, Pross T, Hage AM, Weiler K, et al. Real-world reference scores for EORTC QLQ-C30 and EORTC QLQ-BR23 in early breast cancer patients. European Journal of Cancer 2022;163:128–39. https://doi.org/10.1016/j.ejca.2021.12.020. DOI: https://doi.org/10.1016/j.ejca.2021.12.020
Vrancken Peeters NJMC, van Til JA, Huberts AS, Siesling S, Husson O, Koppert LB. Internal Responsiveness of EQ-5D-5L and EORTC QLQ-C30 in Dutch Breast Cancer Patients during the First Year Post-Surgery: A Longitudinal Cohort Study. Cancers 2024;16. https://doi.org/10.3390/cancers16111952. DOI: https://doi.org/10.3390/cancers16111952
Miret C, Orive M, Sala M, Garcia-Gutierrez S, Sarasqueta C, Legarreta MJ, et al. Reference values of EORTC QLQ C30, EORTC QLQ BR23, and EQ 5D 5L for women with non metastatic breast cancer at diagnosis and 2 years after. Quality of Life Research 2023;32:989–1003.
Kleijburg A, Braal CL, Westenberg JD, Jager A, Koolen SLW, Mathijssen RHJ, et al. Health-related quality of life and productivity costs in breast cancer patients treated with tamoxifen in the Netherlands. Biomedicine and Pharmacotherapy 2023;158:114158. https://doi.org/10.1016/j.biopha.2022.114158.
Miret C, Orive M, Sala M, Garcia-Gutierrez S, Sarasqueta C, Legarreta MJ, et al. Reference values of EORTC QLQ C30, EORTC QLQ BR23, and EQ 5D 5L for women with non metastatic breast cancer at diagnosis and 2 years after. Quality of Life Research 2023;32:989–1003. DOI: https://doi.org/10.1007/s11136-022-03327-4
Kleijburg A, Braal CL, Westenberg JD, Jager A, Koolen SLW, Mathijssen RHJ, et al. Health-related quality of life and productivity costs in breast cancer patients treated with tamoxifen in the Netherlands. Biomedicine and Pharmacotherapy 2023;158:114158. https://doi.org/10.1016/j.biopha.2022.114158. DOI: https://doi.org/10.1016/j.biopha.2022.114158
Mitsis A, Filis P, Karanasiou G, Georga EI, Mauri D, Naka KK, et al. Impact of e-Health Interventions on Mental Health and Quality of Life in Breast Cancer Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Cancers 2025;17:1–19. https://doi.org/10.3390/cancers17111780. DOI: https://doi.org/10.3390/cancers17111780
Hong F, Ye W, Kuo CH, Zhang Y, Qian Y, Korivi M. Exercise intervention improves clinical outcomes, but the “time of session” is crucial for better quality of life in breast cancer survivors: A systematic review and meta-analysis. Cancers 2019;11:1–19. https://doi.org/10.3390/cancers11050706. DOI: https://doi.org/10.3390/cancers11050706
Paulo TRS, Rossi FE, Viezel J, Tosello GT, Seidinger SC, Simões RR, et al. The impact of an exercise program on quality of life in older breast cancer survivors undergoing aromatase inhibitor therapy: A randomized controlled trial. Health and Quality of Life Outcomes 2019;17:1–12. https://doi.org/10.1186/s12955-019-1090-4. DOI: https://doi.org/10.1186/s12955-019-1090-4
Lin Y, Wu C, He C, Yan J, Chen Y, Gao L, et al. Effectiveness of three exercise programs and intensive follow-up in improving quality of life, pain, and lymphedema among breast cancer survivors: a randomized, controlled 6-month trial. Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer 2022;31:9. https://doi.org/10.1007/s00520-022-07494-5. DOI: https://doi.org/10.1007/s00520-022-07494-5
Liu Q, Ye F, Jiang X, Zhong C, Zou J. Effects of psychosocial interventions for caregivers of breast cancer patients: A systematic review and meta-analysis. Heliyon 2023;9:e13715. https://doi.org/10.1016/j.heliyon.2023.e13715. DOI: https://doi.org/10.1016/j.heliyon.2023.e13715
Alkashaf KH, Mohammed SI. Impact of Clinical Pharmacist-Led Interventions on Short Term Quality of Life among Breast Cancer Women Taking Chemotherapy. Iraqi Journal of Pharmaceutical Sciences 2024;33:165–72. https://doi.org/10.31351/vol33iss4pp165-172. DOI: https://doi.org/10.31351/vol33iss4pp165-172
Staynova R, Gavazova E, Kafalova D. Clinical Pharmacist-Led Interventions for Improving Breast Cancer Management—A Scoping Review. Current Oncology 2024;31:4178–91. https://doi.org/10.3390/curroncol31080312. DOI: https://doi.org/10.3390/curroncol31080312
Birand N, Boşnak AS, Diker Ö, Abdikarim A, Başgut B. The role of the pharmacist in improving medication beliefs and adherence in cancer patients. Journal of Oncology Pharmacy Practice 2019;25:1916–26. https://doi.org/10.1177/1078155219831377. DOI: https://doi.org/10.1177/1078155219831377
Pirolli A V., Brusamarello T, Everton SS, Andrzejevski VMS. The role of the clinical pharmacist in guiding adjuvant hormonal therapy in patients with breast cancer. Journal of Oncology Pharmacy Practice 2022;28:1368–74. https://doi.org/10.1177/10781552211029361. DOI: https://doi.org/10.1177/10781552211029361
Bash HS, Rabea IS. Influence of clinical pharmacist counseling on tamoxifen-related knowledge and adherence among women with breast cancer. Pharmacia 2025;72:1–8. https://doi.org/10.3897/pharmacia.72.e154862. DOI: https://doi.org/10.3897/pharmacia.72.e154862
Khadela A, Bhikadiya V, Vyas B. Impact of oncology pharmacist services on humanistic outcome in patients with breast cancer. Journal of Oncology Pharmacy Practice 2022;28:302–9. https://doi.org/10.1177/1078155220988333. DOI: https://doi.org/10.1177/1078155220988333
Fentie MA, Huluka AS, Gebremariam GT, Gebretekle B, Abebe E, Gedif T. Impact of pharmacist-led interventions on medication-related problems among patients treated for cancer : A systematic review and meta-analysis of randomized control trials. Research in Social and Administrative Pharmacy 2024;20:487–97. https://doi.org/10.1016/j.sapharm.2024.02.006. DOI: https://doi.org/10.1016/j.sapharm.2024.02.006
Kelly WN, Ho M, Smith T, Bullers K, Kumar A. Association of pharmacist intervention counseling with medication adherence and quality of life : A systematic review and meta-analysis of randomized trials. Journal of the American Pharmacists Association 2023;63:1095–105. DOI: https://doi.org/10.1016/j.japh.2023.04.024
Fujii H, Ueda Y, Hirose C, Ohata K, Sekiya K, Kitahora M, et al. Pharmaceutical intervention for adverse events improves quality of life in patients with cancer undergoing outpatient chemotherapy 2022:1–9. DOI: https://doi.org/10.1186/s40780-022-00239-w
Schulz M, Griese-mammen N, Schumacher PM, Anker SD, Koehler F, Ruckes C, et al. The impact of pharmacist / physician care on quality of life in elderly heart failure patients : results of the PHARM-CHF randomized controlled trial 2020:3310–9. https://doi.org/10.1002/ehf2.12904. DOI: https://doi.org/10.1002/ehf2.12904
Sakthong P, Soipitak P, Winit W. Comparison of the sensitivities of pharmacotherapy related and disease specific quality of life measures in response to pharmacist led pharmaceutical care for cancer outpatients : a randomised controlled trial. International Journal of Clinical Pharmacy 2024;46:463–70. https://doi.org/10.1007/s11096-023-01692-9. DOI: https://doi.org/10.1007/s11096-023-01692-9