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[The "Gradation instruction" of care: An opportunity to integrate clinical pharmacy activities in the cancer patient journey].

Bulletin du Cancer 2023 March 22
The ten-year cancer control strategy launched in 2021 highlights the structuring of supportive care as a strong axis to limit the side effects of treatments and simplify the patient's journeys. On the other hand, the "Gradation instruction" published in 2020, introduced new invoicing rules for outpatient hospital wards, which facilitates the coordinated interventions of several health professionals (medical, paramedical, or socio-educational) around patients. Among these professionals, the pharmacist has a particular role, inside the multidisciplinary oncology teams, since cancer oral therapies require therapeutic adherence and a continuum of care with retail pharmacists. Until now, these clinical pharmaceutical activities, which include carrying out medication reviews, developing personalized pharmaceutical plans and conducting pharmaceutical interviews with patients, have struggled to develop in a sustainable manner due to a lack of funding in hospitals. Finally, the "gradation instruction" represents a real opportunity to support clinical pharmacy actions, particularly in outpatient hospital wards. In order to save time for hospital teams wishing to initiate or consolidate these activities, we should consider points of vigilance and facilitating factors.

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