Implementation and evaluation of clinical pharmacy services in oncology care setting

Abstract

quotBackground: Quality cancer care requires multidisciplinary patient care approach and safe and responsible use of anti-cancer agents. newlineObjectives: This study was conducted to implement and evaluate clinical pharmacy services in an oncology care setting. newlineMethods: It was a prospective interventional study conducted for a period of four years (April 2013-March 2017) at private academic oncology care setting. Five clinical pharmacy services 1) Medicine and therapeutic information (MTI) 2) Adverse drug reaction (ADR(s)) reporting and monitoring 3) Radiation related adverse event (RRAE(s)) reporting and monitoring 4) Medication therapy management (MTM) and 5) Patient medication counselling were implemented. newlineResults: The MTI queries were requested for ADRs and their management (21.4%), followed by dosage adjustments (15.5%), supportive care related (14.6%), contraindications (14%) and drug-drug interactions (11.9%). Vomiting (23.22%), alopecia (9.53%), diarrhoea (8.67%), myelosuppression (7.42%) were commonly reported ADRs. Inappropriate administration frequency and regimen of anti-emetics (22%), lack of/suboptimal supportive care (18%) and administration errors (16%) had contributed for ADRs. The most commonly reported RRAEs were fatigue (n=39, 17.2%) followed by mucositis (12.8%), pain (10.17%), diarrhoea (10.17%) and gastritis (9.7%). Clinical pharmacy interventions (n=72) were made to provide supportive medical care for patients with untreated RRAEs. The most common MRPs noted were lack of/suboptimal supportive care (17.95%) followed by inappropriate administration of medications (14.56%), untreated indication (14.20%) and wrong dose calculations (12.21%). The most commonly medication counselling was provided to patients with head and neck cancers (18.90%), followed by cervical cancer (17.33%), colorectal cancer (12.43%) and breast cancer (11.23%). newlineConclusion: Clinical pharmacy services were useful in improving patient care in terms of medication safety, quality use of medications and overall transition of care. newlinequot newline