The Princess Alexandra Hospital (PAH) runs a specialist Cancer Pharmacist Outpatient (OP) clinic for patients receiving ongoing cycles of cancer therapy. Prescribed cancer medication and supportive therapy is reviewed(1), and a face-to-face consultation is held with the patient before administration or dispensing of cancer therapy. Changes to medications since the last cycle of therapy are reviewed, as well as side-effect management, symptom-control and the need for further supplies of supportive medication. With over 2000 patients receiving cancer therapy each month at the PAH, measuring the clinical impact of the pharmacist role in these clinics is challenging.
Method
A study was undertaken to provide a snapshot of the pharmacist interventions and recommendations. A sample of patients attending the clinic over one month was taken from the OP electronic appointment system and a retrospective review of the pharmacist clinical notes in the Electronic Medical Record was performed using a standardised checklist. The review collated information including; pharmacist recommendations, interventions, advice to patients and any changes that were made to the patient’s therapy as a result of the consultation.
Results
Of the 1147 patients reviewed in the OP clinic, 161 patients (14%) were included in the sample. 83 interventions or recommendations were made in 64 (40%) of patients with 65 (80%) of these recommendations resulting in a change to prescribing, medication directions, supply or patient monitoring.
Discussion
Cancer Pharmacists have a recognised role in the clinical verification of cancer therapy however the clinical benefits and economic efficacy of providing a face-to-face patient review prior to each cycle of therapy is less well defined. Our initial study demonstrates the clinical value of placing a pharmacist at the point of prescribing with over 32% of patients experiencing an intervention-related outcome from the consultation. Further studies are planned to assess the economic benefits of this role.