Clinical oncology pharmacist: Effective contribution to patient safety

Abstract

Management and prevention of problems related to oncology drugs are particularly important due to the excessive cost, high toxicity, and narrow therapeutic index of the antineoplastic drugs, in addition to the patients' state of health. Therefore, the presence of the pharmacist as a member of the multidisciplinary team is essential to contribute to patient safety. In this work, the interventions performed were identified, quantified, and classified to characterize the work of the clinical oncology pharmacist. This is a prospective and quantitative study, conducted over a period of six months in the outpatient oncology and chemotherapy clinic of the University Hospital of the University of Campinas, Brazil. A total of 3526 medical prescriptions were evaluated for the 780 patients seen and, among these prescriptions, 220 (6.24%) contained errors, representing 6.24% of the total number. The most common error was dose-related with 79 (22.83%) cases of overdosing. Wrong-patient medication error was the least reported (0.29%). Thirty drugs were involved in the pharmaceutical interventions, Carboplatin and Ondansetron being the most frequent. Thirteen types of potential errors were evaluated according to the method proposed by Cardinal and Fernandes. Two (15.38%) included interventions of indication, contraindication, and therapeutic efficacy of a drug. Five of them (38.46%) are related to the treatment regimen, and two (15.38%) were related to prevention of potential adverse events. Four interventions (30.77%) concerned technical interventions in injectable drugs such as dilution, compatibility, and administration time. Of the 346 interventions performed, 1 (0.29%) was classified as potentially lethal, 114 as serious (32.95%), 140 as significant (40.46%), and 91 as minor (26.30%).

Prevalence of Medication Errors and the Associated Factors: A Prospective Observational Study Among Cancer Patients at Mbarara Regional Referral Hospital

“…13 The most common error was dose-related with 79 (22.83%) cases of overdosing. However, the current prevalence is much higher compared to the finding of a study in Brazil that reported a prevalence of 6.24% 14 as well as another study in France that documented prevalence at 5.2%. 15 These differences are probably because of the better health care systems and lower prescriber or nurse to patient ratio in middle income and high-income countries compared to our study that was conducted in a low-income country.…”

“…Our study also revealed that prescription errors were the most common error type, a finding similar to previous studies conducted in the United States, 17 Spain, 18 and Brazil. 14 The high frequency of errors during the prescription process could be due to the shortage of oncology specialists to supervise the prescription process. The absence of updated specific cancer treatment protocols for individual patient files, accompanied by inadequate continuous training of prescribers on efficient use of protocols, could also have led to increased error occurrence during prescriptions.…”

Impact of clinical pharmacy services in a hematology/oncology ward in Morocco

“…There are several publications highlighting the role of the clinical pharmacist in oncology. 6–9 This role was previously described in the USA in 1981. 10 In 1996, Oncology Pharmacy was recognized as a specialty by the US Board of Pharmaceutical Practices.…”

International Society of Oncology Pharmacy Practitioners (ISOPP) position statement: Role of the oncology pharmacy team in cancer care

“…Studies conducted globally have confirmed the benefit of the integration of the OPT as part the MHT within a variety of settings in improving overall patient care. 22–52…”