EPICC study: evaluation of pharmaceutical intervention in cancer care

Vantard, Nicolas; Ranchon, Florence; Schwiertz, Vérane; Gourc, Chloé; Gauthier, Noémie; Guédat, Marie-Gabrielle; He, Sophie; Kiouris, Eléna; Alloux, Céline; You, Benoît; Souquet, Pierre-Jean; Salles, Gilles; Trillet‐Lenoir, Véronique; Rioufol, Catherine

doi:10.1111/jcpt.12242

Cited by 27 publications

(42 citation statements)

References 51 publications

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“…According to the literature, an error occurs in 1.5-8.3% of prescriptions. [18][19][20][21][22] Beyond the oncology context, a study reported the same level of PI in a pediatric unit (5.8%). 23 PIs, which are supposed to improve patient drug health care, can be accepted or refused by physicians who have written the prescriptions.…”

Section: Discussionmentioning

confidence: 94%

“…According to the literature, an error occurs in 1.5–8.3% of prescriptions . Beyond the oncology context, a study reported the same level of PI in a pediatric unit (5.8%) .…”

Section: Discussionmentioning

confidence: 94%

“…The literature has already reported that prescription errors are related to the physician's experience. 8,10,19,34,35 Second, we assumed that the pediatrician would be more alert when writing nonstandardized prescriptions than when writing standardized ones, which are computerized. 7,9 Indeed, the nonstandarized prescription is not automatic.…”

Section: Discussionmentioning

confidence: 99%

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Computerized pediatric oncology prescriptions review by pharmacist: A descriptive analysis and associated risk factors

Hamel

Tortolano

Bermudez

et al. 2017

Pediatric Blood & Cancer

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Not surprisingly, PIs were predominantly to correct dose errors, half of which related to height and weight measurements that were not updated. No significant risk factors for errors were identified for errors except in the standardized status of prescription, which appears to be linked in part to our software that did not automatically reflect dose reduction from one course to the next. Medical double-checking followed by a clinical pharmacist's double check were effective in order to prevent prescription errors.

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Section: Discussionmentioning

confidence: 94%

“…According to the literature, an error occurs in 1.5–8.3% of prescriptions . Beyond the oncology context, a study reported the same level of PI in a pediatric unit (5.8%) .…”

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Computerized pediatric oncology prescriptions review by pharmacist: A descriptive analysis and associated risk factors

Hamel

Tortolano

Bermudez

et al. 2017

Pediatric Blood & Cancer

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“…Previous studies have reported PIs as being needed for 1.5 to 27.6% of injectable antineoplastic prescriptions [20][21][22][23][24]. This wide range can be explained by organizational differences: in a center without computerized prescriptions, 27.6% of prescriptions required a PI [24].…”

Section: Resultsmentioning

confidence: 99%

Clinical, economic and organizational impact of pharmacist interventions on injectable antineoplastic prescriptions: a prospective observational study

Zecchini

Chanoine

et al. 2020

BMC Health Serv Res

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Background: Pharmacists play a key role in ensuring the safe use of injectable antineoplastics, which are considered as high-alert medications. Pharmaceutical analysis of injectable antineoplastic prescriptions aims to detect and prevent drug related problems by proposing pharmacist interventions (PI). The impact of this activity for patients, healthcare facilities and other health professionals is not completely known. This study aimed at describing the clinical, economic, and organizational impacts of PIs performed by pharmacists in a chemotherapy preparation unit.Methods: A prospective 10-week study was conducted on PIs involving injectable antineoplastic prescriptions. Each PI was assessed by one of the four multidisciplinary expert committees using a multidimensional tool with three independent dimensions: clinical, economic and organizational. An ancillary quantitative evaluation of drug cost savings was conducted. Results: Overall, 185 patients were included (mean age: 63.5 ± 13.7 years; 54.1% were male) and 237 PIs concerning 10.1% prescriptions were recorded. Twenty one PIs (8.9%) had major clinical impact (ie: prevented hospitalization or permanent disability), 49 PIs (20.7%) had moderate clinical impact (ie: prevented harm that would have required further monitoring/treatment), 62 PIs (26.2%) had minor clinical impact, 95 PIs (40.0%) had no clinical impact, and 9 PIs (3.8%) had a negative clinical impact. For one PI (0.4%) the clinical impact was not determined due to insufficient information. Regarding organizational impact, 67.5% PIs had a positive impact on patient management from the healthcare providers' perspective. A positive economic impact was observed for 105 PIs (44.3%), leading to a saving in direct drug costs of 15,096 €; 38 PIs (16.0%) had a negative economic impact, increasing the direct drug cost by 11,878 €. Overall cost saving was 3218€. Conclusions: PIs are associated with positive clinical, economic and organizational impacts. This study confirms the benefit of pharmacist analysis of injectable antineoplastic prescriptions for patient safety with an overall benefit to the healthcare system.

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“…(1,2) Over the last years, the discussion about the occurrence of medication-related-problem (MRP) and their importance as a risk factor of morbidity and mortality has gained notoriety. (3,4) …”

Section: Introductionmentioning

confidence: 99%

Implementing a clinical pharmacy service in hematology

Farias

Aguiar

Rotta

et al. 2016

Einstein (São Paulo)

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Objective:To implement a clinical pharmacy service focused on the comprehensive review of antineoplastic drugs used in therapy of hematological diseases.Methods:An interventional study was conducted in a Brazilian tertiary teaching hospital in two different periods, with and without a clinical pharmacy service, respectively. This service consisted of an antineoplastic prescription validation (analysis of patients' characteristics, laboratory tests, compliance with the therapeutic protocol and with pharmacotechnical parameters). When problems were detected, the pharmacist intervened with the physician or another health professional responsible for the patient. Inpatients and outpatients with hematological diseases were included.Results:We found an increased detection of drug-related problem by 106.5% after implementing the service. Comparing the two periods, an increase in patients' age (26.7 years versus 17.6 years), a predominance of outpatients (54% versus 38%), and an increase in multiple myeloma (13% versus 4%) and non-Hodgkin lymphoma (16% versus 3%) was noted. The most commonly found problems were related to dose (33% versus 25%) and cycle day (14% versus 30%). With regard to clinical impact, the majority had a significant impact (71% versus 58%), and in one patient from the second period could have been fatal. The main pharmaceutical interventions were dose adjustment (35% versus 25%) and drug withdrawal (33% versus 40%).Conclusion:The pharmacy service contributed to increase the detection and resolution of drug-related problems, and it was an effective method to promote the safe and rational use of antineoplastic drugs.

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EPICC study: evaluation of pharmaceutical intervention in cancer care

Abstract: This study, highlighting PIs in cancer care, is the first of this scale in terms of number of prescriptions analysed (nearly 30 000). Results demonstrated the specificity of DRPs and PIs for patients with cancer and the value of a dedicated coding system in cancer care.

Cited by 27 publications

References 51 publications

Computerized pediatric oncology prescriptions review by pharmacist: A descriptive analysis and associated risk factors

Computerized pediatric oncology prescriptions review by pharmacist: A descriptive analysis and associated risk factors

Clinical, economic and organizational impact of pharmacist interventions on injectable antineoplastic prescriptions: a prospective observational study

Implementing a clinical pharmacy service in hematology

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