Evaluation of pharmacist interventions in a head and neck medical oncology clinic

Abstract

Introduction Head and neck cancers (HNC) are a complex and heterogeneous group of cancers, often necessitating a multidisciplinary approach across the care continuum. Oncology pharmacists are uniquely qualified to play a vital role on a multidisciplinary team and provide specialized care to optimize medication therapy. Methods This was a retrospective chart review evaluating the role of a board-certified oncology pharmacist in the head and neck oncology clinic at an academic, comprehensive cancer center from April 2017 through March 2018. The primary objective of the study was to describe the types of interventions made by the oncology pharmacists. Secondary objectives included quantifying time spent on patient education and number of prescriptions sent to pharmacies. Results The pharmacist had 873 encounters with 151 patients, resulting in 2080 interventions. Approximately 57% of the interventions were performed in the clinic. Patient education (58%), facilitation of new prescriptions or refill requests (49.9%), and supportive care management (32.6%) were the most frequent interventions. The oncology pharmacist spent 154.1 h on patient education and sent 811 prescriptions to pharmacies, with 63.6% of prescriptions sent to the institution’s cancer center pharmacy. Conclusion The incorporation of an oncology pharmacist in the HNC team optimized patient care through comprehensive and timely interventions across the care continuum. Our study is the first to highlight the vital role oncology pharmacists have in improving the overall quality of care of HNC patients. Future directions include exploring the impact of oncology pharmacist interventions on select Quality Oncology Practice Initiative measures by the American Society of Clinical Oncology.

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…”

Medication Reconciliation Practices in Two Multispeciality Hospitals

“…Lau conducted a retrospective chart review, in which patient education was the most performed intervention (58%), followed by ordering new prescriptions or refill requests (49.9%), and provision of supportive care (32.6%). 22 According to the ratings provided by the panellists 454 (78.27%) discrepancies were classified as Significant, 80 (13.79%) were classified as Serious and 46 (7.93%) were classified as Not Significant. Similar to ours, a study was conducted by Knez et al, where an expert panel provided the clinical significance of medication errors.…”

Clinical pharmaceutical screening in critical situations in a radioiodine therapy management service

“…The total acceptability of pharmacist interventions performed in these situations demonstrates their relevance and signals how the CMM service effectively serves as a valuable screening tool for patients who undergo RITwhich, in itself, poses multiple challenges for health teams. 10,11 CMM is based on a generalist and patient-centered clinical practice, which allows for comprehensive and holistic pharmacotherapy assessments. 13 Therefore, this service allows for the expansion of the team's view of the patient's pharmacotherapeutic needs, which most of the timein the context of oncology and other specialtiesinvolves a limited focus on the condition of their field of work.…”

“…Thus, before the administration of this radiopharmaceutical, the role of a multiprofessional team is paramount and can benefit considerably from the presence of a pharmacist. 9,10 In addition, after RIT, most patients with DTC become cancer survivors because this is an indolent type of cancer that presents low mortality, high overall survival rates, and disease-free survival of over 90% in five years. 8,11,12 This causes DTC survivors to demand a long-term follow-up in the post-RIT period.…”