PS-058 Analysis of pharmaceutical interventions in the onco-haematology area in a tertiary level hospital

Abstract

BackgroundChemotherapy prescriptions validation by the oncology pharmacist often require interventions to optimise some aspects of the treatment, usually related to the safety and effectiveness of antineoplastic agents.PurposeOur pharmacy department has developed an initiative to register these interventions, in order to characterise possible areas of improvement in the prescription validation process.Material and methodsDuring a period of 2 months, we created a database collecting data from the interventions made, which included the following information: date of intervention, medical record number, drug involved, reason/type of intervention and result of the intervention (accepted/not accepted). Sociodemographic, clinical and laboratory data were obtained from medical records. Statistical analysis of the results was performed using Microsoft Excel.Results44 interventions (43 accepted) were recorded. The department in which more interventions were recorded was medical oncology (64%), followed by haematology (29%), paediatrics (4.8%) and radiotherapy oncology (2.4%). Median age of the patients included in the database was 58.5 years (2–87), and 72% of patients were women. The most common reasons for intervention were due to ‘prescribing errors’ (47.7%), ‘pharmacotherapeutic recommendations’ (22.7%), ‘consultations/requests for information’ (15.9%), ‘adverse events’ (6.8%) and some minor reasons grouped into the category ‘others’ (6.8%). The most common types of intervention were ‘dose modification due to an adverse event (AE)’ (34%) and ‘resolution of consultations regarding prescription/medication administration’ (18%). The next types of interventions by frequency were ‘treatment recommendations’ (9.1%) and dose adjustments based on renal function’ (6.81%). Less common intervention types (4.5%) were: ‘changes in prescription’, ‘dose adjustments based on an AE’, ‘dose adjustments based on pharmacotherapeutic recommendations’, ‘changes in route of administration’ and ‘changes in dosing schedule’. Finally, type of interventions such as ‘changes in the regimen of administration’, ‘treatment interruption’ or ‘pharmaceutical compounding’ were reported in 2.3% of cases.ConclusionOncology pharmacist participation in the patient care multidisciplinary team is essential, as is clear from the high rate of acceptance of our interventions. One of the most important aspects of pharmaceutical validation is to identify errors in the prescription and medication administration process, as well as participation in the individualisation of patient therapy through pharmacotherapeutic recommendations, ensuring the effectiveness and safety of the treatment.No conflict of interest.

Analysis of the interventions in antineoplastic therapy by a clinical pharmacy service at a tertiary hospital in Brazil

“…5 The pharmacotherapy review is an important type of pharmaceutical assistance where a pharmacist structurally analyzes the drugs given to a patient, in order to control medication-related risks and improve outcomes of drug therapy, detecting, resolving and preventing drug-related problems (DRP). By analyzing the therapeutic indication, laboratory tests, safety, and effectiveness of treatments, pharmacists can identify errors in the prescription and administration of medication and interfere with the patient's therapy through pharmaceutical interventions (PI) to ensure efficacy and safety 6,7 as well as decrease the incidence of medication errors. 8 Oncological and hematological clinical treatments are costly, especially when medications involve monoclonal antibodies.…”