Contribution of clinical pharmacy services integrating into the outpatient oncology unit: Single institution experience in Mexico.

Abstract

e17531 Background: Clinical pharmacists are contributing to the safe medication use by providing comprehensive management to patients and medical staff. Care efforts remain undocumented, resulting in underestimation of the importance of the pharmacy staff interventions and missed opportunities to find new directions for quality improvement regarding their impact in oncology. Methods: The purpose of this prospective study was to document and evaluate the services of clinical pharmacists and care interventions in a oncology outpatient setting. Medication reviews concerning outpatient adult cancer patients were performed daily during a 5-month period (aug-dec 2014), in an outpatient oncology unit of the State Oncology Center ISSEMYM. Medications problems, interventions and acceptance rate by the oncologists were recorded by 2 pharmacists. Results: Medications problems (n = 255) included inappropriate medications (18%), inappropriate administrations (1.7%), underdosing (4.3%), lack of monitoring (4.3%), drug-drug interactions (10%), overdosing (6%), administration omissions (2 %), side effects (1.2%). Interventions (n = 232) led to drug dosing adjustments (28%), treatment discontinuations (5%), drug additions (5%), alternate routes of administration (1%), therapeutic drug monitoring (1.7%), replacement of a drug by another one (2%). Most (97 %) of the interventions were accepted and implemented by the medical staff. Conclusions: A significant amount of pharmaceutical care was documented by pharmacy staff. The integration of clinical pharmacy services resulted in drug specific interventions in 5.7% of the prescriptions of outpatient adult cancer patients. Medication problems mostly concerned wrong dosage error on prescription. The pharmacy staff intervention had a high rate of acceptance by oncologists and nursing staffs. The outcome of care in the oncology outpatient and medication cost avoidance remains to be measured. To the best of our knowledge, this is the first report describingthe contribution of a Clinical Pharmacy Services Integrating into the Outpatient Oncology Unit in México.