Impact of Pharmacist Participation on Chemotherapy Administration Outcomes in a Low-Resource Setting

Abstract

Abstract 50 Purpose Implementation of specialty oncology pharmacy services is associated with improved patient care and reduced medical errors. Pharmacy capacity is limited in many low-resource countries, with chemotherapy preparation and administration often being performed by other allied health care providers. At Bugando Medical Center in Tanzania, both nurses and pharmacists are responsible for mixing and administering chemotherapy; however, most nurses do not have specialized oncology training, which increases the risk for medication errors. The purpose of the current study was to assess the effects of pharmacist participation on therapeutic outcomes, including verified dosage calculations, chemotherapy administration adherence, and dose documentation. Methods Chemotherapy encounters were observed over a 1-month period. Recorded observations included adherence to prescribed chemotherapy administration times; errors, including spills and extravasation; and administrative adherence, including dose verification and documentation. Results There were 53 observed encounters—32 with a pharmacist and 21 without; 15 were for pediatric patients. Pharmacist participation increased adherence to prescribed administration time (54% v 19%; P = .009) and decreased errors (zero v two extravasations; zero v one spill). Pharmacist participation improved chemotherapy administration documentation (96.8% v 76.2%; P = .049); however, patient safety measures, including intravenous catheter placement verification, secondary dose check, and toxicity monitoring during administration, were not done with or without pharmacist participation. Conclusion Pharmacist participation increased adherence to prescribed chemotherapy administration and documentation, and reduced extravasation; however, additional patient safety training is needed. A larger study can further evaluate the impact of the participation of a specialty pharmacist on patient-related outcomes. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors.