Is there a benefit to having a clinical oncology pharmacist on staff at a community oncology clinic?

Abstract

19570 Background: The John Marsh Cancer Center is an ambulatory oncology clinic located in Hagerstown, MD. In 2004, an on-site clinical oncology pharmacist was hired to help manage therapies and control cost. The objective was to evaluate the clinical interventions and assess the impact of consultations by the clinical oncology pharmacist to patients during therapy. Methods: This was a retrospective descriptive analysis of previous clinical interventions by the clinical oncology pharmacist from September 4, 2004 to October 27, 2006. This study involved a diverse patient population with different tumor types and/or disease states. The evaluation comprised two different categories: drug related problems (DRPs) and consultations, with several sub-categories. The DRPs included medication reconciliation, dosing, and adverse effect management and prevention. Consultations incorporated drug information questions, patient visits, and patient education sessions. The information was extracted from an online documentation program linked to medical charts and analyzed to determine the impact of a clinical oncology pharmacist on staff at the cancer center. Results: A diverse population of 199 patients was identified. Diagnoses included solid tumors 89%, hematological malignancies (3%), and miscellaneous diseases (8%). The 583 clinical interventions documented totaled 5,705 minutes, at an average of 10 minutes per intervention. Of the 583 interventions, 205 were DRPs, including 22 dosing, 52 medication reconciliations, and 131 adverse events. A total of 378 consultation interventions were documented, including 25 drug information questions, 124 patient visits, 143 patient education sessions, and 86 patient follow-ups. The on-site clinical oncology pharmacist saved $210,000 by admixing chemotherapy. Implementation of a carboplatin skin-testing protocol saved over $3,000 by preventing hypersensitivity reactions. Patient and colleague satisfaction surveys found the pharmacist to be a valuable asset with overall positive ratings of 95% and 98%, respectively. Conclusion: Analysis of clinical interventions, cost-savings, and feedback from patients and colleagues confirmed beneficial services provided by a clinical pharmacist in an outpatient oncology center. No significant financial relationships to disclose.