Authors (including presenting author) :
Lam WST(1)
Affiliation :
(1)Pharmacy Department, Queen Elizabeth Hospital
Introduction :
The Integrated Oncology Pharmacist Clinic in Queen Elizabeth Hospital was launched in 2021. In this clinic, oncologists prescribe multiple cycles of chemotherapy regimens, especially those requiring close monitoring every week or biweekly. Credentialed oncology pharmacists (OP) then assess treatment fitness during pre-cycle consultation. One of the common chemotherapy schemes assessed by OPs in the clinic is FOLFIRI/FOLFOX-based regimen, administered biweekly.
Objectives :
This study aimed to assess adherence to the treatment schedule and patient safety under the Integrated Oncology Pharmacist Clinic.
Methodology :
This was a retrospective, controlled, single-centre, service evaluation study using a historical control. Patients who had FOLFIRI/FOLFOX-based regimens and attended the Pharmacist clinic from December 2022 to March 2024 were recruited into the intervention group. Primary endpoint is the relative dose intensity (RDI) per patient. Secondary endpoints include incidence of treatment delay per cycle, reasons for unplanned treatment delays, median actual treatment interval, number of unplanned consultation/ hospitalisation, number of cases requiring further discussion or referral to oncologists, and their reasons.
Result & Outcome :
58 patients were recruited into the Pharmacist Clinic and the historical control group respectively, with 467 treatment cycles in the intervention group and 441 treatment cycles in the control group. The mean overall RDI was 65.76% in the Pharmacist Clinic group versus 61.97% in the control group (P=0.061). Time index, one of the components in the RDI formula, was significantly higher in the Pharmacist Clinic group (P<0.001). Under the setting of the Integrated Clinic model, there was a 14% absolute reduction in treatment delay (P<0.001), and delay caused by limited bed and doctor appointments quota was decreased by 5.41%. In terms of patient safety, the intervention group had a significantly lower unplanned consultation/ hospitalisation rate of 5.35%, compared to 9.30% in the control group (P=0.029). In the Pharmacist Clinic, 74 out of 158 consultations required to seek doctor attention with the most common reason being prescription of supportive drugs. Overall, patients enrolled into the Integrated Oncology Pharmacist Clinic were optimized in their patient management journey. Under the new model of care, adherence to the treatment schedule and treatment safety were improved. These results demonstrated the value of oncology pharmacy services in promoting medication safety and improving cancer care quality, thereby resulting in better treatment outcomes.
