(079) Evaluating the Relationship Between Medication Regimen Complexity & Pharmacist Interventions in a Comprehensive Cancer Center: Utilization of the Medication Regimen Complexity Scoring Tool

Poster Abstract:

Background:
The need to justify for clinical pharmacy support in cancer centers has been problematic since pharmacists integrated into clinical oncology. One common approach used is documentation of pharmacy interventions. However, what is documented and how it is documented is not standardized, making it difficult for the profession to unify and drive the profession forward. Pharmacists in a similarly medically complex setting, critically ill patients, have developed a Medication Regimen Complexity Score (MRC), and it has shown to accurately reflect clinical pharmacy work across organizations. Sikora and colleagues showed that MRC scores positively correlate with pharmacist interventions and total number of drug-drug interactions. Many components of the MRC score, while designed for critical care assessment, are pertinent to cancer patients due to their shared clinical complexities such as chemotherapy & management of disease related complications. Given this connection, the MRC score could be utilized to measure clinical pharmacy interventions for hospitalized hematology patients at a comprehensive cancer center. With further research, we may be able to utilize the MRC score to further justify clinical pharmacy positions and define workload metrics for clinical oncology pharmacists.



Objectives:
The primary endpoint is to evaluate the correlation between MRC score and pharmacist interventions. Secondary endpoints include the correlation between patient’s cancer subtype and MRC score, length of stay and MRC score, average time spent on pharmacy interventions, and validation of the MRC score for cancer patients by comparing MRC scores in hematology patient to MRC scores in ICU patients.



Methods:
Medical records were retrospectively reviewed at Roswell Park Comprehensive Cancer Center to identify patients greater than or equal to 18 years old and admitted to one of the hematology or ICU services between October 16 – November 30, 2023. Patients were excluded if hospitalization was less than 24 hours (hrs), or hospice care initiated within 24 hrs of admission. MRC scores were calculated at 24 hrs and 48 hrs from admission, at discharge and re-calculated at same time points for those who transferred to and from the ICU. Pharmacist interventions were collected via Theradoc™, a clinical surveillance documentation tool. Descriptive statistics were utilized to describe patient demographics and Spearman's rank correlation was used for the primary and secondary endpoints.



Results:
Pending and will be presented at the 2024 HOPA annual conference.



Conclusion:
Pending and will be presented at the 2024 HOPA annual conference.

References (must also be included in final poster): Sikora A, Ayyala D, Rech MA, et al. Impact of Pharmacists to Improve Patient Care in the Critically Ill: A Large Multicenter Analysis Using Meaningful Metrics With the Medication Regimen Complexity-ICU (MRC-ICU) Score. Crit Care Med. 2022;50(9):1318-1328.