(178) Oral breast cancer therapy interventions in an integrated health system: Analysis of patient acceptance rate of clinical specialty pharmacist interventions during medication consultations

Poster Abstract:

Background:
• The National Breast Cancer Foundation reports an estimated 297,790 women and 2,800 men will be diagnosed with invasive breast cancer in 2023.1 The proportion of patients receiving their cancer care outpatient has increased 25% from 2014.2
• As oral cancer therapies are becoming more common, patients are left to manage their medication administration and adverse events independently at their home. Additionally, a high proportion of patients who have cancer are at an advanced age and may be at higher risk for polypharmacy, comorbidities, and renal impairment.3
• Pharmacist-led programs allow for oncolytic therapeutic interventions including medication reconciliation utilizing multiple medication databases, drug-drug interaction identification, adherence instruction, and recommendation and advice to oncology team members regarding prescribing practices and reduction of medication dosing burden or costs.4
• Lumicera is in the process of updating the documentation of clinical interventions in order to align with Version 5.0 of URAC accreditation standards and to improve patient care.5 A trial program will be piloted in the oral breast cancer therapy population as part of this research.

Objective:
• Evaluate the patient acceptance rate of specialty pharmacist’s interventions provided to adult patients utilizing oral breast cancer therapy.

OUTCOMES
Primary outcome: percentage of the interventions accepted by patients.
• As defined by the patient confirming they implemented the action recommended by the clinician
Secondary outcome: will include, but not limited to:
• Summary of types of clinical interventions reported by clinicians and outcomes upon follow-up
• Average time of follow-up recommended by intervention type.
• Follow-up completion rate
• Comparison of documented intervention volumes pre- and post-implementation of new intervention documentation process

Methods:
• The study investigator will conduct retrospective chart reviews through the pharmacy operating system for documentation related to clinical interventions from October 1, 2023, to March 31, 2024.
• Clinical documentation within patient chart will be reviewed to assess intervention recommendations made by the clinician to the patient, the timeframe for follow up and the outcome of the intervention.
• Documentation collected during retrospective chart review will be categorized by intervention type as defined by principal investigator
• Participants meet the following criteria: 18 years or older, active diagnosis of breast cancer as determined by ICD10 code, currently prescribed an oral breast cancer therapy and have documented clinical intervention requiring follow-up with the patient.

Results: Pending

DISCUSSION/

Conclusion: Pending

References (must also be included in final poster): 1. Breast cancer facts & stats: Incidence, age, survival & more. National Breast Cancer Foundation. September 25, 2023. Accessed November 8, 2023. https://www.nationalbreastcancer.org/breast-cancer-facts/
2. Chang J, Sen A. Rising share of chemotherapy services provided in outpatient departments is associated with higher costs for patients and payers. Rising Share of Chemotherapy Services Provided in Outpatient Departments is Associated with Higher Costs for Patients and Payers. March 28, 2023. Accessed November 8, 2023. https://healthcostinstitute.org/hcci-originals-dropdown/all-hcci-reports/rising-share-of-chemotherapy-services-provided-in-outpatient-departments-is-associated-with-higher-costs-for-patients-and-payers
3. De Grégori J, Pistre P, Boutet M, et al. Clinical and economic impact of pharmacist interventions in an ambulatory hematology-oncology department. J Oncol Pharm Pract. 2020;26(5):1172-1179. doi:10.1177/1078155220915763
4. Neuner J, Weil E, Fergestrom N, et al. Feasibility of a pharmacist-led symptom monitoring and management intervention to improve breast cancer endocrine therapy adherence. J Am Pharm Assoc (2003). 2022;62(4):1321-1328.e3. doi:10.1016/j.japh.2022.03.001
5. Zuckerman AD, Mourani J, Smith A, et al. 2022 ASHP Survey of Health-System Specialty Pharmacy Practice: Clinical Services. Am J Health Syst Pharm. 2023;80(13):827-841. doi:10.1093/ajhp/zxad064
6. Bonome H, Donovan J. Pharmacy Hot Take: Tracking your Clinical Intervention Outcomes. lecture presented on: June 22, 2023