(138) Impact of Pharmacist-Led Comprehensive Medication Review in an Outpatient Breast Cancer Center

Poster Abstract:

Background: Oncology pharmacists play an important role in enhancing the quality of cancer care for patients. Services such as pharmacist-led medication reconciliation and patient counseling help to ensure the safe and effective use of medications in complex treatment regimens, thereby reducing medication errors and improving patient outcomes. In a clinical study by Vega and colleagues, medication reconciliation in oncology patients significantly improves drug safety, with the intervention group experiencing only 4% reconciliation errors that reached the patient compared to 30% in the control group, reducing the relative risk by 87% (RR = 0.13, 95% CI = 0.04-0.43; P = 0.0009). Over one third of patients benefit from a thorough review of their existing medication when starting a new chemotherapy regimen, highlighting the value of medication reconciliation in this patient population. Despite the positive impact of oncology pharmacists on clinical outcomes, the literature on their economic impact in ambulatory oncology settings is limited.

Objective: To assess the impact of pharmacist-led interventions on cost savings by estimating the total estimated cost avoidance associated with comprehensive medication review services provided to patients initiating chemotherapy in outpatient breast cancer centers.

Methods: This prospective observational study is being conducted at Memorial Cancer Institute (MCI) from October 2023 to February 2024. Participants include adult breast cancer patients (aged >18 years) undergoing the first 2 cycles of their chemotherapy treatment protocols at MCI outpatient infusion centers. Exclusions are based on the refusal of pharmacy services. A postgraduate year two (PGY2) oncology pharmacy resident prospectively identifies eligible patients via chart reviews, conducts comprehensive medication review and provides patient education. Patient encounters, whether in-person or via telephone, are documented in the health system's electronic health record. Data collection includes the types of interventions made and the time per intervention by the PGY2 pharmacy resident. Each intervention is assigned to a corresponding category and a cost avoidance value based on previous literature.

Results: Results pending.

Conclusions/

Discussion: Conclusion/discussions pending.

References (must also be included in final poster): 1. Segal EM, Bates J, Fleszar SL, et al. Demonstrating the value of the oncology pharmacist within the healthcare team. J Oncol Pharm Pract. 2019;25(8):1945-1967. doi:10.1177/1078155219859424
2. Vega TG, Sierra-Sánchez JF, Martínez-Bautista MJ, García-Martín F, Suárez-Carrascosa F, Baena-Cañada JM. Medication Reconciliation in Oncological Patients: A Randomized Clinical Trial. J Manag Care Spec Pharm. 2016;22(6):734-740. doi:10.18553/jmcp.2016.15248
3. Randolph LA, Walker CK, Nguyen AT, Zachariah SR. Impact of pharmacist interventions on cost avoidance in an ambulatory cancer center. Journal of Oncology Pharmacy Practice. 2018 Jan;24(1):3-8.
4. Trinidad DM, Patel PR. The Impact of an Embedded Oncology Pharmacist in an Outpatient Oncology Center in the Treatment of Hematologic Malignancies. Journal of the Advanced Practitioner in Oncology. 2022 Sep;13(7):673.
5. Mull A, Hawkins C, Punke A, Parkey S, Mallon C. Clinical and economic impact of oncology-trained pharmacist integration in an ambulatory cancer clinic. Journal of Oncology Pharmacy Practice. 2023 Sep 20:10781552231202221.
6. Patel MP, Barbour SY, Moorman MT. Value Assessment of Oncology Pharmacist Interventions. Journal of the Advanced Practitioner in Oncology. 2023 May;14(4):329.