Prescription-related errors and misinterpretation of oral cancer treatment instructions can lead to fatal outcomes or significant patient harm. The impact of clinical interventions made at a Pharmacist-led oral anti-cancer agent clinic (PLOACC) involving a Senior Pharmacist with experience in oncological and haematological malignancies is not known.
Investigate the number and categories of PLOACC interventions made for patients receiving oral anticancer treatment and evaluate staff perceptions of the clinic at an Australian quaternary hospital.
Retrospective data was collected from electronic patient medical records from 2017 to 2020 for patients reviewed by PLOACC. The impact of interventions made by the pharmacist were classified (low, moderate, high, extreme) using a validated tool; classifications were reviewed by an independent interdisciplinary panel.
A prospective online survey of staff was also performed using Qualtrics®.
A total of 248 patients were reviewed (132 [53.2%] female; median age 64 years). Of the 26 tumour groups, breast cancer was the most common cancer diagnosis (58; 23.4%) and of the 31 oral anti-cancer agents, capecitabine was the most commonly prescribed (91; 36.7%). There were 188 interventions of which 14 (7.4%) were classified as extreme, 35 (18.6%) as high and 2 (1.1%) as moderate impact. 49 (26%) patients had an intervention of significant impact (high, extreme). Of the 39 staff (11 cancer specialist doctors, 10 nurses, 12 dispensary and 6 cancer specialist pharmacists) who completed the survey (response rate = 67%), all agreed the clinic added value to the cancer service (69% strongly agreed /31% agreed) and 95% perceived the PLOACC to improve patient outcomes (55% agreed/40% strongly agreed).
This study demonstrated the actual and perceived value of PLOACCs. We identified a large proportion of pharmacist interventions that mitigated high or extreme risk of harm to patients. Further research is ongoing to evaluate patient perceptions.