Clinical pharmacy interventions in cancer services

Objectives: Chemotherapy is high risk medicines. Medication errors in prescribing, preparation and administration may cause serious consequences morbidity and mortality. The objectives of this study was to evaluate clinical interventions made by pharmacists in cancer services.

Methods: The study was conducted at Horizon Cancer Center in Bumrungrad International Hospital, during November 2010 to October 2011. Pharmacists evaluated cancer treatment to assure the quality of service and provide a better use of financial resources. Clinical interventions made by six pharmacists were collected from the hospital’s computer program (Amalga^®) and pharmacy intervention program. Pharmacists detected drug related problems and medication errors by using the daily medical chart review.

Results: A total of 189 clinical interventions on 1,855 prescriptions were documented within 12 months. Pharmacist’s interventions were accepted by the oncologists 90.5% (N= 171/189). The impacts of clinical interventions on patient care were rated to be significant, followed by very significant, minor significant and potential lifesaving. The four most frequent of interventions were incorrect dosing or failure of dose adjustment (42%), Drug formulations and preparations (17%), frequency and duration of administration (13%), and administration (9%). The cost saving from pharmacist’s interventions were approximate 59,851$ per day and 61,202$ per cycle.

Conclusion: Pharmacist’s interventions can improve the quality of patient care, reduce risk and prevent major toxicity. Clinical pharmacists can be beneficial to a multidisciplinary team in oncology and can potentially lead to decrease in healthcare costs.