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Improving medication safety in oncology care: impact of clinical pharmacy interventions on optimizing patient safety

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Abstract

Background Adverse drug reactions (ADRs) monitoring in cancer patients is important to ensure early detection, effective management and possible prevention subsequently. Objectives This study was conducted to detect and monitor ADRs to anti-cancer agents, and to assess impact of clinical pharmacists (CPs)’ interventions in minimizing ADRs to anti-cancer agents. Setting Private, specialty oncology care hospital in South India. Methods CPs prospectively followed cancer patients admitted to inpatient wards and treated at ambulatory care in order to identify ADRs, for a period of 3 years. Identified/reported ADRs were discussed with concerned oncologists and/or nurses, documented electronically and assessed further for their causality, severity, preventability and grading. Based on study findings during year 1, interventions (educational, therapeutic and system based) were developed by CPs and implemented in order to minimize preventable ADRs. Impact of CPs’ interventions was studied during year 2 and year 3. Main outcome measure(s) Preventable factors contributing to ADRs and percentage of preventable ADRs before and after CPs’ interventions. Results A total of 1279 ADRs were reported in 1133 patients from a cohort of 1328 patients. Vomiting (23.22%), alopecia (9.53%), diarrhoea (8.67%) and myelosuppression (7.42%) were the common ADRs reported. Inappropriate administration frequency and regimen of anti-emetics (22%), lack of/suboptimal supportive care (18%) and administration errors (16%) were identified as common contributing (preventable) factors for ADRs in year 1. Percentage of preventable ADRs was 81% during year 1 (pre-intervention), and 45% and 34% in year 2 and year 3 respectively (post-interventions). Conclusion Interventions by CPs helped to minimize preventable ADRs to anti-cancer agents.

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Acknowledgements

Authors thank physicians and nurses of JSS Academy of Higher Education and Research collaborated oncology practice site and, JSS Academy of Higher Education and Research, Mysore, India for their support and encouragement. We thank Ms Karin Nyfort-Hansen, Clinical Pharmacist, South Australia for her comments on the earlier version of this manuscript.

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No funding was received for this study from any source.

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  1. Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru, Karnataka, 570015, India

    Himanshu Patel & Parthasarathi Gurumurthy

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  1. Himanshu Patel
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Correspondence to Parthasarathi Gurumurthy.

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Patel, H., Gurumurthy, P. Improving medication safety in oncology care: impact of clinical pharmacy interventions on optimizing patient safety. Int J Clin Pharm 41, 981–992 (2019). https://doi.org/10.1007/s11096-019-00860-0

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