Type of publication:
Conference abstract
Author(s):
*Flynn K.; *Poulsom R.; *Wilfred D.;* Lindsey K.; *Tibitendwa A.
Citation:
Journal of Oncology Pharmacy Practice. Conference: 26th Annual BOPA Symposium. Wales United Kingdom. 30(1 Supplement) (pp 74), 2024. Date of Publication: 01 Mar 2024.
Abstract:
Introduction / objectives: This Service Evaluation was carried out to assess interventions for oncology SACT prescriptions, identify trends and potential areas for improvement. The primary objective was to quantify and categorise the interventions of the Cancer Pharmacist team, encompassing IV and oral oncology SACT prescriptions in the inpatient and outpatient setting, over a 12-week period. The secondary objective was to look in more detail at the interventions logged under the high-risk categories of 'Regimen query/error', 'Dose query' and 'Dose error'. This would enable greater understanding of the issues contributing to prescription errors and will form the basis for future work to improve patient safety. Method(s): Cancer pharmacists completed a data collection form for each oncology SACT prescription query over a 12-week period. A support document defining each category ensured standardisation among pharmacists when classifying queries. The data was collated and analysed using Microsoft Excel. Each patient case in the specified high-risk categories was examined retrospectively to provide more detailed insight into the intervention and identify common themes. Result(s): In total, 124 interventions were logged (Fig.1), the highest number related to 'funding queries', 36%, with 'missing prescription' and 'dose query' both at 15%. The high-risk categories accounted for 31%, (n = 39). Of the 39 high-risk interventions, 9 related to intended dose changes that had not been actioned; 14 related to patient factors (bloods, DPYD, co-morbidities), of which 6 involved carboplatin; 5 prescriptions were missing a critical element. Discussion / conclusions: Funding queries were identified as the largest category of interventions; consultants were reminded to complete Blueteq forms when planning treatment to ensure the patient is eligible for the chosen regime. Prescriptions not available in advance mean that treatment cannot be ordered in time from third-party compounders. Pharmacy and oncology are working to find an efficient way of identifying patients scheduled for treatment that has not yet been prescribed to reduce delays to patients due to treatment not being available. From the in-depth analysis of high-risk categories, key areas for service development were identified. 1) Establishing a clear process for communicating changes to planned treatment. 2) Creating a policy and educating staff on carboplatin dosing to reduce unnecessary changes. 3) Improving blood test scheduling with the administration team. 4) Reviewing regimens requiring two prescriptions and considering combined prescriptions. This would reduce the number of prescriptions missing a critical element. Our Service Evaluation had limitations, mainly due to manual documentation. There was a noticeable drop in number of queries logged during extremely busy periods; it is likely that some interventions have been missed. Some duplication was identified when collating the data, particularly where more than one pharmacist was involved in following up a query. Of the 39 high-risk interventions, 4 were excluded from the data, 3 were duplicate entries and 1 had the incorrect patient number documented so further follow up was not possible. Future work will involve liaising with the oncology team to address the areas identified above with reference to improvement projects that have been successful in other hospitals.
DOI: 10.1177/10781552241228011
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