Impact of a pharmacist-driven survivorship clinic on adherence to screening and preventive care after allogeneic hematopoietic cell transplant.

BACKGROUND

Allogeneic hematopoietic cell transplantation (allo-HCT) is associated with a high rate of treatment-related morbidity and mortality. Screening and preventative practices for long-term toxicities are recommended in these patients.

OBJECTIVES

A pharmacist-driven allo-HCT survivorship clinic was developed to optimize and provide consistent outpatient care to allo-HCT survivors. The primary objective of this review was to compare adherence rates to recommended screening and preventive practices among allo-HCT recipients pre- and post-implementation of a pharmacist-driven allo-HCT survivorship clinic at day +100, 6 months, and 12 months after allo-HCT.

STUDY

DESIGN

This study was a single center analysis of patients who received an allo-HCT between 2013 and 2021. A pharmacist-driven survivorship program was implemented in January 2019. Adherence to guideline recommended screening and preventive practices among allo-HCT recipients pre-implementation versus post-implementation of the pharmacist-driven survivorship clinic were evaluated.

RESULTS

One hundred patients were included in the pre-implementation group and 41 patients were included in the post-implementation group. At day +100 post-allo-HCT, there was a significant increase in monitoring of urine protein (1% vs. 88%, p<0.0001), ferritin (38% vs. 95%, p<0.0001), vitamin D (6% vs. 98%, p<0.0001), and hemoglobin A1c (11% vs. 98%, p<0.0001) in the post-implementation group compared to pre-implementation group, respectively. At 6 months, there was an increase in monitoring of urine protein (44% vs. 80%, p=0.0005), vitamin D (7% vs. 89%, p<0.0001), hemoglobin A1c (19% vs. 86%, p<0.0001), pulmonary function test (22% vs. 69%, p<0.0001), thyroid stimulating hormone (24% vs. 100%, p<0.0001), and lipid panel (11% vs. 89%, p<0.0001). At 12 months, there was an increase in monitoring of urine protein (31% vs. 88%, p<0.0001), hemoglobin A1c (24% vs. 67%, p<0.0001), thyroid stimulating hormone (15% vs. 73%, p<0.0001), lipid panel (15% vs. 73%, p<0.0001), and dual energy X-ray absorptiometry scan (3% vs. 75%, p<0.0001).

CONCLUSION(S): Implementation of a pharmacist-driven survivorship clinic significantly improved adherence to ASTCT guideline recommended screening and preventive practices for allo-HCT patients.