Journal of geriatric oncology · 2026
Role, impact, and feasibility of a comprehensive pharmacist medication review for patients in the older adult cancer clinic (OACC) at Princess Margaret Cancer Centre.
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Mellor Sabrina, Tyszka Malgorzata, Pathak Neha, Sibley Daniel, Dara Celina, Monginot Susie, Norman Richard, Alibhai Shabbir M H
Аннотация
INTRODUCTION: Older adults with cancer are at greater risk of experiencing drug therapy problems (DTPs), often related to multiple comorbidities, advanced age, and cancer treatments. Increasing evidence demonstrates the value of a pharmacist in geriatric oncology clinics, but little information exists on their practical integration. Our objective is to evaluate the logistics and impact of a pharmacist review of patients referred to a geriatric oncology clinic at an academic cancer centre.
MATERIALS AND METHODS: Starting January 2023, a one-year quality improvement pilot project integrated a pharmacist review of patients referred to the Older Adults with Cancer Clinic (OACC) at Princess Margaret Cancer Centre, Toronto, Canada. Eligibility criteria included: no existing best possible medication history (BPMH), taking ≥5 medications, plan for or undergoing systemic cancer therapy, or if requested by the OACC team. The BPMH, pharmacist assessment, and DTPs/recommendations were documented in the institution's electronic health record and flagged for the OACC team. Key outcomes included DTPs identified, time required by the pharmacists, and lessons learned. Interprofessional meetings were held every 2 to 3 months to review progress and provide constructive feedback. Descriptive and inferential analyses were performed.
RESULTS: Over 49 weeks, the pharmacists reviewed 205 patients, averaging 4 patients per 7-h shift each week. Patients had a mean age of 81 years (SD = 6.6), 51.7% were male, were taking a mean 11.5 medications (SD = 4.8), and 73.7% patients were pre-treatment with a plan for systemic therapy. The mean pharmacist review time was 103.1 (SD = 60.3) minutes per patient. A total of 300 DTPs were identified during the one-year period and the most common DTP was adverse drug reaction. The majority of DTPs (65%) identified were accepted/acknowledged by the OACC geriatricians. Challenges that the pharmacists encountered included: determining which patients to prioritize, obtaining a BPMH remotely, and having only 1 day a week to complete review.
DISCUSSION: This pilot project demonstrated that a pharmacist-integrated model for conducting BPMHs for a geriatric oncology clinic is feasible and clinically valuable. The pharmacists identified many DTPs, including those related to cancer therapies, contributing to safer and more informed treatment planning.
MATERIALS AND METHODS: Starting January 2023, a one-year quality improvement pilot project integrated a pharmacist review of patients referred to the Older Adults with Cancer Clinic (OACC) at Princess Margaret Cancer Centre, Toronto, Canada. Eligibility criteria included: no existing best possible medication history (BPMH), taking ≥5 medications, plan for or undergoing systemic cancer therapy, or if requested by the OACC team. The BPMH, pharmacist assessment, and DTPs/recommendations were documented in the institution's electronic health record and flagged for the OACC team. Key outcomes included DTPs identified, time required by the pharmacists, and lessons learned. Interprofessional meetings were held every 2 to 3 months to review progress and provide constructive feedback. Descriptive and inferential analyses were performed.
RESULTS: Over 49 weeks, the pharmacists reviewed 205 patients, averaging 4 patients per 7-h shift each week. Patients had a mean age of 81 years (SD = 6.6), 51.7% were male, were taking a mean 11.5 medications (SD = 4.8), and 73.7% patients were pre-treatment with a plan for systemic therapy. The mean pharmacist review time was 103.1 (SD = 60.3) minutes per patient. A total of 300 DTPs were identified during the one-year period and the most common DTP was adverse drug reaction. The majority of DTPs (65%) identified were accepted/acknowledged by the OACC geriatricians. Challenges that the pharmacists encountered included: determining which patients to prioritize, obtaining a BPMH remotely, and having only 1 day a week to complete review.
DISCUSSION: This pilot project demonstrated that a pharmacist-integrated model for conducting BPMHs for a geriatric oncology clinic is feasible and clinically valuable. The pharmacists identified many DTPs, including those related to cancer therapies, contributing to safer and more informed treatment planning.