Symptom and urgent review clinics (SURC) for patients receiving systemic anti-cancer therapy (SACT) have been demonstrated to improve patient knowledge, promote early detection and patient self-management of toxicities. Addition of an expanded role oncology pharmacist for 8 hours per week provides medication management expertise to complement the advanced practice nurse role within the SURC. The SURC pharmacist plays a critical role in the management of patients receiving oral SACTs by providing initial education, assessment of understanding and compliance, ongoing monitoring, adverse effect management, and supportive care. The SURC pharmacist also conducts dental, malnutrition, and supportive care screening to identify patients requiring extra supports and allied health referrals.
Method
Patient interactions and pharmacist interventions were recorded in a Microsoft Access database and Excel spreadsheet respectively. Patient experience of the SURC pharmacist model was evaluated via a telephone survey using questions with 5-point Likert scale responses.
Results
Over 6 months, the SURC pharmacist had 122 patient contacts. Of these, there were 19 (15.6%) planned education sessions, 9 (7.4%) SURC attendances, and 94 (77%) telephone calls. Of the 19 patients educated, 47.3% (9/19) had their malnutrition and supportive care screening completed by the SURC pharmacist.
The SURC pharmacist made 17 referrals to supportive services.
The SURC pharmacist made 142 interventions relating to supportive care (46.5%), medications (33.8%), compliance (7%), complementary medicines (5.6%), and practical matters (7%).
In the survey, patients agreed that the initial education with the SURC pharmacist was valuable (9/9, 100%). Patients also agreed that they felt more confident in managing adverse effects (10/10, 100%), and emotionally supported through their treatment (10/10, 100%) after speaking with the SURC pharmacist.
Conclusion
The addition of an expanded role oncology pharmacist contributes to a robust multidisciplinary SURC model that improves patient knowledge, identifies supportive care needs, and assists patients in self-management of adverse effects.