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Clinical pharmacy services in oncology clinics

Objective. To describe the implementation and evaluation of clinical pharmacy services in ambulatory hematology-oncology clinics. Design. A prospective study was conducted to evaluate the impact of the clinical pharmacist in outpatient clinics. Setting. The clinical pharmacist is available to patients and health care professionals for drug consultations in adult hematology-oncology, cancer pain, surgical oncology, pediatric hematology-oncology, and gastrointestinal tumor clinics. The pharmacist also participates in a cancer outreach program in an off-site rural clinic. Interventions. A chart review, pharmacy patient profile review, and patient interview were performed to obtain medication histories. Drug-related problems were identified, resulting in interventions. Patient outcomes were evaluated by follow-up phone calls or by patient interviews on the following clinic visit. Results. A total of 211 interventions were documented within 36 days. The most frequent activity was patient counseling followed by therapeutic recommendations. A majority of the interventions were not related to chemotherapy. The physician acceptance rate was 94.5%. Most of the problems were of high and moderate clinical significance, with positive clinical outcomes after pharmacy interventions. Conclusion. Hematology-oncology clinics provide an excellent opportunity to involve pharmacists. A clinical pharmacist has a significant role in outpatient clinics and can potentially lead to an overall decrease in health care costs and to an improvement of the quality of patient care.