Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Compostos Bicíclicos Heterocíclicos com Pontes/efeitos adversos , Leucemia Mieloide Aguda/tratamento farmacológico , Sulfonamidas/efeitos adversos , Síndrome de Lise Tumoral/etiologia , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Compostos Bicíclicos Heterocíclicos com Pontes/administração & dosagem , Citarabina/uso terapêutico , Decitabina/administração & dosagem , Feminino , Hidratação , Humanos , Hidroxiureia/uso terapêutico , Incidência , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/genética , Leucemia Mielomonocítica Aguda/complicações , Leucemia Mielomonocítica Aguda/tratamento farmacológico , Leucemia Mielomonocítica Aguda/genética , Leucocitose/tratamento farmacológico , Leucocitose/etiologia , Masculino , Pessoa de Meia-Idade , Proteínas de Ligação a Fosfato/uso terapêutico , Fósforo/sangue , Proteínas Proto-Oncogênicas c-bcl-2/antagonistas & inibidores , Estudos Retrospectivos , Sulfonamidas/administração & dosagem , Urato Oxidase/uso terapêutico , Ácido Úrico/sangueRESUMO
PURPOSE: GI medical oncology care presents unique medication challenges. Here, we captured our clinical pharmacy specialists' (CPSs) involvement in patients with GI cancers starting cycle 1 of a new treatment. METHODS: Our quality initiative was performed in three stages (preintervention, intervention, and postintervention). Preintervention: retrospective baseline data collection from May to December 2019. Intervention: one-time telephone encounters were conducted by a CPS between March 15 and June 11, 2021. The primary objective of the quality improvement initiative was to increase patient interaction with a CPS to 80%. Postintervention: data collection to review the impact of CPS telephone encounters. RESULTS: Preintervention: we reviewed the electronic health records of 262 patients. Sixty nine percent of patients reported at least one adverse event (AE; range 1-6 AEs) at the first physician follow-up after treatment start. Most reported AEs (78%) were considered modifiable within the scope of CPS practice. Postintervention: during the intervention, 92% of patients (n = 389) received a telehealth encounter with the CPS. At the encounter, 315 patients (81%) reported at least one AE. CPS provided recommendations and/or additional education for 88% of reported AEs. Medication lists required correction 75% of the time. The median time for CPS encounters (including documentation) was 40 minutes. CONCLUSION: During a 3-month period, this quality improvement initiative successfully provided an early CPS-based telehealth intervention to identify and make initial recommendations for management of AEs for patients on cycle 1 of systemic therapy for GI cancer.