Direct Clinical Pharmacist-Patient Telephone Follow-Up: A Focus on GI Medical Oncology Symptom Management.

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.

Cost-effectiveness of new and emerging treatment options for the treatment of metastatic colorectal cancer.

Cancer of the colon and rectum is now the third most common form of cancer in the United States in both women and men. Approximately 21% of patients with colorectal cancer (CRC) are diagnosed with metastatic spread upon initial presentation, and 50% to 60% of all patients with earlier stage CRC will eventually develop metastases. Advances in systemic therapies have improved overall survival for patients with metastatic CRC (mCRC), but with an increasing cost burden on the healthcare system. Patterns of treatment choice and resulting medical care usage and costs can differ depending on patient-specific characteristics, impacting overall patient care and healthcare usage. The economic burden associated with CRC and its management is affected by several factors, including stage of disease at diagnosis, patient age, time period studied, oncologic therapy choice, and point of view. Available data assessing cost impact have recently been emerging; however, they are complex to interpret given the substantial heterogeneity among study population and the types and duration of analyses.