Presenting Authors: Mark Wagner, PharmD, BCOP, and Colton Zwart, PharmD, BCOP, Cowell Family Cancer Center, Munson Healthcare, Traverse City, MI
Co-Authors: Karen Farris, PhD, University of Michigan College of Pharmacy, Ann Arbor, MI; David Reyes-Gastelum and Katie Young, Michigan Institute for Care Management and Transformation, Ann Arbor, MI; Emily Mackler, PharmD, BCOP, Michigan Oncology Quality Consortium, Michigan Institute for Care Management and Transformation, YesRx, and University of Michigan College of Pharmacy, Ann Arbor, MI
BACKGROUND: Pharmacists play a critical role in team-based care, and this is well established in the primary care setting.
OBJECTIVE: To compare healthcare utilization outcomes before and after the integration of 2 embedded clinical pharmacists in a large community oncology practice via the program, Pharmacists Optimizing Oncology Care Excellence in Michigan.
METHODS: This single-center, retrospective analysis was conducted with data from January 2018 to March 2024. The intervention was clinically embedded pharmacist care, identified by a pharmacist education visit. Up to 400 patients in each of the pre- and postintervention groups were identified. Charts were eligible for abstraction if patients were newly prescribed anticancer therapy for any of the 3 following areas: gynecologic oncology diagnosis, the use of an immune checkpoint inhibitor(s), or the use of an oral anticancer agent(s). The following data were abstracted: patient demographics, medication, cancer diagnosis, emergency department visits and hospitalizations, and reason for emergency department/hospitalization. A chi-square analysis compared pre- and post-intervention time periods.
RESULTS: Abstraction was completed for 398 patients in the preintervention group and 350 patients in the postintervention group. No demographic differences were detected between groups. The preintervention group had a mean age of 67 years (standard deviation [SD], 11.5), 69% were female, and 96% were White. The postintervention group had a mean age of 68 years (SD, 12.5), 57% were female, and 97% were White. The majority of patients in both groups were diagnosed with either ovarian, endometrial, non–small cell lung, prostate, or breast cancer. At 6 months following treatment initiation, the preintervention group had a 24% incidence of hospitalization due to cancer symptoms, treatment-related adverse events, or unknown reason versus 19% in the postintervention group (P=.065). Emergency department visits at 6 months resulting from cancer symptoms, treatment-related adverse events, or unknown reason were 32% in the preintervention group versus 25% in the postintervention group (P=.035).
CONCLUSION: Embedded clinical pharmacist care reduced the incidence of emergency department visits in the first 6 months of anticancer treatment initiation.
- Coe AB, Choe HM, Diez HL, et al. Pharmacists providing care in statewide physician organizations: findings from the Michigan Pharmacists Transforming Care and Quality Collaborative. J Manag Care Spec Pharm. 2020;26:1558-1566.
- POEM program. Accessed October 4, 2024. www.moqc.org/poem