Presenting Authors: Kelsea Seago, PharmD, BCOP, and Christine Barrett, PharmD, BCOP, WVU Medicine, Morgantown, WV
BACKGROUND: Pharmacy practice standards for oral oncolytic management were published by the Hematology/Oncology Pharmacy Association in 2018. These standards set forth a best practice recommendation that oral oncolytic safety and quality standards should be consistent with intravenous treatment standards.1 Recognizing an opportunity to increase the safety of oral oncolytic prescribing based on this best practice recommendation, clinical pharmacists at West Virginia University Cancer Institute’s Mary Babb Randolph Cancer Center (MBRCC) sought to implement an oncolytic prescription verification queue to ensure clinical pharmacist review of all oral oncolytic prescriptions on prescribing. The impact of clinical pharmacist management on oral oncolytics is well documented from clinical and specialty pharmacy perspectives.2-4 However, the use of an oncolytic prescription verification queue in an academic medical center with embedded clinical oncology pharmacists is a novel workflow.
OBJECTIVES: The primary objective was to determine the impact of implementing an oncolytic prescription verification queue by quantifying the number of prescriptions verified and the resulting pharmacist interventions. The secondary objectives were to further characterize the pharmacist interventions into categories and identify specific medications with the highest intervention rates.
METHODS: The verification queue was implemented in October 2023. Initially, the queue allowed retrospective review of prescriptions sent to external pharmacies, prospective review of prescriptions sent to internal pharmacies, and captured prescriptions sent from MBRCC’s outpatient hematology/oncology clinics, as well as 2 inpatient oncology services at J.W. Ruby Memorial Hospital. In March 2024, a process for documentation of pharmacist interventions resulting from the verification queue was standardized within the electronic medical record (EMR). Next, in June 2025, prescriptions for oral oncolytics sent on discharge from any inpatient service also began filtering into a queue for pharmacist verification. Metrics from the queue and associated pharmacist interventions were collected using a custom-built workbench report within the EMR as well as a Tableau dashboard. Descriptive statistics were used for analysis.
RESULTS: The verification queue resulted in a total of 7368 prescription verifications from October 2023 through August 2025, equaling approximately 320 verifications per month. From March 2024 through August 2025, there were 119 documented pharmacist interventions, equaling approximately 7 interventions per month. Interventions were most often classified as coordination of care (29%) and clarification of sig (23%). More than half of all interventions were documented on prescriptions for lenalidomide (34%) or capecitabine (23%).
CONCLUSION: The implementation of a novel oncolytic prescription verification queue resulted in thousands of pharmacist-verified oncolytic prescriptions and more than 100 documented pharmacist interventions in 23 months.
- Mackler E, Segal EM, Muluneh B, et al. 2018 Hematology/Oncology Pharmacist Association best practices of the management of oral oncolytic therapy: pharmacy practice standard. J Oncol Pract. 2019;15:e346-e355.
- Davenport L, Tadros M, Sagheer TA, et al. Clinical role of oncology pharmacy specialists in oral oncolytic management in the outpatient hematology clinic setting. J Hematol Oncol Pharm. 2023;13:264-269.
- Kaymakcalan MD, Thomas J, Nowakowski K, et al. Clinical pharmacist prescriptions review and modification for oral antineoplastic medications at an academic medical center. JCO Oncol Pract. 2023;19(suppl 11):64.
- Kaufman N, Bentivegna N, Orr R. Outcomes of pharmacist-driven clinical interventions in a medication integrated oncology specialty pharmacy practice. Pharmacist Practice in Focus: Oncology. 2025;7:15-19.