Service evaluation assessing the effectiveness of pharmacist input to a chemotherapy unit.

Zaslona FL, Abedin L, Sim Mutch L Laurel Suite, Stepping Hill Hospital, Stockport

Drug counselling has long been an integral part of medicines management. Chemotherapy outpatients will receive new medications and various amendments through their care. Efficient pharmacist counselling is essential to reduce the prevalence of side effects and are a pervasive patient safety issue. (1)

A satellite pharmacy was set up on the chemotherapy unit allowing continuous pharmacy input. The aim was to increase patient-pharmacist interaction utilising the pharmacy skill set, assessing the incidence of side effects and optimise treatment care; ultimately improving patient experience and concordance. The objectives were set to establish the effectiveness of a satellite pharmacy evaluating patient preference and quality of care comparable to the main hospital pharmacy service.

A questionnaire was constructed collecting data from 50 patients using the service. The service evaluation composed of 5 questions with a score system grading from one to five. The questionnaires were answered anonymously and completed during a treatment appointment.

Patient comments Implementation of the satellite pharmacy has proven favorable. All patients preferred to receive prescriptions on the chemotherapy unit expressing a high quality of service with regards to their treatment plan. A highlighted benefit from the satellite pharmacy was the access of pharmacist input to tailor and prescribe medications dependent upon patient specific needs, enabling a more tolerable cancer journey.Chemotherapy patients are both high risk and high cost. Effective pharmacist counselling can increase medication adherence and suitability reducing potential side effects and delays in treatment.

Conclusion

Do you prefer your prescriptions to be dispensed on the Laurel suite or to be collected from the main pharmacy?

Laurel Suite Main Pharmacy100% 0%

Methods

Introduction Results

References

Aims

Questionnaire

‘The guaranteed continuity of this personal

service is important to the patient and dealing

with the pharmacist directly is a BIG plus’

Strongly Disagree

2 3 4 Strongly Agree

0102030405060708090

100

Percentage of pa-tients

Do your medication queries get answered in a timely manner with full explanation by your pharmacist on the Laurel Suite?

Laurel suite satellite pharmacy

Strongly Disagree 2 3 4 Strongly Agree

Do you feel your supportive medications are tailored suitably to your needs? Has the hospital pharmacist helped you achieve this?

Do you feel comfortable to ask your pharmacist for any advice regarding your chemotherapy?

1 (strongly Disagree)

2 3 4 5 (strongly Agree)

- - - 5% 95%

Dispensing on the satellite unit

Do your medication queries get answered in a timely manner with full explanation by your pharmacist on the Laurel Suite?

1 (strongly Disagree)

2 3 4 5 (strongly Agree)

- - - 10% 90%

Laurel suite chemotherapy unit

‘The personal touch of seeing the same pharmacist every treatment

cycle makes a very positive difference. You feel that they know you and are more aware of specific

problems’

Pharmacist working on the unit

Pharmacist counselling on the clinic

‘Previous experience of waiting a full day before discharge whilst the main pharmacy dispensed medication resulted in my very strong preference for the laurel suite approach’

‘Fabulous staff….absolute

excellence’

‘A wonderful service. A personal

service’

‘With the pharmacist on site, all questions are answered

immediately whereas queueing at the pharmacy

would not necessarily give you the immediate answers you

require’

‘The pharmacy set up is brilliant. It allows a good, close relationship between staff and patient, all issues are resolved efficiently and quickly’

Questionnaire – Patient perception of pharmacist input on the laurel suite. Question One: Do you prefer your prescriptions to be dispensed on the Laurel suite or to be collected from the main pharmacy? Laurel Suite Main Pharmacy Question Two: Do your medication queries get answered in a timely manner with full explanation by your pharmacist on the Laurel Suite? 1 (strongly disagree) 2 3 4 Five (Strongly Agree) Question Three: Do you feel comfortable to ask your pharmacist for any advice regarding your chemotherapy? 1 (strongly disagree) 2 3 4 Five (Strongly Agree) Question Four: Do you feel your support medications are tailored suitably to your needs? Has the pharmacist helped you achieve this? 1 (strongly disagree) 2 3 4 Five (Strongly Agree) Question Five: Do you feel you get a suitable explanation of your medications and the possible side effects by your pharmacist? 1 (strongly disagree) 2 3 4 Five (Strongly Agree) Any other comments: Thank you for your time.

Pharmacy counselling role on the Laurel suite:

• Medicines reconciliation• Medication counselling• Phone advice/assessment• Toxicity assessment• Prescribing supportive medication

Results:

• Prescriptions dispensed on the laurel suite provides a desirable service • Treatment of side effects are managed well with a pharmacist based on the unit• Advice is readily available when required• Treatment of side effects can be done so whilst patient is receiving chemotherapy

1) Schnipper J, Kirwin J, Cotugno M et al. Role of Pharmacist Counselling in Preventing Adverse Drug Events After Hospitalization. Archive of Internal Medicine. 2006 Vol.166 No.5