Model for Collaborative Physician-Pharmacist Clinic in Multiple Myeloma
Posted: Monday, February 4, 2019
Incorporating a clinical pharmacist in managing patients with multiple myeloma led to significant improvements in adherence to supportive medications as well as reduced delays in acquiring oral immunomodulatory imide drugs, according to a study published by Karen Sweiss, PharmD, BCOP, of the University of Illinois at Chicago, and colleagues, in the Journal of Oncology Practice. In addition, their proposed collaborative clinic model may be of benefit in the management of patients with other complex malignant diseases.
Over a 1-year period, an oncology pharmacist provided consultation for patients within a specialist myeloma clinic. The pharmacist provided medication-related education and medication therapy management, monitored adherence and treatment-related toxicity and recommended interventions based on International Myeloma Working Group and American Society of Bone Marrow Transplantation guidelines, as well as navigated issues of insurance approval for and access to oral specialty medications.
The collaborative clinic led to significantly improved adherence to bisphosphonates, calcium and vitamin D, acyclovir, post–autologous stem cell transplantation Pneumocystis jirovecii pneumonia prophylaxis, as well as appropriate venous thromboembolism prophylaxis during immunomodulatory imide drugs–based treatment. It also shortened the median time to initiation of bisphosphonate (5.5 vs. 97.5 days) and Pneumocystis jirovecii pneumonia prophylaxis after autologous transplantation (11 vs. 40.5 days). In addition, also reduced were the number and duration of delays in obtaining immunomodulatory imide drugs.
Throughout the collaborative clinic, among 551 physician clinic visits, the pharmacist had 399 documented encounters. During the previous year’s traditional clinic, among 355 physician clinic visits, the pharmacist had 26 documented encounters.
In addition to recommending further studies evaluating the long-term clinical outcomes of collaborative clinics, the researchers theorized that other system modifications may be more cost-effective and produce similar results.
Disclosure: Study authors’ disclosures can be found at ascopubs.org.