Jump to ContentJump to Main Navigation
Show Summary Details

Radiology and Oncology

The Journal of Association of Radiology and Oncology

4 Issues per year

IMPACT FACTOR 2015: 1.736

SCImago Journal Rank (SJR) 2015: 0.631
Source Normalized Impact per Paper (SNIP) 2015: 0.968
Impact per Publication (IPP) 2015: 1.796

Open Access
See all formats and pricing
Volume 44, Issue 4 (Dec 2010)


Evaluation of clinical interventions made by pharmacists in chemotherapy preparation

Lea Knez
  • Academic Department of Pharmacy, Barts and The London NHS Trust, Royal London Hospital, London, UK
  • Pharmacy Department, University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia
/ Raisa Laaksonen
  • Academic Department of Pharmacy, Barts and The London NHS Trust, Royal London Hospital, London, UK
  • Pharmacy Practice Group, Department of Pharmacy & Pharmacology, University of Bath, Bath, UK
/ Catherine Duggan
  • Academic Department of Pharmacy, Barts and The London NHS Trust, Royal London Hospital, London, UK
  • Clinical Pharmacy, Development and Evaluation for East & South East England Specialist Services, NHS, UK
  • The School of Pharmacy, London, UK
Published Online: 2010-09-22 | DOI: https://doi.org/10.2478/v10019-010-0040-x

Evaluation of clinical interventions made by pharmacists in chemotherapy preparation

Background. Cancer drugs are high risk drugs and medication errors in their prescribing, preparation and administration have serious consequences, including death. The importance of a multidisciplinary approach and the benefits of pharmacists' contribution to cancer treatment to minimise risk have been established. However, the impact of services provided by pharmacists to cancer patient care is poorly studied. This study explored the clinical interventions made by pharmacists in dispensing of chemotherapy doses, and evaluated pharmacists' contribution to patient care.

Methods. Pharmacists at the Chemotherapy Preparation Unit at a tertiary cancer centre in London were shadowed by two research pharmacists during the clinical screening of chemotherapy prescriptions and release of prepared drugs. An expert panel of pharmacy staff rated the clinical significance of the recorded interventions.

Results. Twenty-one pharmacists' interventions were recorded during the screening or releasing of 130 prescriptions or drugs. "Drug and therapy" (38%), "clerical" (22%) and "dose, frequency and duration" (19%) related problems most often required an intervention, identifying areas in chemotherapy prescribing that need improvement. The proposed recommendations were implemented in 86% of the cases. Many recorded interventions (48%) were ranked to have had a "very significant" influence on patient care.

Conclusion. Clinical interventions made by pharmacists had a significant impact on patient care. The integration of pharmacists' technical and clinical roles into dispensing of chemotherapy doses is required for providing high-quality cancer services.

Keywords: pharmacy; cancer; chemotherapy; drug compounding; medication errors

  • Phillips J, Beam S, Brinker A, Holquist C, Honig P, Lee LY, et al. Retrospective analysis of mortalities associated with medication errors. Am J Health Syst Pharm 2001; 58: 1835-41.

  • Ocvirk J, Boc M, Rebersek M, Ros T. Cisplatin-induced non-convulsive posterior reversible encephalopathy syndrome in a 41-year-old woman with metastatic malignant melanoma. Radiol Oncol 2009; 43: 120-5. [Web of Science]

  • Department of Health. The NHS cancer plan. London: HMSO; 2001.

  • Goldspiel BR, DeChristoforo R, Daniels CE. A continuous-improvement approach for reducing the number of chemotherapy-related medication errors. Am J Health Syst Pharm 2000; 57: S4-9.

  • Mort D, Lansdown M, Smith N, Protopapa K, Mason M. For better, for worse? London: National Confidential Enquiry into Patient Outcome and Death; 2008. [Web of Science]

  • North East London Cancer Network NHS. Guidelines on the safe prescribing, handling and administration of cytotoxic drugs. London: Department of Health Publications; 2005.

  • German Society of Oncology Pharmacy. Quality Standard for the Oncology Pharmacy Service with Commentary. 4th Edition. Oldenburg: Onko-press; 2003.

  • Adams V, Blake D, Corlett S, Godward D, Low J, McMurray A, et al. Competency Framework for Specialist Oncology Pharmacists. BOPA Newsletter, 2004.

  • Markert A, Thierry V, Kleber M, Behrens M, Engelhardt M. Chemotherapy safety and severe adverse events in cancer patients: strategies to efficiently avoid chemotherapy errors in in- and outpatient treatment. Int J Cancer 2009; 124: 722-8.

  • Jaehde U, Liekwig A, Simons S, Westfeld M. Minimising treatment-associated risks in systemic cancer therapy. Pharm World Sci 2008; 30: 161-8. [Web of Science]

  • Slama C, Jerome J, Jacquot C, Bonan B. Prescription errors with cytotoxic drugs and inadequacy of existing classifications. Pharm World Sci 2005; 27: 339-43.

  • Liekweg A, Westfeld M, Jaehde U. From oncology pharmacy to pharmaceutical care: new contributions to multidisciplinary cancer care. Support Care Cancer 2004; 12: 73-9.

  • Debevec L, Jerič T, Kovač V, Bitenc M, Sok M: Is there any progress in routine management of lung cancer patients? A comparative analysis of an institution in 1996 and 2006. Radiol Oncol 2009; 43: 47-53. [Web of Science]

  • Knez L, Laaksonen R, Duggan C, Nijjar R. Evaluation of clinical interventions made by pharmacists in cancer services. Pharm J 2008; 280: 277-80.

  • Burtonwood AM, Hinchliffe AL, Tinkler GG. A prescription for quality: a role for the clinical pharmacist in general practice. Pharm J 1998; 261: 678-80.

  • Eadon H. Assessing the quality of ward pharmacists' interventions. Int J Pharm Practice 1992; 1: 145-7.

  • Price RN, Rogers A. Intervention monitoring on admissions wards. Hosp Pharmacists 2000; 7: 81-4.

  • Barber N, Batty R, Ridout DA. Predicting the rate of physician-accepted interventions by hospital pharmacists in the United Kingdom. Am J Health Syst Pharm 1997; 54: 397-405.

  • Hawkey CJ, Hodgon S, Norman A, Daneshmend TK, Garner ST. Effect of reactive pharmacy intervention on quality of hospital prescribing. Br Med J 1990; 300: 986-990.

  • Allan EL, Barker KN. Fundamentals of medication error research. Am J Hosp Pharm 1990; 47: 555-71.

  • Bowling A. Research methods in health. Philadelphia: Open University Press; 2002.

  • Macintyre J, Dalrymple H, MacLean F, Lannigan N, Hudson S. Development of a system for reporting pharmaceutical care issues in cancer patients receiving chemotherapy. Pharm J 2003; 271: 266-7.

  • Limat S, Drouhin JP, Demesmay K, Tissot E, Jacquet M, Woronoff-Lemsi MC. Incidence and risk factors of preparation errors in centralized cytotoxic preparation unit. Pharm World Sci 2001; 23: 102-6.

  • Bourret JA, Demeres RF, Wordell D, Irani M, Baker J, Evangelista C. Medication use review process and information systems utilized for oncology chemotherapy quality improvement. Pharm Pract Manag Q 1996; 16: 1-17. [PubMed]

  • Barber N, Cornford T, Klecun E. Qualitative evaluation of an electronic prescribing and administration system. Qual Saf Health Care 2007; 16: 271-8. [Web of Science]

  • Nebeker JR, Hoffman JM, Weir CR, Bennett CL, Hurdle JF. High rates of adverse drug events in a highly computerized hospital. Arch Intern Med 2005; 165: 1111-6.

About the article

Published Online: 2010-09-22

Published in Print: 2010-12-01

Citation Information: Radiology and Oncology, ISSN (Online) 1581-3207, ISSN (Print) 1318-2099, DOI: https://doi.org/10.2478/v10019-010-0040-x. Export Citation

This content is open access.

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

Vanessa Hegele, Paula Stoll, Diego Wüst, Guilherme Ehrenbrink, Luiza Raquel Grazziotin, Juliana Prohonoski Caregnato, and Luciane Pereira Lindenmeyer
International Journal of Clinical Pharmacy, 2013, Volume 35, Number 4, Page 513
Ting Ting Yeoh, Phebe Si, and Lita Chew
Supportive Care in Cancer, 2013, Volume 21, Number 5, Page 1287

Comments (0)

Please log in or register to comment.
Log in