Implementation of a pharmaceutical care model within paediatric oncology

IntroductionDue to the complex needs, paediatric oncology patients require specialized pharmaceutical care provided within an interdisciplinary setting.ObjectiveTo implement a Pharmaceutical Care Model at the Paediatric-Adolescent Oncology Unit (PAOU) at Sir Anthony Mamo Oncology Centre, Malta, focusing on individualised pharmaceutical care issues (PCIs) based on patient specific needs.MethodsA tool consisting of a novel PCI classification system based on the Pharmaceutical Care Network Europe Foundation classification for drug related problems and the DOCUMENT system was developed to document and classify PCIs. The tool was presented in tabular format with eleven PCI categories, category description, PCIs, pharmaceutical interventions, and outcomes. Following ethics approval, the pharmacist attended consultant-led ward rounds where patient files, treatment charts and chemotherapy prescriptions were reviewed to identify PCIs. Identified PCIs were discussed with the healthcare team, pharmaceutical interventions were proposed, and outcomes were recorded.ResultsValidation and practicality testing demonstrated tool relevance, robustness, and practicality for use at the PAOU. Over 8 months, 545 PCIs were identified during 325 pharmaceutical care sessions. Most PCIs featured in the counselling (26.97%), drug selection (23.67%), dose selection (19.27%) and monitoring (15.41%) categories. The majority (95% n = 516) of the proposed pharmaceutical interventions were accepted and implemented by the healthcare professionals or the parents.ConclusionThis study highlights the pharmacist's contribution to paediatric oncology care through a pharmaceutical care model focused on PCIs and patient specific needs. The high acceptance rate of pharmaceutical interventions demonstrates the model's quality, the clinical pharmacist's professional competence, effective interdisciplinary collaboration, and integration within the healthcare team.