Establishing a standardized clinical thinking model for oncology pharmacy outpatients in China: A mixed-method study

BackgroundOncology pharmacy clinics play a crucial role in improving medication adherence, managing drug-related problems (DRPs), enhancing quality of life, and reducing costs. However, standardized protocols for such clinics are currently lacking in China.ObjectivesThis study aimed to develop a standardized clinical thinking model for oncology medication consultations to ensure consistent and high-quality pharmaceutical care.MethodsA mixed-method study was conducted, analyzing 100 oncology medication consultations from January to July 2024 at Shanghai Xinhua Hospital. Retrospective statistics and root cause analysis, using a fishbone diagram across four dimensions (personnel, materials, methods, environment), were employed to identify gaps in current practices. Based on findings, the "Information gathering, Reasoning, Judgement, Enacting a decision" (IRJE) model was developed. Pharmacists received IRJE-based training, and its effectiveness was evaluated using pre- and post-training questionnaires.ResultsA total of 100 medication-related cases were analyzed. The results revealed issues such as incomplete medication evaluations by pharmacists. Root cause analysis using the fishbone diagram identified key factors across the four dimensions. In response, the IRJE clinical thinking model was established to guide safe antitumor medication use. Post-training, pharmacists demonstrated significantly improved confidence in identifying medication-related factors, maintaining standardized records, and conducting medication consultations (p < 0.05).ConclusionsThe IRJE model provides a structured decision-making pathway for oncology pharmaceutical care. It has the potential to standardize consultations and improve patient outcomes across pharmacy clinics in China.