The integration of remote clinical pharmacists into community oncology practices has demonstrated remarkable clinical and financial benefits, according to a new study published in the Journal of Oncology Pharmacy Practice. The US Oncology Network's initiative revealed substantial improvements in patient care efficiency and cost savings across multiple practices.
Clinical Impact and Intervention Patterns
Over a 12-month period, clinical pharmacists conducted more than 5,700 order reviews, identifying necessary interventions in nearly 60% of cases. The study documented over 11,000 anticancer dose modifications, 700-plus supportive care recommendations, and more than 400 additional medication monitoring recommendations.
"We were looking at cycle 1, day 1 chemotherapy prior to the patient getting treated," explained Andrea Roman, PharmD, BCOP, from US Oncology Network and McKesson. "We were looking for things like therapeutic interchanges, dose rounding opportunities, and then any clinical interventions we could make."
Financial Benefits and Resource Optimization
The financial outcomes proved particularly compelling. The program achieved:
- Total medication cost reduction exceeding $5.9 million
- Practice margin improvement of over $1.4 million
- 415% return on investment
- More than 800 hours of provider time saved
Patient Care Enhancement
The integration of pharmacists has shown significant potential for improving patient outcomes. "A lot of the dose changes that we are making are going to be helping patients relieve some of the toxicity that they might experience if they got too high of a dose," Roman noted. "We are helping those on the front end and hoping to prevent hospital admissions, dose reductions, or coming off therapy sooner."
Implementation Strategy
The success of the program relied on building trust between pharmacists and providers, leading to the development of provider-approved policies that allowed pharmacists to work independently on various interventions. These included carboplatin dose adjustments and zoledronic acid renal dosing modifications.
Future Directions
The program's success has sparked plans for expansion. Future initiatives will focus on:
- Analyzing cost avoidance from prevented hospitalizations
- Expanding services to oral chemotherapy management
- Implementing subsequent cycle reviews
- Developing more comprehensive patient monitoring systems
The study demonstrates that incorporating remote clinical pharmacists into community oncology practices represents a sustainable model for enhancing both clinical care and financial performance in oncology practice management.
