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PANDEMIC CRISIS COVID 19: THE DRUGS HOME DELIVERY AS A TOOL FOR ADHERENCE AND COMPLIANCE

European Statement

Clinical Pharmacy Services

Author(s)

BARBARA RE, MARTA DEL VECCHIO, CLAUDIA LAURIA PANTANO, ELIROSA MINNITI , VITO LADISA

Why was it done?

The covid-19 pandemic and the lockdown made it difficult and very often not possible to access hospital pharmacies for dispensing of drugs for cancer treatment

What was done?

Drugs homedelivery has been implemented for fragile patients and at risk both oncological and hemato-oncological, all over the italian territory

How was it done?

Through the telemedicine program, in agreement with the oncologist, patients unable to reach the pathology doctor’s office are contacted and the project explained to them. If the patient accepts the delivery at home, paths with specialized couriers have been activated, in compliance with the GDPR, which ensure the delivery of medicines within 48 hours. Upon delivery The Pharmacist contacts the patient to ensure that they have been received the medicines and reinforces how you take the drug and the potential side effects that need to be reported to doctor and / or pharmacist

What has been achieved?

In the period from March to September 2020, 501 deliveries were made, of which 301 in the regional territory and 200 in the national territory. 423 patients were contacted, A Customer Satisfaction was activated to which 90% of patients with a high degree of acceptance of the service responded

What next?

The Homedelivery service has shown that integrating telemedicine, with the collaboration oncologist and pharmacist, allows, when possible, to avoid fragile patients having to go to the hospital every month to collect the drug needed for their treatment. Furthermore, the role of the pharmacist will be increasingly central in the home clinical management of this patient population to assure Adherence and Compliance even in at Home setting.

INTEGRATED ONCOLOGY PHARMACY UNIT IN MULTIDISCIPLINARY TEAM

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European Statement

Clinical Pharmacy Services

Why was it done?

There was a previous collaboration between the pharmacy and medical oncology but with many problems due to the physical separation between the two units. There was a lack of knowledge of the needs of both services.

What was done?

To provide integral cancer care to the patients. We prepare the standard or investigational treatments the day of analysis and medical consultation. In the pharmacy consultation, we provide information and training to patients and their caregivers about the use of antineoplastic, evaluate their polytherapy and complementary and alternative therapy, drug interactions, conciliation, dispense doses and adjusted to help improve treatment and adherence and tolerance amounts.

How was it done?

Change of hospital, creation of new onco-hematology unit(2003), good feedback, and integration in clinical sessions.

What has been achieved?

The pharmacist reviews each chemotherapy order in relation to all known factors concerning the patient. If questions arise, the physician originating the order is contacted. Orders are verified with a protocol, standard regimen or standard dosing guidelines. The oncology pharmacist contributed to the design of chemotherapy protocols by electronic prescribing program (Farmis_Oncofarm®) and supportive care protocols. Activity (2013):22.770 preparations of intravenous chemotherapy, 9.651 patients consulting pharmacy. Reusing cytostatics in a centralized pharmacy preparation unit (Nplate®saving:129.910€(31.7%)), the preparation of parenteral mixtures at the pharmacy department minimises costs compared to preparation on wards (estimated saving 2.500.000€).The unit is also actively engaged in clinical trials (166 trials) and other research projects (pharmacogenetics and adherence with electronic monitoring system) with several publications (∑IF=84). It is a reference model clinical and teaching, oncology pharmacy unit is a preceptor to residents, staffs of other hospitals. Realisation of the annual attendance course. Unit Growth: 2 oncology pharmacist(BCOP),1 haematology pharmacist (BCOP),1 paediatric pharmacist, 3 nurses,1 technician and 1 investigator. Implantation of Standard UNE 179003 on Risk Management for Patient and ISO9001. 0.5 % errors and avoiding incidents. High average patient satisfaction(93%).

What next?

Allow direct patient interaction through a econsultation platform and twitter. A staff preceptorship and traceability system for the preparation and administration(barcode) implement.