Pharmacist Interventions On Outpatient Leukemia Patients Improve Safety

Background: Transitions between inpatient and outpatient settings, which occur frequently with leukemia patients, (pts) are critical junctures at which patient care can become fractured, particularly with respect to medication reconciliation. Attention to adverse drug events, drug interactions, and dose adjustments for organ function can also minimize medical errors and improve patient care, particularly with chemotherapy regimens, antimicrobial agents, and anticoagulation. We evaluated the prevalence of medication discrepancies and the impact of a dedicated oncology pharmacist in an outpatient leukemia clinic on medication interventions. Methods: All pts discharged from the inpatient leukemia service were seen by an oncology-trained pharmacist within 5 business days of discharge as part of routine transitions of care follow up. The pharmacist provided medication …