Implementation of a pharmacy-managed program for the transition of chemotherapy to the outpatient setting

Ali McBride, Christopher J. Campen, James Camamo, Marie Maloney, Daniel Persky, Sandra E. Kurtin, Nikki L. Barket, Ravitharan Krishnadasan, Emad - Elquza, Faiz - Anwer, Kurt Weibel

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose. Implementation of a pharmacy-managed program for the transition of chemotherapy to the outpatient setting is described. Summary. The University of Arizona Cancer Center and Banner-University Medical Center Tucson are affiliated not-for-profit academic medical centers in Tucson, Arizona, whose facilities include a hospital and ambulatory care clinics that maintain 3 outpatient infusion centers. The cancer center pharmacy currently employs 25 pharmacists, with 4 clinical pharmacists serving both the inpatient and outpatient treatment sites. A multidisciplinary team of staff members was assembled to address the transition of chemotherapy from inpatient to outpatient that included physicians, ambulatory clinical oncology pharmacists, finance, social workers, pharmacy staff, nursing staff, and information technology. The program was initiated in May 2014, with a 2-year postimplementation evaluation of our transition of chemotherapy to the outpatient setting. Chemotherapy order sets were developed in our electronic medical record for transitioning rituximab to the outpatient setting for inpatient chemotherapy orders as well as transitioning leukemia, lymphoma, and solid tumor chemotherapy regimens to be administered in the outpatient setting. Eighteen rituximab-containing regimens and 14 chemotherapy protocols were switched to the outpatient setting, with numerous variants of these regimens also created for outpatient only administration. The realized savings for high-cost chemotherapy transitioned to the outpatient setting with rituximab and clofarabine was $1,902,890. Over 747 inpatient bed days were saved, with an approximated cost savings to the health system of $1,402,866, with a cumulative cost savings to our health system of $3,305,756. Conclusion. This model for transitioning chemotherapy from the hospital to the outpatient setting enhanced access to care, decreased bed utilization in the hospital, and improved clinical and financial metrics.

Original languageEnglish (US)
Pages (from-to)e246-e258
JournalAmerican Journal of Health-System Pharmacy
Volume75
Issue number9
DOIs
StatePublished - May 1 2018

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Outpatients
Drug Therapy
Cost Savings
Inpatients
Pharmacists
Neoplasms
Medical Oncology
Electronic Health Records
Nursing Staff
Health
Ambulatory Care
Lymphoma
Leukemia
Technology
Physicians

Keywords

  • Ambulatory chemotherapy administration
  • Clofarabine
  • EPOCH
  • ESHAP
  • HiDAC
  • Outpatient chemotherapy

ASJC Scopus subject areas

  • Pharmacology
  • Health Policy

Cite this

McBride, A., Campen, C. J., Camamo, J., Maloney, M., Persky, D., Kurtin, S. E., ... Weibel, K. (2018). Implementation of a pharmacy-managed program for the transition of chemotherapy to the outpatient setting. American Journal of Health-System Pharmacy, 75(9), e246-e258. https://doi.org/10.2146/ajhp170138

Implementation of a pharmacy-managed program for the transition of chemotherapy to the outpatient setting. / McBride, Ali; Campen, Christopher J.; Camamo, James; Maloney, Marie; Persky, Daniel; Kurtin, Sandra E.; Barket, Nikki L.; Krishnadasan, Ravitharan; Elquza, Emad -; Anwer, Faiz -; Weibel, Kurt.

In: American Journal of Health-System Pharmacy, Vol. 75, No. 9, 01.05.2018, p. e246-e258.

Research output: Contribution to journalArticle

McBride, Ali ; Campen, Christopher J. ; Camamo, James ; Maloney, Marie ; Persky, Daniel ; Kurtin, Sandra E. ; Barket, Nikki L. ; Krishnadasan, Ravitharan ; Elquza, Emad - ; Anwer, Faiz - ; Weibel, Kurt. / Implementation of a pharmacy-managed program for the transition of chemotherapy to the outpatient setting. In: American Journal of Health-System Pharmacy. 2018 ; Vol. 75, No. 9. pp. e246-e258.
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