A Retrospective Analysis of Pharmaceutical Interventions in Outpatient Cancer Chemotherapy: Survey of Post-Consultation Pharmacist Interventions

Abstract

In the 2024 revision of the medical reimbursement system in Japan, the enhancement fee for cancer pharmacotherapy framework included requiring pharmacist consultations before physician examinations. At Kyoto Katsura Hospital, pharmacists are stationed in the outpatient chemotherapy center and conduct post-examination consultations with all patients to provide pharmaceutical care. This study retrospectively analyzed the interventions of pharmacists over the past 10 years using daily work records to evaluate the impact of post-examination consultations. A total of 13,534 pharmaceutical care cases were recorded, with a physician acceptance rate of 97.3％. Among the interventions conducted during post-consultation interviews, those related to immune checkpoint inhibitor safety management have increased over the years. The involvement of pharmacists in immune-related adverse event management is crucial. Establishing a structured workflow for pre-examination consultations and incorporating laboratory results may help reduce the workload of physicians and improve patient outcomes. Post-examination consultations allow pharmacists to confirm prescription accuracy and address adverse effects based on real-time clinical data. This study indicates that optimizing pre- and post-examination consultations enhances the effectiveness of pharmacist interventions in outpatient cancer chemotherapy. A complementary approach could improve safety, streamline the workload of physicians, and improve patient care. Further studies are required to refine workflow protocols and assess the long-term benefits of pharmacist interventions in cancer treatment settings.