Pharmaceutical audit: first-time treatment validation's impact on oncological patient journey's safety in a private clinic

Keywords

pharmaceutical's audit - oncological treatment - patient safety - pharmaceutical intervention

Background: Antineoplastic treatments are highly complex procedures (HCP) that may be linked to drug-related problems (DRP). Safety during oncological patient's journey depends on the correct recording of specific documentation being evaluated: antineoplastic protocol (drug, dose, interval), high-alert drugs and treatment indication. This study describes internal pharmaceutical audit as a service routine in a private clinic.

Methodology: First-time's treatment or change requests for oral and intravenous oncological treatment were included and subsequently sent to health insurance companies. Data was collected during an internal pharmaceutical audit between December 2023 and June 2024. Medical reports, prescriptions, histopathological, molecular and laboratory tests were evaluated and compared with American Society of Clinical Oncology and European Society for Medical Oncology guidelines. All pharmaceutical interventions were recorded on an Incident Reporting platform and evaluated by the patient safety center (PSC).

Results: A total of 1,738 (100%) treatment requests were included. Among 206 (11.8%) inconsistencies has been founded, 124 (7.13%) were identified as dose discrepancies, 22 (1.3%) antineoplastic protocol's discrepancies (according to histopathological report), 25 (1.4%) discrepancies between report and requested protocol, and 35 (2%) antineoplastic protocol's registration inconsistencies. Interventions scored were accepted by clinical staff, adjusted and evaluated as near miss by PSC.

Conclusion: All action plans defined by PSC are implemented to adjust and improve safety in patient's treatment journey. An effective pharmaceutical audit needs to assess medical progress; medical report with clinical's condition, previous treatment and protocol's data; histopathology and laboratory results. Pharmaceutical audit is recommended as a process to increase patient's journey safety, mitigating inconsistencies and avoiding postpone patient's treatment. Internal pharmaceutical audit process is the first gate to prevent early DRPs without treatment's impact, increases pharmacist's bond with clinical staff and optimizes authorization process by health insurance companies.

Corresponding author: Gisele Fraga Moreira (e-mail: [e-mail]).