Background To our knowledge, there is no pharmacy stratification model for patients in the oncology ambulatory setting.
Purpose To develop a tool to stratify oncology patients that helps us to implement ambulatory clinical pharmacy services.
Material and methods Phase I: a literature review was performed to identify risk factors for hospital admissions or emergency department (ED) visits in oncology patients and patients with care coordination requirements. Phase II: a panel of experts selected the variables of the model based on their impact on clinical pharmacy services and the feasibility of obtaining the data. Relative weight of each of the variables was assigned. Phase III: the stratification model was retrospectively tested on the population of patients that received care in the unit on a random day (13 June 2018). Three cut-offs were established to provide different levels of patient needs.
Results The variables were categorised under four domains (table 1).
The model was tested on a population of 43 patients (48.8% were male; median of age: 64 (IQR:52–73) years; median of ECOG=1 (IQR:0–1)). Patients were on six (IQR: 3.5–10) drugs, and 20 (45.5%) patients took one or more high-risk ambulatory medications. Eleven (25.6%) patients had one or more chronic diseases. Only one patient was identified as PCC/NIA. Three patients were treated with oral antineoplastic agents. Five (11.6%) patients visited the ED or were admitted to hospital in the past 30 days, while 12 (27.9%) were in the following 30 days. The distribution by categories was as follows: high priority (12–8 points; four patients), medium priority (7–5 points; 12 patients) and low priority (4–0 points; 27 patients).
Conclusion The model can be a useful tool for detecting patients that could benefit from clinical pharmacy services, although it needs further validation.
References and/or acknowledgements No conflict of interest.