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4CPS-208 Analysis of the implementation of a multidisciplinary pharmaceutical care project for geriatric haemato-oncology patients
  1. C Alarcon-Payer1,
  2. MDM Sánchez Suárez1,
  3. A Martín Roldán1,
  4. JM Puerta Puerta2,
  5. A Jiménez Morales1
  1. 1Hospital Universitario Virgen De Las Nieves, Pharmacy Service, Granada, Spain
  2. 2Hospital Universitario Virgen De Las Nieves, Hematology Service, Granada, Spain


Background and Importance The elderly constitute a large percentage of patients with haematologic malignancies. It is estimated that this percentage will grow due to the ageing of the population and the new therapeutic targets that manage to control and chronify the disease. They present cognitive impairment, malnutrition, physical dependence and polymedication, requiring a comprehensive and multidisciplinary approach.

Aim and Objectives To design a pharmaceutical care protocol for geriatric haemato-oncology patients and to evaluate the results.

Material and Methods Prospective observational study conducted from January 2022 to September 2023 in the Pharmaceutical Care Consultation for oncohaematologic patients of a tertiary hospital. The haematologist selected the most fragile patients with the G8 scale and with the highest number of comorbidities evaluated with the CIRS-G scale and sent them to the Pharmacy consultation, where the pharmacist in charge made a previous evaluation of home medication, self-medication, alternative medicine with the aim of detecting drug interactions, therapeutic duplications, inappropriately prescribed drugs using the START-STOPP criteria, assessing the possible deprescription of polymedication, and lack of adherence using the Morisky-Green test. In the event of detecting any errors in medication intake, interactions of interest. or adverse reactions, pharmaceutical interventions were made in the patient‘s clinical history for consultation by any health professional.

Results With this new protocol, 40 patients were attended, with a median age of 80 years, 68% men and 32% women. Adherence to haemato-oncologic treatment was improved by 90%. Thirty-five pharmaceutical interventions were carried out: 3 related to the dosage and way of taking the treatment, 10 with pharmacological interactions in which it was necessary to substitute a drug in the treatment, five therapeutic duplications, eight with the use of herbal products and multivitamin complexes that interacted with their treatment, four for not attending their medical check-up in 2 years and five had prescribed medication of little therapeutic value and with a high anticholinergic load that was suspended from the treatment.

Conclusion and Relevance The hospital pharmacist has an important role in the pharmaceutical care of geriatric haemato-oncology patients by creating multidisciplinary work protocols offering personalised treatment.

References and/or Acknowledgements 1. Practical assessment and management of vulnerabilities in older patients receiving chemotherapy: ASCO guideline for geriatric oncology. JCO. 2018.

Conflict of Interest No conflict of interest.

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