TOP PROJECT WINNER: INTERPROFESSIONAL PROGRAMS

Mary Yousef, Tiffany Marr, Anjana Sengar, Allan Mills, Katherine Enright, and Mala Bahl
Trillium Health Partners

Implementation and Evaluation of a Pharmacist-led clinic for CDK4/6 Inhibitors Oral Anticancer Agents: A Shared Model of Care to Support Breast Cancer Patients

Cyclin-dependent Kinase (CDK) 4/6 inhibitors is a class of oral anticancer medications used in treatment of breast cancer patients. Despite their clinical success, these agents have also created several challenges due to their side effect profile and the additional patient monitoring required. With an expected expanded indication of CDK4/6 inhibitors in the adjuvant breast patient population, an increased demand on the oncologists would result in safety and accessibility concerns. In order to address these challenges, a pharmacist-led CDK 4/6 inhibitors clinic was established at Trillium Health Partners as a shared care model with oncologists to support patients undergoing treatment with these agents.

We utilized the Practical Robust Implementation and Sustainability Model (PRISM) domains to frame the overall project and guide the implementation of the clinic. A number of quantitative and qualitative outcomes were collected to measure the performance and sustainability of the clinic.

In the first six months of the clinic implementation, the clinic received total of 40 referrals, with 33 patients attending the clinic. A total of 388 pharmacist interventions were documented, with a focus on adverse effects, care coordination, and therapy monitoring. The initiative saved approximately 90 hours of primary care team time, and both provider and patient satisfaction surveys indicated improvements in provider workload, patient outcomes, adherence, and toxicity management.

This model for implementation demonstrates the value of utilizing the clinical knowledge and expertise of oncology pharmacists to alleviate the current pressures in the oncology clinics especially as it relates to oral anticancer monitoring. This initiative also aligns with Ontario Health Cancer Care Ontario’s recommendation to develop novel models of systemic treatment for cancer patients through enabling multi-disciplinary team members to collaborate effectively and work to their optimal scope of practice.