[Implementation of initial pharmaceutical consultations and follow-up in onco-hematology: Two years review and outlooks].

Objectives: In recent years, the development of oral anticancer drugs has led to an increase in outpatient care for patients with cancer. This strategy brings many advantages but also entails major risks in securing the care pathway for patients undergoing oral chemotherapy in order to secure medication car, the pharmaceutical team, in collaboration with the medical team, has set up pharmaceutical consultations in the healthcare service. This work presents the process of setting up these consultations and produces a two years review.

Methods: The first step is the selection of the patient eligible for the pharmaceutical consultation. The pharmaceutical team has developed supports to harmonize practices, drawing in particular on the recommendations for good clinical practices from the Société française de pharmacie clinique (SFPC) and the implementation of pharmaceutical consultations from "la Société française de pharmacie oncologique (SFPO)". Initiation and follow-up pharmaceutical consultations could be carried out in person but also remotely (telephone and telepharmacy care), with an assessment of knowledge (rating grid out of 18) of compliance (according to the Girerd scale and feelings, associated with satisfaction questionnaire. The resources allocated for the activity were as follows: a pharmacist seconded to the care unit 0,8 full-time equivalent (FTE), a pharmacist 0,1 FTE, an intern in the care unit.

Results: Over two years (from 02/12/12021 to 02/12/2023), 271 consultations (203 initiations consultations and 68 follow-up consultations) were carried out, with 203 patients. One hundred and eighty-four patients benefited from knowledge assessment at initiation, 59,8% (n=110) had a score equal to 18/18 and 40,2% (n=74) a score lower than 18. Among the 74 patients who had a score below 18, 54% (n=40) had a follow-up consultation. From a statistical point of view, a significant improvement in knowledge was noted in these 40 patients (mean: 14 vs. 15.8; P<0.001). The average duration of consultations was 30minutes. Pharmaceutical interventions were carried out for 23% of patients. The latter were overall very satisfied with the consultations with the majority (61.3%) wishing to benefit from another consultation subsequently.

Conclusions: The implementation of initiation and follow-up pharmaceutical consultations within the healthcare service has made it possible to improve patient care. These consultations make it possible, on the one hand, to improve patients' knowledge of the oral anticancer drugs initiated, and on the other hand, to carry out a pharmaceutical analysis of the usual treatment with the new oral chemotherapy and possible associated treatments, while strengthening the link hospital city. One of the next objectives will be to monitor the evolution of compliance as follow-up consultations take place.