Pharmaceutical care in an inpatient pediatric hematopoietic stem cell transplant service.
BACKGROUND
Hematopoietic stem cell transplant patients represent a population at high risk for drug-related problems. Our objective is to describe pharmacist interventions in a hematopoietic stem cell transplant pediatric unit. METHODS AND PATIENTS. The Hematopoietic Stem Cell Transplant Unit of the Centre Hospitalier Universitaire Sainte-Justine performs around 50 hematopoietic stem cell transplants per year. During a pharmaceutical care specialized residency program, a French pharmacist participated in certain clinical activities. Drug-related problems and clinical interventions were compiled over 31 nonconsecutive days using a tool developed by the Société Française de Pharmacie Clinique. Data concerning patients, drugs, intervention, documentation, approval (if needed), and estimated impact were compiled.


RESULTS
During the 31-day period, 525 interventions were collected (16.9 +/- 3.7 per day), targeting 29 patients. The main drug-related problems were adverse drug reactions (N = 125, 23.8%), untreated indication (N = 92, 17.5%) and failure to receive drug (N = 89, 17.0%). The pharmacist's interventions concerned mainly dose adjustment (N = 174, 33.1%) and drug monitoring (N = 132, 25.1%). Among the 324 (61.7%) interventions requiring a physician's approval, 302 (93.2%) were accepted without any change.


CONCLUSIONS
A pharmacist is able to perform clinically relevant interventions in a hematopoietic stem cell transplant unit, given the complexity of the pharmacotherapy. Our description of drug-related problems and interventions may help other pharmacists already working or developing pharmaceutical care in a hematopoietic stem cell transplant unit to compare their practice and it is one of the few reported in the literature.
Prot-Labarthe
Sonia
S
Unité de Recherche en Pratique Pharmaceutique, Pharmacy Department, Centre Hospitalier Universitaire (CHU) Sainte Justine, Montréal, Québec, Canada.
Therrien
Roxane
R
Demanche
Colette
C
Larocque
Diane
D
Bussières
Jean-François
JF
D000293:Adolescent; D002648:Child; D004358:Drug Therapy; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007297:Inpatients; D008297:Male; D010347:Patient Care Planning; D010593:Pharmaceutical Services; D010595:Pharmacists; D010607:Pharmacy Service, Hospital