4CPS-237 Special pharmaceutical care and teleconsultation for the geriatric oncohaematological patient

<h3>Background and Importance</h3> The need has been detected to carry out a comprehensive geriatric evaluation of older adult patients with oncohaematological neoplastic pathologies, in order to make decisions related to their complete therapeutic regimen, avoiding any medication-related harm to the patient. <h3>Aim and Objectives</h3> Implementation of a specialised pharmaceutical consultation where a global evaluation of the pharmacotherapy of older adult patients with oncohaematological neoplastic pathologies is carried out. <h3>Material and Methods</h3> Prospective observational study conducted from December 2023 to September 2024 in a specialised Pharmaceutical Consultation in the geriatric oncohaematologic patient. The haematologist and oncologist selected the most fragile patients using the G8 scale and sent them to the Pharmacy office, where the pharmacist carried out a previous evaluation of home medication, self-medication and alternative medicine with the aim of detecting drug-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. With all these data, the best possible pharmacotherapeutic history will be obtained and pharmaceutical interventions were also made in the patient‘s medical records so that they could be consulted by any health professional and teleconsultations for those patients who were most unable to travel to the pharmacy office. <h3>Results</h3> With the implementation of this new consultation 350 patients were attended, median age 82 years, 65% men and 35% women. Fifty pharmaceutical teleconsultations were carried out in patients with bed-chair life. Adherence to oncohaematologic treatment was improved by 90%. A total of 90 pharmaceutical interventions were carried out: 30 related to the dosage and way of taking the treatment, 20 with pharmacological interactions, 14 therapeutic duplications, 10 with the use of herbal products and multivitamin complexes, six for not attending their medical check-up in 2 years and 10 had been prescribed medication of little therapeutic value and with a high anticholinergic load that had to be suspended from the treatment. <h3>Conclusion and Relevance</h3> The hospital pharmacist has a key role in the pharmaceutical care of geriatric oncohaematologic patients through the implementation of specialised consultations where a complete evaluation of the treatment of these patients is carried out. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest