Outcomes of pharmacist-led oral anticancer agent management among community oncology practices.

293 Background: There is a need to optimize the education and follow-up of patients receiving oral anticancer agents (OAAs) due to toxicities and to support medication adherence. The purpose of this study was to compare patient outcomes before and after the integration of clinical pharmacists within community oncology practices across Michigan, via Pharmacists Optimizing Oncology Care Excellence in Michigan (POEM) program. Before POEM, patients receiving OAAs were educated and received symptom monitoring by nurses, physician assistants, and/or nurse practitioners. Methods: This multi-center, retrospective analysis was conducted January 2019 – January 2024 and is a before-after comparison across 3 practice sites. Chart abstraction for 423 patients before the pharmacists joined the practices (control group) were compared to 463 patients after pharmacists joined (pharmacist care group). Charts were eligible for abstraction if patients were newly prescribed an OAA during the observation period. Data collected from medical records included: demographics, OAA medication, prescribed date, start date, line of therapy, intent of treatment, cancer diagnosis, education date, follow-up visits, 6-month emergency department (ED) and hospitalizations incidence and reasons, 6-month OAA discontinuations and reasons. Categorial variables were summarized with counts and percentages, and numeric variables were analyzed with means and standard deviations. Bivariate comparisons were made with Fisher’s exact test and two independent samples t-tests. Results: Demographics were similar between pharmacist care and control groups (Table 1). More patients in the pharmacist versus control group received education prior to OAA start (77% vs 36%, p < 0.001) and had medication adherence assessed (72% vs 23%, p < 0.001). Reasons for OAA discontinuation were similar between groups with hospice/death, progression or toxicity accounting for 30% in pharmacist group and 31% in control group (p = 0.322). There were no differences in all-cause hospitalizations and ED visits at 6 months. There was a decrease in cancer and treatment-related ED visits at 6 months in the pharmacist care compared to control group (9.5% vs 13.7%, p = 0.006). There was no difference in cancer and treatment-related hospitalizations between groups (8.2% vs 8%, p = 0.54). Conclusions: The incorporation of clinical pharmacists within community oncology practices, led to increased education and adherence assessment as well as a decrease in cancer and treatment related ED visits. All (n=886) Pharmacist (n=463) Control (n=423) p-value Age (yr) 68.26 (sd=12.26) 68.13 (sd=12.88) 68.41 (sd=11.56) 0.74 Gender (Male) 465 (52.5%) 264 (57%) 201 (47.5%) 0.005* Race (White) 817 (92.2%) 431 (93.1%) 386 (91.3%) 0.318 Ethnicity (non-Hispanic) 832 (93.9%) 437 (94.4%) 395 (93.4%) 0.747 Intent of Treatment (Palliative) 737 (83.2%) 383 (82.7%) 354 (83.7%) 0.101