Pharmacist-led interventions in hematological malignancies: a systematic review of clinical, process and economic outcomes

Background: Pharmacist-led interventions are increasingly integrated into hematology-oncology care to address complex pharmacotherapy and medication safety challenges. However, their impact within hematological malignancies has not been comprehensively synthesized across clinical, process-related, and economic domains. Methods: A systematic review was conducted to evaluate pharmacist-led interventions in patients with hematological malignancies across inpatient and outpatient settings. Thirty-three studies were included. Owing to substantial heterogeneity in study design, interventions, and outcome definitions, a structured qualitative synthesis was performed, with findings grouped by clinical, process-related, and economic outcomes. Results: = 8). Pharmacist-led interventions most consistently improved medication management processes, including identification and resolution of drug-related problems, drug interaction management, and care coordination, with high acceptance rates of pharmacist recommendations. Several studies also reported improvements in medication adherence, toxicity management, and selected patient-reported outcomes; however, findings for disease response, survival, and hospitalization were heterogeneous and not consistently statistically significant. Economic evaluations were limited but suggested potential cost savings and favorable returns on investment associated with pharmacist involvement. Conclusion: Pharmacist-led interventions in hematology-oncology care improve medication management processes and may contribute to better adherence and medication safety. However, evidence for effects on clinical and economic outcomes remains limited and heterogeneous, highlighting the need for well-designed prospective studies using standardized outcome measures. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251147239, identifier CRD420251147239.