Implementation of a student pharmacist–led medication review program prior to metaiodobenzylguanidine (MIBG) imaging in pediatric oncology patients

IntroductionMetaiodobenzylguanidine (MIBG) imaging is a diagnostic and staging modality for patients with neuroblastoma and other neuroendocrine tumors. Commonly prescribed medications can interfere with MIBG uptake, resulting in nondiagnostic scans and treatment delays. Ensuring timely identification and discontinuation of interfering medications is essential, but it can be challenging within existing clinical pharmacy workloads. To reduce preventable scan delays and cancellations, a student pharmacist-led outreach process was developed. Student pharmacists have demonstrated value in medication reconciliation and patient outreach activities; however, their role in supporting MIBG imaging workflows has not been well described.MethodsThe primary objective was to determine the percentage of patients successfully contacted within three weeks of a scheduled MIBG scan. Secondary objectives included identifying interfering medications before imaging, characterizing outreach methods, contact attempts, and medication-related interventions. This retrospective observational study was implemented at St Jude Children's Research Hospital between October 1, 2024, and July 31, 2025, and subsequently evaluated retrospectively. Student pharmacists reviewed medication lists for patients scheduled for MIBG imaging, identified potential medication interactions, and conducted outreach using electronic health record (EHR)-integrated patient portal messaging and telephone communication.ResultsOf 139 patient appointments meeting inclusion criteria, 23 were initially identified as having interfering medications and were forwarded directly to providers without patient contact. Among 116 appointments eligible for outreach, 76 patients (65.5%) were successfully contacted within three weeks of the scheduled scan. Successful contacts occurred on the first (26.7%), second (24.4%), and third (64.6%) outreach attempts. The average number of contact attempts per patient was 2.1. Patient portal messaging accounted for most outreach attempts. Four additional interfering medications were identified through patient outreach, resulting in a total of 27 medication-related interventions.ConclusionsA student pharmacist-led MIBG medication review and outreach program, supported by EHR-based tools, successfully identified clinically significant medication interactions prior to scheduled imaging. This real-world experience expands the current literature by demonstrating the feasibility of integrating student pharmacists into specialized oncology workflows. This process helped to optimize imaging readiness, reduce the risk of costly scan delays or cancellations, and extend the reach of oncology pharmacy services. These findings support the use of student pharmacists as valuable clinical extenders within oncology practice models.