Background In the outpatients and day unit department of our paediatric oncology primary treatment centre (PTC), patients receive medication dispensed through various workstreams: outpatient dispensary, clinical trials dispensary and inpatient dispensary. Without a dedicated member of staff to coordinate and provide specialist paediatric oncology medication counselling across all these workstreams, patient frustration, uncollected prescriptions, incorrect use of medication and increased wastage are difficult to prevent. By streamlining medicines related workflow and increasing pharmacy integration into the wider multidisciplinary team, pharmacy technicians in outpatient and day-case settings contribute to improvement in patient experience.¹

Method A maternity leave nursing post was converted to provide a full-time medicines management technician for an initial 12-month trial. A retrospective analysis was performed on data collected around the number of patients who received their medicines and specialist counselling from the new pharmacy technician, as well as the number and nature of clinical interventions made. Further data was collected on cost savings made through return of unused medication. Parents and patients were also asked to provide feedback.

Results Of the total 4,110 patient visits to the CYP unit requiring medication collection, 98.1% of patients received their medication and counselling from the pharmacy technician. Over the 12 months, 100% of the dispensing required for administration on the paediatric oncology day-case unit were dispensed in advance to eliminate delays on the day of treatment. A recorded £61,470 worth of medications that may likely have been inappropriately stored, discarded, or expired on the ward, were returned to pharmacy so they could be re-issued to other patients were considered savings. Of the 123 interventions made, 51% prevented patients leaving the hospital without medication, including critical SACT. Feedback from patients and their families has been positive, highlighting the time saved waiting for medicines, the technician’s professionalism, and knowledge.

Conclusion Implementing a medicines management technician into a paediatric oncology outpatient and day unit setting contributes to better patient experience and medicines safety. Many of the interventions made promote medicines optimisation and were not identified by other members of the multi-disciplinary team. Medicines knowledge and familiarity with pharmacy operational systems positions the medicines management technician optimally for this role, providing a relatable point of contact for patients and their families as well as more comprehensive medicines support.

An argument can be made that the funding for the role was offset by the cost savings made in the reduction of wastage despite the unavailability of a comparative valuation of medication returns prior to introducing the role. In conjunction with overwhelmingly positive feedback from patients and their families, the medicines management technician role for our PTC paediatric oncology outpatient and day unit has since been permanently funded.

Reference

1. Bergsbaken J, Roman D, Earl MA, McBride A, Olin JL, Peele A, Reichard JS. ASHP-HOPA guidelines on the roles and responsibilities of the pharmacy technician in ambulatory oncology pharmacy. American Journal of Health-System Pharmacy 2018;75:1304–1311.