Clinical pharmacy services in a pediatric hematology/oncology clinic: A description and assessment
Bibliographic record
Abstract
Abstract Objectives: To characterize the drug-related needs of ambulatory HO patients identified by a pharmacist; describe the role of the pharmacist in a pediatric hematology/oncology (HO) clinic; assess the impact of clinical pharmacy services in a pediatric HO clinic on patient care; and make recommendations for the future provision of clinical pharmacy services to patients attending the HO clinic. Design: Prospective descriptive study over 12 weeks. Setting: Hematology/oncology clinic in a 411 bed tertiary/quarternary, university-affiliated pediatric hospital. Patients: Thirty-one children who attended a clinic post-bone marrow transplant (BMT) and 27 children who attended an oncology clinic. Methods: Actual or potential drug-related problems (DRPs) were identified or verified by patient/parent dialogue and interventions were made by the pharmacist in consultation with the responsible physician and/or patient/parent. The impact of a subset of these interventions was assessed by two physicians and two pharmacists. Results: 165 DRPs were identified in 31 BMT and 27 ONC patients. The mean number of DRPs identified per patient was 4.8 in BMT patients and 0.6 in ONC patients. The most frequently identified DRP was too high a (35%) in BMT patients and ''inappropriate medication administration (35%) in ONC patients. 177 interventions were made by the pharmacist; 81 % were accepted by the physician and/or patient/parent. The review panel deemed 83.5% of the subset of interventions to have had a positive impact. Conclusions: Children attending the HO clinic have drug-related needs. BMT patients would benefit from dialogue with a pharmacist for assessment, prevention, and resolution of their DRPs while the primary need for newly diagnosed ONC patients is education regarding antineoplastic and supportive therapy. RESUME Objectifs : Determiner les besoins pharmacotherapeutiques des patients ambulatoires en HO (hematologie/oncologie) qu'a identifies le pharmacien; decrier le role du pharmacien au sein d'une clinique d'hematologie/oncologie pour enfants; evaluer l'impact des services de pharmacie clinique dans une clinique d'HO pour enfants sur les soins apportes aux patients; et formuler des recommandations pour la planification de la fourniture des services de pharmacie clinique aux patients qui frequent une clinique d'HO. Plan : etude prospective de prevalence d'une duree de 12 semaines. Milieu : clinique d'hematologie/oncologie dans un hopital pour enfants affilie a une universite, de 411 lits de soins tertiaires/quaternaires. Patients : Trente et un enfants qui ont frequente une clinique apres une greffe de moelle osseuse (GMO) et 27 autres enfants qui ont frequente une clinique d'oncologie (CO). Methodes : Les problemes pharmacotherapeutiques (PP) reels ou potentiels ont ete identifies ou verifies au moyen d'une discussion avec le patient/parent et des interventions ont ete portees par le pharmacien apres consultation avec le medecin traitant et/ou le patient/parent. L’impact d'un sous-groupe de ces interventions a ete evalue par deux medecins et deux pharmaciens. Resultats : 165 PP ont ete identifies chez 31 patients GMO et 27 patients CO. Le nombre moyen de PP identifies par patient etait de 4,8 chez les patients GMO et de 0,6 chez les patients CO. Le PP qui a ete le plus souvent identifie etait «une dose trop elevee» (35 %) chez les patients GMO et «l'administration d'un medicament inadequat» (35 %) chez les patients CO. Un total de 177 interventions ont ete realisees par le pharmacien et 81 % de ces dernieres ont ete acceptees par le medecin et/ou le patient/parent. Le comite de revision a juge que 83,5 % du sous-groupe d'interventions avait eu un impact positif. Conclusions : Les enfants qui frequentent une clinique d'HO ont des besoins pharmacotherapeutiques. Les patients GMO tireraient profit d'une discussion avec le pharmacien pour evaluer, prevenir et resoudre leurs PP, alors que les patients CO qui viennent d'etre diagnostiques ont d'abord un besoin d'education en ce qui a trait aux traitements antineoplasiques et de soutien.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".