Benefits of a Pharmacist Led Oral Chemotherapy Monitoring Program for Patients with Chronic Myeloid Malignancies: A Patient Reported Outcome (PRO) Study

BACKGROUND: Patient reported outcomes (PROs) are increasingly being used as key outcome measures in management of patients with chronic hematologic malignancies. Use of PROs in routine clinical care in hematology has been associated with improved patient-physician communication, enhanced shared decision making, better symptom management, and greater satisfaction with care as well as improved quality of life (QoL) (Breccia M, et al. 2015; Hirji I, et al. 2013). With a therapeutic landscape shifting towards long-term use of oral therapies in chronic myeloid malignancies (myelofibrosis (MF) and chronic myeloid leukemia (CML)), the potential for serious medication adverse events rises. Due to these concerns, pharmacists are increasingly functioning, as integral members of the healthcare team, responsible for the management of oral anticancer agents. The effectiveness and value of pharmacists in the management of oral medications for hematologic malignancies from a patient perspective is limited. Here we designed a prospective patient survey study to assess PROs of a pharmacist-led medication therapy management (MTM) program to monitor adverse events and improve adherence in adults with hematologic malignancies. METHODS: Adult patients (pts) (≥ 18 years old) prescribed an oral targeted therapy for a hematologic malignancy and who were seen by a clinical pharmacist for a MTM session were eligible. A modified validated questionnaire consisting of 22 multiple choice questions and 3 comment questions and incorporating both CTSQ & FACT-Leu (Abetz L, et al. 2005; Cella D, et al. 2012) was completed by each participant. Individual questions and responses were pooled into the following categories: education, monitoring and support. Demographics, disease-specific variables and questionnaire responses were also collected. RESULTS: 66 pts seen in the adult leukemia clinic at Roswell Park Comprehensive Cancer Center in 2019 participated in the study. Baseline characteristics for this cohort are outlined in Table 1. Median age of the cohort was 64 years old (range 31-89 yrs) and 52% were male. Hematologic malignancies included CML (64%), MF (11%), acute myeloid leukemia (AML) (8%), Ph+ acute lymphoblastic leukemia (Ph+ALL) (6%), myeloproliferative neoplasm (MPN) (6%), polycythemia vera (PV) (3%), mastocytosis (1%) and hypereosiniophilic syndrome (1%). The most common oral agents were imatinib (21%), ruxolitinib (18%), and dasatinib (17%). This cohort also included patients