IMPACT OF PHARMACIST LED INTERVENTION ON THE RISK OF BLEEDING AND VTE RECURRENCE AMONG CANCER PATIENTS; A SINGLE CENTRE STUDY
Author(s)
Sajjad Ullah, Mphil.
Student, Abdul Wali Khan University Mardan, Peshawar, Pakistan.
Student, Abdul Wali Khan University Mardan, Peshawar, Pakistan.
OBJECTIVES: Venous thromboembolism (VTE) is a major complication in cancer patients, resulting in heightened mortality and morbidity. Managing recurrence of VTE or risk of bleeding is a major challenge among cancer patients receiving anticoagulants. Therefore, this study assesses the effects of pharmacist-led interventions on risk of bleeding or VTE recurrence among cancer patients
METHODS: This retrospective cross-sectional study analyzed data from a tertiary care cancer hospital in Pakistan, collected from 2019 to 2023. The study included cancer patients aged ≥18 years diagnosed with VTE. The primary exposure variable was pharmacist-led interventions, and the outcomes of interest were bleeding episodes or VTE recurrence. Patient’s demographics, cancer type, comorbidities, and type of anticoagulants were controlled as covariates. The chi-square test and t-test were used in bivariate analyses, at a significance level of p<0.05. A multivariate logistic regression model was used to determine the association between pharmacist-led interventions and the risk of bleeding or VTE recurrence.
RESULTS: Of the 210 individuals, 34.3% (n=72) reported either bleeding or recurrence of VTE. Patients on subcutaneous anticoagulants had a markedly greater incidence of events in contrast to those on oral anticoagulants (77.8% vs. 22.2% respectively, p=0.017). Metastatic cancer (80.6% vs. 52.1%, p=0.0001) and surgical procedures (70.8% vs.47.2%, p=0.0014) were significant predictors of bleeding risk or VTE recurrence. Interventions guided by pharmacists markedly decreased the likelihood of bleeding or VTE recurrence (aOR:0.417, 95% CI: 0.191-0.911, p=0.028) by the optimization of dose, monitoring, and patient education.
CONCLUSIONS: Pharmacist-led interventions markedly enhance outcomes in cancer patients on anticoagulant treatment by decreasing the risk of bleeding or VTE recurrence. The results highlight the necessity of including pharmacists into multidisciplinary cancer care teams. Subsequent research should investigate these therapies in more diverse groups to enhance the validation of their effects.
METHODS: This retrospective cross-sectional study analyzed data from a tertiary care cancer hospital in Pakistan, collected from 2019 to 2023. The study included cancer patients aged ≥18 years diagnosed with VTE. The primary exposure variable was pharmacist-led interventions, and the outcomes of interest were bleeding episodes or VTE recurrence. Patient’s demographics, cancer type, comorbidities, and type of anticoagulants were controlled as covariates. The chi-square test and t-test were used in bivariate analyses, at a significance level of p<0.05. A multivariate logistic regression model was used to determine the association between pharmacist-led interventions and the risk of bleeding or VTE recurrence.
RESULTS: Of the 210 individuals, 34.3% (n=72) reported either bleeding or recurrence of VTE. Patients on subcutaneous anticoagulants had a markedly greater incidence of events in contrast to those on oral anticoagulants (77.8% vs. 22.2% respectively, p=0.017). Metastatic cancer (80.6% vs. 52.1%, p=0.0001) and surgical procedures (70.8% vs.47.2%, p=0.0014) were significant predictors of bleeding risk or VTE recurrence. Interventions guided by pharmacists markedly decreased the likelihood of bleeding or VTE recurrence (aOR:0.417, 95% CI: 0.191-0.911, p=0.028) by the optimization of dose, monitoring, and patient education.
CONCLUSIONS: Pharmacist-led interventions markedly enhance outcomes in cancer patients on anticoagulant treatment by decreasing the risk of bleeding or VTE recurrence. The results highlight the necessity of including pharmacists into multidisciplinary cancer care teams. Subsequent research should investigate these therapies in more diverse groups to enhance the validation of their effects.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
CO91
Topic
Clinical Outcomes
Topic Subcategory
Clinical Outcomes Assessment, Comparative Effectiveness or Efficacy
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)