"IT'S KIND OF FUN TO DO THE IMPOSSIBLE."
A Novel Approach to a Common Problem:
After Hours Care of Cancer Patients with VTE
I was very fortunate to travel to Italy in April 2016 as one of the co-authors of a poster presentation at the International Conference on Thrombosis and Hemostasis in Cancer (ICTHIC).
We shared preliminary results of an exciting pilot program I have been working on with the Tom Baker Cancer Centre. Pictured here is Dr. Jay Easaw, the lead author, and Susan McCall, another co-author our study.
Cancer patients sometimes have blood clots (venothromboembolism, or VTE) that are asymptomatic and diagnosed after the patient has left the cancer clinic. They require treatment with low weight molecular heparin, which they will have to inject daily for 6 months or longer. If they are unable to return to cancer clinic during business hours, they would have to go to Emergency to receive the first dose and be trained on how to administer it to themselves.
Our pilot program consists of the patient coming to our pharmacy instead of emergency which saves the patient many hours of waiting. Specifically, a requisition is faxed to the pharmacy, and the pharmacist:
reviews labwork and conducts medication reconciliation
weighs the patient when they arrive
prescribes the low weight molecular heparin
administers the first dose and trains the patient on on self administration using a bruiseless subcutaneous injection technique
follows up by phone the next day
orders a lab requisition to monitor platelets for heparin-induced thrombocytopenia
The preliminary data have been overwhelmingly positive and it is I believe an innovative application of the abilities pharmacists have in Alberta to prescribe, inject, review lab values, and order labwork. No other jurisdiction in Canada has granted pharmacists these abilities to date.