Pharmaceutical care in an inpatient pediatric hematopoietic stem cell transplant service.

Introduction. Hematopoietic stem cell transplant patients represent a population at high risk for drugrelated problems. Our objective is to describe pharmacist interventions in a hematopoietic stem cell transplant pediatric unit. Methods and Patients. The Hematopoietic Stem Cell Transplant Unit of the Centre Hospitalier Universitaire Sainte-Justine performs around 50 hematopoietic stem cell transplants per year. During a pharmaceutical care specialized residency program, a French pharmacist participated in certain clinical activities. Drug-related problems and clinical interventions were compiled over 31 nonconsecutive days using a tool developed by the Société Française de Pharmacie Clinique. Data concerning patients, drugs, intervention, documentation, approval (if needed), and estimated impact were compiled. Results. During the 31-day period, 525 interventions were collected (16.9±3.7 per day), targeting 29 patients. The main drug-related problems were adverse drug reactions (N=125, 23.8%), untreated indication (N=92, 17.5%) and failure to receive drug (N=89, 17.0%). The pharmacist's interventions concerned mainly dose adjustment (N=174, 33.1%) and drug monitoring (N=132, 25.1%). Among the 324 (61.7%) interventions requiring a physician's approval, 302 (93.2%) were accepted without any change. Conclusion. A pharmacist is able to perform clinically relevant interventions in a hematopoietic stem cell transplant unit, given the complexity of the pharmacotherapy. Our description of drugrelated problems and interventions may help other pharmacists already working or developing pharmaceutical care in a hematopoietic stem cell transplant unit to compare their practice and it is one of the few reported in the literature. [ABSTRACT FROM AUTHOR]