Development and Validation of Protocol-Based Pharmacotherapy Pharmacist Outpatient Clinic for Patients Receiving Oral Anticancer Monotherapy

At Ogaki Municipal Hospital, pharmacists conduct preconsultation interviews to assess medication adherence and adverse events and to provide prescription recommendations to physicians. However, operational challenges, including overlooked or insufficiently addressed recommendations, the occurrence of prescription inquiries, and delays in prescription modifications, have been identified. Protocol-based pharmacotherapy management (PBPM) was introduced in October 2023 to address these issues. PBPM consists of six predefined protocols, including leftover medication adjustment, represcription, modification of supportive care medications, and the addition of essential laboratory tests, allowing pharmacists to correct prescription deficiencies within a physician-approved scope. A retrospective evaluation was conducted of 415 patients (3,390 prescriptions) treated between October 2023 and March 2025. The prescription recommendation rate was 32.4％, and the physician acceptance rate was 92.6％. PBPM was applied to 9.1％ of pharmacist recommendations made during preconsultation interviews, with a median prescription modification time of 8 minutes. PBPM enabled the timely and reliable correction of minor prescription deficiencies. These findings suggest that preconsultation prescription recommendations alone may be insufficient in pharmacist-led outpatient care for oral anticancer therapy. PBPM may serve as a complementary approach to ensure the accurate reflection of pharmacists’ evaluations in clinical practice while contributing to reduced workload for both physicians and pharmacists.