Pharmacist-led Chemotherapy Counseling: Impact on Hospital Admissions, Patient Satisfaction, and Cost Avoidance – A Prospective Pre–post Quality Improvement Study

A BSTRACT Objective: This study evaluated the impact of structured clinical pharmacist-led counseling on hospital admissions due to chemotherapy side effects, patient satisfaction, and cost avoidance in patients receiving intravenous chemotherapy. Methods: A prospective pre–post quality improvement study was conducted at a tertiary care center in Saudi Arabia. The preintervention cohort (October 2024–February 2025, n = 118) received standard care; the postintervention cohort (April–August 2025, n = 135) received structured 30-min pharmacist-led counseling covering regimen-specific education, anticipatory guidance on toxicity, self-management strategies, red-flag symptom recognition, and monitoring protocols. The primary outcome was the hospital admission rate due to chemotherapy-related side effects. Secondary outcomes included side effect-specific admissions, patient satisfaction, and economic impact. Findings: The intervention achieved a 34.4% relative reduction in admission rates (13.56%–8.89%; P = 0.02; number needed to treat = 22). Complete elimination of admissions for gastrointestinal toxicities and 38.8% reduction in febrile neutropenia admissions were observed. Patient satisfaction reached 94.4%, with 97.2% service coverage. Net cost savings totaled $38,850 over 5 months (ROI: 747%), with febrile neutropenia prevention accounting for 76.6% of savings. Conclusion: Structured pharmacist-led counseling significantly reduced chemotherapy-related hospital admissions, achieved exceptional patient satisfaction, and demonstrated strong economic value, supporting its integration as standard supportive care in oncology practice.