Designing a Clinical Pharmacy Service Pathway for Oncology Patients at a Cancer Centre in Lagos State

Cancer patients receiving chemotherapy face complex pharmacotherapy challenges including severe drug interactions, organ toxicity, antiemetic management, and supportive care coordination that require dedicated clinical pharmacy expertise. This study designed a structured clinical pharmacy service pathway for oncology patients at a cancer treatment centre in Lagos, South West Nigeria. A service development methodology was employed, comprising mapping of the existing pharmacy service, literature synthesis on oncology pharmacy best practices from comparable resource-limited settings, and consultations with 20 oncology healthcare workers. An observational study of 60 chemotherapy prescriptions assessed current quality of chemotherapy prescribing and pharmacist involvement. Results showed that pharmacist verification of chemotherapy prescriptions occurred in only 31.7 percent of cases, and no structured toxicity monitoring programme existed. The clinical pharmacy service pathway designed covers pre-chemotherapy pharmacist assessment, chemotherapy prescription verification, antiemesis and supportive care optimisation, toxicity monitoring and management, patient education and adherence support, and treatment outcome documentation. Service quality indicators, documentation templates, and pharmacist training requirements are included. Stakeholder validation by cancer nurses, oncologists, and pharmacists achieved 86 percent consensus on service feasibility. The study recommends formalising the pathway as the standard oncology pharmacy model at the centre, with evaluation at 6 and 12 months post-implementation, and scaling to other cancer centres in Lagos State.

Keywords: oncology pharmacy, chemotherapy, clinical pharmacy pathway, Lagos State, patient safety