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The CLEO tool for evaluation of potential significance of a

pharmacist intervention (PI) was validated in general practice2. This

study aims to test the validity and reliability of the CLEO tool used in

a centralized chemotherapy preparation unit (CPU) at the Grenoble

University Hospital Center.

INTRODUCTION

OBJECTIVES

METHODS

CONCLUSIONS & PERSPECTIVES

Targeted populations was needed to improve concordance (by

subgroup analyses)

• Pharmacists in the CPU (particularly senior pharmacists)

• PIs on Hematogastro – Enterology

• Refused PIs

METHODS

The highest strength of agreement was found for economic

dimension of the CLEO classification, then clinical dimension.

The lowest values were obtained for organizational dimension.

Reproductibility of validity and reliability of the CLEO tool in a

local setting is not always obvious. Subgroup analyses is useful

to target the main sources of disagreement (e.g., panel experts,

pharmacists or types of PIs) and further training of rating and

peer-review process is necessary to improve agreement.

Validation process of the CLEO tool for evaluating potential significance of pharmacist interventions

in a centralized chemotherapy preparation unit

Contact:

Thi Ha Vo

Laboratoire TIMC-IMAG UMR 5525 / ThEMAS

EDISCE - Université Joseph Fourier, Univ. Grenoble - Alpes

38700 La Tronche, FRANCE

Email: havothipharma@gmail.com

Vo Thi Ha1, Zecchini Celine2, Federspiel Isabelle2, Chanoine Sebastien2, ALLENET Benoit1,2, BEDOUCH Pierrick1,2

1UJF-Univ. Grenoble Alpes / CNRS / TIMC-IMAG UMR 5525 / ThEMAS 2Pôle Pharmacie, CHU de Grenoble, Grenoble F-38041, France.

EVALUATION OF IMPACTS OF A PHARMACIST INTERVENTION

BY THE CLEO TOOL

1. CLINICAL IMPACT (CL)

Score Impact Definition: The clinical impact is evaluated according to the most likely case

expected , not the worst / best case

-1C Nuisible The PI can lead to adverse outcomes on clinical status, knowledge, satisfaction,

patient adherence and/or quality of life of the patient.

0C Null The PI can have no influence on the patient regarding the clinical status,

knowledge, satisfaction, patient adherence and or quality of life of the patient.

1C Minor The PI can improves knowledge, satisfaction, medication adherence and/or

quality of life OR

The PI can prevent damage that does not require monitoring/treatment

2C Moderate The PI can prevent harm that requires further monitoring/treatment, but does

not lead or do not extend a hospital stay of the patient.

3C Major The PI can prevent harm which causes or lengthens a hospital stay OR causes

permanent disability or handicap.

4C Lethal The PI can prevent an accident that causes a potentially intensive care or death

of the patient.

ND Non-determined The available information does not determine the clinical impact.

The clinical impact is evaluated for the patient's benefit.

Harm: alteration of the physical and mental capacities arising from an accident or illness.

Quality of life: physical function (autonomy, physical abilities, capacity to perform the tasks of daily life ...),

psychological (anxiety, depression, emotion ...), social (relative to family environment, friendly or

professional, engaging in personal relationships, participation in social and leisure activities ...) and somatic

(symptoms related to the disease).

Monitoring: monitoring clinically relevant (physiological or psychological), biological.

Treatment: changing therapy or adding an additional medical / surgical treatment.

2. ECONOMIC IMPACT (E)

Score Impact Definition

-1E Increase of cost The PI increases the cost of the drug treatment of the patient.

0E No change The PI does not change the cost of drug treatment of the patient.

1E Decrease of cost The PI saves the cost of drug treatment of the patient.

ND Non-determined The available information does not allow to determine the economic impact.

The cost of drug therapy contains two main elements:

o The cost of drugs

o The cost of monitoring of drug therapy (eg, clinical monitoring, kinetic , biological monitoring ...).

The cost of drug therapy is based on the financial cost of the hospital.

3. ORGANISATIONAL IMPACT (O)

Score Impact Definition

-1O Desfavorable The PI reduces the quality of care process.

0O Null The PI does not change the quality of the care process.

1O Favorable The PI increases the quality of the care process.

ND Non-determined The available information does not identify the organizational impact.

The organizational impact is coded regarding the overall impact on the quality of the care process from the

perspective of health care providers (eg, time savings, improved security, knowledge, job satisfaction of

nursing staff; facilitating professional tasks or teamwork, continuity of care, etc.)

RESULTS

References

Period of study : 10 weeks, 214 PIs related to 167 patients.

1. Vo TH et al. Methods assessing the significance of a pharmacist intervention:

literature review. ESCP 2013 International Workshop. Edinburgh, 30 – 31 may 2013,

Scotland (Poster).

2. Vo TH et al. Development and Validation of a multidimensional scale “CLEO”

for evaluating potential significance of a pharmacist intervention. 2014 American

College of Clinical Pharmacy Annual Meeting. Austin, Texas, 12-15 octobre 2014

(Poster).

3. Zecchini C, Vo TH et al. Clinical, economic and organizational impact of

pharmacist interventions during pharmaceutical analysis of injectable

antineoplastics. ESCP 2015 Symposium. Lisbon, Portugal 28-30 October 2015 (Oral

Communication).