Abstract
Introduction: As oral anticancer agents become more prominent in the treatment landscape, their expanded use may raise concerns, such as nonadherence, adverse events, drug monitoring, and high costs. Clinical pharmacists (CPs) provide patient education and medication management to address these concerns. To understand the services and communication offered, interviews were conducted with clinical pharmacists in oncology clinics. Methods: Telephone interviews were conducted with pharmacists from oncology clinics across the US. The interviews evaluated clinical support services provided by CPs for patients on oral chemotherapy, and facilitators and barriers CPs face in implementing communication with the oncology team. The function and support of CPs in this context were assessed. Results: A total of 16 pharmacists were interviewed. As a result, three overarching themes were identified pertaining to typical roles: (1) CPs provide key support to oncology patients; (2) CPs face logistical, coordination, and communication challenges when supporting oncology patients, and (3) CPs contribute to patient safety and quality of care outside of direct patient care. A total of eight subthemes were identified. Conclusion: CPs provide high-quality care to patients according to national guidelines. However, they continue to be pulled in various directions to fill gaps that exist in the patient care pathway. This leads to pharmacists feeling unsupported, leading to burnout. Many CPs expressed not billing for services provided, making it difficult to advocate for additional supportive resources.
References
Tichy, E. M., Hoffman, J. M., Tadrous, M., Rim, M. H., Suda, K. J., Cuellar, S., Clark, J. S., Newell, M. K., & Schumock, G. T. (2023). National trends in prescription drug expenditures and projections for 2023. American Journal of Health-System Pharmacy, 80(14), 899–913. https://doi.org/10.1093/ajhp/zxad086
Mathur, A. D., Maiers, T. A., & Andrick, B. J. (2022). Impact of a pharmacist-led telehealth oral chemotherapy clinic. American Journal of Health-System Pharmacy, 79(11), 896–903. https://doi.org/10.1093/ajhp/zxac038
Muluneh, B., Schneider, M., Faso, A., Amerine, L., Daniels, R., Crisp, B., Valgus, J., & Savage, S. (2018). Improved adherence rates and clinical outcomes of an integrated, closed-loop, pharmacist-led oral chemotherapy management program. Journal of Oncology Practice, 14(6), e324–e334. https://doi.org/10.1200/JOP.17.00039
Mackler, E., Segal, E. M., Muluneh, B., Jeffers, K., & Carmichael, J. (2019). 2018 Hematology/Oncology Pharmacist Association best practices for the management of oral oncolytic therapy: Pharmacy practice standard. Journal of Oncology Practice, 15(4), e346–e355. https://doi.org/10.1200/JOP.18.00581
Gale, R. C., Wu, J., Erhardt, T., Bounthavong, M., Reardon, C. M., Damschroder, L. J., & Midboe, A. M. (2019). Comparison of rapid vs in-depth qualitative analytic methods from a process evaluation of academic detailing in the Veterans Health Administration. Implementation Science, 14(1), 11. https://doi.org/10.1186/s13012-019-0853-y
Hematology/Oncology Pharmacy Association. (2019). Further defining the scope of hematology/oncology pharmacy practice.
Clinical pharmacists in oncology practice. (2008). Journal of Oncology Practice, 4(4), 172–174. https://doi.org/10.1200/JOP.0843001
Rao, K., Gulbis, A., & Mahmoudjafai, Z. (2022). Assessment of attrition and retention factors in the oncology pharmacy workforce: Results of the oncology pharmacy workforce survey. JACCP: Journal of the American College of Clinical Pharmacy, 5(6), 620–629. https://doi.org/10.1002/jac5.1693
Durham, M. E., Bush, P. W., & Ball, A. M. (2018). Evidence of burnout in health-system pharmacists. American Journal of Health-System Pharmacy, 75(23 Suppl. 4), S93–S100. https://doi.org/10.2146/ajhp170818
Golbach, A. P., McCullough, K. B., Soefje, S. A., Mara, K. C., Shanafelt, T. D., & Merten, J. A. (2022). Evaluation of burnout in a national sample of hematology-oncology pharmacists. JCO Oncology Practice, 18(8), e1278–e1288. https://doi.org/10.1200/OP.21.00471