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A Prescription to Optimize Cancer Care: The Expanding Role of...
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A Prescription to Optimize Cancer Care: The Expanding Role of the Oncology Pharmacist

A special issue of Pharmacy (ISSN 2226-4787).

Deadline for manuscript submissions: closed (31 May 2020) | Viewed by 26594

Special Issue Editors

Dr. Lisa Holle

E-Mail Website
Guest Editor
Associate Clinical Professor, University of Connecticut, Storrs, CT, USA
Interests: adherence and appropriate education of oral anticancer agents; role of the oncology pharmacist; oncology supportive care
Dr. Kate D. Jeffers

E-Mail Website
Guest Editor
Ambulatory Oncology Clinical Pharmacy Specialist, PGY1 Pharmacy Residency Program Director, PGY2 Oncology Residency Program Director, UCHealth Colorado Springs, 1400 East Boulder Street, Colorado Springs, CO 80909, USA
Interests: oral anticancer agents; patient education; symptom management
Dr. Eve Segal

E-Mail Website
Guest Editor
University of Washington Medical Center, Seattle, WA, USA
Interests: patient education; thoracic cancers; symptom management; patient reported outcomes

Special Issue Information

Dear Colleagues,

Oncology pharmacy is an evolving specialty area of pharmacy practice. Pharmacists in this a specialty area ensure the safety and appropriateness of anticancer therapy for patients through their training and expertise in oncology diseases and management. Oncology pharmacists have become embedded in many healthcare teams, providing direct patient care or participating in clinical decision making. Oncology pharmacists may also operate in sterile compounding, specialty pharmacy, clinical research, or adminstrative roles.

On behalf of Pharmacy, we invite you to share your experiences in the field of oncology pharmacy to advance our field of practice. We hope this Special Issue will inspire others to futher develop their clinical practice, implement new services, and continue to advocate on behalf of the oncology patients we serve.

Assoc. Prof. Lisa Holle
Dr. Kate D. Jeffers
Dr. Eve Segal
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pharmacy is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Oncology pharmacist
  • Hematology pharmacist
  • Chemotherapy
  • Infusion pharmacy
  • Oral anticancer therapy
  • Patient education

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Published Papers (6 papers)

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Editorial

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5 pages, 181 KiB  
Editorial
The Expanding Role of the Oncology Pharmacist
by Lisa M. Holle, Eve M. Segal and Kate D. Jeffers
Pharmacy 2020, 8(3), 130; https://doi.org/10.3390/pharmacy8030130 - 25 Jul 2020
Cited by 21 | Viewed by 5398
Abstract
Although oncology pharmacists have been involved in the care of cancer patients for over 50 years, the role of the oncology pharmacist continues to expand. Initially, pharmacists were primarily based within either an inpatient or outpatient pharmacy setting and their work focused on [...] Read more.
Although oncology pharmacists have been involved in the care of cancer patients for over 50 years, the role of the oncology pharmacist continues to expand. Initially, pharmacists were primarily based within either an inpatient or outpatient pharmacy setting and their work focused on providing the necessary safety checks to dispense cancer-related medications. With technology freeing up pharmacists from dispensing functions and advanced training in direct patient care (e.g., oncology residency, oncology fellowship), the oncology pharmacist was able to provide direct patient care at the bedside or within the clinic where treatment decisions are made by the healthcare team. In fact, they have become integral members of the healthcare team. This Issue describes several expanding roles of oncology pharmacists in stem cell transplant, hematology, gastrointestinal oncology, and precision genomics, as well as oncology pharmacists preventing a reduction in cancer patient visits as the oncology physician shortage occurs. Oncology pharmacists are an integral part of the cancer care team; their value has been documented in several studies, and is highlighted in this Issue. We encourage the profession to continue to document their value so that one day each patient can have an oncology pharmacist as part of their cancer care team. Full article
(This article belongs to the Special Issue A Prescription to Optimize Cancer Care: The Expanding Role of the Oncology Pharmacist )

Research

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7 pages, 447 KiB  
Article
Evaluation of a Pharmacist Led Oral Chemotherapy Clinic: A Pilot Program in the Gastrointestinal Oncology Clinic at an Academic Medical Center
by Julianne O. Darling, Farah Raheem, Katelyn C. Carter, Elizabeth Ledbetter, Jennifer F. Lowe and Christopher Lowe
Pharmacy 2020, 8(1), 46; https://doi.org/10.3390/pharmacy8010046 - 20 Mar 2020
Cited by 12 | Viewed by 4059
Abstract
Oral chemotherapy represents a major patient-centric advancement in therapy convenience. However, ownership of safe and correct administration of these agents requires significant patient education. To address this challenge, an in-person pharmacist-led oral chemotherapy education clinic in gastrointestinal oncology patients within an academic medical [...] Read more.
Oral chemotherapy represents a major patient-centric advancement in therapy convenience. However, ownership of safe and correct administration of these agents requires significant patient education. To address this challenge, an in-person pharmacist-led oral chemotherapy education clinic in gastrointestinal oncology patients within an academic medical center was created and assessed. In this pilot program, a medication-specific quiz was administered to patients before and after education performed by a pharmacist to assess patient understanding of their new oral chemotherapy. A five-question satisfaction survey was also administered at the conclusion of the pharmacist clinic visit. Primary outcome was the percentage difference between pre-and post-education quiz scores. Secondary outcomes included patient satisfaction, time to treatment initiation, and number of pharmacist interventions. Frequencies and medians were used to describe categorical and continuous variables, respectively. Of the 18 patients analyzed, 50% were male and median age was 59.5 years. Approximately 28% had colon cancer, and 61% were treated with capecitabine. The median post-education scores improved from a pre-education score of 75% to 100%. Overall, seventeen of the eighteen patients responded with “strongly agree” to all satisfaction survey statements. An in-person oncology pharmacist-led oral chemotherapy education session demonstrated an improvement in patients’ understanding of their new oral chemotherapy treatment. Full article
(This article belongs to the Special Issue A Prescription to Optimize Cancer Care: The Expanding Role of the Oncology Pharmacist )
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8 pages, 530 KiB  
Article
Oncology Pharmacists Can Reduce the Projected Shortfall in Cancer Patient Visits: Projections for Years 2020 to 2025
by Katherine Knapp and Robert Ignoffo
Pharmacy 2020, 8(1), 43; https://doi.org/10.3390/pharmacy8010043 - 18 Mar 2020
Cited by 12 | Viewed by 3187
Abstract
Based on the projected need for a larger oncology care workforce, we estimated the patient care visits and care activities that Board Certified oncology pharmacists (BCOPs) could contribute to oncology care from 2020–2025. Using projected counts for BCOPs through 2025, we estimated that [...] Read more.
Based on the projected need for a larger oncology care workforce, we estimated the patient care visits and care activities that Board Certified oncology pharmacists (BCOPs) could contribute to oncology care from 2020–2025. Using projected counts for BCOPs through 2025, we estimated that 2.9–4.1 million 30-min BCOP patient visits were possible at 50% workforce capacity. BCOPs’ clinical activities overlapped strongly with those of nurse practitioners (NPs) and physician assistants (PAs) in patient education and treatment management. BCOPs could help reduce provider stress and burnout concerns by spreading these activities across a broader set of providers. BCOPs were more active than NPs and PAs in clinical trials research. Recent advances in immunotherapy, pharmacogenetics, pharmacogenomics, and oral oncolytic agents make the medication-focused training of OPs particularly useful to care teams. Comparison also showed that BCOPs were less active in providing follow-up visits and prescribing. Fulfilling the projected BCOP numbers through 2025 will require continued growth in Postgraduate Year 2 (PGY2) oncology pharmacy resident programs and on-the-job training programs. Our review of the trends in cancer incidence, mortality, and survivorship suggest a sustained need for the activities of BCOPs and other oncology care providers. Full article
(This article belongs to the Special Issue A Prescription to Optimize Cancer Care: The Expanding Role of the Oncology Pharmacist )
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8 pages, 413 KiB  
Article
Precision Genomic Practice in Oncology: Pharmacist Role and Experience in an Ambulatory Care Clinic
by Farah Raheem, Pauline Kim, Meagan Grove and Patrick J. Kiel
Pharmacy 2020, 8(1), 32; https://doi.org/10.3390/pharmacy8010032 - 8 Mar 2020
Cited by 5 | Viewed by 5338
Abstract
Recent advancements in molecular testing, the availability of cost-effective technology, and novel approaches to clinical trial design have facilitated the implementation of tumor genome sequencing into standard of care oncology practices. Current models of precision oncology practice include specialized clinics or consultation services [...] Read more.
Recent advancements in molecular testing, the availability of cost-effective technology, and novel approaches to clinical trial design have facilitated the implementation of tumor genome sequencing into standard of care oncology practices. Current models of precision oncology practice include specialized clinics or consultation services based on a molecular tumor board (MTB) approach. MTBs are comprised of interprofessional teams of clinicians and scientists who evaluate tumors at the molecular level to guide patient-specific targeted therapy. The practice of precision oncology utilizing MTB-based models is an emerging approach, transforming precision genomics from a novel concept into clinical practice. This rapid shift in practice from cytotoxic therapy to targeted medicine poses challenges, yet brings exciting opportunities to clinical pharmacists practicing in hematology and oncology. Only a few precision genomics programs in the United States have a strong pharmacy presence with oncology pharmacists serving in leadership roles in research, interpreting genomic sequencing, making treatment recommendations, and facilitating off-label drug procurement. This article describes the experience of the precision medicine clinic at the Indiana University Health Simon Cancer Center, with emphasis on the role of the pharmacist in the precision oncology initiative. Full article
(This article belongs to the Special Issue A Prescription to Optimize Cancer Care: The Expanding Role of the Oncology Pharmacist )
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7 pages, 663 KiB  
Communication
The Hematopoietic Cell Transplant Pharmacist: A Call to Action
by Amber Clemmons
Pharmacy 2020, 8(1), 3; https://doi.org/10.3390/pharmacy8010003 - 2 Jan 2020
Cited by 6 | Viewed by 3179
Abstract
Recently, the required training and credentials for as well as the various roles of the hematopoietic cell transplant (HCT) pharmacist have been endorsed by the leading organizations in cellular therapy, the American Society of Transplant and Cellular Therapy and the European Society of [...] Read more.
Recently, the required training and credentials for as well as the various roles of the hematopoietic cell transplant (HCT) pharmacist have been endorsed by the leading organizations in cellular therapy, the American Society of Transplant and Cellular Therapy and the European Society of Blood and Bone Marrow Transplantation. While these documents establish the roles a HCT pharmacist can fulfill within the multi-disciplinary team, few reports have evaluated the impact of the HCT pharmacist on clinical, financial, or quality outcomes. Further, a paucity of information has been reported on types of practice models, such as the use of collaborative practice agreements, or described effective methods to overcome the barriers to the increased utilization of HCT pharmacists. Herein, a brief summary of available information is provided to aid readers in understanding the state of the science for pharmacists practicing in this specialty with the goal to stimulate further research to justify the roles of HCT pharmacists and the correlation of such research to various outcome measures. Practitioners are encouraged to build upon this existing knowledge to create the novel integration and elevation of pharmacy practice to improve outcomes for patients, providers, and payors. Full article
(This article belongs to the Special Issue A Prescription to Optimize Cancer Care: The Expanding Role of the Oncology Pharmacist )

Review

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11 pages, 679 KiB  
Review
Pharmacists’ Role in Managing Patients with Chronic Lymphocytic Leukemia
by Kevin Y. Chen, Kelly M. Brunk, Bianka A. Patel, Kurtis J. Stocker, Jessica J. Auten, Kaitlyn M. Buhlinger and Benyam Muluneh
Pharmacy 2020, 8(2), 52; https://doi.org/10.3390/pharmacy8020052 - 27 Mar 2020
Cited by 5 | Viewed by 4603
Abstract
Chronic lymphocytic leukemia (CLL) is a hematologic malignancy that has seen significant advances in care over the last 5 years with the approval of oral agents such as ibrutinib and venetoclax for the treatment of this disease. As such, there has been a [...] Read more.
Chronic lymphocytic leukemia (CLL) is a hematologic malignancy that has seen significant advances in care over the last 5 years with the approval of oral agents such as ibrutinib and venetoclax for the treatment of this disease. As such, there has been a substantial shift away from the traditional chemotherapy infusions which have allowed patients greater autonomy with oral cancer therapies. This paradigm shift poses new challenges for the medical team, including drug–drug interactions, adherence counseling, and financial toxicity. Pharmacists are uniquely trained and equipped to help to manage the changing landscape of CLL care. From identifying common medications which may impair ibrutinib clearance to ensuring patients are on the appropriate anti-infective prophylaxis while receiving obinutuzumab, pharmacists can play a vital role in ensuring the highest quality of patient care. Furthermore, additional credentialing of clinical pharmacists in select states allows for independent visits with the pharmacists, allowing for greater involvement, particularly for initiation of venetoclax and management of ibrutinib-induced toxicities. Pharmacists are essential to both expanding and enhancing the care of patients with CLL and should be leveraged to improve patient outcomes whenever possible. Full article
(This article belongs to the Special Issue A Prescription to Optimize Cancer Care: The Expanding Role of the Oncology Pharmacist )
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