Trends in the delivery of care to oncology patients in the United States: Emphasis on the role pharmacists on the healthcare team

Abstract

Objective The purpose of this study was to identify trends in oncology care that allow one to forecast workforce supply and demand, the training and skills needed by the oncology pharmacist for the likely future of oncology care. Methods Interviews were conducted with experienced oncology pharmacists in leadership roles at 20 organizations balanced by geographic region and type of practice site (academic or community/ambulatory). Results were analyzed using descriptive statistics and theme identification. Results Practice sites differed widely in numbers of patient visits, practitioner/patient ratios, residency program presence, and other structural features. Despite this, the majority reported an expectation of growth in cancer patients, oncology physicians, oncology pharmacists, pharmacy technicians, oncology nurses, and advanced practice practitioners in the next two to five years. Fifty percent of sites currently support Post Graduate Year 2 (PGY2) oncology residencies. At least 50% reported routine pharmacist involvement in 12 clinical functions. More future involvement was predicted for immunotherapy (80%) and oral oncolytic therapy (90%). Interprofessional involvement was reported for a broad variety of practice-related committees and patient education teams. Limited pharmacist involvement in credentialing, quality measurement, and value-based reimbursement systems was found. Conclusion Anticipated increases in demand for oncology pharmacists strongly suggest the need for more PGY2 oncology residency programs and on-the-job oncology training programs. Oncology pharmacists are currently involved in many clinical and administrative functions including multidisciplinary management. While a core set of clinical functions has been identified, oncology pharmacists must prepare for the increased use of oral oncology agents and immunotherapy. Pharmacist involvement in value-based reimbursement and other data-based quality outcome measurements should be increased to optimize involvement in team-based patient care.

Nurse and pharmacist systemic anti‐cancer therapy review clinics and their impact on patient experience and care: A systematic review

“…Four papers are qualitative (Farrell et al, 2017 ; Hobson et al, 2009 ; Lennan, 2014 ; Siouta et al, 2019 ), two of which use ethnography (Farrell et al, 2017 ; Siouta et al, 2019 ), one grounded theory approach (Hobson et al, 2009 ) and one participatory evaluation (Lennan, 2014 ). Two papers used mixed methods (Farrell et al, 2020 ; Ignoffo et al, 2021 ); eight are observational studies (Bruinooge et al, 2018 ; Dennison et al, 2021 ; Farrell et al, 2010 ; Lam & Cheung, 2016 ; Maier et al, 2018 ; Patel et al, 2016 ; Simons et al, 2010 ; Towle et al, 2011 ); and one used a Delphi design (Ignoffo et al, 2016 ). Two papers (Farrell et al, 2020 ; Siouta et al, 2019 ) undertook secondary analysis on primary data collected in an ethnographic study (Farrell et al, 2017 ) and all three are therefore included in this review.…”

“…Eleven papers are hospital based (Dennison et al, 2021 ; Farrell et al, 2010 ; Farrell et al, 2017; Farrell et al, 2020 ; Ignoffo et al, 2016 ; Lam & Cheung, 2016 ; Lennan, 2014 ; Maier et al, 2018 ; Patel et al, 2016 ; Simons et al, 2010 ; Siouta et al, 2019 ) and four are hospital and community based (Bruinooge et al, 2018 ; Hobson et al, 2009 ; Ignoffo et al, 2021 ; Towle et al, 2011 ).…”

“…Seven studies were undertaken in the USA (Bruinooge et al, 2018 ; Dennison et al, 2021 ; Ignoffo et al, 2016 ; Ignoffo et al, 2021 ; Lam & Cheung, 2016 ; Patel et al, 2016 ; Towle et al, 2011 ); four in the UK (Farrell et al, 2010 ; Farrell et al, 2017 ; Hobson et al, 2009 ; Lennan, 2014 ); one in Germany (Simons et al, 2010 ) and one across nine European countries (Maier et al, 2018 ).…”

Onco-pharmacist led evaluation of knowledge, attitude & practice (KAP) of safe handling cytotoxic drugs among health care professional's (HCP's) in tertiary care hospital: A hospital based interventional Study

“…In a similar way, Maryam et al in their cross-sectional study have reported the mean scores of responses for knowledge, attitude, and practice which were observed to be 54.30 ± 10.86, 32.83 ± 5.88, and 50.35 ± 10.21, respectively. 18 In current study, the increase in the mean score of these parameters depicts the positive effect of training the HCPs using standard guidelines while handling, preparation and administration of anti-cancer drugs by clinical oncopharmacist Similarly, Ali et.al have demonstrated in their study that involvement of clinical oncology pharmacist plays an integral role in minimizing the adverse effect and in raising safety standards 19 while handling the CDs and also, Robert et al have highlighted the importance of the training the oncology pharmacist for the better future of oncology care 20…”

Expanding oncology pharmacist teams: Justifying the return on investment

“…1 Oncology pharmacists are integral in the safe care of patients and remain a sustained need supported by trends in cancer incidence and mortality. 2 Despite the role for these pharmacists being well defined and the expanding responsibilities previously described, position justification for pharmacists is a challenge with prerequisites to optimize efficient processes, promote quality and reduce overall costs. 3,4 Initiation and implementation of new oncology pharmacist services requires a clear description of value to the organization and a strong understanding of workflows.…”