Implementation of the Pharmacy Practice Model Initiative within comprehensive cancer centers.

Abstract

The progress made by cancer centers across the United States adopting the goals and measures of the Pharmacy Practice Model Initiative (PPMI) was studied. In collaboration with ASHP, the official PPMI hospital self-assessment (HSA) questionnaire and a 10-item supplemental survey specific to oncology pharmacy services were disseminated via e-mail to all 41 National Cancer Institute designated comprehensive cancer centers in the United States. The HSA results of 26 (63%) of the 41 institutions surveyed were included in the analysis. Of the 26 participating institutions, 15 (58%) also completed the supplemental survey. Advanced pharmacist roles are highly prevalent among comprehensive cancer centers, with all institutions giving pharmacists discharge counseling responsibilities and deploying pharmacists to patient care units. Twenty-five institutions (96%) provide some level of pharmacist-driven drug therapy management services in at least some areas or situations and most often in the inpatient setting. Implementation of automation and technology in the areas of dispensing and order entry has occurred in over 80% of institutions. Advancement of pharmacy technician roles has received the least attention, with only 13 centers (50%) giving technicians sole responsibility for traditional dispensing functions, and 11 (42%) allowing technicians three or more advanced responsibilities. Only 12 institutions (46%) have established mechanisms to hold their pharmacists accountable for medication-related outcomes. Based on the survey results, suggested areas of improvement include the provision of drug therapy management in the outpatient setting, advancement in technician roles, utilization of automation and technology particularly at the point of administration, and implementation of mechanisms to hold pharmacists accountable for medication-related outcomes of their patients.