Oncology Clinical Pharmacists Research Articles

Empowering survivors, elevating care: The vital role of oncology primary care clinics.

362 Background: Due to increasing numbers of cancer survivors, there is a greater focus on the longitudinal management of treatment-related comorbidities. Cancer survivors have increased risk of cardiovascular (CV) disease, CV-related mortality, and second primary cancers (SPCs). Primary care providers (PCPs) are responsible for most of the care of long-term survivors, however, many report uncertainty around long-term effects and survivorship guidelines. While fostering strong primary care-oncology relationships is one approach to support those impacted by cancer, the development of oncology primary care clinics enhances patient outcomes and ensures patients receive comprehensive survivorship care. Despite this, few tertiary cancer care centers offer such clinics. Methods: In 2021, the University of Cincinnati Cancer Center established an oncology primary care clinic. Patients are eligible if they have a current or prior cancer diagnosis or cancer hereditary syndrome (CHS). The clinic is comprised of two-family medicine physicians, one with survivorship experience, and one fellowship-trained in palliative and hospice medicine. Clinical team members include an RN with oncology experience, medical assistants, a clinical service specialist, two oncology clinical pharmacists, and an oncology social worker. A clinical registry was developed to longitudinally measure patient outcomes. Electronic medical records of patients (n=683) seen between 1/2021 and 1/2024 were extracted and entered in REDCap. Data was summarized using SAS. Results: The mean age was 56 years (range 20-93), and 12% received a diagnosis in the pediatric/adolescent/young adult age range (0-39 years). The most common types included breast (23%),hematologic cancers (15%), and CHS (16%). Notably 43% of patients are on active treatment and 53% completed or are on maintenance treatment. Over 61% struggle with obesity, while 45% report being a current or former smoker. Comorbidities were common with 79% of patients having at least one CV diagnosis. Of 57% patients eligible for cardiomyopathy screening, 78% received recommended echocardiograms. Many patients received their recommended screenings including breast (79%), colon (43%), cervical (56%), prostate (46%), and lung (55%). Patients were referred to a variety of supportive services including physical therapy (42%), cancer exercise (18%) and psychiatry (14%). Conclusions: This model of care is a viable option for connecting cancer survivors with PCPs knowledgeable about survivorship care. CV-related comorbidities were common, and their management is a critical need during and after cancer. Survivors have increased risk of SPCs, and while the number of patients up to date on recommended cancer screenings is low, screenings are on the rise with ongoing efforts. Patient registries enable objective measurement of outcomes and can inform future research and care.

Impact of an Oncology Clinical Pharmacist Intervention on Clinical Trial Enrollment in The US Oncology Network’s MYLUNG Consortium

Introduction: The Molecularly Informed Lung Cancer Treatment in a Community Cancer Network: A Pragmatic Consortium™ (MYLUNG) clinical trial platform aims to advance the use of precision medicine in patients with non–small cell lung cancer through a series of prospective and iterative clinical trials. Timely patient accrual onto oncology clinical trials is a known practice challenge and impaired accrual rates can lead to premature trial closure or properly powered trial outcomes. The US Oncology Network recently implemented a clinical pharmacist (ClinReview) initiative to provide remote clinical services to screen patients for enrollment onto MYLUNG Protocol 2. This study aims to evaluate the effect of the remote clinical pharmacist intervention on study enrollment rates. Methods: An oncology-trained clinical pharmacist remotely reviewed systemic chemotherapy treatment orders during normal workflow and, in addition, a weekly custom recruitment report within six community Network practices (149 physicians). The pharmacist identified, screened, and assisted with the communication regarding eligible patients for enrollment. The onsite research team received timely and relevant patient data to facilitate expedited enrollment. Enrollment and intervention data were tracked to monitor the impact of the pharmacist intervention. Monthly enrollment was evaluated using a paired t-test. Results: Over 8 months, the pharmacist screened 506 potentially eligible patients; 34% were enrolled. Average monthly enrollment was significantly greater following the ClinReview intervention (3.4 vs. 6.6 patients/month; p = .02). Among the 289 patients not enrolled, 73% exceeded their eligibility window, 9% died or enrolled into hospice, 4% declined participation, and 13% transferred care or were treated at outside facilities. Conclusions: Incorporating an oncology clinical pharmacist into the clinical research team was associated with improved clinical trial enrollment. Validation of the effect of multidisciplinary interventions across a broader spectrum of differentially resourced oncology practices will be conducted within future MYLUNG iterations.

Impact of the integration of remote clinical oncology pharmacists into routine precision medicine workflows on biomarker testing rates within The US Oncology Network community-based practices.

e13813 Background: The US Oncology Network implemented a centralized, remote clinical oncology pharmacist review program (ClinReview) into select community-based practices. Initially, pharmacists were integrated into a precision medicine workflow process to increase biomarker testing rates among patients receiving adjuvant treatment for non-small cell lung cancer, with recommendations achieving a 100% acceptance rate. Following this success, metastatic prostate cancer patients were incorporated into the established workflow, following updated guideline recommendations for both germline and somatic testing and the 2023 approvals of PARP inhibitors in the first-line treatment setting. With previously reported testing rates only reaching 60%, we sought to evaluate the impact of the pharmacist integration into the precision medicine workflow on biomarker testing in metastatic prostate patients. Methods: Over a 4-month period, ClinReview remotely identified patients with metastatic prostate cancer during normal order review. The EMR was reviewed to assess germline and somatic testing status. If testing was not ordered, the pharmacist sent a recommendation to the treating provider. Initial testing rates for germline and somatic testing, BRCA+ status and provider acceptance rates for testing recommendations were collected. Additional data was collected utilizing a de-identified database. While additional data collection is ongoing, descriptive statistics were utilized to analyze data and the impact of the pharmacists’ interventions. Results: Across 9 practices, 142 patients were initiated on treatment for metastatic prostate cancer. At the time of initial assessment, germline and somatic testing was not ordered in 50% and 37% of patients, respectively. Pharmacists recommended additional testing in 61 patients (43%) with a 73% provider acceptance rate. Findings showed equitable testing rates across racial demographics. Pharmacist workflow integration enhanced combined germline and somatic testing rates, demonstrating an improvement from a baseline of 57% up to 77% currently. Conclusions: Community oncology practices seek to provide high-value care, including offering the most current evidence-based precision medicine testing. These findings highlight the continued need for improved somatic and germline testing in metastatic prostate cancer. However, the implemented precision medicine pharmacist workflow demonstrates the positive impact a clinical pharmacist can have on both testing rates and the potential to improve therapeutic offerings within this growing treatment space. [Table: see text]

Ambulatory care hematology/oncology pharmacy services: A comprehensive review by the Saudi Oncology Pharmacy Assembly

AbstractSaudi Vision 2030 has driven significant changes in ambulatory care pharmacy services in the Kingdom of Saudi Arabia (KSA), transitioning pharmaceutical care from inpatient to outpatient settings. With a growing need to address non‐communicable diseases, particularly cancer, ambulatory care oncology pharmacy services are of paramount importance. This study aims to evaluate the potential benefits and challenges of establishing such services in the KSA and offers recommendations for clinical pharmacists. A comprehensive literature search was conducted using PubMed, MEDLINE, EMBASE, and Google Scholar, encompassing research from inception to September 2023. The search focused on English language studies related to ambulatory care oncology/hematology pharmacy services. Among the 1351 studies found, those assessing the impact of clinical pharmacists on patient outcomes in outpatient oncology clinics were included. The review of the literature highlights the substantial impact of clinical pharmacists in outpatient hematology/oncology settings. A selection of several studies revealed their role in improving patient care, reducing health care costs, and enhancing treatment outcomes. Notable findings include a high acceptance rate of pharmacist interventions with significant cost savings, increased pharmacist involvement in patient encounters, and reduced emergency department visits and inpatient admissions due to pharmacist interventions. These results showed the valuable contributions of clinical pharmacists in the international outpatient oncology setting. Establishing ambulatory care hematology/oncology pharmacy services in Saudi Arabia is critical, considering the rising cancer burden. The value of specialized oncology clinical pharmacists in the outpatient setting is emphasized by various studies conducted in the United States. This review proposes a framework for patient‐centered oncology practices, serving as a valuable resource for the strategic development of ambulatory care oncology pharmacy services in Saudi Arabia. These efforts align with Saudi Vision 2030's broader goals of enhancing health care quality and patient care.

Geriatric assessment-guided interventions for older adults with multiple myeloma: A feasibility and acceptability study

IntroductionGeriatric assessment (GA)-guided supportive care programs have been successful in improving treatment outcomes for older adults with solid-organ cancers. This study aimed to evaluate the feasibility of a GA-guided supportive care program among older adults treated for multiple myeloma (MM). Materials and MethodsThe study utilized an existing registry of adults with plasma cell disorders at the University of North Carolina. Patients with MM, aged 60 or older, and having a GA-identified deficit in one or more problem area were offered referrals to supportive care resources during routine visits. Problem areas included physical function deficits, polypharmacy, and anxiety or depression. Patients with physical function deficits were offered referral to physical therapy (PT), those with polypharmacy to an Oncology Clinical Pharmacist Practitioner (CPP), and those with mental health symptoms to the Comprehensive Cancer Support Program (CCSP). ResultsOf the 58 individuals identified as having at least one deficit on the GA, PT was the most commonly identified relevant resource (79%), followed by CPP visits (57%). Among individuals that were offered referral(s) to at least one new supportive care resource, the acceptance rate was 50%. Referral acceptance rates were highest among those recommended for a CPP visit (55% of those approached) and lowest for CCSP (0%). DiscussionThe study examined the feasibility and acceptability of a referral program for supportive care resources among older adults with MM who have deficits on GA. The most commonly identified deficit was physical functioning, followed by polypharmacy and mental health. The study found that physical interventions and referrals to CPPs were the most accepted interventions. However, the low proportion of patients who accepted physical therapy referrals indicates the need for tailored and more personalized approaches. Further research is needed to explore the feasibility and impact of supportive care referral programs for older adults with MM.

Potential drug–drug interaction and its determinants among patients with cancer receiving chemotherapy in oncology centres of Northwest Ethiopia: an institutional-based cross-sectional study

ObjectiveThe study was conducted to assess potential drug–drug interactions (PDDIs) and its determinants among patients with cancer receiving chemotherapy.Design and settingAn institutional-based cross-sectional study was used. This study was conducted...

Developing the Form and Content of Implementation Strategies to Prevent Venous Thromboembolism for Ambulatory Patients with Cancer

Introduction To prevent venous thromboembolism (VTE) in people with cancer, guidelines recommend risk-assessment for those receiving systemic therapy and anticoagulation (AC) prophylaxis for those at high risk of VTE. However, these recommendations are significantly underused in clinical practice. Our prior work demonstrated barriers and facilitators contributing to this underuse and identified potential implementation strategies to address these barriers. The objective of this study was to develop the form and content of targeted implementation strategies promoting the uptake in clinical practice of guideline-recommendations for VTE prevention for ambulatory patients with cancer. Methods We conducted multidisciplinary stakeholder focus group discussions and semi-structured patient interviews to iteratively design the form and content of five implementation strategies (Table 1): (1) Conduct clinician education and training on risk-assessment models and anticoagulation thromboprophylaxis; (2) Adapt electronic health records (EHR) to provide interactive assistance; (3) Develop and distribute educational materials for clinicians about the Khorana score, VTE risk, and AC counseling; (4) Develop and distribute educational materials for patients; and (5) Audit and feedback. Stakeholders included oncologists, classical hematologists, an oncology clinical pharmacist, oncology advanced practice providers, and oncology patients, in academic and community-based settings within a single health care system. We conducted the clinician focus groups iteratively: in the first session we reviewed guidelines and evidence to support the use of risk assessment and AC prophylaxis in patients with cancer and shared barriers and facilitators identified in our earlier work. During subsequent sessions, we iteratively designed the form and content of the implementation strategies. In the final session, clinicians were presented a finalized prototype of the implementation strategies and asked to perform exploratory usability testing through simulated patient care encounters. Individual semi-structured interviews were conducted with patients to obtain feedback on the design of the implementation strategies and patient-education resources. Results A workflow for integration of risk-assessment and relevant prophylaxis in clinical practice was created based on participant feedback. Details for selected implementation strategies are shown in Table 1. For EHR support, stakeholders recommended the risk-assessment component be integrated within chemotherapy order sets. In addition, they recommended incorporating aid for AC management within the EHR, including a method to assess bleeding risk, pre-populated options for AC thromboprophylaxis, provision of easily accessible links to resources for peri-operative/procedure AC management, and a list of interactions between anticoagulants and common drugs used in oncology practice. Clinician stakeholders also recommended - and subsequently approved - standard phrases available to incorporate into the EHR documentation, both to guide decision-making and to serve as a reminder to re-assess in future visits. For education resources (clinician and patient), clinicians wanted education resources to be concise, and for the patient-facing resource, to be provided to patients both in existing “chemotherapy education” booklets and sent in after-visit appointment instructions. Regarding audit and feedback, clinicians recommended a personalized report card comparing their use of appropriate VTE prevention to their peers. After reviewing the patient-facing education documents, patients recommended simpler, straightforward language and clarifications for the VTE and AC patient education resources based on their past experiences. Conclusions With multidisciplinary stakeholder input from clinicians and patients, we developed a set of implementation strategies designed to address barriers to uptake of VTE prevention recommendations in oncology clinics. Next steps are to test the implementation strategies in clinical practice to measure impact on increasing these evidence-based interventions.

Annual cost and implementation of remote oncology pharmacist order review within a network of community oncology practices.

30 Background: The US Oncology Network’s ClinReview program employs a team of centralized clinical pharmacists providing remote services to community oncology practices. Literature demonstrating the clinical impact of the oncology pharmacist has been well established. However, comprehensive data supporting the financial value compensating these clinical services continues to prove challenging. The aim of this study is to evaluate the annual cost-avoidance realized by the ClinReview program through clinical and quality interventions. Methods: A team of 6 oncology clinical pharmacists electronically reviewed chemotherapy orders within 9 community oncology practices. The pharmacist identified opportunities to optimize oncology regimens by performing clinical treatment plan reviews, identifying orders requiring dose modifications, symptom management recommendations, clinical consultations, regimen entry, or drug interaction reviews. Recommendations were discussed with the treating provider or modified if permitted by approved practice policies. A retrospective, observational study was performed utilizing clinical intervention data entered by ClinReview pharmacists from October 2022 through March 2023. Interventions were allocated to specific cost-avoidance values based on previously validated studies and extrapolated to an annualized value. Results: During the 6-month study period, a total of 10,195 interventions were documented and categorized as treatment plan management (2,434, 24%), medication regimen/dosing change (6,365, 62%), symptom management (1,145, 11%), drug information consultation (103, 1%), regimen entry, (69, 1%), and drug interaction management (90, 1%). Based on previously validated cost-savings estimates, annualized cost avoidance realized from the ClinReview program was $2,247,818. Taking into account the cost of pharmacist time, the 6-month intervention data demonstrated an annualized net cost-avoidance of $1,896,164. Conclusions: The integration of the ClinReview program into community oncology practices delivers significant quality, safety, and financial benefits, with approximately $1.9 million in annual net cost-savings benefit. [Table: see text]

Impact of an embedded oncology clinical pharmacist in an outpatient oncology center.

424 Background: Oncology pharmacists are uniquely positioned to improve the quality of care provided to patients with cancer within the team-based setting. Some benefits include providing information that supports safe and cost-effective use of medications relative to supportive care management, drug-drug interaction evaluation, patient counseling, answering drug information questions, and reducing physician workload. The primary objective of this study is to evaluate the benefit of a full-time clinical pharmacist in the ambulatory oncology setting through documenting pharmacist-driven clinical interventions, correspondence of those interventions with cost avoidance, and perceived benefit from provider and patient satisfaction surveys. Methods: Pharmacists were in clinic Monday through Thursday, covering three medical oncologists each day. Interventions were documented through EPIC i-Vents. The categories included: adverse events, drug interactions, lab monitoring, medication reconciliation, order clarification, patient education/counseling, drug information, and supportive care. Pharmacist interventions correlated with cost avoidance benefits based on values from prior publications. Weekly surveys were sent to the providers to assess satisfaction of the program and to improve workflow. Results: The data from this pilot program reflects the study period starting January 9, 2023 through June 1, 2023. The financial impact, as calculated from the pharmacist interventions, cost avoidance values and time spent resulted in the estimated cost avoidance of $169,321.10 based on a total of 839 interventions. Other interventions were made that were not given a cost value. Thus, the estimated cost savings is likely an under-estimation of the true cost savings provided from this service during this five-month study period. Extended providers (n = 5) and medical oncologists (n = 3) surveys indicated an overall strong agreement to the benefits of an oncology pharmacist’s involvement in clinic. The pilot program is currently working on a method to gather patient surveys to assess patient satisfaction. Conclusions: This study demonstrates the clinical and financial benefit of an embedded oncology pharmacist in the outpatient oncology clinic. As we move into an era with increasing approvals of oncology medications, coupled with increasing complexity of care, this service may help address some of the unmet gaps to improve collaborative and comprehensive patient-centered care.

Geriatric-assessment-guided interventions for older adults with multiple myeloma: A feasibility study.

12065 Background: Multiple myeloma (MM) is disproportionately a disease of older adults, and aging-related impairments are common in this population. Geriatric assessment (GA) guided supportive care programs have been linked to improved treatment outcomes among older adults with solid-organ cancers. We sought to evaluate the feasibility of a GA-guided supportive care program among older adults treated for MM. Methods: We leveraged an existing registry of adults with plasma cell disorders at the University of North Carolina. Registry participants meeting inclusion criteria were offered referrals to supportive care resources by their MM provider during routine visits in 2021-2022. Inclusion criteria were diagnosis of MM, age ≥60, and presence of ≥1 selected problem areas (physical function, polypharmacy, mental health) on the GA. Function deficits were defined as self-report of requiring assistance with ≥1 instrumental activities of daily living or recent fall(s), polypharmacy as ≥10 daily medications, and anxiety/depression on the Mental Health Index 13. Individuals with physical function deficits were offered referral to physical therapy (PT). Those with polypharmacy were offered referral to an oncology Clinical Pharmacist Practitioner (CPP) for comprehensive medication reconciliation and evaluation for de-prescribing. Patients with mental health symptoms were offered referral to our center’s Comprehensive Cancer Support Program (CCSP). Results: 59 individuals were identified as having at least one deficit on the GA (Table). Of these, 14 were already utilizing all relevant resources, leaving 45 individuals eligible for a new resource. Among these, 16 accepted a referral to at least one resource. An additional 16 were approached and declined all offered referrals. For the remaining 13 screened individuals, providers were prompted regarding a referral recommendation prior to the patient’s visit, but a referral was not offered during the visit. Physical therapy was the most commonly identified relevant resource (n = 46), followed by CPP visits (n = 33). Referral acceptance rates were highest among those recommended for a pharmacy visit (55% of those approached) and lowest for CCSP (0%). Conclusions: Given the prevalence of polypharmacy or physical function deficits and acceptance rates for related interventions, future interventions focusing on collaboration with CPPs or physical therapists appear feasible in this setting. Methods to direct patients to supportive care resources that do not rely on provider recommendations during the limited window of clinic visits may also be beneficial. Clinical trial information: NCT04999085 . [Table: see text]

The clinical and financial impact of remote clinical oncology pharmacist engagement in community-based practices within The US Oncology Network.

The integration of clinical oncology pharmacists into multidisciplinary healthcare teams is not well-described in the community practice setting. This study aims to analyze the clinical and financial impact of a remote-based clinical oncology pharmacist in four community oncology practices within The US Oncology Network. Oncology-trained clinical pharmacists electronically reviewed chemotherapy orders for clinical optimization and financial stewardship within four community oncology practices. Each pharmacist was appointed at 0.5 full-time equivalents per practice. Financial, clinical, and workload metrics were tracked to monitor the impact of pharmacist engagement. Over 12 months, 5716 order reviews were completed with an intervention rate of 57%. The most common interventions identified by the pharmacists were interventions with clinical impact on the patient (36%), followed by dose rounding (35%) and therapeutic interchange (30%). Overall, interventions improved the cumulative practice margins by $1,455,033 and reduced total medication costs by $5,962,551. The average program return on investment was 415% (range 100-915%). Community oncology practices seek to provide high-value care in a lean, resource-constrained model. An oncology clinical pharmacist is a cost-effective and clinically invaluable care team member in community oncology practice. Pharmacists in this setting identified opportunities to improve medication safety and regimen optimization and demonstrated a significant tremendous financial impact on small-scale budgets in community oncology.

NCCN Highlights Best Practices for Challenges in Oncology

NCCN Highlights Best Practices for Challenges in Oncology

Value Assessment of Oncology Pharmacist Interventions.

A review of the published literature confirms the challenge in quantifying the value of oncology pharmacists. This editorial expands on a 2020 study by Meleis and colleagues published in the Journal of the Advanced Practitioner in Oncology and seeks to correlate pharmacist interventions to cost-saving and cost-avoidance measures to show the value of ambulatory oncology clinical pharmacists in patient care. A total of 4,686 interventions were reviewed. The 6-month intervention data demonstrate an annualized value of approximately $1.1 million dollars from nine ambulatory oncology clinical pharmacists showcasing the essential role of the clinical pharmacist in ambulatory oncology settings.

Performance Challenges in a Newly Established Clean Room at Omid Hospital, Isfahan, Iran: A Descriptive Study.

This study aimed to comprehensively assess the challenges faced by a newly established clean room in the oncology center of Omid Hospital, Isfahan, Iran, one of the first of its kind in the country. The research also sought to identify the underlying causes of these challenges and propose potential solutions to address them. A 6-month cross-sectional study was conducted from December 2021 to May 2022. International guidelines such as British Columbia Cancer Agencies' guideline of hazardous drugs, the National Institute for Occupational Safety and Health guideline for working with hazardous drugs, and United States pharmacopeia related to cleanroom performance were studied, translated, and summarized into a checklist. The staff performance in Omid Hospital's clean room was compared to the data collection form, and all medication errors were documented and analyzed. The study also explained the underlying causes of these challenges and proposed potential solutions. Among 1005 chemotherapy regimens, 836 errors were detected, stemming from issues such as engineering and construction challenges, lack of human resources and essential equipment, and budgetary constraints. Despite the involvement of a trained oncology clinical pharmacist, Omid Hospital's cleanroom faces significant challenges within the medical and hospital system, leading to non-standard challenges. The study recommends multidisciplinary approaches in the hospital to mitigate these challenges and improve cleanroom performance.

Optimizing Multidisciplinary Treatment-Related Adverse Effects Detection and Reduction in Patients Undergoing Active Cancer Treatments in Ambulatory Infusion Centers.

The objective of this study was to describe the implementation of an interdisciplinary supportive care program for treatment-related adverse effects (TRAEs) of patients with cancer in two ambulatory infusion centers affiliated with a major health system. A management program of TRAEs was developed on the basis of the collaboration between oncologists, infusion center oncology nurses, and a board-certified oncology clinical pharmacist for patients with cancer in two outpatient infusion centers. Patients received multidisciplinary interventions or oncologist-driven interventions on the basis of their reported symptoms during their cancer treatments. They were followed prospectively at regular intervals for further symptom management interventions. To evaluate this program, a retrospective chart review was performed, and data were collected regarding the number and nature of these TRAEs. The outcomes of their interventions were assessed up to 3 months since initial encounters. Data for patient satisfaction were also collected before and after implementation of the program. A total of 308 patients received 469 interventions initiated either by the multidisciplinary team or by oncologists over a 3-year period. Compared with oncologist-led interventions, multidisciplinary interventions were statistically significant in the number of interventions (P = .004; 95% CI, 17.9 to 36.2) and in reducing occurrences of TRAEs (P = .03; 95% CI, 33.8 to 72.4) such as dermatological toxicities, diarrhea, immune-related adverse effects, mucositis, and nausea or vomiting after 1-month follow-up. Multidisciplinary team captured approximately 40% of TRAEs of all grades that were escalated to oncologists for further management, which led to an overall improvement in management of TRAEs. Multidisciplinary care for patients in infusion centers led to improvement in treatment-related toxicities.

Impact of oncology clinical pharmacist intervention on clinical trial enrollment in The U.S. Oncology Network’s MYLUNG Consortium.

1503 Background: The Molecularly Informed Lung Cancer Treatment in a Community Cancer Network: A Pragmatic Consortium (MYLUNG) clinical trial platform aims to advance the use of precision medicine in non-small cell lung cancer patients through a series of prospective and iterative clinic trials. “Protocol 2” is evaluating the patient and tissue journey of newly diagnosed lung cancer patients presenting for care. Timely patient accrual to oncology clinical trials is a known practice challenge. The US Oncology Network recently implemented a clinical pharmacist (ClinReview) to provide remote clinical services to support Protocol 2 enrollment. Methods: An oncology-trained clinical pharmacist remotely reviewed chemotherapy regimen orders and a weekly custom recruitment report within six community network practices (n = 149 physicians). The ClinReview pharmacist identified, screened, and assisted with recruitment of eligible patients for enrollment in the MYLUNG study. Relevant and concise patient data were provided to the on-site research team to facilitate ease of enrollment. Enrollments and intervention data were tracked to monitor the impact of the pharmacist intervention. The primary outcome of monthly enrollment was evaluated using a paired t-test. Results: Over a 6-month period, the ClinReview pharmacist screened 367 potentially eligible patients, 325 patients were recommended for enrollment, and 103 patients (32%) were consented and enrolled. Enrollment due to this ClinReview intervention increased monthly and ranged from 5 in first month to 33 enrollments in month 6. Average monthly enrollment was significantly greater after ClinReview intervention (3.4 patients/month vs. 6.8 patients/month; p = 0.008). Of the 154 patients recommended for enrollment that were not enrolled, 104 (68%) exceeded their eligibility window allowed by the trial, 15 (10%) were deceased or enrolled into hospice care, 10 (6%) declined trial participation, and 25 (16%) transferred care or were treated at outside facilities. Conclusions: We demonstrate that incorporation of an oncology clinical pharmacist in clinical research teams significantly enhanced clinical trial enrollment. The remote pharmacist easily adapted into clinic workflows in community practices. Validation across a broader spectrum of differentially resourced oncology practices will be conducted as the MYLUNG clinical trials platform is executed. [Table: see text]

The Practice of Scientific Publications by Pharmacists in Saudi Arabia

PTB Reports,2022,8,1,26-36.DOI:10.5530/PTB.2022.8.4Published:April 2022Type:Research ArticleAuthors:Yousef Ahmed Alomi, Sultan Mohammed Al-Jarallah, Juman saad Mohammad Alsaab, Razan Alshehri, and Khawla Ibrahim Al-shahrani Author(s) affiliations:Yousef Ahmed Alomi*, BSc. Pharm, MSc. Clin Pharm, BCPS, BCNSP, DiBA, CDE, Critical Care Clinical Pharmacists, TPN Clinical Pharmacist, Freelancer Business Planner, Content Editor and Data Analyst, Riyadh, SAUDI ARABIA. Sultan Mohammed Al-Jarallah, Bsc. Pahrm, Msc Clin Pharm, Head, Ambulatory Care Pharmacy, Oncology and Hematology Clinical Pharmacist, Pharmaceutical Care Department, Security Forces Hospital, Riyadh, SAUDI ARABIA. Juman Saad Mohammad Alsaab, Erada psychiatric Hospital-Alkharj, Riyadh, SAUDI ARABIA. Razan Alshehri, College of Pharmacy, Taif University, Tail, SAUDI ARABIA. Khawla Ibrahim Al-shahrani, College of Pharmacy, Taif University, Tail, SAUDI ARABIA. Abstract:Objectives: In this study, we aimed to assess the practice of scientific publications by pharmacists in the Kingdom of Saudi Arabia. Methods: In this cross-sectional survey study, we aimed to assess the practice of scientific publications by pharmacists in Saudi Arabia. We used a self-reported electronic survey questionnaire and distributed it to pharmacists from interns to consultants and specialists in Saudi Arabia. The survey collected demographic information and information about the type of publications made by them, the selected elements used during scientific publications, and the social media platforms where they distribute your publication. We used a 5-point Likert response scale system with close-ended questions to obtain responses. The data were collected through the Survey Monkey system and analyzed using the Statistical Package of Social Sciences (SPSS), Jeffery’s Amazing Statistics Program (JASP), and Microsoft Excel software (version 16). Results: A total of 543 pharmacists responded to the questionnaire. Of them, more than one-quarter were from the central region (5 (28.55%)) followed by the eastern region (133 (24.49%)), with statistically significant differences between regions (p=0.000). Females responded (321 (59.12%)) more than males (222 (40.88%)). Based on nationality, Saudi nationals (351 (64.64%)) responded more than non-Saudi nationals (192 (35.36%)), with statistically significant differences between them (p=0.000). The average score for type of journal for scientific publications was 3.99 with high scores obtained “article in the international scientific journal” (4.26) and “article in the local scientific journal” (4.22), with statistically significant difference between responses (p=0.000). The average score of pharmacist practice of unique elements during scientific publications was 3.81, with high scores obtained for the element “are your colleague’s reviewers” (4.10) and “spelling and grammar checker through special software” (3.95). The average score for the “type of social media platforms to distribute your scientific publications” was 3.33, with high scores obtained for WhatsApp (3.73) and YouTube (3.56). The scores for the single-test reliability analysis of McDonald’s ω was 0.939, Cronbach’s α was 0.935, Gutmann’s λ2 was 0.942, Gutmann’s λ6 was 0.976, and greater lower bound was 0.990. Conclusion: The practice of scientific publication by pharmacists was found to be fair in Saudi Arabia. An annual report about pharmacists involved in the scientific publication is suggested. We recommend improving the practice of scientific publications by pharmacists in Saudi Arabia. Keywords:Pharmacist, Practice, Publications, Saudi Arabia, ScientificView:PDF (234.03 KB) PDF PDF Images The Practice of Scientific Publications by Pharmacists in Saudi Arabia

Abstract P1-18-23: Implementation and evaluation of a shared care model between oncologists and pharmacists for advanced breast cancer patients on cyclin-dependent kinase (CDK) 4/6 inhibitors

Abstract Background: The introduction of CDK4/6 inhibitors for advanced hormone receptor positive, HER2 negative, breast cancer patients has contributed to increased ambulatory patient visits for oncologists. Oncology clinical pharmacists have training and expertise in medication management and adherence. The aim of the Medication Assessment by Pharmacist (MAP) program is to evaluate the impact of clinical pharmacists performing medication assessment follow-up visits. Methods: Metastatic breast cancer patients on a CDK4/6 inhibitor (palbociclib or ribociclib) deemed suitable for pharmacist assessment were identified by medical oncologists at British Columbia (BC) Cancer Surrey. Oncologists can book the patient for a pharmacist medication assessment appointment at alternate cycles. The clinical pharmacist uses standardized medication assessment forms, provincial protocols and toxicity management guidelines. Results: Between April 2018 to December 2019, 82 patients were initiated on a CDK 4/6 inhibitor at BC Cancer Surrey. Of these, 12 patients (14.6%) were selected for the MAP program for a total of 17 pharmacist visits. This resulted in 340 minutes of clinic time savings for physicians. Patients who underwent the MAP program were more likely to follow provincial and regional protocols for scheduling clinic visits (99%) as compared to those who did not (96%). Rates of monitoring investigations adhering to provincial protocols were similar between those in the MAP program or not (97.6% versus 97.7%). There was a 100% physician and pharmacist survey response rate with a total of 9 physicians and 9 pharmacists participating. 100% of surveyed pharmacists agreed or strongly agreed when asked whether MAP increased job satisfaction. 100% of physicians indicated that MAP reduced physician workload. Physicians and pharmacists who participated in MAP all agreed or strongly agreed when asked if patients were receptive to meeting with a pharmacist. Only 33% of physicians routinely ask about medication adherence, newly started medications or natural health supplements at each visit, as compared with 100% of pharmacists. 100% of physicians reported that they wanted to see MAP expanded to include additional oncology drugs. Conclusions: This study demonstrates that expanding the role of clinical oncology pharmacists and their integration in a shared care model with oncologists can reduce ambulatory patient visits for oncologists without compromising clinical care. Additionally, leveraging pharmacist expertise helps to enhance care by evaluating medication adherence and concurrent drug therapies. Based on this program, MAP has expanded to include additional cancer centres and other oral cancer therapies. This shared care model in the ambulatory oncology setting may be a way to help alleviate projected shortages of oncology providers. Citation Format: Angela Chan, Sylvie Labelle, Elaine Goh. Implementation and evaluation of a shared care model between oncologists and pharmacists for advanced breast cancer patients on cyclin-dependent kinase (CDK) 4/6 inhibitors [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P1-18-23.

Development and implementation of a pharmacist-led telehealth medication management program for veterans receiving oral antineoplastic therapies through the MISSION Act.

Veterans prescribed oral antineoplastic therapies (OATs) by community providers outside the Veterans Health Administration (VA) may lack access to comprehensive medication management. To address this, our multidisciplinary team developed and implemented a pharmacist-led telehealth medication management program for veterans prescribed OATs by community providers. The program exclusively uses telehealth to connect veterans with a dedicated board-certified clinical oncology pharmacist who provides comprehensive medication management. The program is based on established pharmacy models found in the research literature. We developed a standard operating procedure, communication templates, patient education materials, and a suite of health information technology tools to help streamline pharmacy processes. The Consolidated Framework for Implementation Research was used to design implementation strategies to promote the adoption of the program. In the first year, 64 veterans from 3 VA medical centers were enrolled in the program. The oncology clinical pharmacist performed 342 encounters and 101 interventions. The program saved an estimated $200,724 in medication-related costs. The veterans we surveyed reported high levels of satisfaction with the pharmacy services provided by the program. The delivery of comprehensive medication management through telehealth is feasible from a healthcare system perspective and beneficial for patients. The board-certified oncology clinical pharmacist provided remote pharmacy services to Veterans across three sites in a large and rural service area for the VA. The program realized several benefits, including positive clinical outcomes, high levels of patient satisfaction, and cost savings on medication-related costs.

Knowledge of Pharmacists about Scientific Publications in Saudi Arabia

PTB Reports,2021,7,3,115-125.DOI:10.5530/PTB.2021.7.19Published:December 2021Type:Research ArticleAuthors:Yousef Ahmed Alomi, Sultan Mohammed Al-Jarallah, Juman saad Mohammad Alsaab, Razan Alshehri, and Khawla Ibrahim Al-shahrani Author(s) affiliations:Yousef Ahmed Alomi*, BSc. Pharm, MSc. Clin Pharm, BCPS, BCNSP, DiBA, CDE, Critical Care Clinical Pharmacists, TPN Clinical Pharmacist, Freelancer Business Planner, Content Editor and Data Analyst, Riyadh, Saudi Arabia. Sultan Mohammed Al-Jarallah, Bsc. Pahrm, Msc Clin Pharm, Head, Ambulatory Care Pharmacy, Oncology and Hematology Clinical Pharmacist, Pharmaceutical Care Department, Security Forces Hospital, Riyadh, SAUDI ARABIA. Juman saad Mohammad Alsaab, Erada psychiatric Hospital-Alkharj, Riyadh, SAUDI ARABIA. Razan Alshehri, College of Pharmacy, Taif University, Tail, SAUDI ARABIA. Khawla Ibrahim Al-shahrani, College of Pharmacy, Taif University, Tail, SAUDI ARABIA. Abstract:Objectives: In this study, we aimed to assess pharmacists’ knowledge about scientific publications in the Kingdom of Saudi Arabia. Methods: In this cross-sectional survey, we analyzed pharmacists’ knowledge about scientific publications in Saudi Arabia. We used a self-reported electronic survey questionnaire and distributed it to pharmacists from interns to consultants and specialists. The survey collected demographic information of the responders and their knowledge of selected research paper elements in a scientific journal. We used 5-point Likert response scale system with closeended questions to obtain responses. The data were collected through the Survey Monkey system and analyzed using the Statistical Package of Social Sciences (SPSS) and Jeffery’s Amazing Statistics Program (JASP), and Microsoft Excel (version 16) software. Results: A total of 543 pharmacists responded to the questionnaire. Of them, more than one-quarter of the participants responded from the central region (155 (28.55%)), followed by the eastern region (133 (24.49%)), with statistically significant differences between all regions (p=0.000). Females responded more (321 (59.12%)) than that of males (222 (40.88%)). The majority of the responders were Saudi nationals (351 (64.64%)), followed by non-Saudi nationals (192 (35.36%)), with statistically significant differences between them (p=0.000). The average score for knowledge of pharmacists about writing a section in the research article was 4.07, with high scores obtained for the elements “knowledge of the abstract section” (4.51) and “knowledge of the Introduction section” (4.47), with statistically significant between all responses (p=0.000). The average score for knowledge of pharmacists about various study designs in the manuscript was 3.36, with high scores obtained for the elementary knowledge of cohort study (3.59), case series (3.59), observational study, and Letters to the editor (3.49), with statistically significant differences between responses (p=0.000). The average score for knowledge of pharmacists about journal indexing database was (3.17), with high scores obtained for the elementary knowledge of the Google Scholar (3.78), PubMed (3.60), and Index Medicus (3.43). The scores for the reliability analysis of McDonald’s ω was (0.843), Cronbach’s α was (0.847), Gutmann’s λ2 was (0.888), Gutmann’s was λ6 (0.985), and Greater Lower Bound was (0.994). Conclusion: Pharmacists’ knowledge about writing research sections, study design, and journal indexing database for scientific publications in Saudi Arabia was varied. Therefore, we highly recommend improving pharmacists’ training and education during graduation to improve patients’ pharmaceutical care in Saudi Arabia. Keywords:Knowledge, Pharmacist, Saudi Arabia., Scientific PublicationsView:PDF (385.52 KB) PDF PDF Images Knowledge of Pharmacists about Scientific Publications in Saudi Arabia