Cancer treatment is slowly transitioning away from intravenous drug delivery to oral therapy allowing for more opportunities to improve how drugs are prescribed, dispensed, and monitored. Board certified oncology pharmacists (BCOPs) are in a unique position to improve patient care in each of these areas.1 BCOPs are often regarded as cancer medication experts and have extensive training in medication management and education.2 This unique knowledge set combined with expertise in patient care allows BCOPs to serve as both a resource for multidisciplinary cancer care teams and as a liaison for patient needs.
A recent study has shown that incorporating oncology pharmacists helps to improve capacity, breath, and efficacy, as well as reduce the number of oncology patient visits.3 “The oncology pharmacist is often one of the few team members who fully understands the safety, efficacy, pharmacologic, and financial components of patient care,” said Michael Bourisaw, executive director of the Hematology/Oncology Pharmacy Association.4 On a multidisciplinary team, pharmacists provide up-to-date information and educational materials to their fellow team members about cancer medication, potential drug interactions, and side effects.5 Most importantly, pharmacists are on the frontlines of patient care and are responsible for relaying information to the team about the patient’s response to certain medications and their needs.
Defining the Role of Oncology Pharmacists
BCOPs are involved with patient care at all stages from diagnosis, to treatment decisions, medication management, symptom management, supportive care, to even survivorship programs after treatment completion.2 Oncology pharmacists meet with patients shortly after their diagnosis to learn more about their unique circumstances, including nutritional needs and current medications. Based on this information, they determine the risk of drug interactions and develop a patient-specific treatment plan.
“Then we go over with the patient what we’re prescribing, what it’s for, how to take it, how long they’re going to take it, any side effects they might have from it, and we also touch on adherence,” explained Megan May, PharmD, BCOP, an oncology pharmacist at the Cancer Care Center at Baptist Health Lexington in Kentucky.4 Oncology pharmacists provide a complete set of educational materials to the patient regarding their medication and prescribed administration schedule.1
Literature Support for Pharmacists
In one reported case, including oncology pharmacist consultations as part of a multidisciplinary consultation program for patients before the start of a new oral anticancer therapy improved patient support and treatment. Consultations with oncology pharmacists revealed that 24% of patients needed additional help from a caregiver to take their medication. Additionally, consultations revealed the prescribed medication had drug interactions in 36% of patients, four of whom required a different drug. Altogether, the information delivered by oncology pharmacists improved the ability of local community pharmacists to advise patients by 83%.6
In most cases oncology pharmacists will continue to meet and monitor the patient throughout the treatment course to assess and mitigate potential adverse effects. This helps to build a relationship between pharmacists and their patients and can prove key to identifying and maintaining medication adherence. According to one study, the addition of oncology pharmacists to a multidisciplinary lung cancer treatment team led to significant improvements in patient medication adherence. Oncology pharmacists identified 154 cases in which patients did not adhere to their medication, 43.5% of which placed the patient at high risk. This allowed healthcare providers to intervene in a timely manner, thereby decreasing unplanned admissions and clinic visits.7