DEPOSIT PHOTOS
Oncology care is complex, often involving dangerous, high-risk medications. At the Rutgers Cancer Institute, pharmacists board-certified in oncology play an integral role in the management of patient care, including medication selection and safety to ensure that drugs are delivered to the right patients and meet essential criteria.
Pharmacists, as the drug experts, have an intimate understanding of drug interactions, side effects and co-morbidities that could affect patients. At the RCI, oncology pharmacists educate patients about the therapy they receive, review the dosing schedule and provide patients a comprehensive assessment of other medications and supplements they may be taking.
“Part of my job is to make sure that a patient’s medication profile is safe and able to be adhered to. The longer they are going to be on therapy for their cancer diagnosis then they are going to reap the greatest benefits from that,” said Michael Kane, director of oncology pharmacy services and director of the research pharmacy shared resource.
The pharmacist’s role, said Kane, is to assist physicians and licensed practitioners in oncology in medication selection and medication safety so that they ensure the delivery of medication to the right patient that meets all the safety criteria of their baseline lab work, their diagnostic pathology, medication to medication interaction and their overall well-being.
“Because if you dispense the latest and greatest medication or respond to the prescription of the latest and greatest medication in our time – and it’s not right for that patient – the lack of adherence is going to come as a result of the patient having side effects,” said Kane.
Kane said that oncology pharmacists routinely have conversations with patients about the nature of their disease and their management options.
“We look at blood work to ensure that we are not proceeding down an unsafe path and that we actually match both the drug and the dose of the drug to the patient’s ability to tolerate it safely.”
Historically, oncology pharmacists were not involved in direct patient care, but in recent years they have become key players on the health care team along with physicians and nurses.
Oncology pharmacists, said Kane, are in a unique position to discuss side effects from chemo agents, review other options with patients, address issues such as antiemetic agents and hydration as well as working with dieticians regarding nutritional concerns.
Kane recommends that patients ask to speak to a pharmacist.
“I like to empower patients to ask questions of the health care team at any time.”
Rutgers Cancer Institute pharmacists also have experience in pain management and supportive care. They participate in research including the preparation, handling and storage of investigational agents that are being used in clinical trials.
Board certification
While board certification is not mandatory, certification by the Board of Pharmacy Specialties (BPS) ensures that the pharmacist has advanced knowledge and experience to manage cancer-related and drug-related adverse events or clinical situations not encountered in other disease states due to the increasing number and complexity of drug therapies to treat and prevent cancer.
In addition, board-certified oncology pharmacists are specially trained to recommend, design, implement, monitor and modify pharmacotherapeutic plans to optimize outcomes in patients with malignant diseases and reduce medication errors.
According to BPS, there are more than 2,500 board-certified oncology pharmacists.
Kane
“If you have a cancer diagnosis you want to go to the best center you can get yourself into and be seen by board-certified oncologists. The same principle needs to be applied to every other discipline in oncology care and pharmacy is no different,” Kane said.
“With oncology care being as complicated as it is, I want to make sure that I’m able to provide every patient at least some tangible board-certified pharmacist review of their care before we proceed. It is my goal to have all the pharmacists that work in an organization like this to be board-certified oncology pharmacists.”
Kane noted that non-board-certified pharmacists manage drug therapy and the compounding issues that occur in clean rooms.
“But to be able to provide a board-certified pharmacist assessment of the decision to treat a patient should be standard. It should not be the exception, it should be the rule.”
