Expert: Pharmacists Are ‘Very Involved in Holistic Care of Patients With Multiple Myeloma,’ Beyond Treatment Alone

Pharmacy Times® interviewed Rachel K. Anderson, PharmD, CSP, clinical program manager at Alliance Rx Walgreens Pharmacy, following her participation in a panel discussion titled Clinical/Trend Management: The Multiple Myeloma Journey at the 2022 Pharmacy Benefit Management Institute (PBMI) Annual National Conference.

During the interview, Anderson addressed the role of the oncology pharmacist in the care of patients with multiple myeloma beyond treatment. Additionally, Anderson discusses the impact pharmacists have on treatment decisions for patients with multiple myeloma throughout their care journey.

Pharmacy Times®: How involved is the oncology pharmacist in a patient with multiple myeloma’s care journey, and is that involvement primarily based around communication with other care team members or directly with a patient?

Rachel K. Anderson: At AllianceRx Walgreens Pharmacy, our pharmacists are very involved in the holistic care of our patients. We have a dedicated oncology pharmacy operations team that includes insurance verification specialists, financial service representatives, patient care advocates, and pharmacists, all working together to help ensure an efficient process with timely delivery of medications for our patients.

It is advantageous to have a dedicated team of individuals who are really knowledgeable about oncology, specifically with an in-depth understanding of the medications used to treat multiple myeloma. Our dedicated therapy teams can navigate any potential insurance challenges, and they work collaboratively with patients and their providers to maintain effective communication.

It’s important to engage with the patient through the method that is most convenient for them, whether that is in person at community-based sites, telephonically, or even via a digital method. We connect with patients and their caregivers during new patient onboarding, any time a new medication is started, during monthly refill reminder calls, if the patient reports an issue or wishes to speak to the pharmacist, and any time a patient has a question.

Pharmacy Times®: How involved is the pharmacist in treatment decisions for a patient with multiple myeloma?

Rachel K. Anderson: Each patient’s multiple myeloma journey is unique, and specialty pharmacists play a significant role in the overall management of the patients we are fortunate to serve. Specialty pharmacists show compassion, empathy, and understanding for patients, especially when they face chronic, complex, or life-altering diagnoses like cancer. It is important to help ensure all patients receive complete and comprehensive care so they can achieve the most positive health care outcomes possible.

Treatment decisions are very personal, and patients should discuss all options with their providers in shared decision making to agree on a treatment plan. The array of therapeutic selections for patients has expanded in recent years and choices depend on patient preferences, signs and symptoms, biomarkers, presence or absence of visceral disease, and potential adverse effects (AEs). While selecting and sequencing optimal therapies for patients remains a challenge, newer study data arm patients and providers with the information needed to make important treatment decisions. Practice standards will also continue to evolve. Specialty pharmacists can help develop individualized management plans for patients with multiple myeloma involving the selection of optimal treatment strategies and formulate approaches to managing patients receiving treatment.

Pharmacy Times®: How do oncology pharmacists communicate with other team members on the patient care team, and what are some best practices to facilitate effective communication throughout the care team?

Rachel K. Anderson: The level of support a patient with multiple myeloma needs may vary throughout their treatment journey, so ongoing communication is key. It is important to stay informed of medication therapy changes so that appropriate education and counseling are provided to the patient and/or caregiver.

Additionally, oncology pharmacists help patients and caregivers understand the goals of therapy and what they should expect from treatment, including potential AEs and how to manage them, encouraging adherence to the prescribed regimen, discussing storage and administration, checking for any drug interactions, and other concerns such as financial assistance programs.

Our pharmacists help ensure continuity of care by working closely with the prescriber’s team to address changes in therapy and dosing adjustments, as well as keep them informed of any patient-reported issues. Best practices for maintaining effective communication should include speaking slowly and clearly, avoiding medical jargon, soliciting questions effectively and consistently, simplifying messages, and using a “teach-back” method to be certain to assess the patient’s understanding.

In addition to verbal communication strategies, the use of written tools such as patient education pamphlets, emails, apps, and other digital methods are helpful when corresponding amongst the patient care team. The patient’s health care team must work together to provide the highest quality of care, which includes open communication, sharing data, asking questions, and seeking solutions together.

Pharmacy Times®: How is the care of a patient with multiple myeloma impacted without the presence of an oncology pharmacist working in collaboration with other care team members?

Rachel K. Anderson: All pharmacies, AllianceRx Walgreens Pharmacy included, strive to provide the best individualized patient care. The key differences between specialty pharmacies with oncology team pharmacists and other types of pharmacies are the conditions treated (such as multiple myeloma), types of medications dispensed, and the processes of getting those medications to patients.

Specialty oncology pharmacists often require additional training to be well-versed in the ongoing clinical management of oncology patients such as frequent dosing adjustments, intensive clinical monitoring, extensive patient training and education, compliance issues, complicated treatment regimens, or manufacturer reporting requirements. Working together with other health care providers, specialty oncology pharmacists can help ensure patients achieve optimal outcomes, both clinically and financially.

Regardless of their area of expertise, all pharmacists are an important part of a patient’s health care team and are available to answer questions patients may have about their medication, treatment plan, and AEs.

Pharmacy Times®:What is the role of an oncology pharmacist in patient education regarding treatment expectations, guidance, and outcomes during a patient with multiple myeloma’s care journey?

Rachel K. Anderson: Our pharmacists pride themselves in walking alongside patients throughout their care journey. Pharmacists can provide in-depth medication management for patients. At AllianceRx Walgreens Pharmacy, we emphasize the importance of adherence, guide patients in preventing and managing AEs, and monitor for any potential drug interactions.

Pharmacists also offer disease state counseling, connect patients and caregivers to resources, explore options to help lower costs, and are available 24/7 to provide the best possible care. Oncology-specific clinical programs facilitate pharmacist counseling, drive adherence, and focus on the complete care of each individual patient.

Educating patients on their potential risks for disease complications is important and may encourage adherence to prescribed medications and keeping scheduled follow-up appointments with the prescriber. In addition to helping ensure medications are shipped correctly and on time, oncology pharmacists help patients navigate the health care system, identify ways to live a healthy lifestyle, and provide a caring face for those who may be going through challenging times that accompany living with a condition like multiple myeloma.

Specialty drugs are often associated with higher costs and specialty pharmacies can help patients explore all options to find the most affordable care. This search includes reaching out to various drug foundations and supporting patients in applying for copay assistance or other pharmacy-related financial assistance programs when available. Working together with other health care providers, specialty pharmacists can help ensure patients achieve the most optimal outcomes both clinically and financially.