HOPA Expert: To Mitigate the ‘Great Migration of Hematology/Oncology Pharmacists,’ First We Need to Understand Why

Pharmacy Times interviewed Andrea Iannucci, PharmD, BCOP, member of the Board of Directors of the Hematology/Oncology Pharmacy Association (HOPA); assistant chief pharmacist of oncology and investigational drugs services and PGY2 Oncology Pharmacy Residency Program director at UC Davis Health; clinical professor with UC Davis School of Medicine in the Division of Hematology/Oncology and at the UCSF School of Pharmacy; and a board liaison for HOPA’s Practice Management Committee, which looks at issues pertaining to the hematology/oncology pharmacy practice management field. Iannucci addresses issues pertaining to how HOPA works within and impacts the space of hematology/oncology pharmacy practice management and the role of the Practice Management Committee in the field.

Alana Hippensteele: Hi, I’m Alana Hippensteele with Pharmacy Times. Joining me is Andrea Iannucci, PharmD, BCOP, a member of the Board of Directors of the Hematology/Oncology Pharmacy Association, or HOPA; the assistant chief pharmacist of oncology and investigational drugs services and the PGY2 Oncology Pharmacy Residency Program Director at UC Davis Health; and a clinical professor with UC Davis School of Medicine in the Division of Hematology/Oncology and at the UCSF School of Pharmacy. Andrea is a board liaison for HOPA’s Practice Management Committee, which looks at issues pertaining to the hematology/oncology pharmacy practice management field.

So Andrea, how does HOPA work within and impact the space of hematology/oncology pharmacy practice management?

Andrea Iannucci: So, HOPA is a really great resource for oncology pharmacists in general. The membership of HOPA is packed with oncology pharmacists and practice leaders who have decades of experience in various aspects of oncology and patient care.

This is a group of pharmacists who are ready, willing, and able to share their wisdom, their knowledge, and their expertise with other pharmacists to help support the ongoing evolution of oncology pharmacy practice. Practice management meetings specifically really focus on aspects of patient care and management in the field of oncology practice, which is quite unique as we deal with a patient population that is fairly vulnerable, but also a population that is dealing with treatments that involve high risk and high stakes that are frequently very, very expensive, and really offer a lot of unique aspects and needs in the realm of practice management.

Alana Hippensteele: Right. HOPA hosts an annual scope of practice management meeting, which this year returns to being in person in Washington, DC, in September. Could you tell me a bit more about this meeting and some key areas HOPA is looking to address?

Andrea Iannucci: So, I think that this meeting this year will be very exciting from a lot of perspectives. One, it will be the first time the practice management meeting has been in person since the start of the pandemic, so that is a really great opportunity for people to meet face-to-face in person again with some of their peers and colleagues who they may not have seen much of over the past couple of years.

The theme of the conference this year is perseverance, and I think that that really aligns with what a lot of us are feeling in health care in general. We are now pseudo–post-pandemic, or at least in a transitioning phase, from the peak aspects of the impact of the pandemic. It's a really great opportunity and time for people to kind of reflect on what changes have happened over the last couple of years and how do we keep going in this very dynamic environment of health care, and particularly oncology care, and tapping into the resources of other pharmacists who work in this special area of oncology practice.

Alana Hippensteele: How can professionals in the field work to develop a practice of perseverance in their day-to-day practices?

Andrea Iannucci: I think that's a really good question. I mean, I think that what people really need are some concrete tools to help them learn how to manage change in an agile and graceful way. But also how to maintain some resilience, how to incorporate self-care in a meaningful way that helps prevent burnout, but also continue to be able to practice in an environment that is both rewarding and intellectually satisfying, as well as meaningful to peers, patients, and other providers in the health care setting.

Alana Hippensteele: One of the themes of this meeting is acknowledging personal and professional challenges. What are some common personal and professional challenges that have arisen for hematology/oncology pharmacists during the COVID-19 pandemic?

Andrea Iannucci: So, I think that in general, health care workers didn't really know what to expect going into this pandemic and how it might impact them. I think there was a balance of worrying for your own personal safety, worrying for the safety of your patients, and worrying for the safety of your family as you're coming in and out of the health care setting and going back home.

I think that some of the key things that we dealt with were staffing challenges, like how do we maintain our adequate staffing to support our patient care needs, while dealing with the fact that staff were getting sick and needing to be home. So, there were just a variety of different challenges to balancing both making sure that we had enough people on site to take care of the patients that were here and maintaining the health and welfare of our staff and our family members throughout the time of the pandemic.

Alana Hippensteele: Absolutely. As challenges arise, how can pharmacists work to mitigate the great migration of hematology/oncology pharmacists from the field?

Andrea Iannucci: So, my feeling is that the best way for us to try to address this issue is to try to fully understand why it's happening. I think that there are a lot of data that suggest that pharmacists, and particularly oncology pharmacists, experience a high level of burnout. I think that we need to verify that level of burnout is what contributes to this migration of pharmacists and their career positions. But I think that we also need to explore other reasons for that migration. There may be some generational differences as younger practitioners are entering the field, things that we may not even entirely understand. So, I think that the key is really to try to understand what the true cause of this is and then try to address how to correct that cause.

Alana Hippensteele: Absolutely. Another theme of the meeting is how change affects your daily practice. Why is this a key topic right now and what are your thoughts on how to best prepare for change in practice management?

Andrea Iannucci: Well, I think that we've all gotten a lot of experience and agility, and ability to adapt to changing needs over the course of the pandemic in health care. I think that oncology in general is also a very dynamic field and that therapies continue to be approved that are newer and better than existing therapies.

So oncology is a very dynamic area, but then not only that, but in health care in general, the landscape continues to evolve in terms of what payers will pay for patient care, where medication should be administered, there's all sorts of site of care issues to optimize the administration and treatment of different diseases to patients, and I think that oncology pharmacists in particular have to really be agile and be willing to adapt to the changing landscape of health care in this field in order to continue to support their patients.