HOPA President-Elect: The Message Is Clear That Oncology Practice ‘Has to Change, Needs to Be More Patient Focused’

Pharmacy Times interviewed Heidi D. Finnes, PharmD, BCOP, FHOPA, president-elect of Hematology/Oncology Pharmacy Association (HOPA); senior manager of pharmacy cancer research at the Mayo Clinic Cancer Center; assistant professor of pharmacy in the Mayo Clinic College of Medicine; and director of the Mayo Clinic Cancer Center Pharmacy Shared Resource, on details of the upcoming HOPA 2022 conference as well as her plans for the direction of the organization as she steps into her role as president of HOPA this year.

Alana Hippensteele: Hi, I’m Alana Hippensteele with Pharmacy Times. Joining me is Heidi D. Finnes, PharmD, BCOP, FHOPA, president-elect of Hematology/Oncology Pharmacy Association (HOPA); senior manager of pharmacy cancer research at the Mayo Clinic Cancer Center; assistant professor of pharmacy in the Mayo Clinic College of Medicine; and director of the Mayo Clinic Cancer Center Pharmacy Shared Resource. Heidi is here to discuss the upcoming HOPA 2022 conference as she steps into her role as president of HOPA this year.

Heidi Finnes: Thank you very much for having me today. I've been involved with HOPA since 2004, when it became a formal organization. I think the first couple of years, I was just a member. But I got involved as part of the program committee, which is known as our Annual Conference Committee, and served in that role for several years as a committee member, and then as the chair of the HOPA conference or Annual Conference Committee.

Through HOPA, I met so many interesting and talented pharmacists. I think, at least those first few years, I was in awe of all the things they were doing and suggesting that we talk about at the conference.

So, my first conference was I believe in Salt Lake City, which was I think 10 to 15 years ago. I remember leaving the conference so energized, thinking, ‘Oh my gosh, I need to implement all these things that I've learned into my practice in Minnesota at Mayo Clinic,’ and I've always found the conference to be that inspiring.

I come and hear all these different topics and all these novel things that people are doing to care for hematology/oncology patients, and I think that's helped me to really keep an open mind and to never stop striving to continue to advance my practice and care for patients with cancer. So, I always love the HOPA annual conference every year and look forward to learning from others.

Alana Hippensteele: Absolutely. Since joining HOPA, how have you seen the organization evolve over the years?

Heidi Finnes: I think HOPA has always been known for its strong educational content. We really want HOPA to be the premier provider of continuing education credits, as well as board certification and oncology credits. But as our membership has grown, I've really seen an advancement in HOPA’s mission, which is to have a hematology/oncology pharmacist as an integral member of every cancer patient’s care team, and as we've kind of looked at that, we've created broader strategies other than education. We've become very active in the advocacy community on [Capitol] Hill day, promoting pharmacists as providers and different types of legislation for patients with regards to cost and biosimilars and things like that.

I think we've also really taken a pointed focus to look at the patient's viewpoint on what the pharmacist is, and we've actually developed under Dr. [Larry] Buie’s presidency year a patient panel that has been helping us to direct some of HOPA’s content to be directed to supporting patients seeing the need of having a pharmacist involved to help identify drug interactions and provide the best care possible we can for patients with cancer.

Alana Hippensteele: Right. As you step into your term as president-elect of HOPA this year, what are some key initiatives you are looking to progress?

Heidi Finnes: Well, we want to continue many of the initiatives that have been started by prior presidents. I think one of the issues we have is presidents come yearly, and we all have a bit different agenda. But I think many of the things started by Dr. [David] DeRemer and Dr. Buie will be very important for HOPA to carry out, particularly our [diversity, equity, and inclusion (DEI)] initiatives, as well as some of the other patient-focused activities that have been started, as well as our Oral Research Collaborative.

I'm an investigational drug service pharmacist by training and much has changed for us over our time with COVID-19. So, one of the things that I'm really interested in particularly is seeing the ways in which pharmacists have cared for cancer patients during COVID-19, and how that has really changed.

For example, I couldn't imagine caring for a patient like we're talking today via Zoom, video conferencing, or even phone calls, but COVID pushed us to embrace technology and find ways in which we could interact with patients. I think care traditionally has always been very focused on the patient coming to the institution, versus care focusing really on the patient itself.

So, I think we're hopeful that cancer care, as well as care of patients and clinical trials, continues into that foray where we can bring more care to the patients. So, I think that's one of the things I would like to focus on are these novel practices to take this opportunity as ways that pharmacists can participate in following medications, seeing patients via video visits or telephone visits, to record toxicities, and make assessments so that—particularly during the time with shortages of nurses and physicians—patients can be cared for by pharmacists. I think provider status is going to be ever more important for pharmacists with that mechanism.

The second thing I'd like to focus on is, again, continued collaborations. That's another area that HOPA has really grown. I think over the last 5 to 7 years in the number of organizations we collaborate with to complete projects, I think we've realized there's no need to do everything by yourself, and there's more power in numbers to making things happen.

So, one of those projects that's going to be very important on the horizon is pharmacist burnout. COVID-19, I think, has really highlighted this. A study done by Allison Goldbach, who was one of our PGY2 oncology residents at Mayo Clinic, showed that 61.8% of pharmacists during the 2020 to 2021 timeframe were experiencing burnout. Many of those pharmacists also had severe burnout and were worried about making a medication error.

So, I'm proud that HOPA has stepped up. One of the things we’ve recently done is we've created a wellness taskforce, and we've also hired some consultants to review the data that Allison Goldbach and her colleagues came up with, as well as a review of the literature, because there's much published on physician burnout, but not a lot on pharmacist burnout.

So, we're hopeful to come up with some solutions, whether they be toolkits or collaborations with other organizations, to really let our pharmacists know that we're hearing them and that we're helping to develop metrics that may ease that burnout and prevent those feelings of dissatisfaction with their job and career.

The last thing that I'm hoping to focus on is, again, to deal with collaborations. HOPA frequently gets requests to have HOPA members explain the role of the hematology/oncology pharmacist. One of the things that we've kind of come up with idea-wise is to have a HOPAmbassador—and that's all one word—it's a hematology/oncology pharmacy ambassador, but it also encompasses our name. But we'd like those people to be able to get out to other organizations because we feel that having these types of ambassadors to really bring to life what a hematology/oncology pharmacist is will only help to expand HOPA’s mission to ensure that pharmacists are a part of that care team for patients with cancer.

Alana Hippensteele: Right. That's quite a lot and that's beautiful. So, I understand that diversity, equity, and inclusion, or DEI, was an area that outgoing HOPA president Larry Buie looked to progress both in terms of pharmacists practicing in the field and patients being treated and included in clinical trials. Do you have any plans in this area for your term—you've gone over how this will be a focus, but do you have any further details you could provide?

Heidi Finnes: This will continue to be a major priority for HOPA both within our own organization as a group of pharmacists that also to ensure that this is representative of the patients that we treat within our organizations or institutions.

Under Dr. Buie, we put together a taskforce who was led by Maurice Alexander and Britny Brown, and they have done so much work. It's been impressive to review our strategic plan for HOPA and to integrate into every aspect of our strategic plan our committee structures, our board members, recommendations for how we can have a more diverse as well as inclusive environment for pharmacists within our organization.

They've even gone so far as to make recommendations to how we can do that externally to patients that may be on clinical trials or patients that traditionally may not receive certain types of cancer treatments or standard of care because of lack of knowledge or affordability of those types of things. So, they've finished their review of that and have prioritized some of those activities.

So, we'll look to that taskforce now to become a permanent member of our committee structure in order to implement some of these priorities, and we'll just try to work down the list and reprioritize as other things come up. But I can't thank them enough for all the things that they've tried to do to bring this to light and help us make HOPA a better organization—that helps us to better interact with our cancer patients as well.

Alana Hippensteele: Absolutely. So, building off that, one area we've looked at is issues around regional diversity within clinical trials. Is that something that HOPA will also be looking to address within the context addressing clinical trial patient recruitment and diversity?

Heidi Finnes: I hope so. Again, as someone who's very involved with research, I hope that we will continue to look at ways to work, not just in a silo by ourselves, but with other organizations, ways to make clinical trials more available to patients.

We have a very active Investigational Drug Service Special Interest Group, which is basically a group of pharmacists that all they do is dispense investigational medications for clinical trials, and they care for those patients. I shouldn't say that's all that they do, because they do a lot of things associated with that, but they ensure, basically, the regulatory compliance and reproducibility of a clinical trial.

One of the things we've talked about in that group is the increased need to reach more rural patients, and potentially patients who don't have opportunities to participate in clinical trials. So, we've been talking about different centralized models where you may have a hub and you may have different rural areas that may be kind of bespoke that centralized area delivers drug to for clinical trials.

We've talked about also and really hoped to forge a relationship with the FDA to change some of those regulations that don't permit us to mail investigational drugs. That will require changes to state and federal regulations as well. I think that's not something that's going to change anytime soon. But, I think the message is very clear: practice has to change, and it needs to be more patient-focused. So, we're really looking to ways which we can partner with others to figure out how to do that.