Pharmacist’s Role: Raising Awareness for Clinicians

A discussion on how to bring awareness to clinicians that are not aware of the role of an oncology pharmacist.

Annette Hood, PharmD, BCACP: In terms of making clinicians aware of the role of pharmacists, I think that pharmacists should really get involved in their institution working on policies related to the intravenous chemotherapies, helping with protocol development, order sets, things like that. We do a … review of all of our order sets for ovarian cancer, so pharmacists can really get involved in that as well.

R. Wendel Naumann, MD: One of the important points you brought up is both setting expectations and being proactive with management and counseling of patients about the side effects of these drugs because compliance is a big issue, as you pointed out.

Michael Birrer, MD, PhD: My question is on side of the formulary. For classes of drugs we have multiple contenders. Do you have a formal way of deciding what goes on the formulary and does that involve physicians? How do you handle that?

Annette Hood, PharmD, BCACP: For oral medications we don’t have a specific formulary. It goes usually through our specialty pharmacy, so really whatever the prescriber prefers or whatever the insurance will cover for the patient.

Michael Birrer, MD, PhD: I see, interesting.

Maurie Markman, MD: The importance of what you’re describing just can’t be overstated. I’m showing my age a little bit here, but there might be some in the listening, those viewing this actually know that going back now decades, when the original COOPER regimen was developed for the management of breast cancer, cyclophosphamide was given orally, but it became quickly realized that people didn’t take the oral medication. And so they went to intravenous because the advantage of intravenous, as toxic as it was, you knew the patient was going to get it. You managed side effects. Fast-forward several decades, we’re now into a different era where we are using oral agents but compliance and side effects become incredibly important because obviously if that pill sits in the bottle, it doesn’t help any patient or if it gets thrown down the toilet because the patient doesn’t want to tell their family they’re not taking it. So the role of the pharmacist to help in all this, the side effects and everything else, just becomes unbelievably critical as today and as we move forward. So I really have to emphasize, cannot overemphasize the importance of that role.

Michael Birrer, MD, PhD: I was too young to remember that.