Research Opportunities, Patient Care Attracted HOPA President to Career in Oncology Pharmacy

DAVID DEREMER, PHARMD, BCOP, FCCP, FHOPA

TITLE: Clinical associate professor and assistant Director of Experimental Therapeutics Incubator (ETI), University of Florida College of Pharmacy and UF Health Cancer Center

PHARMACY SCHOOL: University of Kentucky

Q: What motivated you to become a pharmacist and to practice in the oncology space?

A: Prior to attending pharmacy school, I worked in several research labs at the Markey Cancer Center in Lexington, Kentucky, and was contemplating graduate school in an immunology program. However, I sensed I would miss a major aspect that was important to me: patient interaction.

I researched pharmacy training, specifically focusing on oncology pharmacy and the opportunities to engage in clinical research. In 1997, you could graduate with your PharmD degree and complete a 1-year oncology residency. The requirements were increased (PGY1 + PGY2) once I chose the PharmD, path, but I started pharmacy school on day 1 with a future career in oncology pharmacy in sight.

Interactions with my future mentor, Val Adams, in the second professional year of the curriculum solidified my career path. It was during this same year that I lost my mother to breast cancer. This personal connection to cancer had a profound impact on my life and my desire to improve care and quality of life for patients with this disease.

Q: What do you think is the biggest challenge facing oncology pharmacy?

A: The biggest challenges facing oncology pharmacy are professional burnout and moral distress. This continues to be reported and discussed amongst many in our profession. I highly encourage readers to visit HOPA’s virtual Presenter Portal and read the research of Allison Golbach, PharmD, BCPS, and her colleagues from Mayo Clinic and Stanford Medicine.

Dr Golbach surveyed the HOPA membership to assess factors associated with burnout. The COVID-19 pandemic significantly worsened membership wellness. More than 60% of hematology/oncology pharmacists surveyed reported high levels of burnout based upon the Maslach Burnout Inventory. Notably for me was the finding that almost 1 of every 3 pharmacists who were surveyed reported a high level of burnout and said they would be likely to leave their current position within the next 2 years.

As a profession, we simply cannot continue this current path. In my opinion, prior efforts among our professional organizations have not led to significant improvements. We need to continue to strategize new methods to mitigate professional burnout.

Q: What is a recent advancement or success you think will really affect the oncology pharmacy space or that you are excited about?

A: As the president of HOPA, I can say our organization is very fortunate to have Emily Mackler, PharmD, BCOP, on our board. She consistently voices her passion for the emergence of pharmacists in value and quality-based care. I am very excited about the role of the oncology pharmacists in this space. I continue to observe HOPA membership interest and positive deliverables in value- and quality-based care.

This year we partnered with the American Society of Clinical Oncology (ASCO) Quality Training Program (QTP) for a 1-day QTP workshop. There was so much membership interest, we needed to expand the offerings for an additional day.

At the 2020 ASCO Quality Care Symposium, there were 14 presentations led by pharmacy investigators. I am eager to follow the positive advancements by our peers in incorporating health care quality and value in practice.

Q: What do you think will be permanently changed in pharmacy by the COVID-19 pandemic?

A: There was a significant pivot in oncology practices over the past year due to COVID-19. Foremost, the emergence of telehealth in maintaining patient care was substantial. For instance, what was supposed to be a pilot program for telehealth in oral chemotherapy at the University of Missouri-Kansas City School of Pharmacy became standard during COVID-19. So far, outcomes appear to make it a viable model from care-delivery and financial standpoints. Our publications committee wrote about this in our latest issue of HOPA News, which is published quarterly.

In my practice area of clinical trials, I see telehealth visits being conducted to reach patients who would not normally participate in trials. Other potential permanent changes include increased shipping of oral drugs by investigational drug services, remote study initiation visits and monitoring by sponsors, use of more e-signatures for informed consents, and use of local laboratory collections for trials.

Q: What do you enjoy most about practicing (or teaching) oncology pharmacy?

A: In my current practice role, I enjoy being able to provide clinical trial options to the patients with cancer we serve in our catchment area. This ability is driven by a multidisciplinary team collaboration, which ultimately requires a lot of coordination. I enjoy this daily collaboration among our highly dedicated professionals.

Q: As HOPA president, discuss board activity and notable achievements over the past year.

A: As expected, COVID-19 significantly affected our board dynamics with virtual teleconferencing, as well as meeting more frequently over the past year, given some of the organizational changes. I want to commend our board, committees, task forces, and staff for all their efforts, insight, and flexibility during this challenging year. HOPA’s strategic pillars are (1) professional development, (2) professional tools and resources, (3) research, and (4) advocacy. We have advanced in each of these pillars over the past year and plan to highlight some of these during our virtual annual conference, April 12-17, 2021.

HOPA’s board of directors and staff have been deeply concerned about violence and discriminatory practices that negatively affect individuals of color or others based on gender and sexual orientation. HOPA was proud to unite with other organizations within the Joint Commission of Pharmacy Practitioners to take a stand against racial injustice.

Earlier this year, HOPA solicited membership feedback specifically on diversity, equity, and inclusion (DEI) of the organization. These data were discussed and shared during HOPA’s first DEI strategic retreat in January. Because of this meeting, we are in the process of creating a DEI action plan. Larry Buie, PharmD, BCOP, FASHP, [current HOPA president-elect] will discuss some of these activities in his incoming president’s message during our annual conference.

Lastly, HOPA’s membership has grown to more than 4100 members, some of whom participate in the 26 committees and numerous task forces within the organization. The board recently participated in an integrated strategic plan retreat to assess COVID-19’s impact on committee activity and progress on our 2020-2023 strategic plan. We are moving forward with specific governance changes that will optimize the volunteer experience as well as advance the development of committee and task force deliverables.

Q: HOPA’s annual conference is being held this month. What sessions would you recommend for aspiring or new oncology pharmacists?

A: My top 5 selections for new oncology pharmacists would include the following:

1. Patient Advocacy Town Hall
2. All BCOP sessions—stay ahead of your continuing education requirements!
3. The John G. Kuhn Keynote Lecture titled “Dismantling Structural Racism in Pharmacy,” presented by Lakesha Butler, PharmD, BCPS
4. The presentation "Health Disparities in Cancer Care: Racism as a Risk Factor"
5. The presentation by our financial partner Graystone, "Investing 101", which is focused on younger members as they begin to navigate personal finance questions.

Lastly, I would promote any of the networking opportunities found within our program. Because we could not meet as an organization in Portland, Oregon, as originally planned, we wanted to bring facets of this city to members. A Portland-based sommelier will be leading "Time to Wine Down", which will provide networking opportunities as he shares his expertise of wines from Willamette Valley. For a comprehensive view of each day of the conference, visit our website: https://hopaannualconference.org/precon

Q: What is 1 fact about you that your patients and students may not know?

A: Despite the increased presence and impact of social media on our daily lives, my New Year’s resolution this year was to minimize my social media activity and revert back to leisure reading. I have been a huge fan of Jon Meacham, a renowned presidential historian. Currently I am reading his book The Soul of America, which was released in 2018. This indicates how far behind I am on leisure reading. Hopefully, I will catch up in 2021.