The Hematology/Oncology Pharmacy Association (HOPA) supports hematology/oncology pharmacy professionals and promotes the role of the pharmacist in collaborative cancer care. HOPA is celebrating 20 years of optimizing cancer care. Founded in 2004, HOPA provides crucial education, networking, and advancement opportunities frequently sought by pharmacists, pharmacy interns, residents, fellows, students, technicians, researchers, and administrators who specialize in hematology/oncology pharmacy. Its vision is to ensure that all individuals affected by cancer have a hematology/oncology pharmacist as an integral member of their care team.
As medication experts within a multidisciplinary cancer care team, hematology/oncology pharmacists play an integral role in the care of people with cancer. Our extensive training in medication management complements the skill sets of oncologists, nurses, and other cancer care providers. Furthermore, when pharmacists are integrated into oncology practices, time is saved and physician workload is alleviated, which is crucial as we face a national shortage of oncologists in coming years.1
HOPA is made up of nearly 4000 professionals, residents, and students, and our contributions help optimize cancer care in numerous inpatient, outpatient, managed care, and infusion settings. HOPA is also increasingly involved in professional services, advocacy and policy, and industry (pharmaceutical company) careers.
Common Contributions Across the Cancer-Care Continuum
Oncology pharmacy is both complex and niche. It is highly specialized with a concentration on drug-therapy management, yet the breadth of our role is ever expanding. Some of our most common contributions include the following:
- Clinical skills and medication therapy management
- In direct patient care, oncology pharmacists personalize chemotherapy and supportive-care medications and often select, prepare, dose, and dispense the drugs. Our role includes monitoring disease-related symptoms, managing drug levels, assessing drug interactions, and managing adverse effects.
- One of our primary concerns is to mitigate medication errors. As oncology pharmacists, we play a key role in identifying and managing drug interactions, including drug-drug, food-drug, and drug-supplement interactions.
- Health care delivery to meet demands
- To help meet the demands of cancer-care delivery, oncology pharmacists manage formularies and develop clinical pathways, create/prepare order-set designs, navigate drug shortages, and provide chemotherapy stewardship.
- Though not traditionally part of the role of the oncology pharmacist, we often help with access to specialty drugs, manage high-cost medications, and maximize insurance reimbursements.
- Professional services
- Oncology pharmacists are well-suited to lead within professional service organizations, provide mentorship for both trainees and peers, and take part in advocacy efforts. It is increasingly common for oncology pharmacists to conduct clinical, translational, and practice-management research and take part in quality and safety initiatives at the institutional level.
- Advocacy and awareness
- Because of our unique vantage point, oncology pharmacists are often called on to advocate for people with cancer and build awareness of the oncology pharmacy profession. Twice a year, HOPA members take part in Hill Day along with staff and our patient advisory panelists.
- By sharing personal stories with elected officials, in person, virtually, or through letter-writing campaigns, we can send the message about the need to improve the cost, delivery, and accessibility of cancer treatment.
We anticipate the hematology/oncology pharmacy profession to continue to grow in importance as the complexity of cancer therapies continues to increase. Dominated by targeted drugs and biologics, more than 200 oncology drugs were approved for nearly 575 indications between 2000 and 2022.2
Two of the most common practice settings for HOPA members are academic medical centers and community settings. Though roles may vary, clinical oncology pharmacists often manage chemotherapy, immunotherapy, and targeted therapies. We also provide supportive care by recommending medications for adverse effects (AEs), pain, and immunosuppression. We may also be involved in managing comorbid conditions, including depression.
Oncology pharmacists also provide another crucial element of care: education about what to expect while going through cancer treatment. We educate patients and caregivers about the risk of AEs and work to help them avoid infection, blood clots, and unmanaged pain. Perhaps one of the most fulfilling aspects of clinical care is helping patients prevent and treat chemotherapy-induced nausea and vomiting.
Oncology Pharmacists in Academic Medical Centers
As academic medical centers lead the way in medical education, research, and patient care, oncology pharmacists are both a product of and an engine for continued improvements in cancer treatment. In these interdisciplinary settings, we work as both practitioners and instructors to advance oncology pharmacy.
We educate, train, and mentor pharmacy students and residents as well as learners in other medical professions. We often educate health care providers by using peer and interprofessional tactics, teaching informal in-service programs, and delivering continuing education content. HOPA has created Core Competency, an educational program to help bridge oncology pharmacy gaps within the cancer care workforce.
Some of the most complex and challenging cancer cases are referred to academic medical centers. We work closely and collaboratively with a diverse team of health care professionals, including oncologists, surgeons, radiologists, nurses, social workers, and dietitians. Oncology pharmacists in these settings are involved in creating and managing intricate treatment plans, requiring advanced knowledge and problem-solving skills. Our input is vital in navigating the nuances of personalized cancer therapies.
In academic medical centers, oncology pharmacists contribute to research and innovation, collaborate on clinical trials, lead clinical and translational research projects, and publish findings to help advance patient outcomes. Often, our contributions to developing new cancer therapies help ensure emerging treatments are safely and effectively integrated into clinical practice.
Careers in academic medical centers include clinical practice on an inpatient service and/or in ambulatory care; teaching through didactic education, facilitation, course and/or lab coordination, experiential instruction, and serving as a residency preceptor and/or director; research/scholarships, including submitting abstracts, poster presentations, and publishing papers as well as applying for grants to assist with oncology pharmacist-led research; and service to the organization through participation on or chairing institutional committees.
Oncology Pharmacists in Community Cancer Centers
About the Authors
Karen Fancher, PharmD, BCOP, is an associate professor of pharmacy practice at Duquesne University School of Pharmacy and a clinical pharmacy specialist in oncology at the University of Pittsburgh Medical Center Passavant in Pittsburgh, Pennsylvania.
Amanda Seddon, PharmD, BCPS, BCOP, is a medical science liaison, multiple myeloma and lymphoma, at Bristol Myers Squibb in Chicago, Illinois.
Fancher and Seddon currently serve as advocates for the hematology/oncology pharmacy profession as HOPAmbassadors and have worked in multiple cancer-care settings.
Community cancer centers are crucial for making cancer care accessible to a broader population, including those in suburban and rural areas. While many responsibilities mirror those in academic medical centers, there are nuances to providing oncology pharmacy services in community cancer centers.
Oncology pharmacists play a vital role in ensuring high-quality cancer care is delivered close to patients’ homes. In community cancer centers, the accessibility of the oncology pharmacist ensures that patients receive prompt information and personalized aid throughout their treatment journey.
In community cancer centers, oncology pharmacists are focused on comprehensive medication therapy reviews to identify drug interactions and maximize the effectiveness and minimize the toxicity of therapy. Oncology pharmacists formulate monitoring plans for AEs and answer drug-related questions.
Like most health care settings, community cancer centers are faced with burnout and do not have large staff numbers to help soften the impact of constraints on time and resources. As part of the cancer care team, oncology pharmacists play a key role in optimizing available medications, securing necessary treatments, and managing costs. We help with formulary management and drug reimbursements as well.
While large academic medical centers may be known for conducting clinical trials, community cancer centers also participate, often providing patients with more accessible options closer to home. Oncology pharmacists in community settings help bring innovative treatments to local populations, contributing to the advancement of cancer care and diversifying clinical trials.
Conclusion
Hematology/oncology pharmacists are pivotal in optimizing cancer care across various settings, from academic medical centers to community cancer centers. Our specialized training in medication management complements the skills of multidisciplinary teams, allowing for personalized therapy, enhanced patient education, and proactive AE management. As cancer treatments become increasingly complex and the demand for oncology services continues to rise, the role of oncology pharmacists will only grow in importance. Whether involved in clinical care, research, advocacy, or education, our contributions significantly enhance patient outcomes and support the broader oncology care continuum.
REFERENCES
1. Ignoffo R, Knapp K, Barnett M, et al. Board-certified oncology pharmacists: their potential contribution to reducing a shortfall in oncology patient visits. J Oncol Pract. 2016;12(4):e359-e368. doi:10.1200/JOP.2015.008490
2. Scott EC, Baines AC, Gong Y, et al. Trends in the approval of cancer therapies by the FDA in the twenty-first century. Nat Rev Drug Discov. 2023;22(8):625-640. doi:10.1038/s41573-023-00723-4
