Bryk Amy, Koontz Susannah, Mayor JoAl, Betcher Jeffrey, Tombleson Rebecca, Bookout Ryan, Saunders Ila M
1 Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, MD, USA.
2 Koontz Oncology Consulting LLC, Houston, TX, USA.
J Oncol Pharm Pract. 2019 Apr;25(3):558-566. doi: 10.1177/1078155217745145. Epub 2017 Dec 5.
Current workforce shortages within the hematopoietic stem cell transplant field necessitate capitalizing on the role of oncology-trained pharmacists. Working within an agreed-upon protocol, pharmacists are able to expand patient care delivery through optimal medication therapy management.
An electronic survey was developed by the Advocacy & Policy Working Committee of the American Society for Blood and Marrow Transplantation Pharmacy Special Interest Group and distributed to pharmacists involved in the care of hematopoietic stem cell transplant patients. The primary objective was to assess the current state of collaborative practice agreements in the hematopoietic stem cell transplant setting.
Forty-eight responses representing 41 institutions were returned. Respondents were mostly female (67%) and practiced in the adult setting (83%). Reponses represented a range of practice experience in hematopoietic stem cell transplant with the majority of the hematopoietic stem cell transplant positions (83%) funded by the department of pharmacy at an academic medical center. Of the 48 responses, 22 (46%) respondents reported having collaborative practice agreements in place; 10 (21%) respondents did not currently have collaborative practice agreements, but were planning to implement them; and 16 (33%) respondents did not have collaborative practice agreements at their institution. Clinical activities performed under a collaborative practice agreement included medication selection and dosing modifications, therapeutic drug monitoring, supportive care management, and management of comorbid conditions and chronic diseases. The most commonly cited barrier to establishing collaborative practice agreements was the inability to secure reimbursement for services provided. No respondents reported a negative impact on job satisfaction.
The results of this survey provide the pharmacy community with a robust understanding of the current landscape of hematopoietic stem cell transplant pharmacy collaborative practice agreements.
造血干细胞移植领域当前的劳动力短缺使得有必要充分利用接受过肿瘤学培训的药剂师的作用。在商定的方案内工作,药剂师能够通过优化药物治疗管理来扩大患者护理服务。
美国血液与骨髓移植药学特别兴趣小组的宣传与政策工作委员会开展了一项电子调查,并分发给参与造血干细胞移植患者护理的药剂师。主要目标是评估造血干细胞移植环境中协作实践协议的现状。
共收到代表41个机构的48份回复。受访者大多为女性(67%),且在成人环境中执业(83%)。回复代表了在造血干细胞移植方面的一系列实践经验,大多数造血干细胞移植岗位(83%)由学术医疗中心的药房部门提供资金。在48份回复中,22名(46%)受访者报告已达成协作实践协议;10名(21%)受访者目前没有协作实践协议,但计划实施;16名(33%)受访者所在机构没有协作实践协议。在协作实践协议下开展的临床活动包括药物选择和剂量调整、治疗药物监测、支持性护理管理以及合并症和慢性病的管理。建立协作实践协议最常被提及的障碍是无法获得所提供服务的报销。没有受访者报告对工作满意度有负面影响。
本次调查结果使药学界对造血干细胞移植药学协作实践协议的当前状况有了深入了解。