COMMENTARIES
Oncology pharmacy practice
Advances in oncology pharmacy practice Brandon R. Shank, Rowena N. Schwartz, Clarence Fortner, and Rebecca S. Finley Am J Health-Syst Pharm. 2015; 72:2098-100
T
he role of the pharmacist in cancer care has continued to evolve over the last 50 years, in part due to more consistent integration of the pharmacist into cancer care teams. There has been tremendous growth in the number of practitioners who practice as oncology pharmacists since the inception of oncology pharmacy as a distinct practice specialty, with 1626 having earned the Board Certified Oncology Pharmacist (BCOP) designation as of 2014. 1 Not surprisingly, the growth of the specialty has resulted in the expansion of training programs. Currently, there are 85 ASHP-accredited oncology specialty residency programs, accounting for 133 residency positions in 2015.2 Today the scope of oncology pharmacy practice is diverse. A clinical oncology pharmacist may focus on oncology pharmacy operations or patient care—often, the integration of both. The practice environment of oncology pharmacy has also expanded from a predominantly inpatient base to include practice in a variety of ambulatory care settings.
Furthermore, with the ongoing need to develop better and more effective drug therapy for cancer, there is a need for a significant pharmacist presence in the area of investigational drug services. In addition to establishing a strong clinical and operational presence, oncology pharmacists have assumed leadership roles in healthcare settings such as hospitals, health systems, and clinics and in the area of home infusion services. Their roles can expand beyond direct patient care into academia, the pharmaceutical industry, and managed care and payer organizations, as well as areas such as research and informatics and clinical decision support. Oncology pharmacists have continued to develop innovative roles to best support individuals with cancer and their caregivers and to advance healthcare overall. A recent perspective on the role of the oncology pharmacist in healthcare delivery noted that the oncology pharmacist today represents a range of experiences and levels of practice, skills, and responsibilities.3 This diverse scope of practice has fueled continued demand
B randon R. S hank , P harm .D., BCOP, is Clinical Pharmacy Specialist, Division of Pharmacy, University of Texas MD Anderson Cancer Center, Houston. Rowena N. Schwartz, P harm .D., BCOP, is Vice President, Clinical Content and Pharmacy Operations, McKesson Specialty Health, The Woodlands, TX. CAPT (Ret.) C larence Fortner , USPHS, M.S., resides in Rose Valley, PA. Rebecca S. Finley, Pharm.D., M.S., FASHP, is Dean and Professor, Jefferson
College of Pharmacy, Thomas Jefferson University, Philadelphia, PA. Address correspondence to Dr. Shank ([email protected]). The authors have declared no potential conflicts of interest.
2098
Copyright © 2015, American Society of Health-System Pharmacists, Inc. All rights reserved. 1079-2082/15/1201-2098. DOI 10.2146/ajhp150637
Am J Health-Syst Pharm—Vol 72 Dec 1, 2015
for oncology-trained pharmacists to provide optimal care to patients with various malignant diseases and to help manage the complications and challenges of cancer. Historical perspective. In the 1960s, emerging evidence indicated that combinations of cytotoxic drugs had the potential to prolong the survival of or cure selected individuals with advanced cancers. This led to the widespread development and implementation of many promising drugs and complex regimens for cancer care. The exciting possibility of providing meaningful improvements in patient outcomes was tempered by the startling revelation that the successes were coupled with both serious and distressing toxicities and logistic challenges in safe medication preparation and administration. At the time, clinical research on and use of cytotoxic chemotherapy primarily occurred at hospitals associated with research programs, such as the National Institutes of Health clinical center and academic health science centers. Additionally, pharmacy departments were implementing sterile admixture services. It was during this era that pharmacists at these centers began to work closely with the cancer care team, including medical oncologists and nurses, to ensure the integrity of the medicationuse system and to optimize drug therapy—especially in terms of managing drug-related toxicities. In their work, the pioneers of oncology-focused pharmacy practice found a mechanism to communicate informally to share information and strategies. Ultimately, they sought support from ASHP to formalize their network during some of the early ASHP Midyear Clinical Meetings. These efforts quickly
COMMENTARIES
expanded over the next few years to include the development of formal programming at ASHP meetings and Institutes on Oncology Pharmacy Practice sponsored by ASHP at locations across the United States several times a year. In order to disseminate this information to a wider audience of pharmacists interested in oncology, the proceedings of these institutes were published in 1980. 4 During the late 1970s, ASHP established an Oncology Special Interest Group (SIG) whose members worked to assist ASHP in prioritizing the educational needs of members practicing in this area and collaborated with pharmacists in other emerging specialty practice areas as well as the ASHP leadership to develop practice standards and other guidance documents. Specialized training and expertise. In the late 1970s, ASHP received support from partners in the pharmaceutical industry to sponsor an oncology pharmacy fellowship program at one or two academic medical centers each year. Interest in this specialized training program from the profession stimulated the ASHP Oncology SIG to begin collaborating in 1981 with the ASHP accreditation services division to develop and implement the first oncology-oriented residency standards. The first specialized oncology residency program was surveyed and accredited at Walter Reed Army Medical Center in 1984. By that time, many academic health centers had designated pharmacists to practice predominantly as oncology pharmacy specialists and the use of cytotoxic chemotherapy was becoming more widespread in a variety of practice settings such as community hospitals, clinics, and home infusion services. The increasing complexity and recognized risks of cancer therapies led oncology pharmacists, institutional pharmacy directors, and other healthcare professionals caring for individuals with cancer, as well as the
ASHP leadership, to recognize the need to define the practice of oncology pharmacy and designate practitioners with demonstrated knowledge and skills to provide specialized oncology care.5,6 Oncology pharmacy practitioners collaborated within ASHP to define the practice specialty and provide evidence supporting the demand and need for their specialized expertise. This effort ultimately resulted in a petition to the Board of Pharmaceutical Specialties (subsequently renamed as the Board of Pharmacy Specialties) (BPS) to recognize oncology pharmacy as a distinct practice specialty and define a method for credentialing oncology pharmacy practitioners.7 The specialty was recognized by BPS in 1996, and the first certification examination leading to the first conferrals of the BCOP credential occurred in 1998.8 Pharmacists’ roles and responsibilities. An initial focus for pharmacists and pharmacy technicians supporting oncology practice was integrating the clinical and operational aspects of managing chemotherapy. Pharmacists provided pharmaceutical care through the assessment of drug therapy for individuals with cancer and provided oversight to ensure the safe and accurate preparation of chemotherapy.9 Standards were developed to help optimize oncology pharmacy practice and minimize risks associated with the handling of chemotherapy, cytotoxic drugs, and hazardous drugs. Pharmacists developed these standards for pharmacists and other healthcare team members. The standards were made available by ASHP in a technical assistance bulletin published in 1985.10 These standards are continually updated to reflect advances and changes in practice, and additional standards have been published by other organizations and authors to expand on topics such as the safe handling of oral anticancer therapies.11-13 Operational excellence
Oncology pharmacy practice
continues to be a foundational goal for oncology pharmacy practitioners. The application of these standards in practice spans settings ranging from hospitals to patients’ homes. In addition to challenges in the storage and handling of medications, the field of cancer care continues to be marked by drug shortages, which will require vigilant management by oncology pharmacists and other members of the cancer care team.14 The scope of practice of oncology pharmacy practitioners is always evolving in response to changing cancer care needs.15 The scope of practice can be viewed in terms of the oncology pharmacist’s role within the healthcare team, the practice setting, and the area of specialization. The integration of a pharmacist into the cancer care team to support optimal patient care now encompasses collaboration on treatment decisions, therapeutic management, supportive care, and survivorship optimization. Areas of subspecialization for oncology pharmacists range from age-specific practice (e.g., pediatric or geriatric oncology) to disease specialization (e.g., hematology– oncology) and treatment specialization (e.g. bone marrow transplantation, palliative care).16-19 In almost every practice role, the oncology pharmacist is inevitably involved in providing patient or caregiver, and healthcare team education and developing global strategies for the safe and optimal use of antineoplastics. The literature contains many examples of how these roles have advanced cancer care. The Journal of Oncology Pharmacy Practice, the official journal of the International Society of Oncology Pharmacy Practitioners, was launched in 1995 and publishes a wide spectrum of original material from across the oncology pharmacy specialty worldwide.20 It is not surprising that many oncology pharmacists play an integral part in clinical research trial support in a variety of practice settings.21
Am J Health-Syst Pharm—Vol 72 Dec 1, 2015
2099
COMMENTARIES
Oncology pharmacy practice
Oncology pharmacists and pharmacy technicians play a crucial role in investigational oncology studies across the protocol life cycle. The Hematology/ Oncology Pharmacy Association’s “Investigational Drug Service Best Practice Standards” document presents expert recommendations on uniform practices in investigational medication management and the establishment of an investigational drug service to provide guidance to institutions that use investigational medications in clinical research.22 Studies have demonstrated the positive impact of services provided by oncology pharmacists in patients with cancer, including reduction of adverse events, reduction of medication errors, improvement of patient education, enhanced management of supportive care complications, and cost reduction.23,24 Given the narrow therapeutic index of many antineoplastics, medication safety remains an important role for oncology pharmacists, with continued growth expected in initiatives to create systems to reduce errors. Chung and colleagues23 demonstrated a 45% reduction in chemotherapy-related errors after the implementation of an interdisciplinary oncology program that included an oncology pharmacy specialist who was responsible for improving the quality of patient care. Future directions. Pioneers in oncology pharmacy practice have paved the way for continued development of cancer care. Oncology pharmacists continue to create new avenues to support optimization of cancer care. In the future, expansion of collaborative agreements, prescribing privileges, and credentialing may help pharmacists more consistently deliver optimal pharmaceutical care. In addition, implementation of oral chemotherapy programs and management of high-cost medications will be imperative for success as targeted therapies and immunotherapies
2100
become the primary treatment modalities for select cancers. Significant progress in oncology pharmacy practice has occurred over the last half century. In order to best meet the needs of individuals with cancer and the cancer care team, oncology pharmacy practice will need to continue to both adapt and evolve. Advances in cancer care are coupled with complexity, and the oncology pharmacist is a necessary element of managing those complexities. References 1. Board of Pharmacy Specialties. 2014 BPS oncology pharmacy fact sheet (June 2014). www.bpsweb.org/news/ BPSOncologyPharmacyFactSheet.pdf (accessed 2015 Jul 19). 2. National Matching Services Inc. Summary of programs and positions offered and filled for the 2015 Match (2015). www.natmatch.com/ashprmp/ stats/2015summpos.html (accessed 2015 Jul 19). 3. Holle LM, Boehnke ML. Oncology pharmacists in healthcare delivery: vital members of the cancer care team. J Oncol Pract. 2014; 10:e142-5. 4. Oncology pharmacy practice: proceedings of the American Society of Hospital Pharmacists Institute. New York: ElsevierNorth Holland; 1980:1-94. 5. Kolata G. Cancer drug overdoses: rare but deadly (March 24, 1995). www.nytimes. com/1995/03/24/us/cancer-drug-over doses-rare-but-deadly.html (accessed 2015 Aug 2). 6. Gorman C. The disturbing case of the cure that killed the patient (April 3, 1995). http://content.time.com/time/ magazine/article/0,9171,982768,00.html (accessed 2015 Aug 26). 7. Goldspiel BR. Our time has arrived!! Board of Pharmaceutical Specialties approves petition to recognize oncology pharmacy practice as a pharmacy specialty. J Oncol Pharm Pract. 1996; 2:134-5. 8. American College of Clinical Pharmacy. BPS-approved professional development program for BCOP recertification. www. a ccp.com/care ers /b o ard b cop.as p x (accessed 2015 Sep 7). 9. American Society of Health-System Pharmacists. ASHP guidelines on preventing medication errors with chemotherapy and biotherapy. www.ashp.org/DocLibrary/ BestPractices/MedMisGdlAntineo.aspx (accessed 2015 Jul 29). 10. American Society of Hospital Pharmacists. ASHP technical assistance bulletin on handling cytotoxic drugs in hospitals. Am J Hosp Pharm. 1985; 42:131-7.
Am J Health-Syst Pharm—Vol 72 Dec 1, 2015
11. Goodin S, Griffith N, Chen B et al. Safe handling of oral chemotherapeutic agents in clinical practice: recommendations from an international pharmacy panel. J Oncol Pract. 2011; 7:7-12. 12. International Society of Oncology Pharmacy Practitioners Standards Committee. ISOPP standards of practice. Safe handling of cytotoxics. J Oncol Pharm Pract. 2007; 13(suppl):1-81. 13. American Society of Health-System Pharmacists. ASHP guidelines on handling hazardous drugs. Am J Health-Syst Pharm. 2006; 63:1172-91. 14. McBride A, Holle LM, Westendorf C et al. National survey on the effect of oncology drug shortages on cancer care. Am J Health-Syst Pharm. 2013; 70:609-17. 15. Hematology/Oncology Pharmacy Association. HOPA scope of hematology/ oncology pharmacy practice (2013). www.hoparx.org/uploads/files/2013/ H O PA 1 3 _ S c o p e o f P r a c t i c e B k . p d f (accessed 2015 Jul 29). 16. Sokol KC, Knudsen JF, Li MM. Polypharmacy in older oncology patients and the need for an interdisciplinary approach to side-effect management. J Clin Pharm Ther. 2007; 32:169-75. 17. Merten JA, Shapiro JF, Gulbis AM et al. Utilization of collaborative practice agreements between physicians and pharmacists as a mechanism to increase capacity to care for hematopoietic stem cell transplant recipients. Biol Blood Marrow Transplant. 2013; 19:509-18. 18. Beavers MB. Specializing in pediatric hematology and oncology. Am J Health-Syst Pharm. 2007; 64:812-3. 19. Tuffaha HW, Abdelhadi O, Omar SA. Clinical pharmacy services in the outpatient pediatric oncology clinics at a comprehensive cancer center. Int J Clin Pharm. 2012; 34:27-31. 20. Goldspiel B, Sewell G, Chan A. Happy 20th birthday to JOPP. J Oncol Pharm Pract. 2015; 21:83-4. 21. American Society of Health-System Pharmacists. ASHP guidelines on clinical drug research (November 15, 1997). www.ashp.org/doclibrary/bestpractices/ researchgdlclinical.aspx (accessed 2015 Jul 29). 22. Hematology/Oncology Pharmacy Association. HOPA investigational drug service best practice standards. www. hoparx.org/uploads/files/2014/HOPA14_ IDS_Guidelines_Final.pdf (accessed 2015 Jul 29). 23. Chung C, Collins A, Cui N. Development and implementation of an interdisciplinary oncology program in a community hospital. Am J Health-Syst Pharm. 2011; 68:1740-7. 24. Bernstein BJ, Blanchard LM. Economic and clinical impact of a pharmacy-based filgrastim protocol in oncology patients. Am J Health-Syst Pharm. 1999; 56:13303.
Oncology pharmacy practice
Advances in oncology pharmacy practice Brandon R. Shank, Rowena N. Schwartz, Clarence Fortner, and Rebecca S. Finley Am J Health-Syst Pharm. 2015; 72:2098-100
T
he role of the pharmacist in cancer care has continued to evolve over the last 50 years, in part due to more consistent integration of the pharmacist into cancer care teams. There has been tremendous growth in the number of practitioners who practice as oncology pharmacists since the inception of oncology pharmacy as a distinct practice specialty, with 1626 having earned the Board Certified Oncology Pharmacist (BCOP) designation as of 2014. 1 Not surprisingly, the growth of the specialty has resulted in the expansion of training programs. Currently, there are 85 ASHP-accredited oncology specialty residency programs, accounting for 133 residency positions in 2015.2 Today the scope of oncology pharmacy practice is diverse. A clinical oncology pharmacist may focus on oncology pharmacy operations or patient care—often, the integration of both. The practice environment of oncology pharmacy has also expanded from a predominantly inpatient base to include practice in a variety of ambulatory care settings.
Furthermore, with the ongoing need to develop better and more effective drug therapy for cancer, there is a need for a significant pharmacist presence in the area of investigational drug services. In addition to establishing a strong clinical and operational presence, oncology pharmacists have assumed leadership roles in healthcare settings such as hospitals, health systems, and clinics and in the area of home infusion services. Their roles can expand beyond direct patient care into academia, the pharmaceutical industry, and managed care and payer organizations, as well as areas such as research and informatics and clinical decision support. Oncology pharmacists have continued to develop innovative roles to best support individuals with cancer and their caregivers and to advance healthcare overall. A recent perspective on the role of the oncology pharmacist in healthcare delivery noted that the oncology pharmacist today represents a range of experiences and levels of practice, skills, and responsibilities.3 This diverse scope of practice has fueled continued demand
B randon R. S hank , P harm .D., BCOP, is Clinical Pharmacy Specialist, Division of Pharmacy, University of Texas MD Anderson Cancer Center, Houston. Rowena N. Schwartz, P harm .D., BCOP, is Vice President, Clinical Content and Pharmacy Operations, McKesson Specialty Health, The Woodlands, TX. CAPT (Ret.) C larence Fortner , USPHS, M.S., resides in Rose Valley, PA. Rebecca S. Finley, Pharm.D., M.S., FASHP, is Dean and Professor, Jefferson
College of Pharmacy, Thomas Jefferson University, Philadelphia, PA. Address correspondence to Dr. Shank ([email protected]). The authors have declared no potential conflicts of interest.
2098
Copyright © 2015, American Society of Health-System Pharmacists, Inc. All rights reserved. 1079-2082/15/1201-2098. DOI 10.2146/ajhp150637
Am J Health-Syst Pharm—Vol 72 Dec 1, 2015
for oncology-trained pharmacists to provide optimal care to patients with various malignant diseases and to help manage the complications and challenges of cancer. Historical perspective. In the 1960s, emerging evidence indicated that combinations of cytotoxic drugs had the potential to prolong the survival of or cure selected individuals with advanced cancers. This led to the widespread development and implementation of many promising drugs and complex regimens for cancer care. The exciting possibility of providing meaningful improvements in patient outcomes was tempered by the startling revelation that the successes were coupled with both serious and distressing toxicities and logistic challenges in safe medication preparation and administration. At the time, clinical research on and use of cytotoxic chemotherapy primarily occurred at hospitals associated with research programs, such as the National Institutes of Health clinical center and academic health science centers. Additionally, pharmacy departments were implementing sterile admixture services. It was during this era that pharmacists at these centers began to work closely with the cancer care team, including medical oncologists and nurses, to ensure the integrity of the medicationuse system and to optimize drug therapy—especially in terms of managing drug-related toxicities. In their work, the pioneers of oncology-focused pharmacy practice found a mechanism to communicate informally to share information and strategies. Ultimately, they sought support from ASHP to formalize their network during some of the early ASHP Midyear Clinical Meetings. These efforts quickly
COMMENTARIES
expanded over the next few years to include the development of formal programming at ASHP meetings and Institutes on Oncology Pharmacy Practice sponsored by ASHP at locations across the United States several times a year. In order to disseminate this information to a wider audience of pharmacists interested in oncology, the proceedings of these institutes were published in 1980. 4 During the late 1970s, ASHP established an Oncology Special Interest Group (SIG) whose members worked to assist ASHP in prioritizing the educational needs of members practicing in this area and collaborated with pharmacists in other emerging specialty practice areas as well as the ASHP leadership to develop practice standards and other guidance documents. Specialized training and expertise. In the late 1970s, ASHP received support from partners in the pharmaceutical industry to sponsor an oncology pharmacy fellowship program at one or two academic medical centers each year. Interest in this specialized training program from the profession stimulated the ASHP Oncology SIG to begin collaborating in 1981 with the ASHP accreditation services division to develop and implement the first oncology-oriented residency standards. The first specialized oncology residency program was surveyed and accredited at Walter Reed Army Medical Center in 1984. By that time, many academic health centers had designated pharmacists to practice predominantly as oncology pharmacy specialists and the use of cytotoxic chemotherapy was becoming more widespread in a variety of practice settings such as community hospitals, clinics, and home infusion services. The increasing complexity and recognized risks of cancer therapies led oncology pharmacists, institutional pharmacy directors, and other healthcare professionals caring for individuals with cancer, as well as the
ASHP leadership, to recognize the need to define the practice of oncology pharmacy and designate practitioners with demonstrated knowledge and skills to provide specialized oncology care.5,6 Oncology pharmacy practitioners collaborated within ASHP to define the practice specialty and provide evidence supporting the demand and need for their specialized expertise. This effort ultimately resulted in a petition to the Board of Pharmaceutical Specialties (subsequently renamed as the Board of Pharmacy Specialties) (BPS) to recognize oncology pharmacy as a distinct practice specialty and define a method for credentialing oncology pharmacy practitioners.7 The specialty was recognized by BPS in 1996, and the first certification examination leading to the first conferrals of the BCOP credential occurred in 1998.8 Pharmacists’ roles and responsibilities. An initial focus for pharmacists and pharmacy technicians supporting oncology practice was integrating the clinical and operational aspects of managing chemotherapy. Pharmacists provided pharmaceutical care through the assessment of drug therapy for individuals with cancer and provided oversight to ensure the safe and accurate preparation of chemotherapy.9 Standards were developed to help optimize oncology pharmacy practice and minimize risks associated with the handling of chemotherapy, cytotoxic drugs, and hazardous drugs. Pharmacists developed these standards for pharmacists and other healthcare team members. The standards were made available by ASHP in a technical assistance bulletin published in 1985.10 These standards are continually updated to reflect advances and changes in practice, and additional standards have been published by other organizations and authors to expand on topics such as the safe handling of oral anticancer therapies.11-13 Operational excellence
Oncology pharmacy practice
continues to be a foundational goal for oncology pharmacy practitioners. The application of these standards in practice spans settings ranging from hospitals to patients’ homes. In addition to challenges in the storage and handling of medications, the field of cancer care continues to be marked by drug shortages, which will require vigilant management by oncology pharmacists and other members of the cancer care team.14 The scope of practice of oncology pharmacy practitioners is always evolving in response to changing cancer care needs.15 The scope of practice can be viewed in terms of the oncology pharmacist’s role within the healthcare team, the practice setting, and the area of specialization. The integration of a pharmacist into the cancer care team to support optimal patient care now encompasses collaboration on treatment decisions, therapeutic management, supportive care, and survivorship optimization. Areas of subspecialization for oncology pharmacists range from age-specific practice (e.g., pediatric or geriatric oncology) to disease specialization (e.g., hematology– oncology) and treatment specialization (e.g. bone marrow transplantation, palliative care).16-19 In almost every practice role, the oncology pharmacist is inevitably involved in providing patient or caregiver, and healthcare team education and developing global strategies for the safe and optimal use of antineoplastics. The literature contains many examples of how these roles have advanced cancer care. The Journal of Oncology Pharmacy Practice, the official journal of the International Society of Oncology Pharmacy Practitioners, was launched in 1995 and publishes a wide spectrum of original material from across the oncology pharmacy specialty worldwide.20 It is not surprising that many oncology pharmacists play an integral part in clinical research trial support in a variety of practice settings.21
Am J Health-Syst Pharm—Vol 72 Dec 1, 2015
2099
COMMENTARIES
Oncology pharmacy practice
Oncology pharmacists and pharmacy technicians play a crucial role in investigational oncology studies across the protocol life cycle. The Hematology/ Oncology Pharmacy Association’s “Investigational Drug Service Best Practice Standards” document presents expert recommendations on uniform practices in investigational medication management and the establishment of an investigational drug service to provide guidance to institutions that use investigational medications in clinical research.22 Studies have demonstrated the positive impact of services provided by oncology pharmacists in patients with cancer, including reduction of adverse events, reduction of medication errors, improvement of patient education, enhanced management of supportive care complications, and cost reduction.23,24 Given the narrow therapeutic index of many antineoplastics, medication safety remains an important role for oncology pharmacists, with continued growth expected in initiatives to create systems to reduce errors. Chung and colleagues23 demonstrated a 45% reduction in chemotherapy-related errors after the implementation of an interdisciplinary oncology program that included an oncology pharmacy specialist who was responsible for improving the quality of patient care. Future directions. Pioneers in oncology pharmacy practice have paved the way for continued development of cancer care. Oncology pharmacists continue to create new avenues to support optimization of cancer care. In the future, expansion of collaborative agreements, prescribing privileges, and credentialing may help pharmacists more consistently deliver optimal pharmaceutical care. In addition, implementation of oral chemotherapy programs and management of high-cost medications will be imperative for success as targeted therapies and immunotherapies
2100
become the primary treatment modalities for select cancers. Significant progress in oncology pharmacy practice has occurred over the last half century. In order to best meet the needs of individuals with cancer and the cancer care team, oncology pharmacy practice will need to continue to both adapt and evolve. Advances in cancer care are coupled with complexity, and the oncology pharmacist is a necessary element of managing those complexities. References 1. Board of Pharmacy Specialties. 2014 BPS oncology pharmacy fact sheet (June 2014). www.bpsweb.org/news/ BPSOncologyPharmacyFactSheet.pdf (accessed 2015 Jul 19). 2. National Matching Services Inc. Summary of programs and positions offered and filled for the 2015 Match (2015). www.natmatch.com/ashprmp/ stats/2015summpos.html (accessed 2015 Jul 19). 3. Holle LM, Boehnke ML. Oncology pharmacists in healthcare delivery: vital members of the cancer care team. J Oncol Pract. 2014; 10:e142-5. 4. Oncology pharmacy practice: proceedings of the American Society of Hospital Pharmacists Institute. New York: ElsevierNorth Holland; 1980:1-94. 5. Kolata G. Cancer drug overdoses: rare but deadly (March 24, 1995). www.nytimes. com/1995/03/24/us/cancer-drug-over doses-rare-but-deadly.html (accessed 2015 Aug 2). 6. Gorman C. The disturbing case of the cure that killed the patient (April 3, 1995). http://content.time.com/time/ magazine/article/0,9171,982768,00.html (accessed 2015 Aug 26). 7. Goldspiel BR. Our time has arrived!! Board of Pharmaceutical Specialties approves petition to recognize oncology pharmacy practice as a pharmacy specialty. J Oncol Pharm Pract. 1996; 2:134-5. 8. American College of Clinical Pharmacy. BPS-approved professional development program for BCOP recertification. www. a ccp.com/care ers /b o ard b cop.as p x (accessed 2015 Sep 7). 9. American Society of Health-System Pharmacists. ASHP guidelines on preventing medication errors with chemotherapy and biotherapy. www.ashp.org/DocLibrary/ BestPractices/MedMisGdlAntineo.aspx (accessed 2015 Jul 29). 10. American Society of Hospital Pharmacists. ASHP technical assistance bulletin on handling cytotoxic drugs in hospitals. Am J Hosp Pharm. 1985; 42:131-7.
Am J Health-Syst Pharm—Vol 72 Dec 1, 2015
11. Goodin S, Griffith N, Chen B et al. Safe handling of oral chemotherapeutic agents in clinical practice: recommendations from an international pharmacy panel. J Oncol Pract. 2011; 7:7-12. 12. International Society of Oncology Pharmacy Practitioners Standards Committee. ISOPP standards of practice. Safe handling of cytotoxics. J Oncol Pharm Pract. 2007; 13(suppl):1-81. 13. American Society of Health-System Pharmacists. ASHP guidelines on handling hazardous drugs. Am J Health-Syst Pharm. 2006; 63:1172-91. 14. McBride A, Holle LM, Westendorf C et al. National survey on the effect of oncology drug shortages on cancer care. Am J Health-Syst Pharm. 2013; 70:609-17. 15. Hematology/Oncology Pharmacy Association. HOPA scope of hematology/ oncology pharmacy practice (2013). www.hoparx.org/uploads/files/2013/ H O PA 1 3 _ S c o p e o f P r a c t i c e B k . p d f (accessed 2015 Jul 29). 16. Sokol KC, Knudsen JF, Li MM. Polypharmacy in older oncology patients and the need for an interdisciplinary approach to side-effect management. J Clin Pharm Ther. 2007; 32:169-75. 17. Merten JA, Shapiro JF, Gulbis AM et al. Utilization of collaborative practice agreements between physicians and pharmacists as a mechanism to increase capacity to care for hematopoietic stem cell transplant recipients. Biol Blood Marrow Transplant. 2013; 19:509-18. 18. Beavers MB. Specializing in pediatric hematology and oncology. Am J Health-Syst Pharm. 2007; 64:812-3. 19. Tuffaha HW, Abdelhadi O, Omar SA. Clinical pharmacy services in the outpatient pediatric oncology clinics at a comprehensive cancer center. Int J Clin Pharm. 2012; 34:27-31. 20. Goldspiel B, Sewell G, Chan A. Happy 20th birthday to JOPP. J Oncol Pharm Pract. 2015; 21:83-4. 21. American Society of Health-System Pharmacists. ASHP guidelines on clinical drug research (November 15, 1997). www.ashp.org/doclibrary/bestpractices/ researchgdlclinical.aspx (accessed 2015 Jul 29). 22. Hematology/Oncology Pharmacy Association. HOPA investigational drug service best practice standards. www. hoparx.org/uploads/files/2014/HOPA14_ IDS_Guidelines_Final.pdf (accessed 2015 Jul 29). 23. Chung C, Collins A, Cui N. Development and implementation of an interdisciplinary oncology program in a community hospital. Am J Health-Syst Pharm. 2011; 68:1740-7. 24. Bernstein BJ, Blanchard LM. Economic and clinical impact of a pharmacy-based filgrastim protocol in oncology patients. Am J Health-Syst Pharm. 1999; 56:13303.
