Mar 28, 2016
A 2007 report, commissioned by the American Society of Clinical Oncology and written by the American Association of Medical Colleges (AAMC) Center for Workforce Studies, proposed that oncology nurse practitioners and physician assistants could take on increased patient-care roles as a way of addressing an expected, upcoming oncologist shortage. Now, a report in the Journal of Oncology Practice (JOP) suggests that a third group of practitioners—board certified oncology pharmacists (BCOPs)—can also take on aspects of clinical care, potentially covering 2.6 to 3.3 million patients visits per year. This coverage would help offset the shortage of 9.4 to 15.4 million annual visits predicted to occur by the year 2020. The study, “Board Certified Oncology Pharmacists: Their Potential Contribution to Reducing a Shortfall in Oncology Patient Visits,” was published online ahead of print, March 22.
As members of oncology practice teams, BCOPs provide many clinical services. According to the study, the top eight services BCOPs frequently or often provide include: participating in clinical studies; adjusting chemotherapy; assessing response to chemotherapy and/or toxicity; managing nausea, vomiting, and antiemetic therapy; managing symptoms and providing supportive care; providing patient education; providing pain management; and participating in protocol-based activities.
A novel way to address the oncologist shortage
Robert Ignoffo, PharmD, FASHP, FCSHP, the study’s first author, said that by focusing on a group of healthcare providers not identified in the AAMC report, the study shows a third alternative to ensuring that patients with cancer receive the care they need.
“There are going to be millions of patient visits that will not have providers. Nurse practitioners and physician assistants can cover around 2 million visits annually. And we found that BCOPs can cover 2.6 to 3.3 million. That’s a big fraction of the shortfall of 9.4 to 15.4 million visits expected by 2020. It doesn’t solve the problem, but substantially reduces the loss of patient care. For this reason, I think this study is an important one for patients with cancer. By providing care from BCOPs, we would be providing care for patients who might otherwise not receive care.”
How many Board Certified Oncology Pharmacists will be available in 2020?
To estimate the number of BCOPs available in 2020, the researchers looked at data from the American Society of Health-System Pharmacists and Board of Pharmacy Specialties for the years 2008 to 2014. This data was then used to calculate the number of BCOPs who were either in training, newly-certified, or currently practicing. The study estimated that in 2020, there will be 3,639 BCOPs and that about 62% of them will have completed accredited residencies in oncology pharmacy. Residency is part of BCOPs’ extensive training: in addition to four years of graduate training, BCOPs must complete either two years of residency training—one in general pharmacy practice and one in oncology pharmacy practice—or one year of residency plus two years of practice in which at least 50% of the time is focused on oncology activities; or four years of practice in which at least 50% of the time is focused on oncology activities.
Summarizing the study’s findings, Katherine Knapp, PhD, FAPhA, one of the study’s co-authors, said, “There has been a gap identified in the care of oncology patients and the work we have done shows that board certified pharmacists can help fill the gap.”
Robert Ignoffo, PharmD, FASHP, FCSHP, is Clinical Professor Emeritus at University of California School of Pharmacy and Professor Emeritus of Pharmacy and former Assistant Dean of Student Services for the College of Pharmacy at Touro University, California. He has been an ASCO member since 1982.
Katherine Knapp, PhD, FAPhA is Dean Emeritus College of Pharmacy at Touro University, California.
Abstract of the original JOP article.
PDF of the original JOP article.
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. Epub 2016 March 22.
The Exclusive Coverage series on ASCO.org highlights selected research from JCO, JOP, and JGO, with additional perspective provided by the lead or corresponding author.
@ 2016 American Society of Clinical Oncology