Demonstrating the value of the oncology pharmacist within the healthcare team

2019 ◽  
Vol 25 (8) ◽  
pp. 1945-1967 ◽  
Author(s):  
Eve M Segal ◽  
Jill Bates ◽  
Sara L Fleszar ◽  
Lisa M Holle ◽  
Julie Kennerly-Shah ◽  
...  
Keyword(s):  
Patient Education ◽  
Nurse Practitioners ◽  
Meta Analysis ◽  
Clinical Care ◽  
Cost Savings ◽  
Physician Assistants ◽  
Care Patient ◽  
Healthcare Team ◽  
Oncology Care ◽  
Care Outcomes

IntroductionAlthough many oncology pharmacists are embedded members within the healthcare team, data documenting their contributions to optimal patient outcomes are growing. The purpose of this paper is to demonstrate the value of the oncology pharmacist within the healthcare team and describe the knowledge, skills, and functions of the oncology pharmacist.MethodsA systematic literature review of articles that were published on PubMed between January 1951 and October 2018 was completed. Identified abstracts were reviewed and included if they focused on measuring the value or impact of the oncology pharmacist on provider/patient satisfaction, improvement of medication safety, improvement of quality/clinical care outcomes, economics, and intervention acceptance. Review articles, meta-analysis, and studies not evaluating oncology pharmacist activities were excluded. Studies were thematically coded into four themes (clinical care, patient education, informatics, and cost savings) by 10 oncology pharmacists.ResultsFour-hundred twenty-two articles were identified, in which 66 articles met inclusion criteria for this review. The selected literature included 27 interventional and 38 descriptive studies. The value of the oncology pharmacist was demonstrated by published articles in four key themes: clinical care, patient education, informatics, and cost savings.ConclusionWith an expected shortage of oncology physicians and the ongoing development of complex oncology therapies, the board-certified oncology pharmacist is well suited to serve as a physician extender alongside nurse practitioners and/or physician assistants as the medication expert on the oncology care team. The demonstrated value of the oncology pharmacist supports their role as frontline providers of patient care.

scholarly journals Oncology Pharmacists Can Reduce the Projected Shortfall in Cancer Patient Visits: Projections for Years 2020 to 2025

Pharmacy ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 43 ◽  
Author(s):  
Katherine Knapp ◽  
Robert Ignoffo
Keyword(s):  
Clinical Trials ◽  
Patient Education ◽  
Cancer Patient ◽  
Nurse Practitioners ◽  
Training Programs ◽  
Physician Assistants ◽  
Care Providers ◽  
Oncology Care ◽  
Workforce Capacity

Based on the projected need for a larger oncology care workforce, we estimated the patient care visits and care activities that Board Certified oncology pharmacists (BCOPs) could contribute to oncology care from 2020–2025. Using projected counts for BCOPs through 2025, we estimated that 2.9–4.1 million 30-min BCOP patient visits were possible at 50% workforce capacity. BCOPs’ clinical activities overlapped strongly with those of nurse practitioners (NPs) and physician assistants (PAs) in patient education and treatment management. BCOPs could help reduce provider stress and burnout concerns by spreading these activities across a broader set of providers. BCOPs were more active than NPs and PAs in clinical trials research. Recent advances in immunotherapy, pharmacogenetics, pharmacogenomics, and oral oncolytic agents make the medication-focused training of OPs particularly useful to care teams. Comparison also showed that BCOPs were less active in providing follow-up visits and prescribing. Fulfilling the projected BCOP numbers through 2025 will require continued growth in Postgraduate Year 2 (PGY2) oncology pharmacy resident programs and on-the-job training programs. Our review of the trends in cancer incidence, mortality, and survivorship suggest a sustained need for the activities of BCOPs and other oncology care providers.

Efficient and Effective Models for Integrating Advanced Practice Professionals into Oncology Practice

2013 ◽  
pp. e377-e379
Author(s):  
Lawrence N. Shulman
Keyword(s):  
Health Care ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Models Of Care ◽  
Advanced Practice ◽  
Practice Style ◽  
Oncology Care ◽  
Oncology Practice ◽  
Effective Models

Advanced practice professionals (APP), primarily nurse practitioners and physician assistants, are increasingly being integrated into oncology practices. The reasons are numerous, and models of care options are numerous as well. Models of care have developed without much forethought and are often the result of the relative interests of the physician, the APP, and the mutual “comfort” of practice style. The increasing complexity of oncology care, the pressures of the health care crisis and health care reform mean that it is necessary that we examine models of collaborative care in terms of both quality of care and productivity.

Scope of practice of advanced practice providers (APP) in US community oncology.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 6646-6646
Author(s):  
Andrew Klink ◽  
Bela Bapat ◽  
Yolaine Smith ◽  
Chadi Nabhan ◽  
Bruce A. Feinberg
Keyword(s):  
Patient Education ◽  
Supportive Care ◽  
Nurse Practitioners ◽  
Systemic Therapy ◽  
Physician Assistants ◽  
Scope Of Practice ◽  
Advanced Practice ◽  
Bone Marrow Biopsies ◽  
Community Oncology ◽  
Eol Care

6646 Background: Oncology practices are increasingly employing nurse practitioners (NPs) and physician assistants (PAs) known collectively as advanced practice providers (APPs) to improve practice workflow, increase efficiency, and enable physicians to focus on complex patient care. Understanding variations in scope of practice for APPs may help establish a benchmark against which future changes are measured. Methods: US community physicians responded to a web-based survey from Sep to Nov 2018. Physicians were asked how frequently their APPs performed certain tasks on a 5-point scale (i.e., never, occasionally, sometimes, frequently, and always). Responses have been summarized using descriptive statistics. Results: In this study, 163 physicians were surveyed, most (81.0%, n = 132) used APPs in their practice. Among physicians using APPs, 91.7% (n = 121) used NPs and 49.2% (n = 65) used PAs. Most physicians stated that APPs were frequently/always involved in providing patient education (84.1%), ordering imaging and laboratory studies (68.9%), and/or making supportive care decisions (62.1%). Over 85% (57.6%-59.8% occasionally/sometimes; 28.0%-28.8% frequently/always) of physicians agreed that APPs discussed imaging reports and end of life (EOL) care (57.6% occasionally/sometimes, 28.8% frequently/always) with patients. Regarding procedures: 51.9% (28.0% occasionally/sometimes; 24.1% frequently/always) responded that APPs performed bone marrow biopsies and intrathecal chemotherapy. Regarding systemic therapy: 68.2% (58.3% occasionally/ sometimes; 9.8% frequently) allowed APPs to modify existing regimen e.g., dose/schedule change; 39.4% responded that APPs made decisions about new therapy selection. Conclusions: While substantial variation in the role of APPs in community oncology practices was observed, similar themes emerged. APPs appear to be integral in patient education, ordering laboratory and imaging studies, and discussing EOL care. Fewer are involved in managing and selecting supportive care and systemic therapy. Longitudinal and longer follow up are warranted to ascertain whether the scope of these practices change over time.

How do we capture the emergency nurse practitioners’ contribution to value in health service delivery?

2017 ◽  
Vol 41 (1) ◽  
pp. 89 ◽  
Author(s):  
Natasha Jennings ◽  
Matthew Lutze ◽  
Stuart Clifford ◽  
Michael Maw
Keyword(s):  
Health Service ◽  
Service Delivery ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Care Delivery ◽  
Health Service Delivery ◽  
Healthcare Team ◽  
Rigorous Research ◽  
Care Outcomes ◽  
Team Evaluation

The emergency nurse practitioner is now a well established and respected member of the healthcare team. Evaluation of the role has focused on patient safety, effectiveness and quality of care outcomes. Comparisons of the role continue to focus on cost, with findings based on incomplete and almost impossible to define, recognition of contribution to service delivery by paralleled practitioners. Currently there is no clear definition as to how nurse practitioners contribute to value in health service delivery. Robust and rigorous research needs to be commissioned taking into consideration the unique hybrid nature of the emergency nurse practitioner role and focusing on the value they contribute to health care delivery.

scholarly journals Follow-up of ischemic cardiopathy, an essential moment in the communication between in-patient and out-patient setting: problems and opportunities

2008 ◽  
Vol 2 (4) ◽  
pp. 169-179
Author(s):  
Italo Paolini
Keyword(s):  
Cardiovascular Disease ◽  
Patient Education ◽  
Nurse Practitioners ◽  
Critical Time ◽  
Physician Assistants ◽  
Outpatient Setting ◽  
Pharmacological Therapy ◽  
Appropriate Treatment ◽  
Errors In Treatment

It is known that the transition from the inpatient to the outpatient setting is a critical time. Evidence suggests that contact between patients and providers (i.e., physicians, nurse practitioners, and physician assistants) during this interval may be crucial for appropriate treatment modifications and recognition of errors in treatment. Ambulatory follow-up provides opportunities for clinical assessment, patient education, and medication review, which may in turn improve outcomes. However, little is known about the appropriate timing and type of follow-up that is necessary following hospitalization for AMI. In Italian System of Heath contact between general pratictioner and specialists, after dicharge, is critical moment for management of chronic pharmacological and non pharmacological therapy. If professional approaches are not integrated can reduce patients compliance and effectiveness of therapies themselves. Good management of chronic cardiovascular disease requires attention to stenghtening the continuity of information and management of patients.

Bartlett's Medical Management of HIV Infection

2019 ◽  
Author(s):  
John G. Bartlett ◽  
Robert R. Redfield ◽  
Paul A. Pham
Keyword(s):  
Hiv Infection ◽  
Nurse Practitioners ◽  
Medical Management ◽  
Clinical Care ◽  
Hiv Infections ◽  
Physician Assistants ◽  
People Living With Hiv ◽  
Hiv Research ◽  
Reference Format ◽  
Living With Hiv

With more than 30 million people living with HIV, nearly 2 million new HIV infections, and 1 million deaths in 2017 globally, the HIV epidemic continues to exert a considerable deleterious impact on the health of individuals, communities, and the economic growth of nations. However, remarkable advances have also been achieved: improvements in our scientific understanding of the biology of HIV, how it causes disease, and its prevention and treatment, coupled with unprecedented multi-sectoral global efforts, have resulted in rendering HIV infection essentially a manageable chronic disease. The 17th edition of Bartlett’s Medical Management of HIV Infection offers the best-available clinical guidance for treatment of patients with HIV, all in a portable, quick-reference format. Edited by preeminent and pioneering authorities in HIV research and clinical care, it has earned its status as the definitive work for physicians, physician assistants, nurse practitioners, pharmacists, and anyone working in the care of persons with HIV.

scholarly journals Understanding the Role of Advanced Practice Providers in Oncology in the United States

2018 ◽  
Vol 14 (9) ◽  
pp. e518-e532 ◽  
Author(s):  
Suanna S. Bruinooge ◽  
Todd A. Pickard ◽  
Wendy Vogel ◽  
Amy Hanley ◽  
Caroline Schenkel ◽  
...  
Keyword(s):  
Patient Care ◽  
Nurse Practitioners ◽  
Clinical Care ◽  
Gynecologic Oncology ◽  
Physician Assistants ◽  
The United States ◽  
Direct Patient Care ◽  
Advanced Practice ◽  
Patient Counseling ◽  
Number Of Patients

Purpose: Advanced practice providers (APPs, which include nurse practitioners [NPs] and physician assistants [PAs]) are integral members of oncology teams. This study aims first to identify all oncology APPs and, second, to understand personal and practice characteristics (including compensation) of those APPs. Methods: We identified APPs who practice oncology from membership and claims data. We surveyed 3,055 APPs about their roles in clinical care. Results: We identified at least 5,350 APPs in oncology and an additional 5,400 who might practice oncology. Survey respondents totaled 577, which provided a 19% response rate. Results focused on 540 NPs and PAs. Greater than 90% reported satisfaction with career choice. Respondents identified predominately as white (89%) and female (94%). NPs and PAs spent the majority (80%) of time in direct patient care. The top four patient care activities were patient counseling (NPs, 94%; PAs, 98%), prescribing (NPs, 93%; PAs, 97%), treatment management (NPs, 89%; PAs, 93%), and follow-up visits (NPs, 81%; PAs, 86%). A majority of all APPs reported both independent and shared visits (65% hematology/oncology/survivorship/prevention/pediatric hematology/oncology; 85% surgical/gynecologic oncology; 78% radiation oncology). A minority of APPs reported that they conducted only shared visits. Average annual compensation was between $113,000 and $115,000, which is approximately $10,000 higher than average pay for nononcology APPs. Conclusion: We identified 5,350 oncology APPs and conclude that number may be as high as 7,000. Survey results suggest that practices that incorporate APPs routinely rely on them for patient care. Given the increasing number of patients with and survivors of cancer, APPs are important to ensure access to quality cancer care now and in the future.

Associations Among Practice Variation, Clinician Characteristics, and Care Algorithm Usage: A Multispecialty Vignette Study

2019 ◽  
Vol 34 (6) ◽  
pp. 596-606
Author(s):  
David A. Cook ◽  
V. Shane Pankratz ◽  
Laurie J. Pencille ◽  
Denise M. Dupras ◽  
Jane A. Linderbaum ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Family Medicine ◽  
Nurse Practitioners ◽  
Clinical Care ◽  
Physician Assistants ◽  
Practice Variation ◽  
Fold Change ◽  
Vignette Study ◽  
Clinical Vignettes ◽  
Lower Variation

The objective was to quantitatively evaluate clinician characteristics associated with unwarranted practice variation, and how clinical care algorithms influence this variation. Participants (142 physicians, 53 nurse practitioners, and 9 physician assistants in family medicine, internal medicine, and cardiology) described their management of 4 clinical vignettes, first based on their own practice (unguided), then using care algorithms (guided). The authors quantitatively estimated variation in management. Cardiologists demonstrated 17% lower variation in unguided responses than generalists (fold-change 0.83 [95% confidence interval (CI) 0.68, 0.97]), and those who agreed that practice variation can realistically be reduced had 16% lower variation than those who did not (fold-change 0.84 [CI, 0.71, 0.99]). A 17% reduction in variation was observed for guided responses compared with baseline (unguided) responses (fold-change 0.83 [CI, 0.76, 0.90]). Differences were otherwise similar across clinician subgroups and attitudes. Unwarranted practice variation was similar across most clinician subgroups. The authors conclude that care algorithms can reduce variation in management.

scholarly journals Role of Oncology Clinical Pharmacists in Light of the Oncology Workforce Study

2010 ◽  
Vol 6 (5) ◽  
pp. 270-272 ◽  
Author(s):  
Jolynn K. Sessions ◽  
John Valgus ◽  
Sally Yowell Barbour ◽  
Lew Iacovelli
Keyword(s):  
Patient Education ◽  
Patient Care ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Direct Patient Care ◽  
Clinical Pharmacists

To date, the information published regarding workforce implications has focused on physicians, nurse practitioners, and physician assistants. But oncology clinical pharmacists also can assist with direct patient care and patient education activities.

Effects of community-embedded care management model on patients, providers, and payors.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 44-44
Author(s):  
Sheryl Riley ◽  
Samantha Manns
Keyword(s):  
Health Outcomes ◽  
Care Management ◽  
Hospital Admissions ◽  
Treatment Plan ◽  
Cost Savings ◽  
Safety Net ◽  
Healthcare Team ◽  
Care Plans ◽  
Oncology Care ◽  
Improve Health

44 Background: Comprehensive oncology care management is commonly built on expert clinical support and coordinated services, but lacks a community focus during critical phases of the cancer journey. However, a community-embedded approach extends past practice walls by incorporating local resources and identifying barriers to care in-between office visits. The cycle of care management adheres to the following objectives: Improve health outcomes; Engage the patient, their family and healthcare team; Advance payor efficiency and cost savings; Support the treatment plan in the community. Methods: Stratification Technology Platform & Levels of Care: A risk-based process is implemented through proprietary stratification software, which combines all data points of the healthcare system. A three-step risk acuity score is calculated for each patient based on claims data, diagnoses and disabilities to assure care is tailored to meet individual needs. Patients are then designated to care programs in accordance to their various risk levels. This allows for personalized care plans and staff workflows. Care Teams: Teams of a care coordinator, registered nurse and social worker provide consistent healthcare navigation, monitor patients’ treatment adherence and improve health outcomes. They act as a safety net for patients and their families at all times. Results: 31% decrease in ER visits; 51% decrease in hospital admissions; Hospice conversion at 8x national average; Improved side effects management; ROI of 3:1. Conclusions: Through community-embedded oncology care management, patients not only receive the proper level of care, but also show various improved health outcomes. Providers and patients see decreased emergency room visits, shorter hospital stays and improved quality of life, while payers experience tremendous cost savings due to smarter spending and utilization management. Practices continue to recognize community-embedded care management as a transformative standard of treatment that is central to positive health outcomes. However, there is always more to learn and improve upon, so constant evaluations of quality metrics are essential to provide the very best to patients, providors and payers.

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