Purpose/Background: Although the VA is a national health system, individual VA health care systems and clinics are often left to determine how to use staff resources on an individual basis. This often means that there is little to no standard utilization of midlevel providers, including oncology pharmacists. Pharmacists are uniquely situated to facilitate high-quality, team-based care of patients with cancer. We aimed to assess the qualifications of oncology pharmacists throughout the VA system as well as their roles in hematology and oncology units, both formal and informal.
Methods: A survey was developed and sent to the VHA oncology pharmacist nationwide e-mail listserve. This survey asked which activities were a part of regular oncology pharmacist duties, the diseases included in both formal and informal scopes of practice, and professional qualifications. The survey also solicited subjective responses to determine which process improvements would lead to more effective exploitation of the pharmacist skills.
Data Analysis/Results: Forty-two pharmacists responded to this survey. Out of 14 diseases included in the survey, > 50% of the pharmacists responding had a scope of practice that included chemotherapy-induced nausea/vomiting (CINV), constipation/diarrhea, dose rounding of chemotherapies or targeted agents, and oral chemotherapy management. The qualifications of the respondents included board certification in oncology pharmacy (60%, 20 respondents), and about two-thirds of the pharmacists responding were members of at least 1 hematology/oncology organization. Fifty percent of the respondents believed that education would allow more effective use of pharmacists’ clinical skills.
Implications: These data indicate that although the VA is using oncology pharmacists to provide evidence-based oncology care, they may not be used to their full potential. Areas in which pharmacists can be more fully integrated into care include adding more formal scopes of practice to workload already being completed, expanding disease management into more areas of pharmacist expertise, and increasing education to interdisciplinary teams regarding oncology pharmacist skills and qualifications. Limitations of this quality improvement project included the absence of information from oncology units without a pharmacist as well as selection bias.
