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Monday 25 March 2019
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BLOG: Cancer therapy: a look to the future

Oncology pharmacists play an important role as an integral part of the interdisciplinary cancer care team in the provision of high quality care of patients with cancer. In recent years, we have observed a changing landscape in the approach to cancer care: precision oncology, survivorship, new therapeutic options (such as non-cytotoxic drugs), new diagnostic tools, and issues related to sustainability. These are the most important challenges to be faced in the near future.

 

According to this changing landscape, the role of the oncology pharmacist has rapidly evolved from traditional drug-oriented services, such as drug distribution and preparation, to patient-oriented services to address many aspects of direct patient care and to support the overall cancer team. In this context, it is essential to evaluate changes in cancer drug therapy as well as oncology pharmaceutical care to successfully integrate advances in care into practice as appropriate.

 

There are some areas of opportunity for innovation that will expand the role of oncology pharmacist in cancer care teams and will create value. Most important of them will be related to:

  1. Systematic evaluation of new therapeutic options, including pharmacoeconomic evaluations, to demonstrate added value of new therapies in selected patient populations, managing the treatment of comorbidities in cancer patients and adapting outcome measures to new therapy options.
  2. Assuring compliance and traceability. Monitoring adherence to therapy, implementing programmes to enhance compliance, using new technologies to develop tools to improve compliance.
  3. Research opportunities to provide early access to novel therapeutic options through investigational protocols. Evaluate patterns of supplementary/complementary alternative medicine use among different populations of cancer survivors, evaluating adherence behaviours, monitoring and reporting late toxicities from long-term use of targeted therapies.
  4. Play an important role in information technology projects, to analyse clinical Information based on real-life data. Develop a learning healthcare information technology system for cancer based on the analysis of real-world evidence to evaluate outcomes in real-life patients. This will provide us with an extremely useful tool to select the most valuable treatment for every patient based on algorithms resulting from real-world evidence to provide the best result each patient deserves.
  5. Coordinating with primary care providers, to ensure continuity of pharmaceutical care for patients, using CPOE integrating levels of care to provide reconciliation, improve medication traceability, monitor adherence, and implement programmes to enhance compliance, optimisation of access to drug therapy, management of drug–drug interactions and cost of care. Play an active role in survivorship care, as there is a general lack of information about survivorship clinics, and cancer is becoming a chronic disease.
  6. Toxicity evaluation, including late toxicities from long-term use of targeted therapies, based on the development of a quality reporting programme for cancer care as part of a learning healthcare system, with patient reported outcomes integrated in EMR, through IT tools, to analyse and stratify patients depending of their risk.
  7. Participate in patient selection for best results through pharmacogenomics, which will allow clinicians to individualise therapy on the basis of a genetic test result to obtain maximum therapeutic benefit on every single patient, demonstrating added value of new therapies in practice by optimisation of drug therapy in selected patient populations or managing the treatment of comorbidities in cancer patients.
  8. Consider the principles of pharmacoeconomics, to evaluate health outcomes in cancer patients, in order to provide affordable cancer care, as cancer care is becoming more complex and concerns arise over the cost of care and patient access.

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