ReCAP: Board-Certified Oncology Pharmacists: Their Potential Contribution to Reducing a Shortfall in Oncology Patient Visits [Care Delivery]

QUESTION ASKED:

In light of the projected shortage of oncologists, is there evidence that pharmacists could help fill the gap and, if so, what particular clinical services could they provide during those visits?

SUMMARY ANSWER:

We estimated that by year 2020, over 3,000 pharmacists who are board-certified in oncology could contribute 2.6 to 3.3 million 30-minute patient visits. Specific clinical services were identified by board-certified oncology pharmacists (BCOPs) using multiple surveys (Table 1).

METHODS:

We used available data to estimate how many BCOPs could be available by year 2020. We also used a Delphi expert panel process to identify clinical services BCOPs could provide along with how many 30-minute patient visits they could potentially contribute.

BIASES, CONFOUNDING FACTOR(S), DRAWBACKS:

The Delphi panel consisted solely of oncology pharmacists; other health care team members might have responded differently to survey questions. Estimates could be subject to changes in data trends. It is likely that the estimate of available BCOPs by 2020 is high because available data include international BCOPs. A confounding factor is that current regulations from the Center for Medicare and Medicaid Services (CMS) do not recognize pharmacists as health care providers, thereby limiting reimbursement for clinical services. Until the CMS modifies these regulations, the employment of pharmacists to provide patient care will likely be restricted.

REAL-LIFE IMPLICATIONS:

These results suggest that practicing oncologists may benefit by utilizing BCOPs to see some of their patients that need particular clinical services. The clinical services that BCOPs could provide that received the strongest consensus (> 80%) are shown in Table 1. These services overlap and also complement those provided by nurse practitioners and physician assistants. Oncology practices wishing to improve capacity, breadth, and/or efficiency are encouraged to consider using BCOPs, particularly for those services identified in this study.

Table 1.

Characteristics of Delphi Panelists

CharacteristicDescriptionPractice setting10 academic, 3 office basedGeographic locationStates represented by US Census region:Northeast: Maine, New York (2)Midwest: NoneSouth: Alabama, Maryland, North Carolina (2), Oklahoma, TexasWest: Arizona, Colorado, Idaho, OregonHold or have held BCOP status13 (100%)Experience, yearsMedian, 16; mean, 16.8 (SD, 9.0)PGY2 oncology pharmacy residency9 of 13 (69%)PGY1 pharmacy residency8 of 13 (62%)

Abbreviations: BCOP, Board-certified oncology pharmacist; PGY1, postgraduate year 1; PGY2, postgraduate year 2; SD, standard deviation.

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