Oncology stewardship practice in the United States: A Hematology/Oncology Pharmacy Association national survey

Marisela Tan Banez, Department of Pharmaceutical Services, University of California, San Francisco, California, USA.
Sol Atienza, Advocate Health - MidwestFollow
Allison Butts, Department of Pharmacy, UK HealthCare, Lexington, Kentucky, USA.
Megan Derba, Department of Pharmacy, Eastern Maine Medical Center, Bangor, Maine, USA.
Katie Dicke, Department of Pharmacy, OhioHealth, Columbus, Ohio, USA.
Kimberly Haverstick, Pharmacy and Therapeutics Service Line, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Bernadette B. Heron, National Pharmacy Benefits Management, Hematology/Oncology, Department of Veterans Affairs, Hines, Illinois, USA.
Sarah K. Cimino, Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Matthew Shane Loop, Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, Auburn, Alabama, USA.
Shannon Hough, The US Oncology Network, McKesson Specialty Health, The Woodlands, Texas, USA.
Julianna A. Merten, Chimeric Medical Communications, LLC, St Ansgar, Iowa, USA.
Donald C. Moore, Department of Pharmacy, Atrium Health Levine Cancer Institute, Charlotte, North Carolina, USA.
Vishal Shah, Department of Pharmacy, Mayo Clinic, Phoenix, Arizona, USA.
Kate D. Taucher, Department of Pharmacy, UCHealth, Aurora, Colorado, USA.
Junyu Matt Zhang, Department of Pharmacy, University of Chicago Medical Center, Chicago, Illinois, USA.
Zahra Mahmoudjafari, University of Kansas Health System, Kansas City, Kansas, USA.

Abstract

Introduction:The treatment of cancer is associated with high risk for toxicity and high cost. Strategies to enhance the value, quality, and safety of cancer care are often managed independently of one another. Oncology stewardship is a potential framework to unify these efforts and enhance outcomes. This landscape survey establishes baseline information on oncology stewardship in the United States.

Methods:The Hematology/Oncology Pharmacy Association (HOPA) distributed a 38-item survey composed of demographic, institutional, clinical decision-making, support staff, metrics, and technology sections to 675 HOPA members between 9 September 2022 and 9 October 2022.

Results:Most organizations (78%) have adopted general pharmacy stewardship practices; however, only 31% reported having established a formalized oncology stewardship team. More than 70% of respondents reported implementation of biosimilars, formulary management, and dose rounding as oncology stewardship initiatives in both inpatient and outpatient settings. Frequently cited barriers to oncology stewardship included lack of clinical pharmacist availability (74%), lack of oncology stewardship training (62%), lack of physician/provider buy-in (32%), and lack of cost-saving metrics (33%). Only 6.6% of survey respondents reported their organization had defined "value in oncology." Lack of a formalized stewardship program was most often cited (77%) as the rationale for not defining value.

Conclusions:Less than one-third of respondents have established oncology stewardship programs; however, most are providing oncology stewardship practices. This manuscript serves as a call to action for stakeholders to work together to formalize oncology stewardship programs that optimize value, quality, and safety for patients with cancer.

Document Type

Article

PubMed ID

39091073

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