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ASBMT SIG Update

Tracey Walsh-Chocolaad, PharmD, BCOP Chair, ASBMT Pharmacy SIG February 28, 2014

ASBMT Pharmacy SIG Disclosures

•  No financial relationships to disclose

ASBMT Pharmacy SIG Objectives

•  Describe the Transition & Collaboration of Responsibilities between the National Marrow Donor Program System Capacity Initiative (NMDP SCI) and the ASBMT Pharmacy SIG.

•  Identify the Mission of the ASBMT Pharmacy SIG.

•  Outline the Initiatives Accomplished by the ASBMT Pharmacy SIG in 2013-2014.

•  Explain the 5-Year Plan for the ASBMT Pharmacy SIG.

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NMDP & ASBMT Pharmacy Leadership Timeline

2000:  1st  BMT  Pharmacists  Conference  

2011:  NMDP  SCI  Pharmacy  Working  Group  formed  

2012:  ASBMT  Pharmacy  SIG  approved  

2013:  NMDP  iniHaHves  transiHoned  to  SIG  +  mulHple  working  commiLees  formed  

National Marrow Donor Program System Capacity

Initiative (NMDP SCI) Pharmacy Working Group

NMDP SCI Pharmacy Working Group Scope of Work – Years II-III

Top Initiatives Recruitment/Retention •  New education sessions at HOPA and ASBMT Role/Responsibilities of the HCT Pharmacist •  Collaborative practice agreements •  Add pharmacist requirements to standards for

FACT accreditation

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HOPA Boot Camp Background

•  Goal: introduce heme/onc pharmacists to HCT pharmacy in ½ day pre-conference session at HOPA Annual Conference –  1 hour presentations: Intro to HCT, Overview of GVHD, Common

Infections in HCT –  20 minute presentations: Drug interactions, long-term survival

issues, a “day in the life” of an HCT pharmacist

•  Status: completed March 20, 2013 –  Expected 125 attendees – Actual 77 registered

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HOPA 10TH

ANNUAL CONFERENCE

2014 Exhibitor Prospectus

Exhibit Dates: March 26–28, 2014

Conference Dates: March 26–29, 2014

Hilton New Orleans Riverside

New Orleans, LA

HOPA Boot Camp Metrics & Succession

•  Was it successful? –  “supplemented my

knowledge of the care of BMT patients”

–  “I have a greater understanding of what to expect when we send our patients for HCT”

•  The information presented will improve my ability to care for my patients – 80% yes

•  ≈ 65% indicated barriers to implementing changes in care –  Lack of experience (16.5%) –  Lack of time (15.4%)

•  Succession: ASBMT Pharmacy SIG Education Committee

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Fundamentals of HCT Course Background

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•  Goal: provide a new (multi-disciplinary) practitioner with the rudimentary skills required to care for patients undergoing HCT –  2-day course pre-BMT Pharmacists Conference

•  Status: completed February 13-14, 2013 –  Expected 75 attendees – Actual 55 attendees –  Approximately 40 additional binder purchases

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Fundamentals of HCT Course 2013 Attendees

ASBMT  Members  

Non-­‐ASBMT  Members  

0   10   20   30  

Unknown  

NP/PA  

RN/Clin  Coord  

Pharmacists  

8  

8  

11  

28  

#  

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Clin  Coord=clinical  coordinator;  NP/PA=nurse  pracHHoner/physician’s  assistant;  RN=nurse  

Fundamentals of HCT Course 2013 Metrics & Succession

•  Was it successful? –  “great review” –  “valuable materials” –  “will help me educate our PGY2 oncology residents in

BMT” –  “speakers were phenomenal” –  “very impressed with the quality and depth of the work

put into this program” –  “cost is high, but well worth it” –  “hopefully this will be expanded and continued”

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Fundamentals of HCT Course 2013 Metrics & Succession

•  Succession: ASBMT Pharmacy SIG Education Committee organizing a “repeat” –  Lowered registration cost –  Terri Davidson,Syntaxx Communications hired to help

with course coordination & documents –  Grant procurement

•  NMDP: RN CE & CME •  Syntaxx: ACPE (16 hours approved)

–  Began updating/developing program sooner •  New topics added to program binder

•  How often would it be repeated? TBD

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Collaborative Practice Agreements Background

•  A signed contract between a pharmacist(s) and physician(s) which permits a pharmacist(s), in collaboration with the prescriber(s), to select and modify medication therapy within that specified contract

•  Goal: Publish a “how to” paper in a peer

reviewed journal to educate and guide clinicians on the process/potential benefits •  Pharmacist-physician collaboration could free up physician

time (addresses capacity challenge)

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Collaborative Practice Agreements Publication

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Review

Utilization of Collaborative Practice Agreementsbetween Physicians and Pharmacists as a Mechanismto Increase Capacity to Care for Hematopoietic Stem CellTransplant Recipients

Julianna A. Merten 1,*, Jamie F. Shapiro 2, Alison M. Gulbis 3,Kamakshi V. Rao 4, Joseph Bubalo 5, Scott Lanum6,Ashley Morris Engemann 7, Sepideh Shayani 8, Casey Williams 9,Helen Leather 10, Tracey Walsh-Chocolaad 11

1Department of Pharmacy, Mayo Clinic, Rochester, Minnesota2Department of Pharmacy, H. Lee Moffitt Cancer Center, Tampa, Florida3Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, Texas4Department of Pharmacy, University of North Carolina Hospitals and Clinics, Chapel Hill, North Carolina5Department of Pharmacy, Oregon Health & Science University, Portland, Oregon6Department of Pharmacy, University of Washington Medical Center, Seattle, Washington7Division of Cellular Therapy, Duke University Medical Center, Durham, North Carolina8Department of Pharmacy Services, City of Hope National Medical Center, Duarte, CA9 Edith Sanford Breast Cancer Initiative, Sanford Research/USD, Sioux Falls, South Dakota10Division of Hematology/Oncology, College of Medicine, University of Florida, Gainesville, Florida11Department of Pharmacy, National Institutes of Health Clinical Center, Bethesda, Maryland

Article history:Received 23 October 2012Accepted 21 December 2012

Key Words:Hematopoietic celltransplantationCollaborative drug therapymanagementPharmaceutical servicesMedication TherapyManagementPhysician capacityNational Marrow DonorProgram

a b s t r a c tSurvival after hematopoietic stem cell transplantation (HSCT) has improved and the number of allogeneicHSCTs performed annually in the United States is expected to reach 10,000 by 2015. The National MarrowDonor Program created the System Capacity Initiative to formulate mechanisms to care for the growingnumber of HSCT recipients. One proposed method to increase capacity is utilization of pharmacists to managedrug therapy via collaborative practice agreements (CPAs). Pharmacists have managed drug therapy inoncology patients with CPAs for decades; however, there are limited HSCT centers that employ this practice.Engaging in collaborative practice and billing agreements with credentialed pharmacists to manage therapeuticdrug monitoring, chronic medical conditions, and supportive care in HSCT recipients may be cost-effective andenable physicians to spend more time on new or more complex patients. The goal of this paper is to providea framework for implementation of a CPA and address how it may improve HSCT program capacity.! 2013 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

INTRODUCTIONOver 20,000 hematopoietic stem cell transplants (HSCT)

are performed in the United States each year [1]. The numberof HSCT procedures is expected to rise as a result of increasedutilization because of increased diversity and availability ofgraft sources, improved supportive care, more frequent useof reduced intensity regimens, and expanding indicationsfor HSCT [2]. Current projections forecast the number ofallogeneic HSCTs performed by 2015 will double comparedwith 2010 [2,3]. Additionally, advances in transplantationtechniques and supportive care practices have improvedlong-term survival after HSCT [4]. Health care providersare exploring ways to expand the capacity to care forthe increasing number of HSCT recipients. Pharmacists arekey contributors to HSCT recipient care and are routinelyinvolved in therapeutic drug monitoring, managing adverse

drug reactions, addressing drug interactions, providingsupportive care management, and conducting patient edu-cation. Other processes pharmacists may facilitate to imp-rove efficiency and HSCT patient capacity include responsesto prescription insurance prior authorization requests,compliance with Risk Evaluation and Mitigation Strategiesprograms, and medication requests from patient assistanceprograms.

Drug therapy is one of the foundations of health caredelivery. Effective management of complex drug therapyregimens and reduction in medication errors are essential.According to the Institute of Medicine, medication errorsharm approximately 1.5 million patients in the United Stateseach year, resulting in over 3 billion dollars in medicalcosts [5]. A multidisciplinary team approach that includespharmacists in the oncology setting has been shownto significantly reduce medication errors [5,6]. The use ofa collaborative practice agreement (CPA) is one avenue toformalize clinical pharmacy practice as part of the multi-disciplinary team. A CPA is formal partnership betweena pharmacist(s) and physician(s) that permits a pharma-cist(s) to manage a patients’ medication therapy [7-10].

Financial disclosure: See Acknowledgments on page 517.* Correspondence and reprint requests: Julianna A. Merten, Pharm D,

Department of Pharmacy, Rochester Methodist Hospital, 201 West CenterStreet, Ei 1 420B, Rochester, MN 55905.

E-mail address: merten.julianna@mayo.edu (J.A. Merten).

1083-8791/$ e see front matter ! 2013 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.http://dx.doi.org/10.1016/j.bbmt.2012.12.022

Biol Blood Marrow Transplant 19 (2013) 509e518

American Society for BloodASBMTand Marrow Transplantation

FACT-JACIE Standards for Pharmacists Background

•  Goal: Add new Standards specific to pharmacists (as key personnel) to strengthen the role of the clinical pharmacist on the HCT team

•  Status: 2 pharmacist representatives formally appointed

to work with FACT/JACIE on 6th Edition of FACT Standards –  U.S. rep is Connie Sizemore (Atlanta, GA) –  Non-U.S. rep is Tiene Bauters (Belgium)

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*FACT-­‐JACIE=FoundaHon  for  the  AccreditaHon  of  Cellular  Therapy-­‐Joint  AccreditaHon  CommiLee  InternaHonal  Society  for  Cellular  Therapy  and  European  Society  for  Blood  and  Marrow  TransplantaHon  

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FACT-JACIE Standards for Pharmacists Proposed Standards

Proposal includes……(“shall have”) •  24-hour pharmacy service •  Pharmacists trained and experienced in cellular

therapy –  Training shall include……

•  Written guidelines, Policies or SOPs (~12 items) •  Pharmacist:patient ratio appropriate to severity

of patient clinical status for safe care •  Involvement in incident reporting systems

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FACT-JACIE Standards for Pharmacists Metrics and Succession

•  Metric: Proposed pharmacy addition to the 6th edition of FACT Standards will be voted on in February 2014 –  Anticipate publication midsummer 2014

•  Succession: FACT Standards Committee

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ASBMT Pharmacy SIG Audience Response Question #1

Which of the following onset of events is in the correct order? a.  ASBMT Pharmacy SIG 2000 -> BMT Pharmacists Conference

2001 -> NMDP SCI Pharmacy Working Group 2012 b.  BMT Pharmacists Conference 2000 -> NMDP Pharmacy Working

Group 2011 -> ASBMT Pharmacy SIG 2012 c.  BMT Pharmacists Conference 2000 -> ASBMT Pharmacy SIG 2011

-> NMDP Pharmacy Working Group 2012 d.  None of the above

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ASBMT Pharmacy SIG

Present

ASBMT Pharmacy SIG Misson/Purpose

Provides leadership for pharmacists within the ASBMT and facilitates pharmacist representation

on ASBMT committees, as appropriate

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ASBMT Pharmacy SIG Committee Structure

Pharmacy  SIG  (2012)  

Steering  (2012)  

Program  Planning  (≈2000)  

Educa<on  

Advocacy  &  Policy  

Membership  

Research  

Website  

Communica<ons  

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2013  

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ASBMT Pharmacy SIG Scope of Work – Years I-II

•  SIG Achievement Awards

•  ASBMT In-Training Membership

•  SIG Newsletter •  Society Collaboration

–  Shared Advertising –  Booth Exchange

•  SIG Webpage •  Research •  Advocacy & Policy •  BMT Pharmacists

Conference •  NMDP SCI Workforce

Summit IV

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ASBMT Pharmacy SIG Scope of Work – Years I-II

•  Steering Committee –  Charters –  Strategic Plan –  Standardization

•  Forms •  Reporting

–  ASBMT Pharmacy SIG Awards –  Committee Recruitment/Nominations

ASBMT Pharmacy SIG Achievement Awards

•  ASBMT Pharmacy SIG Awards –  Lifetime Achievement Award –  New Practitioner Award

•  Award Includes: –  Free registration to BMT Tandem Meetings –  Formal recognition at BMT Pharmacists Conference

•  Benefits –  Recognition for commitment to profession –  Improve morale and career satisfaction

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ASBMT Pharmacy SIG In-Training Membership

•  Membership Committee Initiative •  Formal proposal to ASBMT Board of Directors to

include pharmacy residents for In-Training ASBMT Membership –  Proposal submitted August 2013 –  Proposal approved September 2013

•  Benefits –  Reduced membership fee ($75) for residents in-training –  Expose residents to the profession early

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ASBMT Pharmacy SIG Newsletter

•  Communications Committee Initiative

•  Quarterly Newsletter –  First two editions being distributed globally

•  1st edition (Fall 2013) distributed September 2013 •  2nd edition (Winter 2014) distributed January 2014

–  Limited to ASBMT Pharmacy SIG members beginning Spring 2014

•  Benefits –  Improve communication with members –  Education

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ASBMT Pharmacy SIG Newsletter

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ASBMT Pharmacy SIG Society Collaboration: Shared Advertising

•  Steering and Education Committee Initiative •  Working on collaborations with other oncology

societies to share advertising efforts –  Oncology Nursing Society –  International Society of Oncology Pharmacy

Practitioners (ISOPP) –  Hematology/Oncology Pharmacy Association (HOPA)

•  Benefits –  Increase visibility of conferences to more people –  Recruitment into HCT profession and ASBMT

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ASBMT Pharmacy SIG Society Collaboration: Booth Exchange

•  Steering Committee Initiative •  Collaborating with HOPA for shared booth exchange at

annual meetings –  Proposal submitted & approved by ASBMT October 2013 –  Proposal approved by HOPA November 2013

•  Benefits –  Forego charges required to set up exhibit and advertise at

meetings –  Tap into large # indicating HCT as area of practice

•  Currently practicing in HCT, but not ASBMT members •  Students/residents in-training considering career path

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ASBMT Pharmacy SIG Webpage

•  Website Committee Initiative •  Sections

–  Membership information •  Links to application

–  Committee information –  LISTSERV access –  Meeting information –  Archived newsletters –  Access to annual BMT Pharmacists Conference

presentation slides for registered attendees –  Archived presentations –  Job board

•  Initial Rollout: January 15, 2014 30  

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ASBMT Pharmacy SIG Webpage

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ASBMT Pharmacy SIG Research Committee Initiatives

•  Ongoing –  Review and vote on abstracts submitted to BMT

Tandem Meetings, Pharmacy category •  “Best Pharmacy Abstract” award

•  In development –  Assist with developing pharmacy standards for CTN

trials? –  Increase pharmacist review of CTN trials? –  Collaborative research?

•  PK study

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ASBMT Pharmacy SIG Advocacy & Policy Committee Initiatives

•  Advocacy 101 guide –  Planned completion early 2014

•  Recognition letters and certificates –  1st distribution February 2014

•  Collaboration with other societies •  Needs assessment survey

–  Update and distribute pharmacy survey to define advocacy efforts to focus on

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ASBMT Pharmacy SIG BMT Pharmacists Conference

•  Program Planning Committee Initiative –  Planning: Year long effort that begins before current

conference ends

•  BMT Pharmacist Conference Details –  CE credit: 2014 course, 13.5 ACPE hours –  GOING GREEN!!!!

ASBMT Pharmacy SIG NMDP SCI Workforce Summit IV

•  Details –  November 19, 2013 –  13 pharmacy representatives attended –  Will there be a year V?

ASBMT Pharmacy SIG Audience Response Question #2

The content of the ASBMT Pharmacy SIG Webpage is 100% closed and only accessible to ASBMT Pharmacy SIG members. a.  True b.  False

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ASBMT Pharmacy SIG

Future

ASBMT Pharmacy SIG Five-Year Plan

•  Streamline ongoing efforts –  Form multidisciplinary committee(s) within ASBMT?

•  Several needs/initiatives overlap •  Foster teamwork

•  Expand membership to support new initiatives –  Currently 99 ASBMT Pharmacy SIG members –  Can we double our membership? YES!

•  Strengthen research involvement –  PK study –  CTN involvement

•  Create business plan

ASBMT Pharmacy SIG Conclusion

•  New ASBMT Pharmacy SIG Steering Committee, 2014-2015: –  Jamie Shapiro, Chair –  *Tippu Khan, Chair Elect – WELCOME!! –  Tracey Walsh-Chocolaad, Past Chair –  Kelly Gregory –  Julianna Merten –  *Alison Gulbis – WELCOME!! –  *Susanne Liewer – WELCOME!!

*new member nominees will be officially voted on this afternoon

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NMDP SCI Pharmacy Working Group Members

•  Members cont. –  Connie Sizemore –  Tracey Walsh-Chocolaad –  Casey Williams

•  NMDP Lead Staff –  Lyndsey Aspaas, CHTC –  Pam Robinett –  Susie Burke (admin.)

•  Chair –  Helen Leather

•  Vice Chair –  Laura Wiggins

•  Members –  Joe Bubalo –  Ashley Morris Engemann –  Chris Fausel –  Alison Gulbis –  Tippu Khan –  Scott Lanum –  Julianna Merten –  Jamie Shapiro –  Sepideh Shayani

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ASBMT Pharmacy SIG Committee Membership

•  Program Planning –  Alison Gulbis, Chair –  Tippu Khan, Past Chair –  Amber Lawson, Chair Elect –  Kelly Gregory –  Josh Howell –  Sara Kim –  Justin LaPorte –  Tracey Walsh-Chocolaad –  Julie Merten –  Colleen Timlin –  Terri & Ross Davidson, Syntaxx

Comm., CE Provider/Logistical support, non-voting

•  Steering –  Tracey Walsh-Chocolaad, Chair –  Helen Leather, Past Chair –  Jamie Shapiro, Chair Elect –  Kelly Gregory –  Kathy Hogan Edwards –  Julianna Merten –  Meredith Moorman –  Ashley Morris Engemann

(2012-2013) –  Janelle Perkins (2012-2013)

 

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ASBMT Pharmacy SIG Committee Membership

•  Advocacy & Policy –  Susannah Koontz Webb, Chair –  Tippu Khan, Chair Elect –  JoAl Mayor –  Ila Maewal Saunders –  Rebecca Tombleso –  Jill Rhodes, Communications

Committee Liaison [non-voting] –  Amy Wiglesworth Bryk,

volunteer [non-voting]

•  Education –  Michael Westmoreland, Chair –  Melisa Stricherz, Chair Elect –  Helen Leather –  Joe Bubalo –  Alex Ganetsky –  Amanda C.C. Peffer –  LeAnne Kennedy –  Sara Kim, Program Planning

Committee Liaison [non-voting] –  Tippu Khan, ASBMT Committee

on Education Liaison [non-voting]

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ASBMT Pharmacy SIG Committee Membership  

•  Membership –  Ryan Bookout, Chair –  Amber Clemmons, Chair Elect –  LeAnne Kennedy –  Zahra Mahmoudjafari –  Jamie Shapiro –  Ashley Glode –  Scott Lanum

•  Communications –  Meredith Moorman, Chair –  Angela Hsieh, Chair Elect –  Ashley Glode –  Ashley Newland –  Sarah Hopps –  Jill Rhodes, Advocacy

Committee Liaison [non-voting] –  Elizabeth Irvine, Website

Committee Liaison [non-voting]

43  

ASBMT Pharmacy SIG Committee Membership  

•  Website –  Bill O’Hara, Chair –  Zahra Mahmoudjafari, Chair

Elect –  Scott Lanum –  Helen Leather –  Jim Hart –  Elizabeth Irvine,

Communications Committee Liaison [non-voting]

•  Research –  Joe Bubalo, Chair –  Steve Stricker, Chair Elect –  Alex Ganetsky –  Alison Gulbis –  Felecity Wright –  Christine Walko, volunteer [non-

voting] –  Sean DeFrates, volunteer [non-

voting]

44  

ASBMT Committee Representatives 2013-2014

•  Committee on Quality Outcomes: Michael Westmoreland

•  Committee on Education & Sub-Committee on Web-Based Learning: Tippu Khan

•  Committee on Reimbursement: Kathy Hogan Edwards

•  Committee on Practice Guidelines: Helen Leather

•  Committee on Older Patients: Jamie Shapiro