Characterization of Collaborative Practice Agreements (CPA) Held By Hematopoietic Cell Transplant (HCT) Pharmacists

  • Bryk A
  • Koontz S
  • Tombleson R
  • et al.
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Background: With projected and current workforce shortages within the HCT field, a collaborative approach utilizing the unique skill set of the oncology-trained clinical pharmacist is crucial. Working within an agreed-upon protocol, pharmacists are able to expand patient care delivery, providing desired patient-centered outcomes via optimal medication therapy management. Methods: An electronic survey was developed by the Advocacy & Policy Working Committee of the American Society for Blood and Marrow Transplantation (ASBMT) Pharmacy Special Interest Group (SIG) and distributed using the internet-based survey tool to members of the BMT Pharmacists Google group and the ASBMT Pharmacy SIG email listservs. The primary objective was to assess the current state of CPAs already in place in the HCT setting. Additional objectives were to characterize these CPAs, describe commonly encountered barriers to implementing CPAs in this setting, and to describe perceived job-related benefits resulting from CPA implementation. Results: 48 responses representing 41 different institutions spanning 4 small (< or 50 transplants/year), 18 medium (51-150 transplants/year) and 19 large (≥ 150 transplants/year) HCT programs were returned. Respondents were mostly female (67%) and practiced in the adult setting (83%). Reponses represented a range of practice experience in HCT: 0-2.99 years (21%), 3-5.99 years: (27%), 6-10.99 years (21%), 11-15.99 years (15%), ≥16 years (17%). The majority of the HCT positions (83%) represented by the survey responses were funded by the department of pharmacy at an academic medical center. Most respondents were from HCTcenters in the US with the largest number located in the South (16) and the fewest in the Northeast (3). Of the 48 responses, 22 (46%) respondents reported having CPAs in place, all which covered both in-and outpatient settings; 10 (21%) respondents did not currently have CPAs, but were planning to implement them; 16 (33%) respondents did not have CPAs at their institution. The clinical activities performed under the auspices of a CPA included renal dose adjustment, therapeutic drug monitoring, supportive care management, anticoagulation, antimicrobial management, and management of co-morbid conditions and chronic diseases. The most commonly cited barrier to establishing CPAs across all respondents was the absence of a mechanism to secure reimbursement for services provided. No respondents reported a negative impact on job satisfaction, while positive attributes included an increased sense of autonomy and recognition as a vital team member. Conclusions: Although data analyses are ongoing, this survey provides the pharmacy community with a robust understanding of the current landscape of HCT pharmacy CPAs. We anticipate results from this survey will assist HCT pharmacists with the development and implementation of future HCT CPAs.




Bryk, A. W., Koontz, S., Tombleson, R., Betcher, J. A., Eddy, B., Khan, T., … Saunders, I. M. (2016). Characterization of Collaborative Practice Agreements (CPA) Held By Hematopoietic Cell Transplant (HCT) Pharmacists. Biology of Blood and Marrow Transplantation, 22(3), S118.

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