Overview
Modeling Best Practices of Medically Integrated Pharmacies to Improve Treatment Monitoring and Therapy Adherence in Patients With HR+/HER2- Breast Cancer
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Pharmacists are involved in all phases of a patient’s cancer journey and their role continues to expand in response to the rapid pace of therapeutic advances. This evolving role is especially critical in the complex treatment of patients with HR+/HER2- metastatic breast cancer. Availability of cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors has shifted the treatment paradigm but identification of which patients may benefit from particular CDK4/6 inhibitors must consider assessment of a patient’s ability to tolerate treatment-related adverse events (AEs) and continue therapy.
To meet this need, evolving interprofessional approaches to patient care offer proven methods for monitoring and managing AEs, improving therapy access, and further supporting personalized care; however, for more patients to realize the benefits of this approach, comprehensive training is needed to ensure pharmacists, employed in a variety of settings, can perform integrated care functions. This training program offers pharmacists the education, tools, and resources necessary to model best practices of medically integrated pharmacies and improve outcomes for patients with HR+/HER2- metastatic breast cancer. Upon completion of the training program, pharmacists can customize a curriculum to facilitate peer-to-peer learning and action planning with their own team, considerate of the size and resource mix of their practice.
This activity is intended for oncology pharmacists, clinical pharmacists, and specialty pharmacists who are part of the multidisciplinary team treating patients with HR+/HER2- breast cancer.
HR+/HER2- is the most common subtype of breast cancer, accounting for approximately 70% of cases. Although most breast cancers are diagnosed early (stages I-III), the 5-year survival rate is only 35.4% for distant/metastatic disease compared with 100% for localized disease. Management of metastatic breast cancer involves a variety of treatment strategies including endocrine therapy (ET), chemotherapy, targeted therapies, and cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors. Approved CDK4/6 inhibitors abemaciclib, palbociclib, and ribociclib, in combination with ET, have all shown improvement in progression-free-survival (PFS) in both the first- and second-line settings. However, although these agents all inhibit CDK4/6, there are differences in target specificity, dosing schedules, and toxicity that prescribers need to consider before initiating therapy.
Ultimately, clinicians must identify patients who will benefit from CDK4/6 inhibitors and must consider individual patient characteristics and treatment preferences. Clinical judgement based on clinical data and guidelines is key for optimizing treatment for individual patients, as is assessment of patient ability to tolerate adverse events and continue therapy. Within this context, oncology pharmacists play a critical role in the management of patients with metastatic breast cancer. Indeed, at treatment centers with collaborative practice agreements that create avenues for pharmacists to expand clinical services, evolving integrated frameworks are having pharmacists lead the monitoring and management of adverse events with oral anticancer therapies. For more patients to realize the benefits of this approach, these center-of-excellence practices must be adapted for cancer centers of all sizes, and pharmacists at these sites need operational frameworks they can easily model and efficiently implement to achieve similar success in their practice.
Upon completion of this activity, learners will be able to:
•Review examples of medically integrated pharmacies (MIP) and discuss possible benefits to expanding clinical services for monitoring and managing AEs in patients treated with oral anticancer therapies.
•Implement pharmacy-led strategies to proactively monitor and mitigate CDK4/6 inhibitor-associated AEs to improve patient adherence and clinical outcomes in breast cancer patients.
•Create pharmacy-driven coordination of care protocols to enhance patient education and facilitate feedback collection and interpretation.
•Review examples of medically integrated pharmacies (MIP) and discuss possible benefits to expanding clinical services for monitoring and managing AEs in patients treated with oral anticancer therapies.
•Implement pharmacy-led strategies to proactively monitor and mitigate CDK4/6 inhibitor-associated AEs to improve patient adherence and clinical outcomes in breast cancer patients.
•Create pharmacy-driven coordination of care protocols to enhance patient education and facilitate feedback collection and interpretation.
• CDK4/6 Inhibitors in HR+/HER2- Breast Cancer
• AE Monitoring and Management in Patients Treated With CDK4/6 Inhibitors
• Considerations for Individualizing Treatment
• Physician-Pharmacist Integration Strategies
• AE Monitoring and Management in Patients Treated With CDK4/6 Inhibitors
• Considerations for Individualizing Treatment
• Physician-Pharmacist Integration Strategies
Provided by the Purdue University College of Pharmacy and the Academy for Continued Healthcare Learning (ACHL)
This activity is supported by an educational grant from Lilly.
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6. Allow ActiveX controls to run on your computer: If the yellow strip appears on the top of your web browser while running the Webcast, right click on it and select Allow blocked contents to run.
7. Turn the Pop-up blocker off: On the Tools menu, point to Pop-up Blocker, and then click Turn Off Pop-up Blocker
2. Compatible with Windows PC and MAC (256 MB of RAM or higher)
3. Activity is best viewed on Internet Explorer 9.0 or higher, Safari 5.0 or higher and Firefox 29.0 or higher
4. Adobe Flash Player 12.0 (or higher). Click here to download Adobe Flash Player for free.
5. Adobe Reader to print certificate. Click here to download Adobe Reader for free.
6. Allow ActiveX controls to run on your computer: If the yellow strip appears on the top of your web browser while running the Webcast, right click on it and select Allow blocked contents to run.
7. Turn the Pop-up blocker off: On the Tools menu, point to Pop-up Blocker, and then click Turn Off Pop-up Blocker
This activity offers two training pathways to best align with each learner’s goals. Pharmacists interested in earning CPE and/or developing a customizable curriculum to support training of their teams follow one educational path, whereas a second path is available to pharmacists interested in becoming a recognized Pharmacy Cancer Care Educator to be included in a faculty directory (akin to a noncommercial speaker’s bureau).
All learners participate in an assessment and receive a personalized learning summary to identify areas of strength or improvement. Individuals interested in becoming an educator will complete a more comprehensive assessment modeled from the CDC Training of Trainers framework. However, all learners will have access to education and practice resources supporting pharmacists in their evolving role in the management of patients with HR+/HER2- breast cancer, as well as ACHL CustomED® with 90+ slides to build dynamic, personalized education for you, your team, or other stakeholders.
Start your personalized training today!
Scott Soefje, PharmD, MBA, BCOP, FCCP, FHOPA
Director of Pharmacy, Cancer Care
Assistant Professor of Pharmacy
Mayo Clinic
Rochester, MN
Director of Pharmacy, Cancer Care
Assistant Professor of Pharmacy
Mayo Clinic
Rochester, MN
Jodi Taraba, PharmD, MSc, BCOP
Breast Cancer Clinical Pharmacy Specialist
Assistant Professor of Pharmacy
Mayo Clinic
Rochester, MN
Purdue University College of Pharmacy and the Academy for Continued Healthcare Learning (ACHL) require that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships within 24 months (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with all ineligible companies. All relevant financial relationships have been mitigated prior to this activity.
The following financial relationships have been provided:
Scott Soefje, PharmD, MBA, BCOP, FCCP, FHOPA
Consultant/Advisory Board: Glaxo Smith Kline, Regeneron
Research Grant: AstraZeneca, Janssen
Jodi Taraba, PharmD, MSc, BCOP
Consultant/Advisory Board: AstraZeneca, Change Healthcare, Lilly, Novartis
Clinical Forum: MJH Life Sciences
Purdue University College of Pharmacy, ACHL staff members and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.
The content for this activity was developed independently of any ineligible company. All materials are included with permission. The opinions expressed are those of the faculty and are not to be construed as those of the publisher or grantor(s).
This educational activity was planned and produced in accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education. Recommendations involving clinical medicine in a continuing medical education (CME/CE) activity must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported, or used in CME/CE in support or justification of a patient care recommendation must conform to the generally accepted standards of experimental design, data collection, and analysis.
This CME/CE activity might describe the off-label, investigational, or experimental use of medications and/or devices that may exceed their FDA-approved labeling. Physicians should consult the current manufacturers’ prescribing information for these products. Purdue University College of Pharmacy and ACHL require the speaker to disclose that a product is not labeled for the use under discussion.
Discussion of Off-Label, Investigational, or Experimental Drug/Device Use: None
To receive credit, learners are required to complete the assessment, view the content , and complete the posttest and evaluation. To receive credit, 75% must be achieved on the posttest. A certificate will be immediately available. There is no fee to participate in the activity or for the generation of the certificate.
Purdue University College of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This is an application-based, continuing education activity of Purdue University, an equal access/equal opportunity institution.
This activity has been approved for 2.50 contact hours.
ACPE Universal Activity Number: 0018-9999-25-008-H01-P
Activity Type: Application
Partial credit may not be awarded for CPE credit; participation in the complete activity is required to receive credit. CPE credit will be submitted to CPE Monitor® within six weeks of participation.
