Pharmacy Perspectives - Summer/Fall 2017 - 5


Ross Camidge, MD, extolls the virtues and values of oncology pharmacists




ne would like to imagine
that physicians have
all knowledge at their
fingertips. Here's the dirty
little truth. We don't," said
Director of the UCHealth Thoracic Oncology
Program Ross Camidge, MD.

While that may not be the world's biggest revelation, Camidge makes that admission to illustrate
why he values Lung Cancer Clinic Pharmacist
Ronni Miller, PharmD, and other oncology clinic
pharmacists as much as he does.
Camidge's knowledge extends to anti-cancer
treatments for the numerous types of chest and
lung cancers; Camidge said that he is not an expert
on the detailed side effects of cancer medications,
drug interactions between those medications, or
supportive medications used to help minimize or
counterbalance those side effects.
While he or his nursing staff can look up that
information or carefully read the literature that accompanies the drugs, it takes time way from what
they do best - treat and care for patients.
Miller, who works three days a week as the oncology pharmacist at the medication access and renewal
center (MARC) and two days a week at the clinic,
helps Camidge and other staff members by focusing
on what she does best - educating patients about
medications. But she does way more than that.

Thoracic oncologist Ross Camidge, MD, considers embedded pharmacists to be invaluable members
of the treatment team.
Miller has become an invaluable part of the
thoracic oncology team since she started working at
the clinic about a year ago. In addition to educating
patients about their medications (how to take them,
when to take them, potential side effects, what to do
if they experience side effects, etc.), she also checks
in with them regularly to see if they're having any
problems. She can make recommendations like
crushing a pill or cutting it in half if it's too difficult
to swallow or about which pills to take together and
when to take them.
Outpatient Oncology Manager Adam Poust's
goal is to have a clinic pharmacist in every oncology
clinic. "Instead of leaving patients with a sheet of
paper with instructions to read, I walk them through
it so they understand and can ask questions," Miller
said. She often describes herself as the voice at the
end of a prescription drug television commercial that
talks about all the potential side effects of a drug.
Another important aspect of her job that's beneficial to both patients and physicians is helping to
get access to treatments, especially expensive ones,
that insurance may or may not cover. Part of her
job at MARC is to handle prior authorizations for
prescription medications. Sometimes those prior
authorizations are denied, or a patient has trouble
meeting a co-pay, and she either recommends therapeutic alternatives, appeals the decision, or enlists the
help of specific drug companies' foundation assistance
programs that provide discounted or free drugs.
"The means of access to these drugs is incredible," said Camidge. "Before Ronni, we didn't have
the staff to even figure out how to do that, and
now we have somebody that, as part of their job,
is dedicated to it."
Miller is one of five, soon to be six, oncology
clinic pharmacists. But, according to Outpatient
Oncolog y and Infusion Pharmacy Manager
Adam Poust, every one of the 13 oncology clinics
want one.
"The benefits of having a pharmacist in the clinic
is very obvious. That's why one of my goals is to
have one in every clinic," Poust said.
So far, clinics with a pharmacist include the
Bone Marrow Transplant Clinic, with one fulltime clinic pharmacist, Jenni Tobin, PharmD, and
soon to be two; the Gynecologic and Urologic
Cancer Clinics, which split clinic pharmacist
Sarah Weisdack, PharmD; and the Gastrointestinal
Cancer and Phase 1 Clinical Trial Clinics split two
part-time pharmacists, who are also professors at
the Skaggs School of Pharmacy, Cindy O'Bryant,
PharmD, and Ashley Glode, PharmD.

The program started when O'Bryant, who manages the PGY2 (post-graduate year 2) oncology
residency program, joined Skaggs in 2000 and was
tasked to develop an outpatient clinical oncology
pharmacy program. "We'd always had pharmacists
involved on the inpatient side, but when it came to
the outpatient cancer side, the main role of pharmacy was more of a traditional dispensing and mixing role," O'Bryant said. There was no one working
in the clinic with the patients and doctors, unless
called in for an emergency situation. Her goal was
to minimize those emergencies proactively.
She first served on a consulting basis to all the
oncology providers, helping with specific patient
drug issues. About that time oncologist Gail
Eckhardt, MD, was starting the Phase 1 Clinical
Trials program and had worked at another facility
with a clinic pharmacist, and wanted one. O'Bryant
and Eckhardt worked together to refine the clinic
pharmacist's role, and it grew from there.
"The Cancer Center has grown, and many of the
people I had worked with started asking me to work
with them. But there are 5,000 patients and only
one of me, so that's not feasible," O'Bryant said. As
people began seeing the value of having a pharmacist
within the clinic, demand started growing. The first
clinic pharmacist hired after O'Bryant created the
job was one of her oncology pharmacy residents,
Jenni Tobin. UCHealth Memorial Hospital in
Colorado Springs has two clinic pharmacists, Kate
Jeffers, PharmD, and Joseph Kalis, PharmD.
"I think we add to the quality of care that the patients are getting because we're able to be the experts
in what we do, which allows the doctors to be able
to be the experts in what they do," said O'Bryant.
"I think that meshes really nicely in providing total
patient care here at the cancer center."
First appeared in the April 24th edition of UC Health

Faculty member and oncology pharmacist Cindy O'Bryant, PharmD


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