Specialized Pharmacy Oncology Technician: FUNCTIONS ASSIGNED TO SPOT
Collecting Laboratory Data
The collection of laboratory data usually precedes dosage calculations and computer order entry, as laboratory values may dictate pertinent dosage changes or delays in therapy, according to treatment protocols. The SPOT was trained via a didactic lecture (given by the pharmacy manager/clinical practice leader, A.L.) based on the content of the pharmacy guide to chemotherapy protocols available at the BCCA website. The lecture emphasized the importance of understanding the relevance of counts of white blood cells, including neutrophils, red blood cells, and platelets; hemoglobin values; and other laboratory values reflecting renal and hepatic functions.
The SPOT is responsible for collecting the data through the hospital’s laboratory system. The data are used routinely by the oncology pharmacist to assess the effectiveness of chemotherapy treatments.
Printing Patient-Specific PharmaNet Profiles
The SPOT is responsible for printing recent patient profiles from PharmaNet, the provincial drug database, which records medication orders filled outside the hospital. The oncology pharmacist reviews these profiles as part of monitoring each patient’s medication regimen.
The SPOT calculates chemotherapeutic drug dosages before performing computer order entry. The pharmacist provides the training required to perform these complex calculations, which include determining body surface area and creatinine clearance. The SPOT is responsible for checking the dosage of each drug prescribed by the ordering oncologist on the basis of body surface area. One example of a complex calculation is the determination of carboplatin dosages using the Calvert formula, where dose (mg) = area under the curve x (glomerular filtration rate + 25). The SPOT is trained to double-check his own work. However, despite double-checking, errors have been made. Hence, as a final quality assurance step, the pharmacist verifies all calculations before order entry.
Triaging Oncology-Related Calls
All oncology-related calls are forwarded to the SPOT for triage according to the complexity of the questions. The SPOT answers simple questions relating to drug availability. He also gathers resources and looks into drug—drug interactions as requested by the physician, nurse, or patients. Finally, he reports his findings to the pharmacist before distributing the information.
Making Requests to Compassionate Access Program and Performing Billings
The Compassionate Access Program encompasses drugs for which special approval from the BCCA is required because the proposed regimen deviates from standard BCCA protocols.
The SPOT gathers all pertinent information, such as evidence of progression of disease and change of patient status from what is recorded in the patient’s health record, to support the submission of such requests. He is trained to identify different types of protocols, to retrieve relevant information from patients’ health records and submit it to the Compassionate Access Program within 24 h of the initial request, and to follow up on approval of the requests. In addition, the SPOT is assigned to perform monthly online billing and communicates with finance clerks if questions arise. canadian cialis online
The SPOT participates in limited patient counselling, which is a vital component of successful chemotherapy. Reinforcing compliance with antiemetic therapy enhances the tolerability of chemotherapy for the patients. The oncology pharmacist creates a cue card with a list of questions for the SPOT to ask patients during these counselling sessions. Examples of questions are “Did you remember to take the pre-chemotherapy medications (for example, ondansetron or dexamethasone)?”, “Do you have enough antiemetics or anti-diarrhea agents?”, and “Do you have any problems with your medications?” Concerns requiring professional decisions are referred to the pharmacist. There are many other topics for which the SPOT can provide some patient counselling (e.g., management of anemia, management of pain, constipation, use of vitamins and herbal medications), but a discussion of these topics is beyond the scope of this article.
Tags: DEVELOPMENT, FUNCTIONS ASSIGNED, Pharmacy Oncology