Expert: The Medication Use Process in a Health System Is the Foundational Requisite for Safe Use of Medication

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Dapo Amosu, MS, PharmD, DPLA, discusses his thoughts on how to advance medication use processes in inpatient and ambulatory settings and the role of the pharmacist in this endeavor.

Pharmacy Times interviewed Dapo Amosu, MS, PharmD, DPLA, on his thoughts on how to advance medication use processes in inpatient and ambulatory settings, the role of the pharmacist in inpatient and ambulatory settings, and the role technology and AI may play in the future as they come to the fore in pharmacy processing of data. Amosu stepped into his new role as the senior director of pharmacy at Fox Chase Cancer Center (Fox Chase) in Philadelphia on August 7, 2023.

About the Expert

Dapo Amosu, MS, PharmD, DPLA, began his tenure on August 7 as the senior director of pharmacy at Fox Chase Cancer Center (Fox Chase) in Philadelphia. As well as overseeing the medication use process for both the inpatient and ambulatory care environments, Amosu will serve on key committees within Fox Chase, such as the Research Review Committee and Performance Improvement Committee, and will also represent Fox Chase in the broader oncology arena, including on the guidelines committees of the National Comprehensive Cancer Network and the Pharmacy Directors Committee of the Alliance of Dedicated Cancer Centers. He will work closely and collaboratively with clinicians, senior leadership, and colleagues from various departments regarding pharmacy programs and related patient care services, including the delivery of pharmaceutical services, the state of relevant technology and equipment, and patient safety matters.

Amosu has over 25 years of pharmacy experience, with expertise in hematology/oncology pharmacy, clinical research, and pharmacy management. He recently managed oncology clinical pharmacy services for Beebe Healthcare in Southern Delaware, and prior to this he spent nearly 10 years at Medstar-Georgetown University Hospital – Vince Lombardi Comprehensive Cancer Center in Washington, DC, in roles in oncology and research pharmacy services. During the latter role, he also served as an adjunct clinical professor at Howard University School of Pharmacy. Amosu received his BS in Pharmacy and PharmD degrees from Howard University, and he holds an Health-System Pharmacy Administration from The Ohio State University.

Pharmacy Times: As you step into this role as senior director of pharmacy, what challenges do you see ahead as being pivotal to advance medication use processes in inpatient and ambulatory settings at Fox Chase facilities?

Amosu: Medication use process is the foundational system that provides the requisite framework for safe use of medication within the health system. Cancer care is usually delivered in a complex environment and safe use of medication remains one of the overriding factors in the delivery of care to our patients. All efforts must be made to ensure that the safe medication use is maintained. Putting necessary safeguards in place to ensure that the ongoing supply chain disruption does not negatively impact our medication use process is a critical issue that we will continue to manage.

Clinical pharmacy specialists in all patient care settings play essential roles in ensuring that our patients continue to receive the most effective treatments; their participation in multidisciplinary treatment coordination, engagement in transition of care and continuum of care processes, and preventing inappropriate use of medication that can potentially lead to patient harm, suboptimal health outcomes, and increase cost of care is essential to advancement of medication use process.

Inclusion of a pharmacy specialist in a clinically-oriented, multidisciplinary team-based practice model yields good treatment outcomes and prevents suboptimal health outcomes. Fox Chase is committed to guaranteeing that these services are delivered by our pharmacy team as we develop strategies to tackle pharmacist and pharmacy technician recruitment and retention challenges. We will continue to utilize available technology including automation, to optimize delivery of pharmaceutical services with the goal of advancing every aspect of the medication use processes.

Pharmacy Times: How has the role of the pharmacist in inpatient and ambulatory settings changed in recent years, and what more would you like to see done to advance that role?

Amosu: Pharmacists’ role in patient care continues to evolve in both inpatient and ambulatory settings. Some of the emerging pharmacist’ roles in the inpatient setting include pharmacy participation in transition of care (TOC), which focuses on the continuity of patient care from the hospital to home upon discharge, and vice-versa.

TOC pharmacists reconcile patient medication record to prevent medication errors, ensure continuity of therapy, and reduce readmission rates. Studies have shown that TOC pharmacy program reduces 30-day hospital’s readmission rate by 14.5%.

Also, medication safety pharmacists are essential in all health care settings. They identify deficiencies in the medication use process by analyzing medication safety reports and identify opportunities to improve the safety of medication use including changes to prescribing practices. Pharmacist’s role in pharmacy-based acute oncology care optimization program will continue to expand; this includes selection of best treatment plans and appropriate supportive care agent(s), patient education, and monitoring plus management of treatment-related adverse events (AEs).

Pharmacy Times: What is the role of the pharmacist in patient care currently in inpatient and ambulatory environments at the Temple University Hospital (TUH)?

Amosu: Our pharmacists are actively involved in all aspects of the medication use process, making clinical interventions and therapy recommendations for improved patient outcomes, and also participating in the development and implementation of practice policies across the TUH System. Their roles are focused on delivery of safe, effective, patient-centered pharmaceutical services. Their scope of practice has extended into care coordination within their respective multidisciplinary team and continuum of care beyond hospital stay.

Our pharmacists are actively involved in all aspects of the medication use process, making clinical interventions and therapy recommendations for improved patient outcomes, and also participating in the development and implementation of practice policies across the TUH System. Image Credit: Adobe Stock - natali_mis

Our pharmacists are actively involved in all aspects of the medication use process, making clinical interventions and therapy recommendations for improved patient outcomes, and also participating in the development and implementation of practice policies across the TUH System. Image Credit: Adobe Stock - natali_mis

Pharmacy Times: How is Fox Chase being impacted by supply chain challenges currently, and how is it responding to these challenges?

Amosu: Shortages of pharmaceuticals including intravenous solutions continue to beset the health care systems. Despite the challenges presented by this supply chain disruption, FCCC continues to meet the pharmaceutical needs of our patients. We are able to accomplish this through implementation of best practices recommendations that include therapeutic interchange, dose adjustment, conversion from IV to oral formulation, when appropriate, and change in route of administration, intermittent infusion to IV push. In limited cases, we have worked with our multidisciplinary team to revise treatment plans so we can make other treatment options available to our patients. All these were implemented without disruptions in care delivery or compromise in quality of treatments administered.

Pharmacy Times: How has your experience in a privately owned outpatient cancer treatment center helped to inform your perspective around your work at Fox Chase Cancer Center?

Amosu: The practice challenges are similar across these 2 settings including the economic burden (financial toxicity) that cancer patients experience from the costs of treatment.

Treatment and management of cancer continue to shift into the hospital ambulatory and community space. Many of the chemotherapy regimens that were administered in the inpatient setting in the past are now safely administered in the outpatient setting, and the importance of ensuring that these regimens are administered safely in this fast-paced environment cannot be overemphasized. The number of patients receiving chemotherapy services through the Fox Chase - TUH network continues to increase as we endeavor to meet the needs of our patients and expand our reach to immediate communities. Our goal is to ensure that we deliver effective pharmaceutical care safely and efficiently.

Pharmacy Times: What is your view on the future we are heading toward as the role of technology and AI come to the fore in pharmacy processing of data?

Amosu: Technology continues to positively impact all steps in the medication use process. AI is being used in many areas of the health care system to prevent medication errors and as a predictive analytic tool to manage treatment outcome, drug inventory, and medication adherence; it can also help to predict the severity of AEs based on available patient’s genetic information. AI will be very useful in the selection of the most “cost-effective regimen” especially for high cost treatment options. Some of these attributes will directly or indirectly lead to reduction in hospital readmissions.

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