How Oncology Pharmacists Can Provide Support, Address Barriers to Care for Patients With Cancer

Sarah Wheeler, PharmD, BCOP, clinical pharmacy specialist in Hematology/Oncology at UF Health Shands Cancer Hospital, discusses some of the barriers patients with cancer may experience that oncology pharmacists can help them navigate through.

Pharmacy Times interviewed Sarah Wheeler, PharmD, BCOP, clinical pharmacy specialist in Hematology/Oncology at UF Health Shands Cancer Hospital, on her session at the Hematology/Oncology Pharmacy Association 2022 annual conference session, ‘And the Title We Didn’t Train for: Navigating the Balance Between Being a Caregiver AND an Oncology Pharmacist.’

During this discussion, Wheeler explained some of the barriers patients with cancer may experience that oncology pharmacists can help them navigate through.

Sarah Wheeler: Being an oncology pharmacist, a lot of times I can see barriers and how patients navigate the health care system in general. So sometimes they're like, ‘Sarah, 6 pm, I can't get a hold of anybody.’ You search, trying to help them to know how to navigate the system, make sure they have phone calls for the on-call people who can be helpful.

Other conversations that we'll have will be around costs, as a lot of times cost of medications is a big barrier that I ran into a lot—either cost or accessibility. So, if patients don't have insurance, how can we get those medications for them. So, there's a lot of patient systems programs that are through the manufacturer, there's paperwork that we can fill out to get medications for them for free. So that's a barrier that a lot of times I help them to overcome is being able to have those medications.

For patients who do have insurance, we often run into the cost of the medications being a problem. So, working through co-pay assistance or grants, something that a lot of times we'll work through, and a big barrier that we'll work on.

Other barriers sometimes can be communication with their health care providers and feeling like they're not always being well understood, or if they don't feel like their symptoms are being managed or listened to, well, sometimes they'll talk to me about them, and I can help facilitate with the provider about getting a plan or getting something changed for them from that standpoint, to help them with that. Being part of the health care system, I can help them navigate with it sometimes as well.

So, if they do feel like they're getting lost in the shuffle, potentially, I can help coordinate them or get them in touch with the coordinator, somebody that might be able to help them to navigate through the maze of the health care system, especially if it's in the bigger places, as it’s kind of easy to get lost. So sometimes that will come up when I'm talking with patients as well—is helping them to work their way through those different things. Sometimes coordination of care can help them with that, too. If they're complaining, like, ‘Hey, Sarah, we have a 4-hour drive, but we've got to see so and so on this day, and so on and so at this distance, so and so on this day.’ [I’m] like, ‘Okay, hold on, let me see if I can kind of coordinate this for you.’

So that kind of barrier sometimes will come up that, I can help them with kind of navigating the health care system, that's being able to send an email or staff message or something like, ‘Hey, can we consolidate things a little bit or is there a different way we can do this.’ So that's another way that I do think oncology pharmacist can help.

Another barrier—sometimes the caregiver and the patient both can feel lost and feel overwhelmed, and they’re not sure where to turn. So, we also can be helpful in helping them find resources for support groups, local support groups, or online support groups. Facebook has a lot. And kind of navigate through those kind of barriers of feeling alone and helping them to find the resources pointing towards spiritual guidance or different podcasts or books that might be helpful for them too. Sometimes that's something we can also assist with because a lot of patients will talk to us about this kind of thing as well.