Pharmacist Engagement in MM Treatment Landscape


Medical experts highlight the significant impact of pharmacists in multiple myeloma treatment pathways.

Ryan Haumschild, PharmD, MS, MBA: Let’s talk about pharmacist engagement strategies. I’m a big believer in the important role that pharmacists play on a multidisciplinary care team. And having physician and provider support makes it one of the best care models for our patients. With that being said, Dr Hinojosa, I’d love to hear your thoughts. As we talk about treatment and pharmacist involvement, how are clinical pathways developed and utilized for multiple myeloma [MM] within your facility and cancer center? [Is] the EMR [electrical medical record]…where they’re built into, and [are you] utilizing clinical treatment pathways through the utilization of order sets?

Gabe Hinojosa, PharmD, BCOP: Clinical pathways are an invaluable tool and in many disease states can be a little more straightforward than in the world of MM. To answer the first part of your question, our clinical pathways are developed through a multidisciplinary team. There’s a group that reviews these pathways annually, and they’re primarily protocol driven. We’re looking at NCCN [National Comprehensive Cancer Network] guidelines [and] updated data from major national and international cancer association meetings and delving to put that information and develop a pathway that’s going to guide our prescribers in choosing the perfect regimen or the perfect combination of drugs for that specific patient. In the MM world, we have so many drug choices, and often a lot of the choices…could be appropriate for the same patient. In those scenarios, it becomes a little harder to nail down the exact pathway. So [although] our pathway does exist and is accessible through the EMR, [it] can get cumbersome in the world of myeloma with so many treatment options for the same patient. In these settings, what we tend to follow [is that] the prescribers are able to select their treatment plans outside our pathway. But in that process, they are required to enter the number of lines of therapy the patient has had, certain diagnostic criteria so that [the] pharmacist, during their clinical review, can look at [them] and make sure it is an appropriate regimen selection based on those clinical pathways and intervene if necessary.

Ryan Haumschild, PharmD, MS, MBA: That’s such a great thing. As you mentioned, you want to be so specific to the individual patient and be considerate if there are any types of mutations that we need to worry about. Is there high-risk disease or standard-risk [disease]? At the same time, how can we create a best-practice approach to MM? When we know that patients are presenting in a variety of settings, how do we create consistency of best practices so we get the ultimate outcomes? I recognize the difficulty in boiling that down to specific protocols but [it’s about] utilizing the EMR to help drive that utilization. And then you can look at your data afterward and make sure we are doing what’s best for our patients. And what a great way to at least have them reviewed annually by that disease state working group.

Transcript edited for clarity.

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