Agha, Agha A.

PURPOSE Oncology pharmacists (OPs) play a crucial role in cancer care, treatment, survivorship, and multidisciplinary teams (MDTs). OPs have specialized training in designing, administering, monitoring, and modifying oncology chemotherapy; managing adverse events; and evaluating clinical trials and investigational drugs. Yet, the state of OP has remained largely unknown in the clinical oncology workforce of the West African region. Therefore, this study aimed to understand who reconstitutes chemotherapy and to explain the OP educational and practice needs, challenges, and solutions in Nigeria. MATERIALS AND METHODS Using a concurrent embedded mixed method design, 35 OPs completed a questionnaire, and 12 others responded to a semistructured interview. The data were then subjected to inductive thematic and descriptive analyses. RESULTS The findings showed that 54% of the OPs were responsible for chemotherapy reconstitution, and only 60% of the oncology centers had a biosafety cabinet. 91% of OPs were practicing; however, only 54% were trained in OP, and none of the OPs were board-certified. Most of the OPs spent time weekly on reconstitution, administrative duties, teaching, and training; only 3% spent on oncology clinical trials and conferences and 8% on noninterventional research. We identified four themes: (1) Some OPs are not reconstituting chemotherapy: A Call for MDT, (2) For OP, No Training is Enough, (3) Board Certification will give OPs Recognition, and (4) Introduction of OP Course in Universities. CONCLUSION To improve patient treatment outcomes, training on chemotherapy reconstitution should be prioritized, integration of OPs into MDTs, and the safe handling of chemotherapy in centers should be mandated in the region. The West African Postgraduate College of Pharmacists should be supported in expanding its curriculum and introducing OP fellowships.

e21021 Background: West Africa, especially Nigeria, faces a disproportionate burden of cancer incidence and mortality, along with disparities in cancer care and management. Oncology pharmacists (OPs) play a crucial role in cancer care, treatment, and survivorship and MDTs. OPs have specialized training in designing, administering, monitoring, and modifying oncology chemotherapy, managing adverse events, and evaluating clinical trials and investigational drugs. Yet the educational needs and state of OPs have remained largely unknown in the West African region. Methods: Using a concurrent embedded mixed method design, 35 oncology pharmacists (OPs) completed a questionnaire, and 12 others responded to a semi-structured interview. The data were then subjected to inductive thematic and descriptive analysis. Results: The quantitative findings showed that 54% of the OPs were responsible for chemotherapy reconstitution, and only 60% of the oncology centers had a biosafety cabinet. 91% of OPs were practicing oncology pharmacy (OP); however, only 54% were trained in OP, and none of the OPs were board-certified. Most of the OPs spent time weekly on chemotherapy reconstitution, administrative duties, teaching, and training; only 3% spent on oncology clinical trials and conferences and 8% on other research. Respondents ranked developing medication therapy management programs as the topmost priority area for better OP practices, and chemotherapy reconstitution is the area of OP that requires the most attention for improving patient treatment outcomes and survivorship. Inadequate training, lack of equipment, non-recognition of oncology pharmacy, availability of oncology medicines, and non-integration of multi-disciplinary teams (MDT) were the major challenges in OP practice in Nigeria. In the qualitative findings, four themes were identified: (i.) Some oncology pharmacists are not reconstituting chemotherapy: A Call for MDT, (ii.) For Oncology Pharmacy, No Training is Enough, (iii.) Board Certification will give Oncology Pharmacists Recognition, and (iv.) Introduction of Oncology Pharmacy Course in Universities. Conclusions: The findings suggest that oncology pharmacists should be included in MDTs and other cancer management, which is a critical step toward improving patient outcomes in the region. Our findings show that the safe handling of chemotherapy is problematic in this region. Hence, the National Institute for Cancer Research and Treatment and other West African countries should urgently institute a national and state task force to watchdog all oncology chemotherapy centers and ensure that those preparing chemotherapy to save cancer patients are also saved from carcinogens.

Abstract BackgroundNigeria has the highest cancer burden in Africa with 124,815 cancer cases and 78,899 cancer deaths in 2020. The limited number of oncology specialists, inaccessibility of essential cancer medicines like chemotherapies, and suboptimal delivery of cancer care lead to poor treatment outcomes. Oncology pharmacy (OP) practitioners are critical oncology professionals in the multidisciplinary team (MDT) for cancer treatment globally. In Nigeria, there is a limited number of OP practitioners providing services like reconstitution of chemotherapy, clinical research, safe use of biosafety cabinets, and monitoring of adverse drug reactions. Although the interest in oncology pharmacy is increasing, the educational needs, available skill sets, and directed training in oncology pharmacy across the nation are unknown. In this study, we examined the educational needs of OP practitioners and worked with the West African College of Pharmacy West African Postgraduate College of Pharmacists (WAPCP), Oncology Pharmacy Practitioners Association of Nigeria (OPPAN), and the International Society of Oncology Pharmacy Practitioners to upgrade the oncology pharmacy practice in Nigeria. MethodA cross-sectional study with a semi-structured questionnaire was done in 2021 with 39 pharmacists working in oncology centers across Nigeria. General descriptive statistics and qualitative analysis was performed. ResultsThere is no board-certified oncology pharmacist in Nigeria. More than 50% of the general pharmacists working in oncology centers are responsible for chemotherapy reconstitution. Understanding chemotherapy reconstitution (automation of chemotherapeutic mixing, use of radiopharmaceuticals, etc), use of biosafety cabinets, knowledge of pharmacology, designing treatment protocols, data management, immunotherapy delivery, and oncology clinical trials were some of the most significant educational needs of the OP practitioners in Nigeria. OP practitioners are lacking in most cancer centers and MDTs. ConclusionThere is an urgent need for a specialty postgraduate training programme in oncology pharmacy in Nigeria. This would help increase oncology clinical trials, improve delivery of cancer medicines, quality of care, and management of toxicities. The West African Postgraduate College of Pharmacists and OPPAN need appropriate training resources to develop an oncology pharmacy curriculum, promote the specialty and collaborate with global institutions for board certifications. Citation Format: Runcie C. Chidebe, Ramatu M. Alabelewe, Darlingtina K. Esiaka, Gloria C. Okwu, Tochukwu C. Orjiakor, Nwamaka Lasebikan, Jacinta Emejulu, Adamu A. Umar, Ndifreke Okwuegbunam, Funsho David, Toyosi Adepoju, Krishna Prasad Sapkota, Candidus C. Nwakasi, Agha A. Agha, Simeon C. Aruah, Katy Graef, Richard Mshelia, Rob Duncombe, Matthew O. Nwaneri, Noel Wannang, Cindy O’Bryant, R. Donald Harvey, Peace C. Babalola, Folakemi T. Odedina. Who reconstitutes my chemotherapy? Examining the educational needs of oncology pharmacy practitioners in Nigeria [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 723.