Describing the role of the hematology/oncology clinical pharmacist in health information technology.

PURPOSE: To describe the role of hematology/oncology clinical pharmacists in health information technology as well as their perceptions of the impact of technology expansion on patient care. METHODS: A single-center, web-based survey was distributed to 30 hematology/oncology clinical pharmacists by email over the two-week-period of 24 September 2018 to 8 October 2018. The anonymous survey was composed of 19 questions, with varying formats including multiple choice, fill-in-the-blank, and rank order. Primary endpoints were quantification of time spent in the electronic health record and perceptions on how technology expansion has impacted the safety, quality, and efficiency of patient care. RESULTS: Twenty-seven hematology/oncology clinical pharmacists (90% response rate) completed the survey in its entirety. Respondents reported that they spend an average of 84.1% of their work day in the electronic health record. Based on a 40-h work week, clinical pharmacists indicated that they spend approximately 32.2 h each week performing direct patient care tasks in the electronic health record compared to 3.7 h on indirect patient care tasks. All respondents reported a greater utilization of technology over the last five years, and most respondents felt that patient care is safer, of better quality, and more efficient with technology expansion. The majority of respondents (81.5%) indicated that clinical pharmacists have the best understanding of the health information technology system, followed by generalist pharmacists and informatics pharmacists. CONCLUSION: The hematology/oncology clinical pharmacist is well positioned to serve as a health information technology leader on the interdisciplinary healthcare team.

Activity of PD1 inhibitor therapy in advanced sarcoma: a single-center retrospective analysis.

BACKGROUND: Sarcomas constitute a heterogeneous group of tumors with different clinical behaviors and variable responses to systemic therapies. Recent immunotherapy studies with PD1 inhibitors (PD1i) show promising results with use in certain soft-tissue sarcomas; however, the clinical and molecular features that best predict response to PD1i remain unclear. METHODS: Demographic, imaging, histologic, and genetic sequencing data was collected for sarcoma patients who received nivolumab or pembrolizumab (PD1i) treatment at our institution between January 1st 2015 and April 23rd 2018. The primary objective was to determine progression-free survival (PFS) in patients with advanced sarcomas receiving PD1i. Secondary objectives included determining overall survival (OS) and assessment of characteristics associated with response to PD1i. Fifty-six patients who were treated with PD1i therapy met inclusion criteria for this study. RESULTS: Partial response towards PD1i treatment was seen in 3 in 26 evaluable patients, but no complete responses were observed (overall response rate 11.5%). Within this group of patients, the 90 day PFS was found to be 48.8%. In patients in whom PD1 expression was known, there was a statistically significant positive correlation between expression of PD1 and longer PFS and OS rates. Patients that were treated with more than four cycles of PD1i therapy were also more likely to have a greater OS. CONCLUSIONS: This study suggests activity of PD1i in a pretreated cohort of advanced sarcoma patients, particularly for the subset of patients with PD1 positive tumors. Our results highlight the importance of further research to better target the optimal patient population and markers of response.