Development and implementation of pharmacy department and pharmacy resident well-being programs.

PURPOSE: Burnout in healthcare can have serious consequences, as it decreases patient care quality. Recent studies have found pharmacy employees have high rates of burnout, but formalized pharmacy well-being programs are not reported in the literature. METHODS: We developed a departmental pharmacy well-being program and focused residency well-being program in October and July 2020, respectively. The program committees sent anonymous surveys to all pharmacy employees to identify opportunities to improve well-being. The feasibility and impact of ideas were assessed by committee members and presented to pharmacy leadership who endorsed and supported all proposed initiatives prior to implementation. Pharmacist distress scores were measured using the Well-Being Index (WBI). RESULTS: The WBI was completed by 49% of invited pharmacists (137 of 278) in November 2020 and 41% (116 of 283) in June 2021. There was a numerical improvement in mean (SD) WBI scores from 2.06 (2.47) in November 2020 to 1.52 (2.49) in June 2021 (P = 0.09). Pharmacy residents had significantly higher distress scores than nonresident pharmacists (P = 0.01). However, pharmacy resident scores improved by almost 50% between the 2 time points, from 4.43 (2.13) to 2.40 (2.42); P = 0.03. CONCLUSION: The development of a system-wide pharmacy well-being program creates a structure to collect ideas from employees, implement well-being initiatives, measure burnout using a validated tool such as the WBI, and continue to build, evaluate, and adapt new interventions. Importantly, the program went beyond addressing individual needs and addressed institutional opportunities that impact well-being. This can serve as a model for other pharmacy departments looking to implement similar programs.

Multicenter comparison of high-dose cytarabine-based regimens versus liposomal daunorubicin and cytarabine (CPX-351) in patients with secondary acute myeloid leukemia.

Liposomal daunorubicin/cytarabine (CPX-351) gained FDA approval for secondary AML after demonstrating improved outcomes over daunorubicin and cytarabine (7 + 3). A number of study limitations prompted a comparison of safety/efficacy of CPX-351 against regimens containing a purine analogue and high-dose cytarabine (HIDAC). This retrospective study compared complete response rates with/without count recovery (CR/CRi) between HIDAC-based regimens and CPX-351 in 169 patients with newly diagnosed sAML. The CR/CRi rate was 62.7% in the HIDAC-based therapy arm vs. 47.9% in the CPX-351 arm (p = 0.002 [one-sided for non-inferiority]). Median time to absolute neutrophil and platelet count recovery was shorter after HIDAC-based therapy (18 and 23 days, respectively) compared to CPX-351 (36 and 38 days; p < 0.001). Median overall survival was 9.8 months in the HIDAC-based group and 9.14 months in the CPX-351 group. 30-day mortality was greater with CPX-351 (8.5%) compared to HIDAC-based (1.3%; p = 0.039). These results reveal comparable efficacy and favorable safety with HIDAC-based regimens.