Advancing hospital pharmacy practice through new competences in advanced therapy medicinal products

The role of hospital pharmacists in supporting the appropriate and safe use of CGT/ATMPs: a scoping review of current insights

BACKGROUND

The role of hospital pharmacists in managing cell and gene therapy (CGT) and advanced therapy medicinal products (ATMPs) is gradually being recognized but the evidence about impact of their role has not been systematically reported.

OBJECTIVE

This study was aimed to summarize the professional services provided by hospital pharmacists on managing CGT/ATMPs and the evidence about the effects on patient care, as well as to identify the perceptions about pharmacists assuming a role that supports the appropriate and safe use of CGT/ATMPs.

METHODS

Literature from 4 electronic databases (PubMed, ScienceDirect, Web of Science, Scopus) were searched following PRISMA checklist to yield publications on the interventions provided by hospital pharmacists in the management of CGT/ATMPs dated since 1 January 2013 till 30 April 2023.

RESULTS

Thirty-four publications were included in this review. Eight studies involving hospital pharmacists participating in interventions for 1,012 hematopoietic stem cell transplant (HSCT) patients from 8 hospitals in 5 countries were identified. Common pharmacist-led interventions centered on medicine administration, prescribing, and monitoring of medicines use, resulting in significant improvement in patient adherence, satisfaction and knowledge. Of 26 studies, the perspectives assuming their roles in CGT/ATMPs management were categorized when patients receiving ATMPs (n = 2), HSCT and cellular-based therapy (n = 12), gene therapy (n = 6), and the chimeric antigen receptor (CAR) T-cell therapy (n = 6), mainly covering procurement, influences on prescribing, preparation and delivery, administration, monitoring of medicines use, human resources, training and development. The anticipated impact was primarily intended to promote pharmacy practice, multidisciplinary collaboration and improve patient clinical outcomes.

CONCLUSION

Leveraging the role of hospital pharmacists in multidisciplinary healthcare teams to develop a coordinated approach that supports pharmacy practice will better meet the management of CGT/ATMPs. For hospital pharmacists to step up their role in the multidisciplinary healthcare team, advancing their skillset in terms of clinical practice standards and medication management is essential.

[Advanced therapy medicinal products' (ATMP) pharmaceutical circuit in France: Current situation and outlook]

OBJECTIVES

Advanced therapy medicinal products' reconstitution is an innovative pharmaceutical activity. The purpose of this work is to evaluate the current situation in France within hospital pharmacies.

METHODS

An electronic questionnaire (90 questions) was sent to previously identified French pharmaceutical teams exploring advanced therapy medicinal products' reconstitution process in its various aspects.

RESULTS

Thirty-eight pharmacists completed the survey. The ATMPs reconstitution is very largely carried out by pharmaceutical teams in charge of other activities, even if dedicated teams are beginning to appear. Gene therapy represents majority among advanced therapy medicinal products. The premises are very often shared, especially the controlled atmosphere areas. These vary greatly in nature, as do facilities used. The ultra-low temperature storage is most frequently used and the nitrogen equipment of hospital pharmacies is yet observed and tends to expand. Simple reconstitution processes (thawing, dilution) are mostly carried out in hospital pharmacies. The traceability still largely relies on different software and/or the use of paper formats. The reconstitution process needs devoted pharmaceutical time according to the active queues, sometimes exceeding 200 patients per year.

FINDINGS

If the hospital pharmacists is going to take charge of this activity on a constant basis, the regulatory context and the increase in active queues will require a real investment plan from the public authorities in this activity to effectively implement ATMPs reconstitution to the greatest benefit of patients.

Directions of Changes in the Profession of Hospital Pharmacist in Poland

The Act on the Pharmacist Profession, adopted on 10 December 2020, is a breakthrough for the entire community of pharmacists in Poland. Due to the scope of the changes introduced in the Act, the question is whether pharmacists in Poland are suitably prepared for pharmaceutical care and clinical pharmacy services. The main aim of the study is to assess the readiness of hospital pharmacists to introduce changes in the way the profession functions. The result of the study is the presentation of the concept of a new model of pharmacist functioning in healthcare entities and the indication of actions necessary to carry out such a change. The questionnaire was addressed to all hospital pharmacists in Poland. Two hundred and seventy-seven hospital pharmacists were included in the research. The analysis of the data revealed that almost all (96.1%) respondents indicated the need to introduce changes to the model of functioning of pharmacists in medical entities. Two-thirds of pharmacists declared readiness to start work to introduce changes. Hospital pharmacists recognize the importance of clinical pharmacy in their current practice; however, the biggest barrier is the lack of financing, an insufficient number of staff, a lack of knowledge and skills, and a lack of tools to use the service.