Investigating the educational and practice needs of oncology pharmacists in West Africa: A case study of Nigeria.

Abstract

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.