Between the high costs of medication, the array of drugs on the market and the often complicated rules of insurance companies, starting chemotherapy can sometimes confuse and overwhelm cancer patients and their families.
But pharmacists like City of Hope’s Cecilia Lau, R.Ph., B.C.O.P., act as partners with physicians to clear away that confusion — so patients can focus on fighting their disease.
|Cecilia Lau accompanies medical oncologist Dean Lim during his gastrointestinal cancer clinic.|
Lau, who joined City of Hope in 1995, spends every day dealing directly with patients. Certainly, some pharmacists work behind a counter and dispense pills, tablets and creams, but Lau’s role calls for her to work one-on-one in the clinic with physicians, nurses and nurse practitioners, and the outpatients they serve.
The model is called clinical pharmacy, and it aims to involve pharmacists in the care of patients from its very beginning. “There’s so much that we can offer as pharmacists,” Lau said. “We’re drug information specialists.”
City of Hope began its clinical pharmacy model in the clinic more than two years ago. Lau works specifically with Gastrointestinal Cancer Program medical oncologists Vincent Chung, M.D., Dean Lim, M.D., and Stephen Shibata, M.D., though she also helps other physicians if they need it. On any given day, she follows one of the three oncologists throughout his clinic appointments.
“It’s really a team,” Lau said. “I talk with the doctor and nurse practitioner, and we discuss the treatment plans and the therapy options.”
Lau prepares chemotherapy orders, gets them signed and works with infusion nurses and other pharmacists so patients can start their treatment. By being involved from the beginning, Lau can also ease patients’ initial worries about chemotherapy, provide them introductory information about how medications work and what side effects to expect, and anticipate any paperwork or financial problems.
“In one day, I’ll get stopped by six or seven patients who have questions,” she said. “It makes it easier on them to know that I’m a resource.”
Sometimes she helps patients maneuver their insurance companies’ lists of covered drugs; at other times, she has to make sure that all medications, such as antinausea drugs, are ready and waiting for patients when they start chemotherapy.
Patients appreciate it. For example, a patient and her family recently successfully battled nasopharyngeal carcinoma, and the tangle of challenges the disease brings, with Lau’s help. “We were amateurs dealing with thousands of new medical terms, treatments and routines,” the family wrote in a letter to Sally Htoy, Pharm.D., clinical pharmacy manager. “Cecilia helped us progress from mere beginners to advanced students ... she walked us through several treatments from setting up TPN [intravenous nutrition] nightly to getting us free medicine samples when the insurance would not cover [it.]”
Lau, a native of Hong Kong and graduate of the University of Wisconsin at Madison, is accompanied in the outpatient clinic by Greg Hendrix, Pharm.D., and Kim Yu, Pharm.D., B.C.O.P. Pharmacy administrators hope to dedicate Yu to work with breast cancer outpatients if the program can expand.
“Cecilia embodies the values of our pharmacists,” said Carl Kildoo, Pharm.D., director of pharmacy. “She has gone out of her way to make sure patients are well-prepared when they start chemotherapy, and she stays there for them throughout the course of their treatment.”
Noted Dale Adams, Pharm.D., vice president and chief pharmacy officer: “Pharmacists are a critical part of the care team here at City of Hope. Their pharmaceutical expertise complements the skills and knowledge of our doctors and nurses, all to the benefit of our patients.”