The performance of the pharmacist in oncology: what is expected with the minimum degree requirement?

Abstract

The involvement of the pharmacist in the care of the cancer patient has more than 50 years and, since the end of the 70´s, this professional has been looking for mechanisms to qualify to search for a more
effective and quality performance1. The work of the pharmacist in oncology in Brazil has gained greater
prominence since the 1990s. Despite the advances, some difficulties in the professional practice have been reported, compromising the safety and quality of the care provided. In this sense, the publication of the Resolution of the Conselho Federal de Farmácia (CFF) nº 623 of April 29, 20162 is a new reference for the pharmaceutical profession in Brazil. The complexity of cancer and its therapies, the inherent risks of professional practice, the need to ensure patient safety and the environment, among other aspects, underpinned the importance of requiring a minimum degree for the pharmacist in oncology.
However, what are the prospects of progress with the publication of this Resolution? Firstly, it is expected that the quality of the care provided to cancer patients will be continuously improved. Cancer is one of the most frequent diseases in Brazil and the world and represents the second main cause of mortality, tending to be the first in the next 10 years3. The prevention and control of the disease depend on an integrated work and highly qualified professionals, including the pharmacists. Pharmacotherapy used in the treatment of cancer has the potential to prolong life and cure patients in specific situations. However, because of their serious toxicities and their logistical and safety challenges in the preparation and use, these same drugs can lead to negative outcomes1. Specialized pharmacists can contribute adequately to the control of these variables and favor the achievement of positive results. Another aspect is the elimination of medication errors in oncology. The diversity of drugs and protocols used in the treatment of different types of cancer favors errors in prescription, preparation, dispensing and administration. Little experienced or unprepared professionals may make small misconceptions that result in major fatalities. Thus, it is expected that the requirement of higher qualification of pharmacists can minimize the impacts of medication errors in oncology. It is also noteworthy the expectation of advances in the management of technologies, considering the evaluations and incorporations of new products and the shortage of the market of drugs used in cancer treatment. Costs with cancer pharmacotherapy cannot be neglected, as can the consequences of non-incorporation or discontinuation of treatments due to lack of products.
Pharmacists who work in oncology need to be able to develop management plans that aim to solve
these aspects. It is expected that pharmacists will be more involved in clinical, epidemiological and translational research in oncology area. This action will be essential to subsidize clinical, political and economic decisions adequately and to increase the effectiveness, safety, and usefulness of pharmacotherapy used in the treatment of cancer in Brazil. The scope of the pharmacist´s performance in oncology is constantly evolving, and his role has been identified as vital for the care and incremental survival of cancer patients. This new paradigm and the inherent responsibilities of practice require adequate and differentiated preparation. In this context, the expectation is that better humanistic, clinical and economic results will be achieved, as well as advances in professional practice and an increase in national scientific production.