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Massachusetts General Hospital Cancer Center

TOP - February 2017, Vol 10, No 1

The Mass General Cancer Center is an integral part of a top-flight academic medical center: Massachusetts General Hospital. The Mass General Cancer Center is among the leading cancer care providers in the United States, and is a National Cancer Institute–designated comprehensive cancer center as part of the 7-member Harvard Medical School consortium. This consortium forms the largest research collaborative in the country, and has participated in developing promising new therapies that have revolutionized the treatment of cancer.

The Mass General Cancer Center provides customized multidisciplinary care to children and adults. In addition to medical oncology, surgical oncology, and radiation oncology, the cancer center offers a full range of cancer care–related programs. These include the Katherine A. Gallagher Integrative Therapies Program, which offers free wellness programs for patients and their caregivers; the Lifestyle Medical Clinic for patients and survivors who want a personalized consultation to improve their overall physical fitness and quality of life; a sexual health clinic; the Marjorie E. Korff PACT program, which offers psychoeducational support for parents who are patients; and the Center for Psychiatric Oncology and Behavioral Sciences, which helps patients cope with the psychological and behavioral impact of their cancer.

The Oncology Pharmacist spoke with Gayle Blouin, PharmD, BCOP, Clinical Lead Pharmacist, Ambulatory Oncology, Massachusetts General Hospital Cancer Center, Boston, about her role and responsibilities.

TOP: What are your responsibilities at the Mass General Cancer Center?
Gayle Blouin:
My job is exciting! I manage the clinical oncology pharmacy practice and am involved in direct patient care activities. My role has evolved over the time I have been here. I started working in the infusion pharmacy and expanded my role when I became the Clinical Lead to include providing pharmacy consultations and patient education, developing medication and practice guidelines, teaching, and conducting clinical research, along with my committee work and administrative responsibilities.

Approximately 2 years ago, I received additional resources to expand our clinical pharmacy services, and, this year, we have expanded our program further. Currently, we have 3 clinical pharmacists with dedicated time working in the multiple myeloma, lymphoma, breast oncology, and thoracic oncology clinics. The clinical pharmacists meet with patients to conduct comprehensive medication reconciliation, provide patient education, and monitor for drug-related toxicity and medication adherence. They also develop medication-related education for patients and the clinics, and serve as valuable drug information resources for clinicians and nurses.

Last year, we started a postgraduate year 2 (PGY2) oncology pharmacy residency program, and I am the director of the program.

TOP: How long has the clinical pharmacy program been in existence?
Dr Blouin:
The clinical pharmacy program started approximately 8 years ago when the Clinical Lead for Ambulatory Oncology position was created. I was fortunate to be selected for this new position. The clinical pharmacy program was expanded approximately 2 years ago when we added a part-time clinical pharmacist to work in the multiple myeloma clinic. We recently expanded this program further, as I mentioned earlier.

TOP: What are your biggest challenges?
Dr Blouin:
Last year, we started a PGY2 oncology pharmacy residency program. This is an additional year of postgraduate pharmacy education focused on the care of patients with cancer. Starting a residency program was very labor-intensive, but also very rewarding. Developing a program based on American Society of Health-System Pharmacists accreditation standards was an enormous undertaking, and I could not be more pleased with how well our first year went. And I was fortunate to be able to hire our resident after graduation; he is one of the clinic pharmacists.

TOP: What is your greatest reward?
Dr Blouin:
I work with passionate and committed colleagues. I am grateful that we as pharmacists are contributing to patient care and making a difference in the lives of individuals with cancer. We monitor patients closely to ensure they are receiving the right treatment at the right dose at the right time, and that they understand their medications. In addition, through our residency program, we are contributing to the development of the next generation of oncology pharmacists. This is what makes me excited to come to work every day.

TOP: What are you excited about in the field of oncology right now?
Dr Blouin:
The most exciting thing to me is that pharmacists are expanding their role in patient care at a time when we are seeing unprecedented FDA drug approvals. This is an ideal time for pharmacists to be recognized as medication experts, and to be a part of the patient care team. The role of pharmacists continues to evolve, and we need to be poised to take on greater patient care responsibilities.

TOP: Do you encounter colleagues who are reluctant to take on the extra responsibilities?
Dr Blouin:
Yes, there are those colleagues who do not want to take on additional work in a high-volume, complex, patient care setting. However, I am fortunate to work with a number of colleagues who support the pharmacy department’s mission of expanding clinical pharmacy services and residency training. Pharmacists serve as residency preceptors, whereas others support the residency by providing pharmacy coverage during meeting or rounding times. Colleagues do take on additional work and also attend staff development resident lectures.

TOP: How did you become an oncology pharmacist?
Dr Blouin:
I graduated magna cum laude with a Bachelor of Science degree in pharmacy from Northeastern University, Boston, MA. I accepted a pharmacist position in managed care. I worked there for approximately 10 years, and really enjoyed working closely with patients and clinicians. At that time, there were few clinical pharmacy positions. Advancement generally meant moving to management, and, for me, it meant taking the Chief position, which really was not what I was looking for. I left that position and accepted a lead pharmacist position at Lahey Clinic, Burlington, MA.

I was hired to open a satellite pharmacy that served patients with cancer and a couple of other clinics. This was my first experience in oncology, and I loved it. This position led me to the Cancer Center at Mass General Hospital, where I was originally hired to manage an ambulatory pump program. My position evolved over the years; I went back to pharmacy school and got a PharmD degree, and went on to do a PGY2 oncology residency at Dana-Farber Cancer Institute, Boston, MA. The rest is history.

TOP: What would you do if you won the lottery? Would you continue your work?
Dr Blouin:
Winning the lottery would be nice; however, my work is not done. There is still a significant amount to accomplish, and I want to see it through and stay engaged in it. I am passionate about growing the clinical pharmacy program by adding more pharmacists in our outpatient clinics, and expanding the oncology residency program. I have 3 children and am very busy with family, friends, and life; however, my career is also important to me. I work hard to balance the personal with the professional.

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