Recipients of the Certificate of Recognition for Exemplary Research on Quality of Care in Oncology

Introduction

The Quality Oversight Committee of the Hematology/Oncology Pharmacy Association (HOPA) extends its congratulations to the recipients of the Certificate of Recognition for Exemplary Research on Quality of Care in Oncology. This honor, known as the HOPA Quality Research Certificate (QRC), is designed to highlight and promote outstanding quality improvement initiatives in oncology care. Each year, the certificate is presented at the HOPA Annual Conference to the authors of top abstracts submitted in the Trainee, Late-Breaking, or Completed Research categories. Up to five abstracts are selected annually based on their focus on quality, innovation, and a clear demonstration of the pharmacist's role, value, and impact in practice.

Why is Quality Improvement Work Important for Pharmacists and their Practice?

Engagement in quality improvement (QI) work is essential to pharmacy practice as it offers a systematic, evidence-based approach for enhancing medication-use processes, patient safety, and clinical outcomes. By engaging in QI, pharmacists not only demonstrate the value of their practice within the healthcare system but also identify gaps and opportunities to reduce variation in processes and outcomes and introduce lasting changes that boost reliability, efficiency, and equity in care. Participation in QI assists organizations in meeting regulatory and accreditation standards, aligns pharmacy operations with organizational goals, and ensures that the positive impact of pharmacist interventions is measurable and clearly visible. Ultimately, QI involvement empowers pharmacists to position themselves as part of the solution, promote collaboration across  healthcare teams, and help advance collective efforts toward continuous improvement and high-quality patient care.

At the 2026 HOPA Annual Conference in New Orleans, Louisiana, two QRC awards were presented. Together, these two abstracts exemplify how pharmacists advance quality, drive innovation, and deliver tangible value in oncology care through evidence-based, patient-centered practice. Both initiatives address clinically important gaps by applying structured pharmacist interventions to complex areas of care.

Pharmacist-Led Growth Factor Review of Intermediate-Risk Therapy Plans and Its Impact on Acute Care Use¹

Presenter: Kyle Allbee, PharmD

Febrile neutropenia (FN) is a clinically significant and costly complication of myelosuppressive chemotherapy, contributing to preventable emergency department visits and hospital admissions.² The Centers for Medicare & Medicaid Services (CMS) OP-35 is a quality measure tracking healthcare utilization for cancer patients within 30 days of receiving outpatient intravenous chemotherapy and focuses on reducing potentially preventable complications in adult patients.³ Current guidelines outline recommendations for primary prophylaxis with granulocyte colony-stimulating factor (G-CSF) support based on regimen-specific FN risk, as well as patient-specific risk factors. However, despite these guideline recommendations, previous studies have shown underutilization of growth factor support in intermediate-risk regimens.^4,5 Therefore, investigators at the Avera McKenna Hospital & University Health Center evaluated the implementation and early impact of a pharmacist-led growth factor optimization protocol for adult oncology patients receiving chemotherapy regimens classified as having an intermediate risk of FN.

The primary objective was to evaluate whether pharmacist-guided addition of G-CSF reduced preventable acute care use (PACU), defined as emergency department visits or hospital admissions within 30 or 90 days of initial chemotherapy for potentially preventable causes (e.g., neutropenia, fever, pneumonia, or sepsis). Secondary objectives included identifying regimens or malignancies associated with higher healthcare utilization rates and evaluating whether a pharmacist-led protocol for G-CSF use based on FN risk improves guideline adherence.

Adult patients (≥18 years) receiving at least one intermediate-risk regimen were included from October 2024–March 2025 (pre-intervention, n=63) and October–December 2025 (post-intervention, n=19), with data extracted from electronic health records including demographics, regimen characteristics, FN risk factors, G-CSF use, and 30- and 90-day PACU following first chemotherapy. The intervention embedded pegfilgrastim orders into all intermediate-risk regimens with a mandatory pharmacist consult to assess guideline-based eligibility and remove G-CSF when patient-specific criteria were not met. Following implementation, guideline-concordant G-CSF use increased significantly (11% pre-intervention vs 68% post-intervention, p<0.0001), while the proportion of patients with at least one FN risk factor remained similar (>80% in both cohorts). No statistically significant reduction in PACU at 30 or 90 days was observed in this interim analysis, likely due to limited sample size and insufficient power, though PACU rates were comparable to national averages pre-intervention. An unintended increase in G-CSF use among low-risk patients after empiric dose reductions was noted, and certain regimens (e.g., bendamustine/rituximab and carboplatin-based combinations) were identified as potential targets for future, more focused interventions.

Overall, this project demonstrates the feasibility and effectiveness of a pharmacist‑led protocol in improving guideline‑concordant G‑CSF utilization for intermediate‑risk chemotherapy regimens. Although reductions in PACU were not observed, the findings highlight the importance of pharmacists in supportive care optimization and identify areas for further investigation to reduce preventative healthcare utilization in the oncology patient population.

From Trendy to Trustworthy: Developing a Systematic Approach to Supplement Review in Oncology at an Academic Medical Center⁶

Presenter: Meera Patel, PharmD

Dietary supplements and herbal products are widely used by the general public as alternatives or adjuncts to conventional medicine to support overall health and wellness, with U.S. consumer spending reaching an estimated $55.7 billion in 2020.⁷ Regulatory oversight of dietary supplements is governed by the Dietary Supplement Health and Education Act (DSHEA) of 1994, which permits these products to be marketed without requiring demonstration of efficacy or providing extensive premarket safety data. Supplement use is particularly prevalent among oncology patients, with an estimated 43% reporting concurrent use of herbal products alongside their cancer therapy.⁸ This practice presents clinically significant risks, including adverse effects and potential interactions with anticancer treatments that may influence therapeutic efficacy or increase toxicity. With the growth of the integrative oncology program at UW Health Carbone Cancer Center, and widespread, often undocumented supplement use, the investigators identified an opportunity to explore a standardized, systematic approach to reviewing supplement usage among adult patients within cancer care.

The primary objective was to develop and implement an evidence-based, pharmacist-led approach to evaluating dietary supplements and herbal products in oncology to support patient safety, assess potential efficacy and interactions, and guide responsible use alongside cancer treatment. Secondary objectives included standardizing the review and documentation of supplement use within the electronic health record, characterizing the types and frequency of pharmacist interventions aimed at risk reduction (e.g., bleeding risk, drug-drug interactions), and evaluating the impact and utility of a structured supplement review process within an academic integrative oncology program.

Pharmacists conducted comprehensive supplement evaluations informed by an internally developed reference document based on primary literature evaluating safety risks, drug–drug interactions, and theoretical efficacy. A standardized electronic health record survey was developed to document supplement reviews, interventions, and clinical rationale. Recommendations were communicated directly to the patient or relayed to other members of the healthcare team for further communication. Between November 2025 and January 2026, 53 patients were evaluated, representing both solid and hematologic malignancies across curative and palliative treatment intent, with a median of two supplements per patient. In total, 61 unique supplements were reviewed, and 66 pharmacist interventions were implemented, most commonly addressing risks such as bleeding potential, CYP-mediated interactions, and gastrointestinal or hepatic toxicity.

Overall, the results demonstrate that a structured, pharmacist-driven supplement review process is feasible in an ambulatory oncology practice. Although risk reduction was largely theoretical due to limited available high-quality data on supplement efficacy and safety, the work highlights the critical role of pharmacists in standardizing supplement evaluation, supporting informed decision-making, and promoting safer integration of supplements alongside cancer therapy.

Conclusion

The 2026 QRC-recognized abstracts underscore the vital and expanding role of pharmacists in advancing quality across the oncology care continuum. Whether optimizing guideline-concordant supportive care or establishing systematic frameworks for supplement safety, both initiatives reflect the core principles of QI: identifying gaps, implementing structured interventions, and generating measurable outcomes that support safer, more effective patient care. Importantly, these projects also illustrate that meaningful QI work need not await perfection in data or endpoints; early feasibility and process improvements lay the groundwork for sustained practice change. As oncology care continues to grow in complexity, pharmacist-led QI efforts like these will remain essential to ensuring that evidence-based, patient-centered care is not only aspirational but reliably delivered. HOPA congratulates both teams and encourages continued innovations in this important area.