WINSTON-SALEM – 2025/07/04 07:48:41 – According to a recent interview with Pharmacy Times, LeAnne Kennedy, PharmD, BCOP, CPP, FHOPA, oncology clinical manager at Atrium Health Wake Forest Baptist in Winston-Salem, North Carolina, highlighted the notable role of pharmacists in the Wake Outpatient Transplant program.

The integration of pharmacists into the outpatient transplant care team has revolutionized patient management, according to Kennedy.

pharmacists’ Role in Outpatient Transplant Care

“Our pharmacists are there from the very beginning, prior to them ever being a patient or ever coming to transplant,” said LeAnne Kennedy, PharmD, BCOP, CPP, FHOPA. “We have an education session, and even before that education session, we’re reviewing the plan to make sure that it’s correct.”

Kennedy also noted that pharmacists in North Carolina have the ability to prescribe medications through the Clinical Pharmacist Practitioner (CPP) designation. “So we are licensed by the medical board and also by the board of pharmacy,” she explained.”Not everybody, but transplant was kind of the first one in oncology.”

“Our pharmacists are there from the very beginning…reviewing the plan to make sure that it’s correct.”

Pharmacists send prescriptions to the specialty pharmacy, ensuring patients receive their medications before starting transplant. “Okay,these are the meds you’re going to take,” Kennedy tells patients. “Let’s go over what you’re taking at home. Now let’s talk about what we need to take. Are there crossovers? Do we need to hold some things? Do we need to start some things? Do we need to talk about what they’re doing?” This approach helps build a strong bond with patients.

The pharmacists’ involvement extends to daily patient care, ensuring medication adherence and managing side effects like nausea, vomiting, diarrhea, and constipation.As patients prepare to go home, pharmacists counsel them on their medications to ensure a smooth transition.

Improvements in Patient Outcomes

Since launching the outpatient model, Kennedy has observed improvements in patient outcomes. The transition from a hybrid model to a fully outpatient approach, where patients are only admitted if they develop febrile neutropenia or severe nausea and vomiting, has been a key factor.

“One of the things was going from a hybrid model-where we started outpatient and then, like on day plus one, we admitted them-to being able to say, “Okay, now we can do it all outpatient until they have febrile neutropenia or nausea, vomiting, or something that requires them to come in,” Kennedy stated. “Looking at that is a way of tracking the success of that.”

The team tracks the number of days saved due to reduced hospital stays. While patient satisfaction is evident through anecdotal feedback,Kennedy suggests that a formal research project to gather hard data on patient-reported outcomes would be beneficial.

Ensuring Smooth Transitions

To ensure smooth transitions from inpatient to outpatient care, the team focuses on medication management and interaction. “So I think making sure that we have the right medications in the right place, making sure there’s communication with the dispensing pharmacy-whether that’s the outpatient pharmacy or, becuase our patients are in the inpatient tower, the inpatient or acute care pharmacy dispensing those-then we have to make sure it’s reimbursed correctly,” kennedy explained.

The team addresses logistical challenges, such as ensuring medications are delivered promptly and that reimbursement processes are handled correctly. They also work to change perceptions within the Department of Pharmacy to recognize the unique needs of outpatient transplant patients.

Future Directions

The program is continuously evolving, with a current focus on CAR T patients undergoing cellular therapy. The goal is to keep these patients in the outpatient setting as long as possible, which benefits both the institution and the patient.

“Really, the part that’s kind of evolving now is our CAR T patients-those going through cellular therapy-and trying to make sure we can keep them outpatient provided that possible,” Kennedy stated. “These are even more expensive therapies,and so if we can do this outpatient,that is really the best thing for the institution,but also for the patient.”

The team is also exploring the possibility of performing allogeneic stem cell transplants in the outpatient setting, possibly using a hybrid approach that combines outpatient chemotherapy and cell infusions with inpatient care during periods of high risk.

Expanding Pharmacist Involvement

The lessons learned from the outpatient transplant program are being applied to other areas, such as bispecific therapies, notably in solid tumors. Additionally, Atrium Health is sharing its outpatient transplant expertise with its Charlotte location.

“With bispecifics being such a key and evolving area, I think this is something where we’ve taken what we’ve learned through our CAR T outpatient process and applied that to our bispecifics,” kennedy noted. “That is something we have definitely taken from transplant and shared with our other bispecific programs-especially now that we do bispecifics in solid tumors.”

The success of the Wake Outpatient Transplant program has paved the way for atrium Health in Charlotte to launch its own outpatient transplant program.