Empowering pharmacists for healthier futures
Ask any transplant team who to get advice on the medication list of a patient on antivirals, an mTOR inhibitor and a conditioning regimen with a narrow therapeutic window, and the answer is the same: the pharmacist.
Ask how the next generation of SCT pharmacists is trained, develops the field scientifically, and the answer is much less consistent.
That gap — between what pharmacists do in stem cell transplantation and cellular therapy, and how visible and structured that contribution is across Europe — is what the EBMT Pharmacist Committee is working to close. We see three practical routes:
- building a training pathway that does not depend on which hospital or country you happen to work in,
- growing our research output and
- embedding pharmacists into the Working Parties through named liaisons.
Training the next generation of pharmacists
In most countries, pharmacists inherit a service, a shelf of protocols and the phone number of a colleague who has done it longer. Formal training for junior is lacking, and therefore the competencies of SCT pharmacists vary widely.
To address this lack of training possibilities, we have been working on an EBMT Pharmacist Training Passport: a competency-based record of what a transplant pharmacist has been trained in and signed off to do. A passport would be modular, mapped to the EBMT e-learning offering and the EBMT Handbook, recognised across member centres, and usable by all pharmacists working in the EBMT transplant centres. It also gives centres something concrete to point to during JACIE certification when demonstrating pharmacy competence.
While the Passport covers online learning and gives an overview of competencies, this does not replace being in a room with an expert, working through cases and meet with your fellow pharmacists. We therefore want to establish a formal two-day live EBMT Training Course in SCT pharmacology, taught by internationally recognised experts in transplant pharmacy practice.
Through the Passport and the Training Course, we envision to empower the European SCT pharmacists to be better equipped to tackle those every day pharmacological issues.
Research: From describing our role to shaping practice
The Pharmacist Committee has worked on the consensus recommendations on the role and competencies of the EBMT clinical pharmacist and clinical pharmacologist (Langebrake et al., Bone Marrow Transplantation 2020;55:62–69). The identified 32 distinct key activities that pharmacists and clinical pharmacologists should be performing were then compared to the actual practice in a survey (Duncan et al., Bone Marrow Transplantation 2023;58:829–831), showing how far actual practice across member centres matches the consensus, and where the variation sits.
Most recently we moved from describing practice to changing it. A practical guide to therapeutic drug monitoring in busulfan: recommendations from the Pharmacist Committee of the EBMT (Domingos et al., Bone Marrow Transplantation 2024;59:1641–1653) reviews the evidence linking busulfan exposure to outcome in adults and children and then does something guidelines often avoid: it gives a step-by-step implementation guide covering the clinical, pharmacological, laboratory and administrative aspects of running a TDM service.
We have developed a scientific output agenda for the next four years, with projects on optimal drug dosing in special populations (obesity, infants, organ dysfunction), drug interactions and reflections on current pharmacological research.
Working Party liaisons: being in the room
While the members of the Pharmacists Committee have a plethora of knowledge on most topics in SCT pharmacology, we are relatively infrequently approached for input on research, protocols or patient care. To bring our committee and the EBMT Working Parties together, we propose to assign a pharmacist liaison for each EBMT Working Party. Having a dedicated pharmacology expert to approach for questions on whether a proposed study needs PK sampling or TDM data to be interpretable, to carry the Working Party's questions back to the Committee, and to make sure pharmacological endpoints make it into Registry data collection will most certainly improve the overall quality of the EBMT patient care and research.
Get in touch through the Pharmacist Committee page on the EBMT website or find us at EBMT 2027 Pharmacists' Day.