Celebrating World Pharmacist Day with ANZCHOG Pharmacy Group Chair, Johnathan Soggee
Wednesday 25 September 2024
During Childhood Cancer Awareness Month, we’re sharing the A to Z of ANZCHOG on our LinkedIn and Twitter (X). The A to Z highlights a comprehensive look at some of the work we do both in clinical trials and as the peak body for paediatric haematology and oncology in Australia and New Zealand. Today’s letter is V which is for Vincristine. Vincristine is a type of chemotherapy drug, which gives us the opportunity to highlight all the amazing paediatric oncology pharmacists for #WorldPharmacistDay
To help us learn more about the role of a paediatric oncology pharmacist, we spoke with ANZCHOG Pharmacy Group Chair, Johnathan Soggee from Perth Children’s Hospital. Read more below …
Can you explain a bit about the role of a paediatric oncology pharmacist? What does a typical day look like?
In paediatric oncology, pharmacists play a pivotal role in delivering high-quality clinical care to patients and families, facilitating world-class clinical trials to improve access to better and less toxic therapies, and ensuring the safe use of some of the most toxic medications. Additionally, paediatric oncology pharmacists ensure that the use of medicines is restricted to those that truly make a difference in the outcomes that patients and families care about. Some of these medicines can cost more than $50,000 per dose. By ensuring cost-effective medicines management, pharmacists help ensure that more health system dollars are available for patients and families in need. Pharmacists in paediatric oncology also manage the electronic systems that support operations across the Oncology Units in which they work, including the development of electronic care plans that guide therapy based on high-quality research publications. These electronic systems facilitate safe practice in oncology departments and protect patients from potentially fatal medication errors.
My favourite days are my clinical days, which start with a morning interdisciplinary handover followed by attending the bedside during the morning ward round with the medical team where clinical pharmacists manage the diagnosis made using medication regimens. The bedside is where I experience the greatest privilege of being in the trenches with patients and their families. At midday, our pharmacists usually attend the infectious diseases (ID) meeting with the ID clinical pharmacist to provide expertise in the antimicrobial management of our patients. Throughout the day, the clinical pharmacists formulate complex discharge medication regimens and counsel families on these. They ensure that baseline tests are completed, supportive care medications are charted, and treatment regimens are accurate and optimal for patients commencing therapy. Additionally, they assess patients arriving on the ward to develop medication plans for their inpatient stay. This is just a glimpse into the vital role of paediatric oncology pharmacists working in acute inpatient units, and it also extends to pharmacists working in day treatment units and outpatient clinics.
One of the best aspects of the day is being embedded in the interdisciplinary team, where nurses, doctors, and allied health staff continuously approach us with questions about managing patients’ medication regimens. In the late afternoon, our clinical pharmacists run a clinic to assess patients coming in for therapy the next day, reconciling and preparing their medication regimens. We are now using ‘Pharmacist Partnered Medication Charting’ to chart patients’ regular medications and their supportive care regimens, including medications for nausea and vomiting. This model allows us to provide stewardship in compliance with supportive care and nausea and vomiting guidelines, which we know leads to a better patient experience and improved outcomes.
In addition to all this, our clinical pharmacists tirelessly work on research and quality improvement projects aimed at enhancing care for patients. It’s important to highlight that, given the capacity and resource constraints of our health system, our pharmacists often engage in this work outside their regular hours, sacrificing time with loved ones or personal self-care in the face of the challenges of a demanding job. Our government needs to do better than relying on the goodwill of these employees, as we are increasingly losing pharmacists to private industry—often to roles they aren’t as passionate about—due to better wages and working conditions that support their families. A way forward is to establish a remuneration structure for clinical pharmacists that supports clinical pharmacy career pathways and values contemporary pharmacy practice including the complex financial, operational, and clinical risks they help mitigate. Improved staffing ratios and halting wage cuts by increasing salaries in accordance with inflation are also necessary so that pharmacists in paediatric oncology can effectively meet the needs of our patients and families. We are simply asking for the basics.
What did the journey look like for you to get to your current role? Were you always interested in this field?
I have always been interested in the management of cancer. This interest began with a desire to work in cancer research while studying molecular biology and biomedical sciences. However, after completing these studies, I wanted to apply my knowledge in a clinical setting and build relationships with patients and the interdisciplinary team—pharmacy was the path I chose. Specialising in oncology and haematology was a no-brainer for me, as I was drawn to how pharmacists play a clinical leadership role in complex medication management to achieve the best outcomes for these patients. I had the opportunity to work in cancer care for children, and I’ve never looked back. Being part of a team that strives for the mission that every child and adolescent with cancer should survive and thrive is incredibly special to me. I love watching the kids be kids and worry about “kid things,” not “cancer things”—this is how we know we are doing our job. Children have so much to offer this world—they are our future.
The journey to my current role was hard, filled with challenges and perceived failures that became valuable lessons. I share this because I want future generations to know that resilience is what gets you to where you want to be. I had to seize every opportunity and often create my own. My guiding principle has always been doing what’s best for patients, and this has led me to a position where I can honestly say I love my job. My current focus is on improving clinical practice by supporting the next generation of pharmacists in creating new roles, opportunities, and career pathways. I also want to focus my energy on translational and practice-based research. Ultimately, my goal is to harness the unlimited potential of pharmacists to make life better for patients and families.
As chair of the ANZCHOG Pharmacy Group, can you share some of the group’s key priorities? Why is collaboration across AU/NZ sites in the field of pharmacy so important?
The key priorities of the ANZCHOG Pharmacy Group are to build and nurture productive stakeholder relationships, foster a culture of innovation, quality improvement, and research, maximize the capability and capacity of available resources, and teach and train paediatric oncology pharmacists.
Collaboration is the cornerstone of how we deliver better outcomes for children and adolescents with cancer. Benchmarking the quality of care we provide, both among ourselves and against the highest global standards, helps us identify areas for improvement. Collaboration allows us to achieve more with less in a world of limited resources, and learning from and inspiring each other fosters innovation in the care we provide to patients and families. We have seen these positive outcomes from collaboration within the pharmacy group, including benchmarking meetings that featured the Paediatric Oncology Group of Ontario’s Chemotherapy-Induced Nausea and Vomiting guideline; a review of the COG Extravasation Reference, COG Administration Guidelines, and several EviQ paediatric resources; as well as the hard work of Rachael Lawson in developing the ANZCHOG study entitled “Serum Asparaginase Activity and Associated Toxicity in Children with Acute Lymphoblastic Leukaemia and Lymphoblastic Lymphoma” and bringing the BuGenes study to the Australian setting.
This year has been a highlight of my career, featuring visits to St. Jude’s Research Hospital in Memphis, Tennessee; The Hospital for Sick Children in Ontario, Canada; and Memorial Sloan Kettering (MSK) Hospital in New York, as well as attending the North American COG Group Meeting in New Orleans, Louisiana. Collaboration among AU/NZ pharmacists and these world leaders allows us to aspire to set the direction for pediatric oncology pharmacy, striving to achieve a level of practice comparable to these centers of excellence and delivering world-class pharmaceutical care to children and adolescents with cancer in Australia and New Zealand.