Infusion Pharmacy: Career Insights From an Infusion Pharmacist
July 31, 2024Jeffrey Clark, PharmD '21
Jeffrey Clark, PharmD '21, was in the second year of his Health System Pharmacy Administration and Leadership
(HSPAL) residency at UW Health when he had his first opportunity to directly manage
a team of technicians and pharmacists.
The managerial role was part of a longitudinal experience designed to provide residents
with the skills needed to succeed as a pharmacy leader. While the experience was challenging,
it helped prepared Clark for his current role as the pharmacy supervisor for oncology
infusion services at Wellstar Cobb Infusion Center.
What Is Infusion Pharmacy?
Infusion pharmacy is a specialized field within pharmacy that focuses on the preparation
and administration of medications via intravenous (IV) routes. Both IVs and injections
may be classified as infusion pharmacy.
While patients often encounter infusion pharmacy within a hospital setting, Clark’s
work focuses on outpatient settings.
Key Points
Infusion pharmacy is a growing field that focuses on preparing and administering medications
intravenously.
Infusion pharmacists require a strong foundation in pharmacology, pharmacotherapy,
and pharmacy law, as well as the ability to manage complex medication regimens, educate
patients, and comply with regulatory requirements.
Aspiring infusion pharmacists should seek out rotations and residency programs that
offer specialized training in infusion pharmacy to gain hands-on experience.
“Infusion pharmacy tends to refer to ambulatory sites where that is their primary
business—dealing with infusions that are not done in a hospital,” Clark explained.
“We deal primarily with patients who are stable enough to be released from the hospital
but they are on some type of drug, or their disease is so advanced that oral drugs
are not cutting it.”
The patient comes to the infusion center to have their medication administered by
healthcare professionals. Infusion pharmacists often work closely with patients, explaining
how the medications work, monitoring for adverse reactions, and adjusting therapies
in collaboration with healthcare providers. Clark noted that this level of interaction
is more intensive compared to traditional community pharmacy roles.
Medications administered at infusion centers are typically higher risk drugs designed
to treat cancer, autoimmune disorders and infections. Often the drugs must be administered
over an extended period of time.
“It’s a really big, growing field,” Clark said. “It used to be limited to antibiotics
and cancer but now it has really grown to just about everything.”
Home Infusion Pharmacy
In some cases, patients may be able to take advantage of home infusion services. For
these patients, medications are delivered to the home and then either self-administered
or administered by a caregiver.
A home infusion nurse will typically provide instructions, demonstrate how the medications
are to be administered and then follow up with the patient periodically throughout
the course of their treatment. The main methods of administration include administering
the medication through a peripherally inserted central catheter (PICC) line with a
syringe, an elastomeric pump or an IV bag. Home infusion pharmacists prepare the medications,
provide clinical oversight of the patient and coordinate care with other members of
the patient’s healthcare team.
While home infusion may offer more comfort and convenience, sometimes a patient or
caregiver may decide medication administration is outside their area of comfort.
“I’ve had some patients that were home infusion patients who said ‘I cannot do this
at home.’ So now they come to the infusion center to get their medication,” Clark
said.
“We have so many patients that want to come to our site. No one wants to go to the
hospital,” Clark said. “We’re at capacity each day.”
For those interested in pursuing a career as an infusion pharmacist, the path begins
with a Doctor of Pharmacy (PharmD) degree. During pharmacy school, aspiring infusion pharmacists take the same classes as those pursuing other specialties. The main difference, Clark explained, is that
infusion pharmacists must have a different level of mastery of certain subjects.
“You need more clinical knowledge,” he emphasized.
Infusion pharmacists must have a solid understanding of disease states, the ability
to manage complex medication regimens and the skills to effectively interact with
patients. Infusion pharmacists are also tasked with handling the regulatory requirements
related to safe compounding, handling and storage. Additionally, they help determine
the appropriate pharmacological therapy for the patient. This, Clark added, means
infusion pharmacists are involved at multiple stages in a patient’s treatment.
“You have to understand a little bit more on our side because of where we fall in
the care model,” he said. "I have pharmacists whose main role is to serve as a clinical
medication expert and provide clinical resources for providers and mid-level providers
(PA/NP) that help them decide care for the patient and select the right treatment."
These pharmacists, he added, tend to have board certification in disease states (oncology for example).
"We have pharmacists who serve in a hybrid clinical and operational role where they
are the main pharmacist who are reviewing and verifying the right treatments are ordered
and made appropriately," Clark explained. "This role requires advanced clinical knowledge
and experience because they tend to work across multiple disease states."
Advice for Aspiring Infusion Pharmacists
For those interested in pursuing a career in infusion pharmacy, Clark recommends gaining
a strong foundation in pharmacology, pharmacotherapy, and pharmacy law. Infusion pharmacists
must also be prepared for the challenges of continuously educating oneself about new
medications.
“There are so many,” Clark said. “The field keeps growing and that is one of the tough
things to keep up with.”
He also suggests seeking out rotations and residency programs that offer specialized
training in infusion pharmacy.
“To really understand it, you need to be in it,” he said. According to Clark, infusion
pharmacists do a lot of the same work as hospital pharmacists, but the infusion space
offers more autonomy. He believes it is important for aspiring pharmacists to understand
the unique aspects of ambulatory care (which includes infusion pharmacy), acute care and community pharmacy.
“Get some type of experience in infusion pharmacy so that you can understand the difference,”
he advised.
Choosing a Pharmacy School
Clark chose PCOM School of Pharmacy because of its proximity to home, the welcoming environment and because he felt it
offered him the best opportunity for success.
“Some of the bigger schools I thought I’d be more of a number,” he said.
During his time at PCOM, Clark became close with several faculty members. He credited
them with helping him secure applicable rotation experiences as well as his first
job in hospital pharmacy.
“I keep in contact with faculty all the time,” he said. “It’s really nice to have
those bonds and relationships.”