JL1034C: Understanding the Role of Oncology Advanced Practice Providers in Prescribing Anticancer Therapies and Related Privileging Practices

BACKGROUND
Oncology Advanced Practice Providers (APPs) include Nurse Practitioners (NP), Physician Assistants (PA), Clinical Nurse Specialists (CNS), and Pharmacists, all of whom work in collaboration with physicians to provide high quality, specialized cancer care. Given the growing US population, aging physician population and increasing number of cancer survivors, significant oncologist shortages are projected in the next several years. This workforce shortage creates an opportunity to expand the services and clinical support provided by oncology APPs. Critical to this process is ensuring that APPs are well trained and privileged to function at the top of their scope of practice. While APPs are integral members of the oncology care team, data is lacking on individual APP function within different practice settings, specifically around the prescribing of anti-cancer therapies. By understanding the current state of APP privileging and prescribing practices across the US, we have the potential to uniformly expand the scope of APP services and improve access to safe and efficient care delivery.

AIMS
Our primary objective is to conduct a prospective, national, web-based survey to understand APPs’ roles and operational workflows for prescribing anti-cancer therapies and the related privileging process(es), if any, in both academic and community oncology practice settings. Our secondary objectives are to understand the competency and ongoing evaluation processes for privileging APPs to prescribe anti-cancer therapies.

METHOD
Participants will complete a 38-question survey developed based on a review of published oncology APP data sets and expert input. Cognitive interviewing was performed with key APP informants to iteratively formulate final survey questions. Survey domains include basic respondent demographics, practice setting information, and prescribing and privileging practices. The survey protocol was submitted to University of California at San Diego’s (UCSD) IRB for exempt research consideration.

RESULTS
The survey will be distributed nationally via email to approximately 6,000 oncology APPs, including NPs, PAs, CNSs, and Pharmacists, who practice within UCSD or are members of ACCC or APSHO, and are practicing in academic or community oncology settings. Our target accrual is to achieve 2,400 survey responses.

IMPLICATIONS FOR PRACTICE
The aggregate data on APP privileging for and prescribing of anti-cancer therapies is primarily limited to case reports, experiential presentations at national APP meetings, and editorials. This project will catalog current practices for credentialing oncology APPs to prescribe anti-cancer therapies, with the goal of identifying more uniform best practices based on a comprehensive survey assessment of a large number of APPs from diverse clinical settings.