Research Round-Up

The following are highlights of research success stories at the College of Pharmacy.

Dr. Chris Bland Reviews a ‘Baker’s Dozen’ of Antimicrobial Stewardship Intervention Publications

The Southeastern Research Group Endeavor (SERGE-45)—a network of more than 40 institutions and 80 members who specialize in infectious diseases clinical practice—recently published its review of 13 articles, highlighting novel and actionable strategies to enhance antimicrobial stewardship programs in both hospital and non-hospital settings. Led by Dr. Chris Bland, the Albert W. Jowdy Professor of Pharmacy at the College’s extended campus in Savannah, the review collectively affirms de-escalation, rapid communication of test results, infectious disease education for healthcare employees, avoidance of unnecessarily long durations of therapy, and continuous quality control as strategies for improving patient outcomes. Common themes in the SERGE-45 review included managing bloodstream infections and optimizing antimicrobial therapy during transitions of care, both of which are especially pertinent strategies due to the increasing regulatory demands for antimicrobial stewardship excellence.

Two New Studies Highlight the Value of Interprofessional Education

In a new review article published in PeerJ earlier this semester, Dr. Joshua Caballero, Associate Professor in Clinical and Administrative Pharmacy, highlights the value of interprofessional working relationships between pharmacists and social workers. According to the research, when the two professions work together, 30-day readmission rates are reduced, confidence in assessing patients with suicidal ideation is increased, and diseases are better managed. The need for collaboration between the professions is evidenced by the fact that although nearly 99% of social workers in psychiatric fields regularly encounter patients taking at least one medication for a mental health condition, more than 30% of social workers don’t well-equipped to help patients make decisions related to their medications.

And, in a recent publication in the American Journal of Health-System Pharmacy, a team of CoP clinical and experiential faculty, including Drs. Anthony Hawkins, Andrew Darley, Susan Smith, Andrea Sikora, Chris Bland, and Trisha Branan, advocate for the development of interprofessional share days in community hospital rotations for students and residents alike. A longitudinal shadowing experience with nursing staff, the authors suggest, could better help students and pharmacists understand IV pump functions, objective measures of pain and delirium, the use of different access lines and tubes, and prophylactic measures to prevent pressure ulcers and other hospital-acquired illnesses. These findings demonstrate the value of the College’s numerous interprofessional education (IPE) initiatives, which include an annual event for third-year PharmD students, in collaboration with second-year medical students, senior nurse practitioner students, and graduate social work students.

The Micro-Credential Could be a Macro-Disruptor in Pharmacy Education

While completion of a PharmD program and successful passing of licensure exams will continue to define the pathway towards pharmacy practice, micro-credentials (MCs)—stackable, short, focused, personalized, and competency-based educational programs—are prime to disrupt the pharmacy education landscape, suggests Dr. Andrew Darley, Director of Professional Education, in a recent review article he co-authored in the American Journal of Pharmaceutical Education. MCs, and programs similar to them, have long been hallmarks in the business and technology spaces, seen as opportunities for upskilling and career advancement—think Six Sigma certifications, Microsoft 365 credentialing, or Amazon Web Services certificates. In pharmacy, specialization and career advancement has largely been achieved through certifications offered through national pharmacy organizations, with the most widely utilized MC-esque programs being provided through the American Pharmacists Association and the American Society of Health-System Pharmacists. According to Dr. Darley’s research, there may be a benefit in adopting MCs throughout pharmacy education. The flexibility of MCs are appealing to students and practitioners alike, and the opportunity to align MCs with the individual interests of a student would offer added personalization to commonly rigid, “lock-step” degree programs. Further, previous research suggests that MCs, and digital badges associated with them, are particularly motivating to students and may increase student engagement. As the pharmacy profession continues to expand in scope, flexible MC educational programs which are not time- or unit-bound may be particularly attractive avenues for learners to differentiate themselves in the workplace.

Dr. Crich Receives Patent

Dr. David Crich has received a patent for “Diversity-Oriented Synthesis of N,N,O-Trisubstituted Hydroxylamines from Alcohols and Amines by N-O Bond Formation. Said Dr. Crich, “This patent covers the underlying chemistry for the generation of trisubstituted hydroxylamines by N-O bond formation that underlies and enables our work on the use of trisubstituted hydroxylamines as bioisosteres in medicinal chemistry as described by research published from our laboratory.”

Safety in Gender-Affirming Hormonal Treatments

Dr. Lorenzo Villa-Zapata recently was published in Sage Journals about his research on the use of the FDA Adverse Event Reporting System database to investigate safety in gender-affirming hormonal treatments. The article, titled “Exploring Safety in Gender-Affirming Hormonal Treatments: An Observational Study on Adverse Drug Events Using the Food and Drug Administration Adverse Event Reporting System Database,” can be viewed here.

Xiong’s Lab Publishes Review and Research Papers

Dr. May Xiong and her laboratory team recently published research and review papers. The research paper, “Bile Acid–Targeted Hyaluronic Acid Nanoparticles for Enhanced Oral Absorption of Deferoxamine,” was published in the American Association of Pharmaceutical Scientists Journal and can be found here. The review, titled “Genetic Targets and Applications of Iron Chelators for Neurodegeneration with Brain Iron Accumulation,” was published by the American Chemical Society and can be found here.

Patient Access to Emerging Technologies Is Key for Health Equity

In a Letter to the Editor of the Journal of Pharmacy Practice, Drs. Sharmon Osae, Daniel Chastain, both faculty members in the Clinical and Administrative Pharmacy Department at the extended campus in Albany, and Dr. Henry Young, Head of the Department, argue that access to media and emerging technologies (AMET), and its careful and intentional stewardship, is vital for health equity and positive patient outcomes. In a digital age when everything from accessing telehealth appointments and health information online to managing chronic disease states with technology like a continuous glucose monitor is reliant on AMET, pharmacists must “…leverage AMET and adopt a holistic approach to patient care,” the authors write. Certainly, “…the risks of misinformation, disinformation, and politicization” are non-zero with media and emerging technologies, Dr. Osae and her colleagues concede, but the ubiquity of these technologies demands their principled uptake throughout the profession, especially when they are well positioned to increase patient access to healthcare in underserved communities and healthcare deserts. So long as pharmacists recognize their responsibility for helping patients and peers navigate the potential downfalls of new technologies, the benefits of “…leveraging media and emerging technologies to provide patient-centered care” likely outweigh the risks and “…should [thus] be directly addressed in the didactic and experiential pharmacy curricula in order to equip future pharmacists with the skills needed to practice in an ever-changing technological environment.”

Relationship Between Diabetes Mellitus and Respiratory Health

A recent study utilizing datasets from the Fluid and Catheter Treatment Clinical Trial led by doctoral students Abdulaziz Alanazi and Sultan Almuntashiri, alongside Drs. Somanath Shenoy, Andrea Newsome, and Duo Zhang have revealed significant insights into the intricate relationship between diabetes mellitus and respiratory health. Their findings illuminate a notable correlation between diabetes and more challenging clinical outcomes in Acute Respiratory Distress Syndrome (ARDS) patients, suggesting a substantial negative influence on respiratory functions and survival rates. The team is poised for further comprehensive studies to deepen understanding and advance targeted interventions. This marks a significant stride in enhancing healthcare outcomes for individuals navigating the complexities of diabetes and respiratory health. Click here to read the full manuscript.

CAP Faculty Publish Paper in JAPhA

Drs. Jordan Khail, Smita Rawal, Josh Caballero and Henry Young from Clinical and Administrative Pharmacy recently published an article in the Journal of the American Pharmacists Association. The article, titled Addressing buprenorphine supply barriers: A guidance commentary, proposes a practical solution to the buprenorphine supply barriers that are currently causing damage to patients in recovery.

Insulin Copay Caps Reduce Patient Costs, Other Benefits Still to be Proven

In late 2022, the signing of the Inflation Reduction Act set a $35 copay cap on insulin for Medicare beneficiaries nationwide. Two years earlier, though, Utah acted first, passing a law to set a $30 limit for 30-day-supplies of insulin for all patients with commercial insurance. According to new research co-authored by Dr. Niying Li, Assistant Professor in Clinical and Administrative Pharmacy, and published in the Journal of Managed Care & Specialty Pharmacy, the legislation may not have had all of its intended effects. While the average out-of-pocket cost of insulin decreased significantly from $65 to $27 following enactment, the total cost of the drug (that is, the total cost incurred by the patient and the health plan, combined) did not decrease, and patient outcomes were not positively impacted by the change. Adherence to basal insulin regimens was no better despite the lowered cost, and patient A1c levels—a biomarker for how well diabetes therapy is working—were not significantly different pre- and post-policy change. While the cost-shifting findings of this study align with results of similar previous research, that diabetes outcomes did not improve following cost-reduction measures is odd; the authors hypothesize that this is likely due to disruptions in care that occurred during the COVID-19 pandemic, which overlapped with this paper’s study period. For this reason, Dr. Li and her colleagues urge caution in extrapolating the results of the study too broadly, emphasizing the need for continued research on a larger and more diverse sample across longer time intervals.

Systemic Regulatory and Institutional Barriers Limit Collaborative Practice in Georgia

While pharmacists can positively impact patient outcomes and the management of chronic diseases by engaging in collaborative drug therapy modification (CDTM)—a type of collaborative practice agreement—in Georgia, CDTM remains exceedingly underutilized, with fewer than 1% of eligible pharmacists holding an active CDTM license in the state. To better understand barriers, Dr. Sharmon Osae, Clinical Associate Professor at the extended campus in Albany, and a team of seven other CoP colleagues surveyed pharmacists about factors that both facilitated and prevented development of CDTM activities. Their findings, published in the Journal of the American Pharmacists Association, suggest that regulatory and policy issues, along with provider apprehension, are major barriers to uptake. The Georgia Board of Pharmacy’s requirements to initiate CDTM, said many pharmacists, are burdensome, lengthy, and unclear. Institutional restrictions, such as a lack of resources or administrative support, and systemic issues, like the inability to adequately bill for clinical services rendered by pharmacy personnel, pose significant barriers as well. Collectively, these issues point to a need for systems-level change and new organizational efficiencies at all levels (institutional, regulatory, and otherwise) if the potential of CDTM is to be fully seen throughout Georgia.

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