Research Projects Page

This study compared patient access to dalfampridine before versus after Vanderbilt Specialty Pharmacy obtained access to dispense the drug. Findings highlight how integrated specialty pharmacists can provide effective medication monitoring, counseling, and access when limited distribution networks are removed.

Adherence and persistence to specialty medications can be challenging during transitions in sites of care, provider types, specialty medications, and financial coverage changes. In this report, we review obstacles encountered within these transitions and the role of the specialty pharmacist in overcoming obstacles. Case examples for each type of specialty transition provide insight into the unique complexities faced by patients and shed light on pharmacists’ vital role in patient care.

Sorafenib and regorafenib are oral multikinase inhibitors used to treat some cancers, but adverse events for both drugs are common and often cause patients to discontinue therapy or reduce their dose within several months of initiating therapy. This study found that a pharmacist-initiated tailored intervention reduced sorafenib and regorafenib discontinuations (29% to 13%) and dose reductions due to adverse reactions (18% to 13%).

A case series identifying patients with multiple sclerosis whose lymphocyte counts were stable on dimethyl fumarate, and then they subsequently developed lymphopenia after switching to diroximel fumarate prompting its discontinuation.

This was a case series/descriptive report that aimed at describing patient characteristics, insurance access, and response to therapy in patients prescribed risankizuamab more frequently than the FDA-approved SQ maintenance dosing of 180mg or 360mg every 8 weeks. To date, no other data has been published to describe this topic.

This study evaluated factors impacting the transition timing from clinic administered infusion to self-administered, subq injection ustekinumab for Crohn's disease and Ulcerative Colitis and potential delays or barriers in the patient journey. Subq prescriptions from the integrated health-system specialty pharmacy were more likely to ship in the appropriate timeframe window post infusion.

Integrated Health System Specialty Pharmacy (IHSSP) pharmacists perform numerous actions to facilitate specialty medication education, access, adherence, and persistence regardless of the patients' ability to utilize the IHSSP for fulfillment. Lack of visibility in the patient journey and increased workload on providers and health systems is created when payers and manufacturers lockout IHSSPs.

This quality improvement project aims to evaluate implementation of a standardized process for specialty pharmacists to document and monitor patient disease severity and response to therapy using the Short Inflammatory Bowel Disease Questionnaire (SIBDQ), a patient reported outcome, administered via the electronic health record patient portal.

Oral options, such as ibrutinib, acalabrutinib, and venetoclax for CLL may have significant adverse events. Our objective was to evaluate pharmacist interventions on these adverse events at Vanderbilt Specialty Pharmacy. The majority of the pharmacist interventions were resolved and resulted in chart review and patient counseling as well as dose changes and holding medication.

This study evaluated how allergic comorbidities affect dupilumab persistence when prescribed for asthma and chronic rhinosinusitis with nasal polyposis (CRSwNP). Non-persistence was 19% and 22% at 3 and 6 months, respectively. The median time to non-persistence was 66 days (IQR 25-95). Patients with commercial insurance and those with AERD were more likely to persistent.