Research Projects Page

This study assessed patient-reported outcomes in patients prescribed specialty medications by an IBD clinic at a health system and dispensed by an integrated specialty pharmacy. A total of 515 MRQs were completed (median of 3 per patient; IQR 2, 3) during the study period. There were 2 reports of adverse effects and 11 reports of missing one or more medication doses. Medication effectiveness was rated as “excellent” in 13% (n=69) and “good” in 84% (n=433) of MRQ responses.

Patients initiated on vesicular monoamine transport 2 inhibitor (VMAT2i) therapy for Tourette Syndrome and chronic tic disorders had a 50% discontinuation rate within the first 12-months of therapy. Patient reported adverse events were the main driver for discontinuation with most events being reported within 100 days of VMAT2i initiation. Further studies exploring persistence rates of VMAT2i therapy in the setting of common comorbid conditions are needed within this population.

Patient reported outcomes (PROs) are used to assess response to medication and the need for therapeutic adjustments in patients with rheumatologic disease states. Vanderbilt Specialty Pharmacy, an integrated health-system specialty pharmacy, assesses PROs through monthly refill questionnaires to guide specialty pharmacist interventions and improve patient care.

Patients are recommend to receive all necessary vaccines prior to starting immunosuppressive specialty DMARD therapy. This quality improvement project developed a vaccine screening protocol for patients initiating new specialty medications at an outpatient rheumatology clinic. This protocol was effective in delivering patient-specific vaccine recommendations and was rated as efficient by specialty pharmacists.

The objective of this study was to measure time to medication access for prescription CBD from patient referral to first shipment when insurance approval process is managed by embedded specialty pharmacy team.Median time from initial assessment to first shipment was 7 days (IQR 4-13). Of patients for whom the CPhT helped obtain financial assistance (n = 14, 10%), all had $0 costs after assistance.

This study assess the impact of pharmacist-led tailored monitoring for patients initiating encorafenib and binimetinib combination therapy. A retrospective study showed that in the first 90 days of treatment 44% of patients required at least 1 treatment interruption, 39% required at least 1 dose reduction, 11% discontinued therapy. A prospective study reporting the impact of implementing a pharmacist-led targeted monitoring program is forthcoming.

This study examins the use and pharmacotherapy of direct acting antivirals to treat hepatitis C in transplant patients receiving positive donor hearts. While results of this practice have proven successful, management of drug-drug interactions between transplant medications and DAAs is necessary to ensure safety and efficacy.

This study of patients with RMS and ≥3 fills of DMT from a health-system specialty pharmacy evaluated DMT persistence. The probability of remaining persistent for 3 years was 0.51. Non-persistent patients mostly switched to a new DMT (39%), discontinued the DMT (26%) discontinued, or transferred care to a new specialty pharmacy or provider (27%). Specialty pharmacists played a key role in DMT transitions and initiated 7% of DMT discontinuations and 36% of DMT switches.

This study evaluates PCSK9i persistence at 2, 12 and 24 months after initiation of therapy, reasons for non-persistence and percent change in LDL.

This two-part study aimed to identify the rates and reasons of PMN for specialty oral oncolytic agents. In Part I, we used 24 methods to calculate PMN based on combinations of three parameters. In Part II, we reviewed electronic medical records of 198 prescriptions considered PMN by our previous calculation.