Health-System Specialty Pharmacy Outcomes Research Consortium

Completed and Ongoing Research Projects (As of Winter 2024):

Adherence to self-administered biologic disease-modifying antirheumatic drugs across health-system specialty pharmacies

PI: Autumn Zuckerman | VUMC

• This large, multisite retrospective cohort study was the first to demonstrate adherence rates across several HSSPs and provided novel insights into rates and reasons for appropriate gaps in therapy
• Across 20 participating sites, the median adherence rate (measured by proportion of days covered [PDC]) was 0.94 using data from 29,994 prescriptions and 3,530 patients.

View poster | View manuscript

Management of Patients with Multiple Sclerosis within Health-System Specialty Pharmacies: Actions and Outcomes

PI: Autumn Zuckerman | VUMC

• This multisite prospective cohort study was the first to report adherence and outcomes in patients with MS across multiple health-system specialty pharmacies. Additionally, it provided needed insight into health-system specialty pharmacy management of patients with MS.

View pharmacist actions poster | View persistence poster | View PRO poster | View adherence poster | View persistence manuscript

Clinical Services Provided by Health-Systems Specialty Pharmacies: A Survey of Current Practice

PI: Autumn Zuckerman | VUMC

• The objective of this multi-phased survey is to aggregate data to demonstrate the benefits of a health-system specialty pharmacy (HSSP) by demonstrating the clinical services provided by HSSPs.
• The Consortium partnered with ASHP to disseminate a survey to HSSPs assessing currently provided clinical services.

View literature review manuscript | View survey manuscript

Use of Deutetrabenazine Above Food and Drug Administration Maximum Recommended Dose

PI: Kayla Johnson | VUMC

• This study is evaluating the effectiveness of deutetrabenazine doses greater than 48 mg per day as measured by changes in the Unified Huntington's Disease Rating Scale (UHDRS) with the hypothesis that higher doses offer additional benefit in movement control as seen by reduction in UHDRS scores post-increase. Additionally, this study is assessing safety outcomes associated with high dose deutetrabenazine such as adverse effect rates and reasons for discontinuation, if applicable.
• Data collection, analysis, and conference poster presentations associated with this study took place in 2023. A manuscript is currently being written and is expected to be submitted to a journal in 2024.

View adherence poster | View safety poster

DAA Treatment Failure and Retreatment Strategies Following NAT+ HCV Solid Organ Transplantation in HCV-Negative Recipients: A Case Series

PI: Alicia Carver | VUMC

• Given the high efficacy rates of DAA treatment in patients following NAT+ HCT SOT in HCV-recipients, little data is available to guide retreatment selection. This study aims to fill this gap by polling data from multiple treatment sites, assessing the retreatment strategies and SVC rates of said strategies.
• Data collection, analysis, and a conference poster presentation took place in 2023. A manuscript is currently being written and is expected to be submitted to a journal in 2024.

View poster

Safety Screening in Patients Initiating Biologic Specialty Medications

PIs: Kimhouy Tong | Yale New Haven Health & Karen Thomas | UIC

• This prospective cohort study is evaluating the role HSSPs and specialty pharmacists play in patients safely initiating self-administered biologic therapies.
• Data collection and analysis took place in 2023. A conference poster and podium presentations took place in 2024, and a manuscript is currently being written.

View poster

Identifying Outcome Measures for Specialty Pharmacists in Rheumatoid Arthritis Using the Delphi Method

PIs: Autumn Zuckerman | VUMC, Mary-Haston Vest | UNC, & Karen Thomas | UIC

• This study aims to use a modified Delphi method to identify important and actionable clinical outcomes to be used in specialty pharmacy practice for patients with rheumatoid arthritis.
• Data collection and analysis is ongoing.

Unmasking Alternative Funding Programs: Frequency and Impact on Specialty Medication Carve Out Models

PI: Autumn Zuckerman | VUMC

• This study aims to describe the frequency and impact of AFPs among health system specialty pharmacies.
• Study design and execution are currently in process.

Multisite Analysis of Pharmacist Actions that lead to Cost Avoidance

PIs: Morgan Pettite and Rachel Mitchell | WVU, Nicole Cowgill | Atrium, Jennifer Langley and Megan Beuchel | U of Wisconsin, Autumn Zuckerman | VUMC

• This study aims to evaluate direct cost avoidance from pharmacist interventions that identify inappropriate (ineffective or unsafe) medication use and result in medication discontinuation, dose adjustment, medication hold, or medication switch.
• Study design and execution are currently in process.

Identifying Outcome Measures for Specialty Pharmacists in Inflammatory Bowel Disease Using the Delphi Method

PIs: Autumn Zuckerman | VUMC, Karen Thomas | UIC, Shubba Bhat | CCF, David Choi | UIC

• This study aims to use a modified Delphi method to identify important and actionable clinical outcomes to be used in specialty pharmacy practice for patients with IBD.
• Study design and execution are currently in process.

Networking and Educational Events:

Journal Club and Hot Topic Roundtables

The Consortium hosts a monthly event that alternates between a journal club, wherein authors present results from an applicable study, and a hot topic roundtable on a specialty pharmacy topic of interest. Both events include a brief presentation followed by discussion between presenters and attendees.