Research Projects Page

This was a single-center, retrospective analysis of persistence on droxidopa for the management of orthostatic hypotension in adults patients. This study also evaluated adherence, patient-reported adverse events and falls as well as healthcare resource utilization.

This study highlights how specialty pharmacists with access to patient medical records were able to postpone requesting oral anticancer medication refills for patients with upcoming follow-up and sufficient medication on hand. Therapy was discontinued or changed in 98% of postponed requests accounting for over $750,000 in costs avoided based on AWP-20% pricing.

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.

This study evaluated how specialty pharmacists manage prescription cannabidiol. Pharmacists play an integral role in medication access, resulting in a high approval rate and all patients being able to access therapy. Due to multiple drug interactions with prescription cannabidiol, pharmacists commonly changed the dose of interacting medications. Patient counseling and support for AE management was also a pharmacists key role found in this study.

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.

Patient reported outcomes can be used to measure therapeutic response, as well as overall health status, functioning, quality of life, and disease management. Patients with inflammatory conditions who fill medication within an integrated HSSP model reported low rates of missed doses and side effects, and most rated high perceived medication effectiveness.

This project harnessed an underutilized feature of the institution's electronic health record to streamline reporting and workflow in specialty pharmacy. Implemented in the Hepatitis C Clinic, duplicate documentation was reduced and manual reporting was replaced with a near real-time report dashboard. Overall, more time is available to focus on patient needs which has boosted staff morale.

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.