Las Vegas—The five winners of the American Society of Health-System Pharmacists (ASHP) Research and Education Foundation’s 2012 Literature Awards will be recognized at the Midyear Clinical Meeting in Las Vegas. To honor their extraordinary contributions, Pharmacy Practice News spoke to each of the honorees.
Award for Sustained Contributions
With nearly 70 teaching, scholarship, service and research awards, one might expect being recognized yet again by her peers would be old hat for Mary H.H. Ensom, PharmD. However, she said that she was “honored and humbled” to receive the award for Sustained Contributions.
With a modesty that belies her 34 years of service to the profession, Dr. Ensom partly attributed her success—and her marriage—to the ASHP.
“I don’t think I would be Mary Ensom today if not for ASHP,” said Dr. Ensom, a professor in the Faculty of Pharmaceutical Sciences and a Distinguished University Scholar at the University of British Columbia (UBC) as well as a clinical pharmacy specialist at Children & Women’s Health Center of British Columbia, in Vancouver, Canada.
“I met my husband, Robin, when I was working as a pharmacist at the Medical University of South Carolina in Charleston back in 1979—he happened to be the first of a series of Canadian pharmacists to pursue his PharmD degree there,” she recounted. “We lost contact for a few years, but it was at my first ASHP Midyear that we reconnected, and [we] eventually married in 1997.”
The couple’s choice of occupation has proven contagious. Dr. Ensom’s 26-year-old daughter, Hannah Chandler, is pursuing a postgraduate year 1 residency in pharmacy at the University of Kentucky, with interests in emergency medicine, critical care and psychiatry.
“I am one proud mama!” Dr. Ensom—or Mary, as she insists on being called—gushed in an interview.
The award recipient has set a high bar for her daughter to meet: Her publications have been cited more than 1,800 times, also attesting to the seminal nature of some of her work. Of note, her team was the first to systematically and longitudinally study the pharmacokinetics of both unfractionated and low-molecular-weight heparin as well as intravenous immunoglobulin in women with recurrent pregnancy loss. They also conducted some of the first pharmacokinetics studies of mycophenolate and its glucuronidated metabolites in lung transplant recipients.
Accomplishments like these made nominating Dr. Ensom for this award an easy decision for Robert Sindelar, PhD, a professor and the dean of UBC’s Faculty of Pharmaceutical Sciences.
“I cannot think of anyone more suited to being selected for such a prestigious award,” Dr. Sindelar said. “Dr. Ensom is unique in our faculty as she contributes substantially to the academic triad of teaching/learning, scholarship/research and service to the profession.”
Award for Innovation In Pharmacy Practice
For Kristine Crews, PharmD, BCPS, the theme of marriage transcends the 12-year partnership she has cultivated with her husband, James. Dr. Crews has coupled her research interests with a dedication to patient care and has managed to balance the infinitesimal nature of her work in pharmacogenetics with a love for expansive spaces, camping, hiking, swimming, and generally spending “lots of time outdoors” with her husband and three young children.
Despite a “very busy” life, the awardee set aside a few minutes to discuss the pharmacist-led clinical pharmacogenetics service—one of the first in the country—that she helped establish and for which she is receiving recognition. “You could say the burgeoning field of clinical pharmacogenetics and my career have grown up together,” mused Dr. Crews, who is the director of the Translational Research Laboratory at St. Jude Children’s Research Hospital, in Memphis.
Dr. Crews’ broad interest in research was sparked during her pharmacy school years at Rutgers University, in New Jersey, and she ultimately followed up a residency in clinical pharmacokinetics with a research fellowship focusing on clinical pharmacokinetics and drug development.
The pharmacogenetics service she helped establish at St. Jude’s, detailed in the American Journal of Health-System Pharmacy (2011;68:143-150), is the culmination of her research and clinical interests. The service relies on pharmacists to review and interpret the results of pharmacogenetic tests, which are conducted preemptively at St. Jude’s in patients likely to require one of several drugs that are metabolized by polymorphic enzymes and for which there is pharmacogenomic information. Pharmacists provide a written consultation that is included in a patient’s electronic medical record, and drug-specific alerts appear if a genotype contraindicates the use of a particular medication or suggests a higher- or lower-than-normal dose should be administered.
With a growing list of gene–drug pairs, Dr. Crews believes pharmacists will see clinical pharmacogenomics become an important aspect of hospital-based pharmacy. “With our knowledge of medications, pharmacists are well positioned to lead new initiatives in the field,” she noted.
Dr. Crews received praise from co-author James Hoffman, PharmD, MS, BCPS, a medication outcomes & safety officer at St. Jude. She “was a pleasure to work with on this paper and on all of our ongoing efforts to implement pharmacogenetics,” Dr. Hoffman said. “Her broad knowledge of both laboratory research and patient care give Dr. Crews unique insights into the application of pharmacogenetics for our patients, and her innovative practices continue well beyond this paper.”
Drug Therapy Research Award
After a dinner out with a soon-to-be-colleague from the University of Connecticut/Hartford Hospital’s Evidence-Based Practice Center, where Olivia Phung, PharmD, was applying for a fellowship position, the pair dropped in for an informal visit at the home of C. Michael White, PharmD, a professor of pharmacy practice and the head of the center, to “set the stage for the next day’s interview.”
“It was 2007, and my wife was out of town and I was looking after my two very small children,” recounted Dr. White. “My cats were interested in who the new people were so they were walking around us the whole time. I had no inkling Olivia was horribly allergic to cats until her eyes swelled and other symptoms kicked in big time. I knew then that if she was willing to risk death to be my fellow, she was serious about success and would accomplish great things!”
Dr. Phung’s work, and the particular study for which she is being recognized—a Bayesian mixed treatment comparison of oral antidiabetic drugs for the prevention of type 2 diabetes—fills a significant gap that exists in light of a paucity of head-to-head drug trials, Dr. White said.
“With a multitude of placebo-controlled trials but scant information regarding direct therapy comparisons, the use of this analytical approach can provide insights into the relative efficacy of these drugs where large-scale, head-to-head trials are under way or are unlikely to be conducted,” Dr. White pointed out.
Dr. Phung’s analysis of 20 randomized controlled trials of antidiabetic drugs showed that α-glucosidase inhibitors, biguanides and thiazolidinediones significantly reduced the relative risk for developing diabetes compared with control, but the latter had the greatest effectiveness in this regard (Diabetic Med 2011;28:948-964).
Dr. Phung, now an assistant professor of pharmacy practice and administration at the Western University of Health Sciences, in Pomona, Calif., said that improving patient care through research is her modus operandi. “By highlighting the existing evidence, synthesizing it and disseminating the results, I’m contributing to overall scientific knowledge which can then be applied to patient care,” she said.
Given the urgent need for improved treatment and prevention of type 2 diabetes, Dr. Phung added, “I can only see my involvement in diabetes-related research growing.”
Pharmacy Practice Research Award
As a pharmacy resident at Henry Ford Hospital in Detroit, Jessica Schillig, PharmD, came to be known as a “pitbull.”
“She was tough, not afraid to advocate for the patient and for the safe use of anticoagulant medications, and she wasn’t easily rattled by the occasional professional disagreement or conflict that she encountered in starting a new service,” recalled James Kalus, PharmD, BCPS, Dr. Schillig’s residency director at the time. Dr. Kalus, the senior manager of patient care services at Henry Ford and the senior author of a study examining the clinical and safety impact of the inpatient pharmacist-directed anticoagulation service (PDAS) that Dr. Schillig helped create and for which she received the Pharmacy Practice Research Award.
The study included 500 internal medicine or cardiology patients receiving warfarin, randomized to drug management by either the PDAS or a physician (J Hosp Med 2011;6:322-328). PDAS-initiated and managed in-hospital warfarin treatment involved pharmacists providing patient education and a dosing schedule upon discharge, as well as including a summary of warfarin administration in the patients’ electronic medical records.
“Our paper is one of only a handful to evaluate standardized pharmacist-directed inpatient management of anticoagulation therapy, and it demonstrates similar safety outcomes to traditional physician management, and even suggests improved safety with the PDAS in high-risk subpopulations,” said Dr. Schillig, who is now clinical pharmacist at LifeCare Hospitals of Fort Worth, Texas.
The awardee’s interest in pharmacy can be traced back to a stint as a pharmacy clerk in Grafton, Ohio, during high school, where she “realized the impact and relationship that the pharmacist could have with a patient.” Her focus on pharmacist-managed inpatient anticoagulation treatment grew during a longitudinal residency rotation at Henry Ford’s outpatient anticoagulation clinic. Discussions at the time on how best to meet the Joint Commission’s National Patient Safety Goal 03.05.01, which emphasizes harm reduction among inpatients receiving anticoagulants, was the impetus for the creation of the PDAS.
“Dr. Kalus approached me about developing the PDAS, and I was up for the challenge,” she said.
Thanks to Dr. Schillig’s persistence and perseverance, Henry Ford’s PDAS—one of the first in the country—has expanded the range of clinical services that hospital pharmacists can offer. Clearly, her pitbull attributes serve not only herself, her hospital and her patients but also the profession as a whole.
Student Research Award
The pithy Twitter name speaks volumes: @OracleofPharma. Tech-savvy, ambitious and innovative, Ronak Savla, PharmD, has always had his eye on the future.
“My interest in nanotechnology started when I attended a magnet school for math, science and engineering,” Dr. Savla said from his lab at the Department of Pharmaceutics at Ernest Mario School of Pharmacy at Rutgers, The State University of New Jersey, in Piscataway. “The subject seemed very futuristic.”
Appropriately, the title of the abstract for which he received the Student Research Award carries a sci-fi feel: “Tumor Targeted Quantum Dot-Mucin 1 Aptamer-Doxorubicin Conjugate for Imaging and Treatment of Cancer.”
The research examined the ability of a modified doxorubicin molecule to increase drug delivery directly to tumors (J Control Release 2011;153:16-22). The investigators created the modified molecule by conjugating it with a quantum dot—a nano-drug carrier—and with a DNA aptamer that binds to mutated mucin-1 receptors, which are overexpressed in many cancer cells. To further limit the drug’s release to tumors, they designed the doxorubicin-quantum dot bond to hydrolyze in mildly acidic environments, like those of lactic acid–filled tumors.
“The results of our in vitro and mouse model biodistribution studies have been promising,” said Dr. Savla.
The drug showed a greater degree of cytotoxicity than the currently used form of the agent, and the decreased amount of systemic drug release should reduce drug-related toxicity, he said. Furthermore, fluorescence emitted by the quantum dot only when it is attached to the doxorubicin molecule can help clinicians monitor treatment, Dr. Salva noted.
As a researcher and a student, Dr. Savla has proven himself to be “exceptional,” senior study author Tamara Minko, PhD, told Pharmacy Practice News. “Since he joined Rutgers, Ronak has been on the Dean’s Honors list every semester and has received several scholarships and awards,” noted Dr. Minko, a professor and the chair of the Department of Pharmaceutics at Rutgers. Dr. Savla also is one of the first students in the School of Pharmacy’s newly created PharmD/PhD program, she added.
With an interest in the business of pharmaceuticals and seemingly unlimited ambition, it would be no surprise if Dr. Savla also pursues a business degree—and puts it to good use. “My goal is to start a biotech company and eventually go into venture capital, helping other companies develop their own ideas,” he said.
In preparation, he is making note of therapeutic pipeline developments and sharing his insights on his blog, wtpharma.blogspot.com.
As he closely tracks industry developments, you can be sure that Dr. Savla himself will be an innovator to watch out for.