PRISM Pain Management, Oncology, and Drugs of Abuse

In collaboration with UConn Health, Yale New Haven Hospital, and a local hospice program; we have a unique strength in optimizing pain and palliative care management both in the home and within the institutional setting.  With the opioid epidemic overlaid upon the need to reduce human suffering, there is a critical role for the pharmacist in pain, palliative care, and reducing opioid addiction and its ramifications (respiratory depression, blood borne disease transmission).  We are assessing and disseminating strategies to improve the care of patients with pain and addiction.  We are involved with the State Opioid Overdose Prevention Workgroup and have organized a group of pharmacy students dedicated to the dissemination of information to their peers and the community regarding safe and appropriate use and disposal of medications and awareness of naloxone availability and use.  Dr. Nathaniel Rickles has led several discussions with pharmacists and other pharmacy stakeholders about the use of community pharmacy guidelines to facilitate optimal safe opioid and controlled substance dispensing behaviors and management.  He is currently pursuing a federal grant to explore the role of one-to-one outreach to community pharmacists to engage them in best practices involving safe opioid and benzodiazepine dispensing and management.

Aside from opioids, there are many other drugs of abuse for which clinicians have limited information to understand and treat adverse effects.  We have published manuscripts reviewing major drugs of abuse [e.g. MDMA, GHB, synthetic cannabinoids, bath salts (synthetic cathinones), and kratom) to support emergency management of overdoses and adverse effects.

In collaboration with UConn Health, Yale New Haven Hospital, and community pharmacies; we have a unique strength in optimizing cancer screening, prevention, treatment, and survivorship. Oncology pharmacists are often viewed as the medication experts and provide the healthcare team with a unique perspective on disease management, which encompasses individual patient care but also the institution and health care system perspective. Although oncology pharmacists play a vital role in the delivery of cancer-related care, not every individual with cancer has an oncology pharmacist as part of their care team. Thus, we perform research needed to document the value of the pharmacist as part of the interprofessional care team.

Publications in this area include:

Patel JM, Holle LM, Clement JM, Bunz T, Niemann C, Chamberlin KW. Impact of a pharmacist-led oral chemotherapy-monitoring program in patients with metastatic castrate-resistant prostate cancer. J Oncol Pharm Pract. 2016;22(6):777-783.

Holle LM, Michaud LB. Oncology pharmacists in health care delivery: vital members of the cancer care team. J Oncol Pract. 2014;10:e142-e145.

Holle LM, Puri S, Clement JM. Physician–pharmacist collaboration for oral chemotherapy monitoring: Insights from an academic genitourinary oncology practice. J Oncol Pharm Pract; 2016;22:511-516.

Holle LM, Harris CS, Chan A, Fahrenbruch RJ, Labdi BA, Mohs JE, Norris LB, Perkins J, Vela CM. Pharmacists’ Roles in Oncology Pharmacy Services – Results of Global Survey. J Oncol Pharm Pract. 2016 Feb 622 [Epub ahead of print) DOI .1078155216629827

White CM. Mephedrone and 3,4-Methylenedioxypyrovalerone (MDPV): Synthetic Cathinones With Serious Health Implications. J Clin Pharmacol. 2016 Nov;56(11):1319-1325

White CM. How MDMA’s Pharmacology and Pharmacokinetics Drive Desired Effects and Harms. J Clin Pharmacol 2014;54(3):245-52.

White CM. The Pharmacologic and Clinical Effects of Illicit Synthetic Cannabinoids. Journal of Clinical Pharmacology 2017 57 (3), 297-304

White CM. Pharmacologic, Pharmacokinetic, and Clinical Assessment of Illicitly Used γ-Hydroxybutyrate. J Clin Pharmacol. 2017 Jan;57(1):33-39.

Funded grant projects in this area include:

Pharmacist intervention in colorectal cancer screening initiative. Principal investigator: Lisa M. Holle, PharmD (funded; UConn CHIP Seed, $35,000)