Pharmacists Step Up to Help Solve the COVID-19 Pandemic
The COVID-19 pandemic has swept across the world and changed our lives. As the healthcare system works to solve the COVID-19 crisis, pharmacists are stepping up and filling necessary roles.
Infectious disease pharmacists like Sara Revolinski, PharmD, BCPS, Director of Experiential Education and Assistant Professor in the Department of Clinical Sciences at the MCW School of Pharmacy, have been working on establishing guidelines on how to best treat patients with COVID-19. “We research current data around COVID treatment and analyze the data to come up with our recommendations for treatment, based on our best interpretations of the literature,” she says. The infectious disease pharmacists at Froedtert & the Medical College of Wisconsin (Froedtert &MCW) also review information that they find on list-servs or guidelines shared from other institutions.
“We put guideline recommendations down on paper, then share with physicians for feedback before distributing the guidelines to the practitioners at large,” Dr. Revolinski says. Pharmacists are also continually reviewing new data to update guidelines. Dr. Revolinski and Kristen Bunnell, PharmD, BCCCP, Assistant Professor in the Department of Clinical Sciences at the MCW School of Pharmacy, recently published guidelines on the usage of hydroxychloroquine for COVID-19, intended for healthcare providers to use when talking to patients.
Researchers have been quickly working to establish new protocols for the treatment of COVID-19. Kristin Busse, PharmD, BCPS, Assistant Professor of Pharmacy Administration and Regulatory Sciences and the Research Oversight Program Director at the MCW School of Pharmacy is helping to develop a protocol in collaboration with the Versiti Blood Center.
“Versiti has had up to five people a day call wanting to give plasma to try to treat patients,” says Dr. Busse. “They are in the process of opening up a healthy donor bank to draw the blood of patients who have recovered from COVID-19, take the plasma, and then isolate the antibodies and turn them into a serum that can be given to patients who are currently sick. We need a protocol for drawing donor blood, as well as a master protocol from the FDA for the treatment portion of this.”
Dr. Busse serves as the Institutional Review Board (IRB) chair for Human Research Protections Program at MCW. The IRB is a group that reviews and monitors research involving human subjects to protect their rights and welfare. “We meet on a weekly basis to turn around situations like this where there is a need to quickly amend protocol,” she says. “It’s basically an all-hands on deck situation at the treatment office to help usher this through as quickly as possible.”
In addition, Dr. Busse is helping the research team decide if there is a need for an Investigational New Drug Application with the FDA for the biologic-therapeutic product, remdesivir that has recently shown promise in a national clinical trial.
Dr. Busse was an investigational drug pharmacist at Froedtert & MCW for the last 10 years before beginning her position in the Office of Research in partnership with the MCW School of Pharmacy.
“I think there is very little info out there on the drug approval process, so having that background from pharmacy school in understanding both the medicinal chemistry of drugs as well as their therapeutic application gives me a good fundamental understanding of the importance of a medication, as well as the facilitation of the drug approval process. I am able to educate others, whether patients or doctors, and fill in the knowledge gap of how the FDA operates,” says Busse.
Pharmacists working in Froedtert & MCW’s Milwaukee Emergency Room, including Matthew Stanton, PharmD, BCPS, DABAT, Clinical Assistant Professor in the Department of Clinical Sciences at the MCW School of Pharmacy, have been assisting in making callbacks to patients who were tested with COVID-19 to inform them of their results “We have the knowledge and training to inform patients of test results. We also have training to show empathy and recognize that these results are not the usual results we inform patients about.”
Dr. Stanton also works as a clinical toxicologist at the Wisconsin Poison Center, where he has been fielding an increased number of calls regarding accidental poisonings from household cleaning product exposures.
Paul Hoffman, RPh, Experiential Education and Skills Specialist at the MCW School of Pharmacy, fills a unique pharmacist role at the Bread of Healing Clinic (BOHC), which is a primary care clinic for uninsured adults that assists primarily the medically underserved zip codes in Milwaukee. BOHC provides patients with about 225 prescriptions per day.
COVID-19 has provided many pharmacists, including Professor Hoffman with a new set of challenges. “It has been necessary to redesign the practice for the safety of the staff and patients. Since our clinics are in churches, we not only had to protect the patients and staff, but also the church facility and church staff that we share space with,” he says.
BOHC eliminated routine visits and only is requiring patients to come to medication visits, which were redesigned to reduce patient contact while still providing adequate monitoring. “COVID-19 presents uncertainties daily and requires practice adjustments often. More patients will visit a pharmacist than any other health professional during this time. We truly are essential to the health of the country,” says Professor Hoffman.
During this time, students from the MCW School of Pharmacy are continuing their clinical rotations at BOHC, as well as at other sites. “The pandemic environment offers tremendous opportunities for our Introductory Pharmacy Practice Experience and Advanced Pharmacy Practice Experience students to engage patients in a unique way,” says Professor Hoffman. “Limiting exposure and providing adequate assessment, monitoring, and counseling is important. MCW students are critical to providing medication monitoring and education to patients.”
The MCW School of Pharmacy students are also continuing their Doctor of Pharmacy (PharmD) education in specialty practice areas that can help in the fight against infectious disease pandemics.
The MCW School of Pharmacy students receive education in biological and chemical disasters in their required Critical Care, Toxicology, and Substance Abuse course. The opportunity for MCW School of Pharmacy students to do an independent study with Dr. Stanton in disaster medicine is also available. “We can help foster the education for interested students to carve a path to a career in disaster medicine pharmacy,” says Dr. Stanton.
The MCW School of Pharmacy’s PharmD curriculum also includes a two-course sequence on infectious disease. They also can pursue clinical rotations in an infectious disease specialty, guided by pharmacists.
The MCW School of Pharmacy gives students who are interested in clinical research to do so through Scholarly Pathways, which is a two-year program allows students to pursue different specialties in pharmacy. “The Clinical Translational Research Pathway is a good first step for students to understand the research process. That is a very unique pharmacy education. A lot of other pharmacy schools don’t cover research, to this extent with immersion,” says Dr. Busse. She hopes to take students on rotation in the future so that they can have a hands-on experience with the regulatory issues of new drugs.
The MCW School of Pharmacy, is assessing a concentration in research, among others, for the PharmD students in the coming year. George E. MacKinnon III, PhD, MS, RPh, FASHP, Founding Dean and Professor at the MCW School of Pharmacy, stated, “This is a unique opportunity to help differentiate MCW PharmD graduates as some move on to post-graduate training. Being at an academic medical center in partnership with Froedtert & MCW, and Children’s of Wisconsin is essential to such an offering.”