Perspectives on Geriatrics by Pioneers in Aging: Reflections of a Clinical Pharmacist

Joseph T. Hanlon PharmD, MS, BCGP, AGSF

Disclosures

J Am Geriatr Soc. 2021;69(4):896-899. 

In This Article

Late Career

An opportunity arose to move to the University of Pittsburgh to be closer to family and to work again with Dr Stephanie Studenski, MD, MPH, a colleague I first worked with when she was a geriatric fellow at Duke. During my 14 years there, I was the PI/Co-PI of four R01s (AG027017, HS017695, HS018721, AG034056), a Donoghue Foundation grant and a K07 (AG033174) leadership award to build a program for pharmaceutical outcomes research in aging. Three grants focused on various types of polypharmacy (i.e., CNS medications, antihypertensives, and anticholinergics) and their impact on various geriatric syndromes outcomes (i.e., falls/fractures, cognitive impairment, urinary incontinence). In particular, we showed that taking 3+ standardized daily doses (SDD) of CNS medication increased the risk of serious falls in older nursing home residents with a previous fall history.[26] To aid in the calculation of SDD, I refer you to a pamphlet on our Pepper Center website (https://www.pepper.pitt.edu/wp-content/uploads/2019/07/PreventFalls_Trifold.pdf) and an online calculator (https://globalrph.com/medcalcs/cns-medication-burden/). CNS polypharmacy is now part of the explicit criteria for potentially inappropriate medication use in the United States.[22]

Two other grants focused on the underuse of medications and the impact of Medicare Part D on racial disparities and another on the impact of early detection and management of adverse drug events in the nursing home. Particularly gratifying was that these three grants were done with two junior (now senior) faculty (Steve Handler, MD, PhD and Julie Donoghue, PhD) as Co-PI's since I previously had served as their Kl2 mentor. Also, with the support of my K07 and Dr. Studenski's T32 training grant, I co-mentored three geriatric pharmacy fellows. In part due to these activities, I had the opportunity to travel to give lectures, write book chapters/reviews on various geriatric pharmacotherapy topics, collaborate with researchers around the world and serve on the American Geriatrics Society (AGS) Beers criteria expert panel. I was humbled to receive a number of prestigious awards including the William B. Abrams Award in Geriatric Clinical Pharmacology from the American Society for Clinical Pharmacology and Therapeutics, the Sustained Contributions to Research Literature Award from the American Society of Health System Pharmacy, the Edward Henderson Lecture Award from AGS and the George F. Archambault Award from the American Society of Consultant Pharmacy (ASCP).

Overall, I was fortunate to have had a great career. I am proud that I influenced geriatric health care professionals to appreciate the critical role that medications play in the health and wellness of older people both in a positive and negative way. I also have been honored to have mentored the previously mentioned 12 geriatric pharmacy fellows, along with 12 geriatric pharmacy residents, over two dozen junior faculty members and nine graduate students. It is my hope that these individuals will continue to pay it forward and to generate new knowledge in geriatric pharmacotherapy.

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