Doctoral programme Clinical Pharmacy

The Doctoral programme Clinical Pharmacy at the University Hospital of Munich was initiated in 2013 within the Munich Medical Research School (MMRS). It is recognised by the GraduateCenterLMU as a structured PhD programme.

The Foundation Patient & Clinical Pharmacy supports the framework, research projects, travel grants, workshops, congress participation and the annual symposia.

Further details can be found here.

Funded doctoral theses include/were:

Completed:

Impact of pharmacist-led intersectoral interventions on symptoms of palliative patients

Dr. Dominik Bauer, Apotheker, Klinik und Poliklinik für Palliativmedizin des LMU Klinikums, München
Dr. Constanze Rémi, pharmazeutische Betreuerin, Apothekerin,
Klinik und Poliklinik für Palliativmedizin des LMU Klinikums, München
Prof. Dr. Claudia Bausewein PhD MSc, Direktorin,
Klinik und Poliklinik für Palliativmedizin des LMU Klinikums, München

Palliative care patients often suffer from a variety of distressing symptoms. Pharmacotherapy is essential in palliative medicine to palliate symptoms e.g. pain or dyspnea. Besides potential benefits, pharmacotherapy requires pharmaceutical expertise for instance to minimize drug-related risks and increase patient safety. The aim of this study was to evaluate pharmaceutical interventions on drug therapy safety and symptom distress in an inpatient palliative care unit. To identify and assess drug-related problems (DRP), patients’ pharmacotherapy was evaluated by a pharmacist according to various aspects following a specific intervention pathway. All patients admitted to a palliative care unit over a 12-months period were screened for eligibility. 41 patients were included. Overall, 207 DRP were documented (median 5 DRP/patient). After recording a DRP, the pharmacist directly intervened in order to solve the DRP; 88% of all recommendations were accepted by the treating phycicians. Distressing symptoms were significantly palliated during the inpatient stay and kept controlled after discharge. In summary it can be stated that clinically relevant DRPs are common in palliative medicine and can be addressed efficiently by pharmacists. This can result in optimized drug therapy, subsequently having a positive effect on symptom control and quality of life. Furthermore the pharmaceutical intervention plan can be used as a best practice model to include pharmacists as a part of the palliative care team.

Why is this project important for providing safe drug therapy for patients?

Pharmacists can play an important role in identifying, solving and avoiding drug related problems. Reducing drug risks can result in optimized drug therapy, subsequently having a positive effect on symptom control and quality of life.

Ongoing:

Increasing drug therapy safety at sectorial borders: identification and characterisation of impaired liver function as a risk factor of hospitalized surgical patients

An impaired liver function can change distribution, metabolism and clinical effect of drugs. As a consequence, drug selection as well as dosage of drugs need to be adjusted for each patient individually. In order to ensure safe drug therapy in hospital, screening for impaired liver function at hospital admission is important.
Since no established screening tool is available yet, the MELD-Score (model of endstage liver disease) will be tested in this project by pharmacists in clinical routine as a screening tool for impaired liver function. Patients identified at risk for hepatic impairment will be reviewed for necessary drug adjustments and relevant drug information will be communicated to the physicians on ward.

Why is this project important for providing safe drug therapy for patients?

The establishment of a screening tool for impaired liver function enables rapid identification of patients with liver disease during hospital admission. An immediate patient-specific suggestion for adjusting drug therapy by the pharmacist could increase drug therapy safety.

The Interprofessional Training Ward in Munich (MIPA) – A promising environment to foster clinical pharmacists’ competencies

Research has shown that interprofessional collaboration strengthens healthcare systems and leads to better patient outcomes. The first experience in interprofessional collaboration should be gained during training in order to lay the foundation for later successful collaboration between the various health care professions, such as physicians, pharmacists and nurses. One possibility is to establish interprofessional training wards in the clinics.

At the LMU Hospital, this type of ward was launched at the end of 2020, the MIPA - Interprofessional Training Ward in Munich. On MIPA, for a period of 5 weeks, two medical students, one pre-registration pharmacist and four nursing trainees are given the responsibility of providing care for six patients. The MIPA participants work in two teams, each looking after three patients. Together they discuss which diagnostics and treatments are necessary, who can be discharged and who is responsible for which tasks. The MIPA participants should gain insights into the tasks and responsibilities of their own and other professions and practise teamwork. Profession-specific tutors from the medical, pharmaceutical and nursing fields accompany their work and can intervene in case of any mistakes. For the first time in Germany, pre-registration pharmacists are integrated into an interprofessional training ward.

The MIPA is designed to promote communication skills, the recognition of patients' needs, and the understanding and strengthening of the participants' individual professional roles. The aim of the project is to assess the learning progress in the profession-specific as well as interprofessional competencies of pharmacy students on MIPAs.

MIPA

Why is this project important for providing safe drug therapy for patients?

The MIPA participants jointly develop the standards for pharmaceutical care and learn to use the specific knowledge and experience of the individual professions, especially in the area of pharmaceutical care.

Expansion and further development of an antibiotic stewardship program (ASP) in a university children's hospital

Elena Jaszkowski, Hospital Pharmacy, University Hospital, LMU Munich and Division of Pediatric Infectious Diseases, Dr. von Hauner Children’s Hospital, University Hospital, LMU Munich
Prof. Dr. Johannes Hübner, Division of Pediatric Infectious Diseases, Dr. von Hauner Children’s Hospital, University Hospital, LMU Munich
Dr. Alenka Pecar, Division of Pediatric Infectious Diseases, Dr. von Hauner Children’s Hospital, University Hospital, LMU Munich

Inappropriate antibiotic use is a main driver for bacterial resistance. Antibiotic stewardship programs aim to use antibiotics wisely and responsibly to prevent resistance and to optimize the quality of antibiotic prescriptions in terms of antibiotic selection, dosage, application and duration of therapy. Especially in children, antibiotics are among the most frequently prescribed drugs. Therefore, in pediatrics it is particularly important to measure and to analyze antibiotic use and to optimize antibiotic therapies as a core component of an ASP. In this project, antibiotic use in various pediatric wards is analyzed and multiple methods of measuring antibiotic use are compared to identify the best possible metrics in children. Additionally, as antibiotic resistance is a global health problem, antibiotic prescriptions and resistance patterns in the intensive care units of the German pediatric hospital are compared with those of Brazilian pediatric hospitals. Furthermore, therapeutic drug monitoring (measurement and interpretation of drug levels in the blood) for the broad-spectrum antibiotic meropenem is introduced with the aim of improving antibiotic therapy in critically ill children through patient-specific dose adjustments.

Why is this project important for providing safe drug therapy for patients?

Antibiotics are drugs that can be life-saving for patients with serious infections. To ensure their effectiveness, it is very important to use them responsibly and to avoid the development of resistance.