Doctoral program Clinical Pharmacy
The Doctoral Program Clinical Pharmacy at the LMU 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 doctoral projects focus on questions related to improving medication safety. The aim is to make a significant contribution to increasing patient safety in various disease patterns. Furthermore, the program seeks to expand the scientific evidence base in the field of applied clinical pharmacy.
Doctoral candidates are offered an inspiring research and working environment. Projects are supervised interprofessionally by pharmacists and physicians, ensuring intensive exchange on both fundamental and therapeutic topics. The program is complemented by regular seminars and workshops, as well as numerous opportunities for professional exchange with supervisors and fellow doctoral candidates in the excellent scientific environment in Munich.
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:
Ongoing:
Drug therapy safety in supportive care
Impact of a supportive care Pharmacist Consultation Service (scPCS) on drug therapy safety in oncology patients
Problem/patient group
During drug-based tumor therapy, side effects occur that can impair patients' quality of life and that may complicate the achievement of treatment goals. Supportive care aims to treat the adverse effects of cancer treatment and cancer itself. However, guideline recommendations for supportive care are not always implemented. In addition, symptoms that should be treated sometimes remain unrecognized in everyday clinical practice. This may compromise drug therapy safety.
Aim
The project investigates whether pharmaceutical care for outpatients with cancer, focusing on supportive care, can increase drug therapy safety. The impact on guideline-adherent implementation of supportive care and the symptom burden of patients are examined as important parameters for drug therapy safety.
Implementation
Participants in the study are patients with solid tumors who are starting intravenous tumor therapy. The therapy may be supplemented by oral medication. An observation phase is followed by an intervention phase introducing pharmaceutical care. This consists of three components: (I) advising treating physicians on supportive care, (II) training ward staff in supportive care measures, and (III) training patients in dealing with side effects of the therapy and accompanying symptoms of the disease. In order to draw conclusions about the drug therapy safety during the two phases, a comparison is made between the observation and intervention phase to determine how well guideline recommendations for supportive care are being implemented and to what extent patients are affected by symptoms.
Results
The observation phase started in December 2025. The results of an interim evaluation following the observation phase are expected in the fourth quarter of 2026.
Patient benefit
The implementation of pharmaceutical care aims to improve guideline adherence and to reduce the symptom burden for patients. Overall, the project intends to enhance drug therapy safety during outpatient intravenous tumor therapy.
Image source: Larissa Weller
Individualisation of Antibiotic Therapy in Intensive Care Patients Using Dosing Software Tools
Individualization of antibiotic therapy by evaluating software tools for model-based precision dosing of Piperacillin and Meropenem in critically ill patients
Problem/patient group
In critically ill patients, target attainment of blood levels of antibiotics like piperacillin and meropenem is often low due to organ impairments, organ support and disease-related changes in body functions, when using standard dosing [1]. While regular measurements of concentrations help control and guide therapy regimens, they do not support initial dosing or provide clear recommendations for dose adaptions in case of non-target attainment. A next step towards personalised antibiotic therapy is the development of dosing software tools that model antibiotic concentrations considering individual patient factors and calculate appropriate dosages [2]. Available dosing software tools differ in their methodological approach, functionality and design – and thus also in their appropriateness for clinical use [3].
Aim
My project aims to compare dosing software tools for piperacillin and meropenem in critically ill patients, focussing on their accuracy of predicted concentrations, calculated dose recommendations and user friendliness.
Implementation
After identifying suitable dosing software tools, their predicted concentrations will be compared with measured concentrations to assess their accuracy. For that, data from multiple clinical trials from different hospitals will be used (number of measurements/patients: piperacillin 3654/561; meropenem 3924/486). The most promising tools will be compared regarding clinically relevant differences in dose recommendations. Finally, a usability study will be conducted.
Result
In the systematic search, 120 dosing software tools were identified and assessed for eligibility. Currently, eleven tools are included and accessible. An interim analysis showed that at least 22 different piperacillin and 19 meropenem models are implemented in these tools.
Patient benefit
The use of dosing software tools for precision dosing of piperacillin and meropenem aims to increase target attainment of intensive care patients – and thereby decrease the risk for therapy failure, antibiotic resistance and toxicity [1]. My project supports the rational selection of such tools to ease their integration into clinical routine.
Figure 1: Stepwise Evaluation Process of Dosing Software Tools for Piperacillin and Meropenem in Critically Ill Patients
Image source: Sabrina Böing
Drug Therapy Safety in Uro-Oncology
APTURO – Medication Reconciliation and Patient Information for Tumor Therapy in Uro-Oncology
Problem/patient group
Uro-oncology patients usually develop urothelial, prostate or renal cell carcinoma for the first time at an advanced age. As a result, they often already suffer from concomitant diseases at the time of diagnosis and take additional medication. The upcoming complex oncological treatment regimens require extensive patient information and education. Overall, uro-oncology patients therefore represent a special risk group for drug-related problems (DRP).
Aim
The APTURO study investigates how pharmaceutical care can contribute to increasing drug therapy safety and patient satisfaction of uro-oncology patients with information on tumor therapy. The improvement in drug therapy safety is measured by the number of unsolved DRP per patient. A validated, specialized questionnaire records whether patient satisfaction can be improved.
Implementation
The pre-post study is divided into an observation and an intervention phase. The number of unresolved DRP and the satisfaction of patients, first without and then with pharmaceutical care, consisting of medication histories with medication analyses and pharmaceutical patient training, are recorded and can then be analyzed and compared with each other. To increase satisfaction, patient-friendly information sheets for all common uro-oncological tumor therapies were developed between the two phases. These are distributed as part of the patient training sessions and are also discussed verbally.
Result
Recruitment for both study phases has already been completed, but data collection is still ongoing. An initial interim evaluation of patient satisfaction in the observation phase showed that this depends on different treatment situations such as the form of application. The data from the intervention phase must show whether an improvement can be achieved through pharmaceutical care.
Patient benefit
The networking of physicians with pharmacists to form an interdisciplinary care team enables an increase in drug therapy safety and a reduction in the symptom burden during tumor therapy. Targeted training should increase patient knowledge regarding their therapy and thus improve patient adherence to their (tumor) medication.
Image source: Judith Fischer
Completed:
Impact of pharmacist-led intersectoral interventions on symptoms of palliative patients
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Dr. Dominik Bauer, Apotheker, Klinik und Poliklinik für Palliativmedizin des LMU Klinikums, München
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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.
