Patient Safety Awareness Week with Dr. Christine Cadiz, Dr. Nana Entsuah, Dr. Lee Nguyen, and Student Pharmacists Zynab Haidary and Manroop Samra

One of the most essential roles of pharmacists is ensuring the safety of patients. Side effects are possible with every medication, and drug interactions and health conditions can present additional risks. Pharmacists use their knowledge of medications to protect patients from harm.

This Patient Safety Awareness Week (March 10-16, 2024), we’re highlighting three faculty members and two student pharmacists in the UC Irvine School of Pharmacy & Pharmaceutical Sciences. This week is observed annually in March to recognize healthcare professionals who dedicate themselves to providing safe and effective care for their patients.

Dr. Christine Cadiz manages medications for patients with advanced heart failure and left-ventricular assist device (LVAD) implants.

“Patients with heart failure take a combination of medications — medication regimens can be very complex. It is important for patients to sit down with their healthcare team to learn about their medications. For example, many patients do not know that commonly prescribed medications may need to be adjusted when they are ill,” said Dr. Cadiz.

She continued, “Patient education is key for medication safety — patients should have a thorough understanding of why they are taking their prescribed medications, how to take them, and what to expect or look out for. Moreover, consistent adherence to prescribed medication regimens is essential for managing heart disease effectively. I truly value the team-based care I provide to patients with advanced heart failure. Medication-related problems are prevented through close monitoring, extensive education, addressing barriers to access, and communication with multidisciplinary team members regarding potential medication-related issues.”

Dr. Nana Entsuah, whose focus is primarily on geriatric pharmacy care, works to create safe medication plans for this vulnerable population. 

“As a geriatric clinical pharmacist, I collaborate with members of an interdisciplinary team to address complex medication-related issues comprehensively,” she said. “I conduct medication reviews to streamline medication regimens, and minimize polypharmacy by prioritizing essential therapies and eliminating unnecessary medications to reduce the risk of falls, drug interactions, and other serious adverse effects. As a clinical pharmacist, I take into consideration factors such as age-related changes in drug metabolism, renal and hepatic function, comorbidities, cognitive status, and functional impairment when developing individualized medication management plans for older adult patients.”

For elderly patients, polypharmacy (taking multiple medications at a time) and declining health present significant safety concerns. Older people commonly live with several health issues and may have a number of medications, healthcare providers, and therapy plans at once. Additionally, the natural changes that occur as we age tend to impact how our bodies react to medication.

Dr. Entsuah explained, “Elderly individuals often manage multiple chronic conditions, leading to the use of multiple medications concurrently. This poses a medication-related safety issue, as there are age-related changes in pharmacokinetics and pharmacodynamics which can lead to alterations in drug absorption, distribution, metabolism, and elimination. This is a concern because it results in increased sensitivity to certain medications and higher risk of adverse effects. Older adults often transition between various levels of healthcare including inpatient, outpatient, skilled nursing facilities, and long-term care. It is important for patients and providers to be aware of the importance of medication management during transitions of care.”

Dr. Lee Nguyen works with HIV patients, who are often prescribed medications that present significant side effects and can be impacted by other medications.

“The main safety concern is when patients start new medications that may interact with the HIV medication,” Dr. Nguyen stated. “For example, multivitamins or multivalent cations such as calcium carbonate (Tums) can reduce the therapeutic effect of integrase inhibitors such as Biktarvy, Tivicay, or Dovato.”

He emphasized the importance of pharmacists in preventing medication-related safety issues: “Pharmacists are normally the last healthcare provider the patient sees before they start their medications. This is the most opportune time to help patients understand the benefits of the medication and potential expected side effects. Prior to patients receiving their medications, we are able to check for potential medication interactions. We provide extra face time with patients and the opportunity to open up about any subject.”

Dr. Cadiz, Dr. Entsuah, and Dr. Nguyen identified some key points in regard to patient safety:

Polypharmacy can be dangerous if medication use is not monitored and potential issues are not identified, including drug-drug and “drug-herb” interactions. 

“When we see patients, we have the opportunity to discuss medications not on their profile such as herbal products, over-the-counter products, or dietary/vitamins and supplements. Most individuals don’t recognize herbal products or supplements as medication, but they have similar potential to adversely impact prescribed medications,” Dr. Nguyen explained.

Pharmacists must work closely with others who are involved in a patient’s care. 

Dr. Entsuah stated, “Effectively caring for patients requires a holistic approach, including collaborating with nurses, social workers, physicians, and other allied health professionals to optimize patient care.”

Interprofessional collaboration within the UCI Susan & Henry Samueli College of Health Sciences and the UCI Health system allows for increased patient safety — pharmacists are able to communicate and work closely with other medical professionals who can provide a complete picture of a patient’s health journey, informing evolving approaches.

Patient communication and education are crucial to patient safety — those who are comfortable with their healthcare providers can communicate openly, allowing them to take charge of their own health.

“At UCI, we focus on shared decision making, where we provide patients with options for the best therapy course and have them make the decision,” said Dr. Nguyen. “This allows patients to be more vested in their health outcome.”

Dr. Cadiz elaborated, “By actively engaging with patients, addressing their concerns, and involving them in decision-making processes, we can educate patients about their medications and empower patients to take an active role in their own health care. This collaborative approach not only enhances patient understanding and adherence to medication regimens but also fosters a sense of ownership and responsibility for their own health outcomes.”

Learning about patient safety and potential medication errors should be a priority for any aspiring pharmacist.

“Among the best practices is ensuring patients have a thorough understanding of their disease states and medications,” said third-year student pharmacist Zynab Haidary. “Pharmacists are the most accessible health care providers, especially with regard to medications. Additionally, the importance of being thorough and providing individualized care that takes into account patient-specific factors should be emphasized.”

Manroop Samra, another student pharmacist in the Class of 2025, stated: “This is a team effort. We must collaborate with other healthcare professionals to ensure coordinated care. Aspiring pharmacists should also remember that a career in pharmacy is a lifelong educational journey — pharmacists need to engage in professional development and stay up to date on the latest drug developments, evidence-based practices, and guidelines.”