Faculty Spotlight: Susan Blalock
Susan Blalock is a researcher with a passion for community pharmacy.
After earning her undergraduate degree in pharmacy from the University of Michigan in 1976, she worked off and on as a community pharmacist for more than a decade before completing her graduate education. She says her own experience behind the counter helped develop her passion for the role of community pharmacists once she entered the research field.
Blalock, a faculty member in the UNC Eshelman School of Pharmacy’s Division of Pharmaceutical Outcomes and Policy, focuses much of her research on how community pharmacies work with patients on issues such as illness prevention and disease management.
“I think that community pharmacists have an incredible amount of potential to improve drug-therapy outcomes by working with patients because they are in regular and continuous contact with patients,” she explains.
Cutting Down on Falls
Currently, Blalock is involved with two research projects that have community pharmacy at their core. One of these projects, which is being conducted in collaboration with Kerr Drug, focuses on using enhanced pharmaceutical care to prevent falls in older adults. Stefanie Ferreri, PharmD, and Mary Roth, PharmD, serve as co-investigators on the project, which is funded by the Centers for Disease Control and Prevention through the UNC Injury Prevention Research Center.
Falls are currently the leading cause of fatal and nonfatal injuries among adults age sixty-five and older in the United States. While some studies suggest that reducing inappropriate medications can reduce the risk of falls in patients, the impact of modifying medications alone is unknown.
In the falls project, Blalock and colleagues identify adults sixty-five and older who have fallen in the past year and who are at increased risk for recurrent falls based on the medications they are taking.
“It’s an intervention study where we’re actually having community-pharmacy residents deliver the intervention,” says Blalock, who is the project' s principal investigator. “The pharmacy resident contacts the people and asks them to come in for a medication review. It’s very similar to medication therapy management but really focused on falls prevention.”
The pharmacist works with the patient and the patient’s physician to identify any drug-therapy problems that might increase the risk of falls, Blalock says. This includes discontinuing high-risk medications and substituting lower-risk medications where appropriate.
Blalock says the goal of the project is to reduce the number of falls patients experience by better using community pharmacists to manage patient medications. At present the project is still underway, so the full impact of the study is not known.
Blalock is also involved in a study that aims to increase the rates of pneumonia immunization among high-risk individuals by involving community pharmacists. Ferreri is the principal investigator of the project and Dennis Williams, PharmD, is a co-investigator. The project is funded by a grant from the Centers for Disease Control and Prevention.
Study investigators are working with Kroger pharmacies to increase rates of immunization for pneumonia among high-risk individuals with certain chronic conditions, including cardiovascular disease, diabetes, and pulmonary disease. Patients are identified based on their medications and are flagged in the pharmacy’s profile system.
When flagged patients visit the pharmacy, the pharmacist counsels them about pneumonia, and offers to immunize them.
“The goal of this project is to educate the public about the importance of the pneumococcal vaccine,” Ferreri says. “Pharmacists are ideal health-care professionals to do this because they know the diseases that place these patients at risk. Pharmacists have access to patients’ medication records, which is very telling of what disease they may have. Also, North Carolina pharmacists are now able to immunize patients for pneumococcal disease if the patients have a prescription from their doctor.”
Counseling and Osteoporosis
A third study Blalock was involved with examined patient knowledge regarding glucocorticoid-induced osteoporosis. This study involved 227 patients currently taking oral prednisone, which increases the risk of developing osteoporosis. The questions assessed patients’ current calcium and vitamin D intake and their history of bone mineral density (BMD) testing.
Blalock found that only a third of the participants reported receiving osteoporosis-prevention counseling. Just over half of the participants were getting the recommended amount of calcium, and even fewer were getting the recommended amount of vitamin D or had received a BMD test within the past year.
Although not conducted in a community pharmacy setting, Blalock says the study’s findings have important implications for community pharmacists.
“[The results] basically underscore the point that patients appear not to be receiving much counseling about osteoporosis prevention,” she says. “It’s not enough to tell a person one time, because they’re not going to remember. It has to be something that is sustained, and community pharmacists are in an ideal position. They can see people when they come in and are on chronic prednisone therapy. They’re in an ideal position to ask people if they’re taking calcium or Vitamin D and, depending on their relationship, also to inquire about BMD testing.”