OneFlorida researcher Steven M. Smith, Pharm.D., MPH, received a K01 Mentored Research Scientist Career Development Award from the National Heart Lung and Blood Institute to use observational research methods with large-scale electronic health record (EHR) data from the OneFlorida Data Trust to improve drug therapy selection for individuals.
“Hypertension is the leading risk factor for death worldwide, and yet for nearly half a century, prescribing drugs for patients with hypertension has been an exercise in trial and error,” said Smith, assistant professor of pharmacy in the department of pharmacotherapy and translational research in the College of Pharmacy at the University of Florida (UF). With support from the 5-year, $760,000 grant, Smith plans to use EHR data in the OneFlorida Data Trust to better understand real-world use of antihypertensive drugs and factors that influence patient responses to these drugs.
“The goal is to create prediction models for use in clinical decision support tools that will enable physicians to make personalized hypertension management recommendations based on their patients’ individual clinical profiles,” Smith said. “These personalized recommendations may ultimately lead to more efficient achievement of blood pressure control and reduced risk of drug side effects by minimizing use of ineffective or counterproductive antihypertensive drugs.”
Smith said that broad adoption and use of EHR by physicians and health systems has created opportunities for using routinely collected clinical data to inform evidence.
“By applying principles of causal inference, this data can be used to identify clinical factors that influence variations in treatment response,” he said. “These factors can be used to develop statistical models for predicting future treatment responses in individuals.”
Specific research aims of the project include (1) characterizing real-world antihypertensive drug prescribing patterns and their determinants; (2) identifying treatment effect modifiers for both effectiveness and safety of two common antihypertensive classes: angiotensin-converting enzyme inhibitors (ACE-Is) and thiazide diuretics; and (3) developing models for predicting response to ACE-Is and thiazide diuretics to maximize antihypertensive efficacy.
The National Institutes of Health established the K01 awards to support postdoctoral or early-career research scientists seeking advanced research training and additional experience. The program provides support and protected time for an intensive, supervised career development experience in the biomedical, behavioral, or clinical sciences leading to research independence.
Smith will combine his current training and experience in clinical pharmacy, public/population health, hypertension care and applied biostatistics with new training incorporating biomedical informatics, pharmacoepidemiology, multilevel modeling, and leadership to ensure the success of the proposed work and broaden his skills as a research scientist.
Smith will work closely with a multidisciplinary mentorship team led by Rhonda Cooper-DeHoff, Pharm.D., M.S., associate professor in the department of pharmacotherapy and translational research at UF and associate director of the UF Center for Pharmacogenomics. Cooper-DeHoff is also lead investigator of the OneFlorida hypertension working group, which affords trainees the opportunity to work at an epidemiologic level to explore population-level questions about hypertension. Smith’s mentorship team also includes experts in pharmacoepidemiology (Almut Winterstein, RPh., Ph.D., FISPE, professor and chair and Dr. Robert and Barbara Crisafi Chair of Pharmaceutical Outcomes and Policy in the College of Pharmacy at UF); biostatistics (Matthew Gurka, Ph.D., professor in the department of health outcomes and biomedical informatics in the College of Medicine at UF); biomedical informatics (William Hogan, M.D., M.S., professor in the department of health outcomes and biomedical informatics, director of biomedical informatics at UF’s Clinical and Translational Science Institute, director of the OneFlorida Data Trust, and a member of the OneFlorida Executive and Steering committees); clinical hypertension (Carl Pepine, M.D., professor of medicine in the department of cardiology at UF); and leadership (Anne Libby, Ph.D., vice chair for academic affairs and professor at the University of Colorado School of Medicine in Denver).