UNC Researchers Awarded Emerging Challenges Grants

In a joint effort between the UNC School of Medicine Office of Research, the UNC Medical Center, and the NC Translational and Clinical Sciences (NC TraCS) Institute, two groups of researchers have been awarded two $50,000 Emerging Challenges in Biomedical Research (ECBR) grants.

“The UNC School of Medicine and UNC Health care are dedicated to piloting and adopting innovative initiatives to provide the best health outcomes for the people of North Carolina and beyond,” said Blossom Damania, PhD, UNC School of Medicine vice dean for research, member of the UNC Lineberger Comprehensive Cancer Center, and professor of microbiology and immunology. “These grants are part of a much larger effort at the school and across the health care system to understand and meet the individual health care needs of patients and foster collaborations between the UNC School of Medicine and the health care system”

One group, led by Jill Bates, PharmD, a clinical oncology precision medicine pharmacist in the Department of Pharmacy at the UNC Medical Center, member of the UNC Lineberger Comprehensive Cancer Center, and associate professor of clinical education at UNC Eshelman School of Pharmacy, will evaluate a new approach to using pharmacogenomics data in clinical settings. Another group of researchers, led by Alison Stuebe, MD, associate professor of obstetrics and gynecology at the UNC School of Medicine, and Ana Whitney, MS, population health project manager at UNC Health Care, will focus on various social determinants that affect maternal health throughout pregnancy and the first two years of motherhood.

Pharmacogenomics encompasses how a person’s genetic makeup affects their response to therapeutics. The goal is precision medicine: to develop drugs and doses tailored to individuals for optimal positive effect. Currently, the standard of care is to obtain pharmacogenomics testing when a medication is needed. Typically this includes pharmacogenomics data for a single medication, which is not necessarily available at the time a patient needs the drug. Creating a system in which pharmacogenomics data are accessible when doctors prescribe a drug may optimize medication outcomes. Evidence is mounting to support a pre-emptive approach where experts genotype multiple pharmacogenes collectively and in advance of medication needs.

Bates’s team will conduct research to critically evaluate the feasibility, adoption, and acceptability of pre-emptively obtaining pharmacogenomics data and using these data to provide clinical decision-making support and to create educational tools to guide the prescription of medications. Additionally, the researchers will examine the effectiveness of an educational strategy to support leukemia and gastrointestinal oncology providers who care for patients that obtain pharmacogenomics results as part of this evaluation.

Co-investigators are William Kim, MD, associate professor of medicine at the UNC School of Medicine and UNC Lineberger member; Tim Wiltshire, PhD, associate professor and director of the Center for Pharmacogenomics and Individualized Therapy at the UNC Eshelman School of Pharmacy; John Valgus, PharmD, assistant director of pharmacy at the UNC Medical Center; and Scott Savage, PharmD, regional director of pharmacy at the UNC Medical Center and Chatham Hospital.

“A key element of accelerating the pace of moving research from bench to bedside is engagement of multidisciplinary teams in the research,” said Ian Buchanan, MD, MPH, senior vice president of operations and chief research officer at UNC Health Care. “The UNC Medical Center is excited to co-sponsor these grants that encourage investigators from all types of health professions to work together to advance science and improve patient care.”

In the second ECBR pilot grant, Stuebe and Whitney’s team will work to improve the care of new mothers and their babies before birth and during the first two years of the child’s life.

The 1,000 days from conception to two years of age is a critical window for health and wellbeing for mothers and children. During this period, nutrition, chemical exposures, and social contexts interact with genetic traits and epigenetic processes to set health trajectories for life for both mother and child. Maternity care, then, is a critical window for personalized medicine to impact health across two generations. Social determinants of health (SDoH) are critical drivers of maternal and infant health outcomes.

Although recommended by the American College of Obstetrics and Gynecology and the American Academy of Pediatrics, screening and mitigating determinants has not been systematically incorporated into health care during the 1,000 Days. Incorporating assessment of these complex and multifaceted issues into clinical care is challenging. Patient-centered care – including trained health team members who conduct culturally tailored assessment and facilitate shared decision-making – is essential to assess and address these sensitive issues before wide-scale adoption. To address this unmet need, Stuebe and Whitney’s research team will engage patients and key stakeholders to form a strategy for implementing Epic@UNC’s new SDoH module in maternity care to assess and manage the delivery of precision health care across the UNC Health Care system.

Co-investigators are Kim Young-Wright, population health solutions coach at UNC Health Care; Kristin Tully, PhD, research associate at the Carolina Global Breastfeeding Institute at the UNC Gillings School of Global Public Health; Sarah Verbiest, DrPH, director of the Jordan Institute for Families at the UNC School of Social Work and executive director of the Center for Maternal and Infant Health at the UNC School of Medicine; and Katherine Bryant, MA, program manager for the Center of Maternal and Infant Health.

Media contact: Mark Derewicz, 984-974-1915, mark.derewicz@unchealth.unc.edu