Improving Patient Outcomes in Thromboembolic Disorders: Focus on Anticoagulant Therapy

Wendy Cantrell, Pharm.D., BCPS, CACP, is Assistant Professor of Pharmacy Practice at the University of Southern Nevada College of Pharmacy and Cardiovascular Clinical Pharmacy Specialist at University Medical Center in Las Vegas, Nevada. Dr. Cantrell earned her Doctor of Pharmacy degree at the University of Arizona and completed a pharmacy practice residency at the VA Medical Center in Tucson, Arizona. She is a board-certified pharmacotherapy specialist and certified anticoagulation care provider.

Dr. Cantrell is also Pharmacy Practice Residency Director at University Medical Center (UMC) and Clinical Assistant Professor at the University of Nevada School of Medicine. She serves as Co-Director of the Anticoagulation Clinic and rounds daily with the UMC cardiovascular service.

Dr. Cantrell is a member of the American Society of Health-System Pharmacists and the American College of Clinical Pharmacy. She has lectured extensively on the topics of acute coronary syndrome and venous thromboembolism.

Paul P. Dobesh, Pharm.D., FCCP, BCPS (AQ Cardiology), is Associate Professor of Pharmacy Practice at the University of Nebraska Medical Center in Omaha, Nebraska. Dr. Dobesh earned both his Bachelor of Science in Pharmacy and Doctor of Pharmacy degrees from South Dakota State University. He completed a specialty residency in internal medicine at the University of Texas at Austin at Brackenridge Hospital.

Dr. Dobesh’s current responsibilities at the University of Nebraska Medical Center (UNMC) include clinical practice in both internal medicine and cardiology services. He is responsible for teaching pharmacy and medical students, as well as residents. He lectures about ischemic heart disease, antithrombotic therapy, and other cardiology and critical care topics. Dr. Dobesh recently received the UNMC College of Pharmacy Educator of the Year Award.

Dr. Dobesh has conducted research on antiplatelet and antithrombotic therapy, focusing on the real-world use of these therapies and health-care economics. He has also published book chapters and several manuscripts in this field.

William E. Dager, Pharm.D., FCSHP, FCCP, FCCM, is a board-certified pharmacotherapy specialist who currently holds three academic positions. He is Clinical Professor of Pharmacy at the University of California, San Francisco (UCSF) School of Pharmacy and Clinical Professor of Medicine at the University of California, Davis (UC Davis) School of Medicine. He also serves as Clinical Professor at the Touro School of Pharmacy in Vallejo, California. As a clinical specialist at UC Davis Medical Center, he is responsible for managing difficult cases in anticoagulation, pharmacokinetics, and critical care. Dr. Dager also is clinically active with the cardiology service and serves as the director of the postgraduate year two (PGY2) residency in cardiology at UC Davis.

Dr. Dager earned his Doctor of Pharmacy degree at UCSF and completed a residency at the UC Davis Medical Center in Sacramento. In addition, he completed the University of Pittsburgh Nephrology Pharmaceutical Care Preceptorship. He is a fellow of the California Society of Hospital Pharmacists, American College of Clinical Pharmacy (ACCP), and Society of Critical Care Medicine (SCCM).

Dr. Dager's research interests focus on anticoagulation, critical care medicine, cardiovascular disease, and pharmacokinetics and pharmacodynamics. He has authored numerous articles, book chapters, and scientific reviews, and he has made numerous presentations at national and international educational conferences. He serves as a reviewer and editorial board member for several medical journals, and he currently is chair of the Editorial Advisory Board Panel on Anticoagulation for The Annals of Pharmacotherapy. Dr. Dager also is a site coordinator for the American Society of Health-System Pharmacists (ASHP) Research and Education Foundation Antithrombotic Pharmacotherapy Traineeship.

Dr. Dager has received multiple teaching and professional awards, including the 2008 ACCP Best Practice Award. He is a member of numerous organizations, including ACCP, ASHP, Sacramento Valley Society of Health-System Pharmacists, Anticoagulation Forum, International Society of Thrombosis and Haemostasis, and SCCM. He also currently serves as an instructor and regional affiliate faculty member in advanced cardiac life support for the American Heart Association.

John Fanikos, M.B.A., R.Ph., is Assistant Director of Pharmacy at Brigham and Women's Hospital (BWH) in Boston, Massachusetts. Mr. Fanikos is also Assistant Professor of Clinical Pharmacy Practice at Northeastern University and at the Massachusetts College of Pharmacy (MCP), both of which are his alma maters. He earned his Bachelor of Science degree in pharmacy at MCP and his Master of Business Administration degree at Northeastern. He completed an American Society of Health-System Pharmacists (ASHP)-accredited residency at BWH.

Mr. Fanikos has served in a number of different roles at BWH, including investigational drug pharmacist, inpatient and outpatient pharmacy supervisor, clinical preceptor, and pharmacy administrator. While fulfilling these roles, he has worked with patients on orthopedic, oncology, cardiology, and general medicine units. For the past 10 years, he has worked closely with the BWH Venous Thromboembolism Service, and he has authored and co-authored many articles on the complications of anticoagulation therapy.

Mr. Fanikos currently chairs the Voluntary Hospital Association (VHA) Northeast States Clinical Pharmacy Council. He is a member of several professional societies, including ASHP, Massachusetts Society of Health-System Pharmacists, and New England Council of Hospital Pharmacists.

Brian Grover, Pharm.D., BCPS, CACP serves as Clinical Specialist for Internal Medicine and Antithrombosis Services at the University of Maryland Medical Center in Baltimore, Maryland. He also holds an appointment as Clinical Assistant Professor with the University of Maryland School of Pharmacy. Dr. Grover earned his Doctor of Pharmacy degree at the University of Maryland and completed a Primary Care Specialty Residency at the Ralph H. Johnson VA Medical Center in Charleston, South Carolina.

Dr. Grover is Director for the PGY-1 Residency in Pharmacy Practice at the University of Maryland Medical Center and maintains an inpatient clinical practice in internal medicine as well as an outpatient practice in the Antithrombosis Clinic.

Dr. Grover is a member of the American Society of Health-System Pharmacists and the American College of Clinical Pharmacy. He has given lectures on topics related to diabetes, antithrombosis management and medication adherence. Dr. Grover’s research interests include appropriate medication use and anticoagulation management.

Michael P. Gulseth, Pharm.D., BCPS is Program Director for Anticoagulation Services at the Sanford University of South Dakota Medical Center, Department of Pharmaceutical Services in Sioux Falls, South Dakota. Dr. Gulseth received his Doctor of Pharmacy degree in 1999 from North Dakota State University in Fargo, North Dakota. He completed residency training at United Hospital in St. Paul, Minnesota. He is lead author and editor of Managing Anticoagulation Patients in the Hospital: the Inpatient Anticoagulation Service, published in 2007 by the American Society of Health-System Pharmacists.

Dr. Gulseth is a member of the Editorial Advisory Board of the American Journal of Health-System Pharmacy. Dr. Gulseth is an active member of several professional pharmacy organizations, including the American Society of Health-System Pharmacists, the Minnesota Society of Health-System Pharmacists, and the American College of Clinical Pharmacy. His research interests include evaluation of antithrombotic therapies in the inpatient setting and evaluation of the benefits of pharmacist-managed inpatient anticoagulation services.

Stuart T. Haines, Pharm.D., FCCP, FASHP, FAPhA, is Professor in the Department of Pharmacy Practice and Science at the University of Maryland School of Pharmacy in Baltimore, Maryland. Dr. Haines also serves as Clinical Pharmacy Specialist in the Diabetes Management Clinic at the West Palm Beach VA Medical Center in West Palm Beach, Florida. He is a Past-President of the American College of Clinical Pharmacy (ACCP) having served on the ACCP Board of Regents from 2002-2008 and is currently a member of the American Society of Health-System Pharmacists (ASHP) Commission on Credentialing (COC) – the body that sets standards and accredits pharmacy residency and technician training programs in the United States. He has served on numerous editorial boards including Pharmacotherapy, the Annals of Pharmacotherapy, Current Medical Research and Opinion, American Journal of Health-System Pharmacy (AJHP), the Journal of the American Pharmacists Association (JAPhA), as well as the Pharmacists' Letter.

Dr. Haines earned his Bachelor of Science in pharmacy from the Massachusetts College of Pharmacy and Allied Health Sciences and his Doctor of Pharmacy from the University of Texas at Austin. He completed a pharmacy practice residency at the Brigham and Women's Hospital in Boston as well as an ambulatory care residency at the University of Texas Health Science Center in San Antonio. He is a board-certified Pharmacotherapy Specialist (BCPS), and he is also board-certified in advanced diabetes management (BC-ADM). Dr. Haines is a fellow in the American College of Clinical Pharmacy (FCCP), American Society of Health-System Pharmacists (FASHP), and the American Pharmacists Association (FAPhA). In 2006, Dr. Haines was elected a Distinguished Practitioner in the National Academies of Practice.

Dr. Haines' scholarly interests include medication use behavior, diabetes management, women's health, cardiovascular disease prevention, and the evaluation of instructional methods.

Edith A. Nutescu, Pharm.D., FCCP, is Clinical Associate Professor of Pharmacy Practice at the University of Illinois at Chicago College of Pharmacy and Director of the Antithrombosis Center at the University of Illinois at Chicago Medical Center. Dr. Nutescu is also an affiliate faculty member at the University of Illinois at Chicago, Center for Pharmacoeconomic Research. She earned her Doctor of Pharmacy degree with high honors at the University of Illinois at Chicago College of Pharmacy. After graduation, Dr. Nutescu completed an American Society of Health-System Pharmacists (ASHP)–accredited pharmacy practice residency at Lutheran General Hospital–Advocate Health Care and a primary-care specialty residency at the University of Illinois at Chicago Medical Center.

As a clinician and educator, Dr. Nutescu has contributed extensively to the care of patients and the education of students and health care providers on topics related to cardiovascular therapeutics. The Antithrombosis Center at the University of Illinois at Chicago Medical Center, which Dr. Nutescu directs, has served as a training site and model for pharmacists and other health care providers throughout the United States and other countries, including Thailand, Hong-Kong, Japan, and Singapore.

Dr. Nutescu maintains an active clinical practice and research program. Her research and practice interests are in the areas of thrombosis, antithrombotic therapy, cardiovascular diseases, and stroke. Dr. Nutescu has authored or co-authored over 100 scientific articles, book chapters, and abstracts published in the science and medical literature and has served as a reviewer for the literature in her field. She has lectured extensively both nationally and internationally on topics related to hyperlipidemia, thrombosis, stroke, and cardiovascular diseases.

Dr. Nutescu serves on the board of directors of the Anticoagulation Forum, and she was nominated to serve on the steering committee for the National Quality Forum and the Joint Commission - National Consensus Standards for the Prevention and Care of Venous Thrombosis.

Darryl S. Rich, Pharm.D., M.B.A. FASHP, is a surveyor for The Joint Commission in the hospital, home care, and ambulatory accreditation programs. In addition, he serves as an internal resource and external representative for The Joint Commission on various issues related to pharmacy and medication management. He previously served as Associate Director for Surveyor Management and Development at the Joint Commission for 11 years. Dr. Rich has been with The Joint Commission since January 1993.

Dr. Rich received his Doctor of Pharmacy degree from the University of California at San Francisco and a Master's degree in Business Administration in Health Care Management from Bryant University in Smithfield, Rhode Island. He also completed a residency in hospital pharmacy accredited by the American Society of Health-System Pharmacists (ASHP) at Rhode Island Hospital in Providence. Before coming to The Joint Commission, Dr. Rich was National Director of Pharmacy Services for Critical Care America, a national home infusion company. He also served as Director of Pharmacy Services at Boston University Medical Center and Clinical Assistant Professor of Pharmacy at Northeastern University in Boston, Massachusetts.

Dr. Rich is an active member and fellow in ASHP and a past president of the New England Council of Health-System Pharmacists. He has received numerous awards, including the 2000 Cheers award by the Institute for Safe Medication Practices, as well as a Certificate of Appreciation from the ASHP Board of Directors in 2004 for his work in medication safety at The Joint Commission.

Dr. Rich has over 500 invited professional presentations and 74 publications in refereed journals, including eight books and four video series.

Sarah A. Spinler, Pharm.D., FAHA, FCCP, BCPS, is Professor of Clinical Pharmacy in the Department of Pharmacy Practice and Pharmacy Administration at the Philadelphia College of Pharmacy, University of the Sciences in Philadelphia. She is also an adjunct faculty member in the Cardiovascular Division in the Department of Medicine at the University of Pennsylvania.

Dr. Spinler received her Bachelor of Science and Doctor of Pharmacy degrees from the University of Minnesota in Minneapolis. She completed a pharmacy residency and fellowship in cardiovascular critical care pharmacy at the University of Illinois at Chicago, and she is a board-certified pharmacotherapy specialist with added qualifications in cardiology. She serves as a preceptor to pharmacy students and performs clinical research at the Hospital of the University of Pennsylvania, coronary intensive care unit.

Dr. Spinler is a member of the steering committee for the CRUSADE Registry, a national quality improvement initiative designed to increase the practice of evidence-based medicine for patients hospitalized with acute coronary syndrome (ACS). She has authored more than 100 research articles, reviews, and book chapters in the area of antithrombotic therapy, and in 2004 she was awarded the American Society of Health-System Pharmacists (ASHP) Award for Sustained Contributions to the Literature of Pharmacy Practice. Dr. Spinler serves on the editorial boards of several biomedical journals, including The Annals of Pharmacotherapy, Pharmacotherapy, and American Journal of Managed Care.

Dr. Spinler was appointed to the Council of Experts for the United States Pharmacopeia (USP) for a five-year term beginning in 2005, serving as the chair of USP’s Cardiology Expert Committee. As an USP Expert Committee Chair, she also serves on the Medicare Model Guidelines Committee. She is a fellow of the American College of Clinical Pharmacy (ACCP) and served as a Regent of ACCP between 2004 and 2007. Dr. Spinler is also a member of ASHP.

Zachary A. Stacy, Pharm.D., BCPS, is Associate Professor of Pharmacy Practice at the St. Louis College of Pharmacy. Dr. Stacy earned his Bachelor of Science degree in chemistry and biology from Blackburn College and his Masters in Chemistry degree from Southern Illinois University in Edwardsville. He then went on to complete his Doctor of Pharmacy degree at the St. Louis College of Pharmacy and a specialty residency in internal medicine at St. Luke’s Hospital in Chesterfield, Missouri. He is a board-certified pharmacotherapy specialist.

Dr. Stacy’s didactic responsibilities include ischemic heart disease, hyperlipidemia, acute coronary syndrome, heart failure, peripheral arterial disease, and venous thromboembolism. His primary research interests include prevention of venous thromboembolism and peripheral arterial disease. He also maintains a clinical practice on the internal medicine and cardiology services at St. Luke’s Hospital in Chesterfield.

Toby C. Trujillo, Pharm.D., BCPS, is Associate Professor of Clinical Pharmacy at the University of Colorado - Denver, School of Pharmacy in Aurora, Colorado. He also serves as a Clinical Specialist in cardiovascular pharmacotherapy and anticoagulation at the University of Colorado Hospital.

Dr. Trujillo earned his Bachelor of Science degree in biochemistry from the University of California, Davis and his Doctor of Pharmacy degree from the University of California, San Francisco, where he also completed a residency in pharmacy practice. Dr. Trujillo completed a fellowship in cardiovascular pharmacotherapy at The University of Arizona, and he is a board certified pharmacotherapy specialist with added qualifications in cardiology.

Dr. Trujillo's current responsibilities at the University of Colorado Hospital include providing clinical pharmacy services to cardiology, as well as directing the inpatient anticoagulation program. He also serves as co-chair of the anticoagulation subcommittee of P and T. Dr. Trujillo currently serves as a preceptor to both pharmacy students and residents. Lectures topics at the School of Pharmacy include ischemic heart disease, antithrombotic therapy, and other cardiology and critical care topics.

Dr. Trujillo was recently appointed to the Clinical Pharmacology Committee, which resides under the Council on Clinical Cardiology within the American Heart Association. Dr. Trujillo has also served a number of committees within the American College of Clinical Pharmacy, served as a speaker on numerous occasions on a national level, and authored several papers/book chapters in the area of cardiovascular pharmacotherapy. In addition to being a member of ASHP, Dr. Trujillo helped develop current standards for PGY2 cardiology residency training programs.

Ann K. Wittkowsky, Pharm.D., CACP, FASHP, FCCP, is Clinical Professor of Pharmacy at the University of Washington School of Pharmacy and Director of Anticoagulation Services at the University of Washington Medical Center. As a clinician and educator in the field of antithrombotic pharmacotherapy, she has contributed extensively to the care of patients and the education of health care providers regarding antithrombotic pharmacotherapy. She is the author of over 100 scientific papers, book chapters and abstracts, and co-editor of the textbook Managing Oral Anticoagulation Therapy: Clinical and Operational Guidelines. She has lectured widely throughout the United States and Canada, maintains an active clinical research program, and is board certified as an anticoagulation care provider.

Dr. Wittkowsky serves as an editorial board member for Pharmacotherapy and the Journal of Thrombosis and Thrombolysis, as a reviewer for numerous medical and scientific journals, and as a member of the board of directors of The Anticoagulation Forum, a multidisciplinary organization of anticoagulation care providers. She is the director of the Northwest Anticoagulation Consortium, a preceptor for the ASHP Research and Education Foundation’s Antithrombotic Pharmacotherapy Traineeship, and a member of the American College of Chest Physicians’ 8th Conference on Antithrombotic and Thrombolytic Therapy.