Giants of MS Awards Recognize Pharmacist’s Contributions to the Field

In an interview with Pharmacy Times, Jacqueline Bainbridge, PharmD, BSPharm, FCCP, MSCS, FAES, from the University of Colorado, discussed what it meant to one of the recipients of the 2024 Giants of MS awards. Bainbridge said she believes pharmacists will play a growing role in multiple sclerosis care, and neurology more broadly.

"I want to encourage more and more pharmacists to go into neurology practices, specifically multiple sclerosis."

Q: Can you give a little background on what you do in pharmacy?

Jacqueline Bainbridge, PharmD, BCPharm, FCCP, MSCS, FAES: Sure, so I'm Jacqueline Bainbridge, otherwise known as Jacci Bainbridge, and I am a professor at the University of Colorado and have a shared position in the School of Pharmacy, and then in the Department of Neurology in the School of Medicine. I created a residency after my pharmacy program in neurology, spending time learning how to kind of framework or mold a practice with other people that were also working in neurology, and there's not very many of us. And then I created my position at the University of Colorado in the Skaggs School of Pharmacy and Pharmaceutical Sciences, in neurology specifically. So, I see research patients, obviously one of my biggest goals is teaching, so I'm in the classroom and I teach all the neurology and psychiatry in the spring semester for our students. And then we also see patients in neurology clinic, so multiple sclerosis, epilepsy, Huntington disease, movement disorders, and so forth. So, yeah, we kind of cover the gambit of things and the way that I am, I've always wanted to continue to give back. So, I have 2 fellows that I pay for through clinical research grants and we take students on rotation, obviously, under my hat as a professor. So, that's it.

Q: How did you become interested in neurology?

Bainbridge: Well, it’s a very long story. But I had neurologic conditions in my family, so my mother had MS and then my father had a stroke early on, and seizures as a result of that stroke, which is very common. So, I really was passionate about the brain and the fact that many people really didn't understand drug–drug interactions with neurologic agents—and I'm talking about my counterparts in the US, health care providers just didn't understand it as well. And it kind of was difficult. So, because we didn't have a lot of knowledge about the interaction piece of neurological agents and other medications that patients trade traditionally, I really felt passionate about wanting to grow that field. I started with critical care, I guess I should say that, and I covered all aspects of critical care, surgery, medicine, and also neurology. So, that's how I really learned that many people lacked an understanding of how to use on medications in that population, so I was very passionate about it. And I did a lot a lot of my early work in clinical trials, and I've done a lot of work in advanced age and epilepsy, as well.

Q: Where do you see such an important role for pharmacists in neurology, with both clinical roles as well as educating patients and providers?

Bainbridge: One thing that I can say about that is we definitely are hiring. It has taken me so long to actually have the hospital department realize that we needed a neurology expert in the ambulatory care clinics. And as of like 4 years ago, they hired their first person who was perfect for that role because she did a fellowship with me, so she was very well educated in neurologic conditions and neurology. So, she fit in and she mainly covers the MS clinic. She works with the headache group as well and some other areas in neurology, so I'm very excited about that.

And what I see now is our [disease-modifying therapies] have become so much more complex, that we use the drugs that we use as our mainstay practice for multiple sclerosis. And many pharmacists are hired into those roles in the MS clinics, because of the complexity of our disease-modifying therapies, the interactions, and the fact that there's a lot of bad things with those medications. But they're not training in neurology at all, so it's all kind of on-the-job training and other health care providers kind of saying, “This is why you need to do that.” So, I guess my goal is to create some smaller training program for pharmacists that are hired into the multiple sclerosis clinics and give them some support and background. And we really started that work with PharMS. So, PharMS is our special interest group, or SIG, through CMSC, and actually one of my fellows and I are the ones that coined that name. So, at least it's a place for pharmacists to go and have support in the MS clinic, so we're hoping to grow that to a bigger entity through CMSC.

Q: You recently received the Giants of MS award at the 2024 Centers for Multiple Sclerosis Care Annual Meeting. How did that feel to be so recognized by your colleagues?

Bainbridge: It was amazing, so amazing. So, I was on the committee for the first couple awards, and it was so, so amazing to pick the pharmacists that preceded me with that particular award. So, I'm very honored. I mean, for me, I think right now I have 2 of our pharmacy Bibles that I'm the lead author on those book chapters about multiple sclerosis. So, this has really been my lifelong journey and work, so it was amazing. I mean, it was very emotional for me.

Q: How do you see the future landscape of MS changing, with so many new therapeutic options?

Bainbridge: It's really kind of exciting about all the new agents and the role of pharmacists. So, because we're learning a lot more about DMTs and maybe we're not just looking at the parent molecule, but we're looking at metabolites of those molecules. And, again, there are many more agents in the pipeline and we've got to deal with biosimilars now, so how do you actually approach that from a formulary standpoint? And then managing patients in the clinic. So, I see the role of pharmacists as just evolving and continuing to grow in the neurology space and, very importantly, the multiple sclerosis space.

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Q: How do you see the role of pharmacists changing?

Bainbridge: I think that they're just going to become more powerful and more valuable in the MS clinic, both on the outpatient ambulatory care side as well as the inpatient side, and then in the infusion centers. That's another huge role for pharmacists in this space, and not just ordering a medication or making sure that it's ordered, but monitoring to make sure the infusion is appropriate for the patient at the time that they're scheduled to receive the infusion. So, ordering lab values to make sure they're safe to give the infusion and then managing that, being that conduit. Some places do practice that way, but it's really important to have 1 person along with the main practitioner in communication with the patient for that shared decision-making as to safety for our MS patients. So, I think the role of pharmacists is just going to expand. And also on the education side, so many schools of pharmacy don't have any education or much education in the neurology space, so I think that, again, is going to take off and just evolve with the future.

Q: Is there anything you’d like to add?

I want to encourage more and more pharmacists to go into neurology practices, specifically multiple sclerosis. You know, all the neurologic areas are just robust with new agents and the pipeline is just gangbusters, which is exciting. It wasn't until 1993 in MS that we had something we could actually offer patients to help to treat their disease state. So, I just want to encourage more pharmacists to get involved and also join CMSC with us so that we can really expand our role within the organization and, you know, also the National MS Society, as well.