Five Questions With: E. Paul Larrat

E. Paul Larrat, a respected professor, epidemiologist, and health policy and health economics analyst, has been named dean of the University of Rhode Island’s College of Pharmacy. He served as interim dean of the college since February 2013. An alumnus of the university, he holds a doctorate in epidemiology from Brown University, and two graduate degrees from URI.

PBN: You have worked in very diverse environments during your career, including as a NASA fellow at the Kennedy Space Center and a congressional health policy fellow in the United States Senate. How did those positions influence your work as a pharmacy professor?
LARRAT:
My motivation for pursuing the NASA experience was primarily driven by a childhood dream to be an astronaut. With a little creativity, I was able to mesh my training in epidemiology with a rooted interest in the challenges of extended space travel. My return to URI allowed for quite a bit of collaboration with my NASA associates, and some great stories to enliven my lectures!

By serving in the office of Sen. Ron Wyden, D-Ore., chairman of the Senate Finance Committee, I had hands-on exposure to creating health policy and legislation in a very challenging political climate. I was able to integrate lessons learned there into my course offerings and into developing research and service initiatives across a diverse range of disciplines. An added bonus was the creation of an extensive network of helpful colleagues and political connections.

PBN: Students attending URI’s College of Pharmacy have a pharmacy employment rate of 97 percent upon graduation. Why is pharmacy such a desirable career option and will there be a sufficient supply of pharmacists to meet the demand in the next few years?
LARRAT:
According to many industry experts, we are moving toward equilibrium in the pharmacy employment marketplace, as a result of a significant increased number of pharmacy graduates over the past decade. That said, the profession has evolved along with the entire health care industry. Pharmacy graduates are blessed with a diversity of career options where they can use their extensive scientific and clinical knowledge. More frequently, we find pharmacists outside of hospitals and retail settings, as we move to a health model that encourages home-based and community patient care.

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PBN: With the College of Pharmacy one of the top 20 college pharmacy programs receiving federal research funds, what are the College of Pharmacy’s most exciting current research initiatives?
LARRAT:
We have so many exciting initiatives under way; I’ve identified only some of them here. Our researchers are dedicated to: developing novel, laser-based approaches to transdermal drug and vaccine delivery; discovering natural products from medicinal plants offering potential as new therapies for cancer, diabetes, inflammation and Alzheimer’s disease; and developing new nanomedicines (therapies delivered by particles that are 1/1000 the width of a human hair) for cancer diagnosis and treatment.

Other research initiatives focus on: understanding how genetic and environmental factors influence the expression of genes involved in drug response and the ‘oncogenic switch’; using health information technologies to improve medication management; expanding community pharmacists’ roles in preventing opioid overdose and infectious disease; discovering new approaches to preventing, inhibiting and treating drug resistant bacteria in clinical settings; developing new approaches to treating Alzheimer’s disease and looking at the ocean as a source of novel antibiotics.

Statewide, we work with such partners as Brown, Lifespan, Care New England and the U.S. Department of Veterans Affairs to create a statewide collaborative to focus on brain health and projects that accelerate “bench to bedside” research. Our National Institutes of Health-financed IDeA Networks of Biomedical Research Excellence program continues to build our academic biotechnology infrastructure in Rhode Island.

PBN: Your initiative between the College of Pharmacy and the Rhode Island Department of Corrections has saved the state some $19 million in prescription costs since 2001. Where do the savings come from and could this program be replicated in other environments such as nursing homes, group homes or the Eleanor Slater Hospital?
LARRAT:
For more than a decade, the College of Pharmacy and the Department of Corrections have built a team-based model for pharmacy practice for inmates emphasizing coordinated medication therapy management. Corrections’ medical and nursing staff have partnered with my colleague, Professor Rita Marcoux, and me to develop evidenced-based disease treatment protocols that manage patients, using standard-of-care guidelines and practices. Many of these strategies have been a cornerstone of the private sector’s managed care pharmacy system. Other health care sectors, such as hospitals, long-term care facilities and group homes, have incorporated these practices to ensure quality of care in the most cost-effective manner.

PBN: With health care policies and practices continuing to rapidly evolve, what do you see as the most significant challenges for tomorrow’s pharmacists?
LARRAT:
I believe it will be keeping abreast – and being a part – of all the changes occurring in a rapidly evolving health care environment. The profession I entered 30 years ago is significantly different than today’s. The pace of medical treatment discoveries is accelerating, care models that “deinstitutionalize” patients as quickly as possible are being introduced and there’s greater emphasis on effectively collaborating with other health care professionals and organizations to deliver patient care. This all promises better care for the patients we serve, but will require tomorrow’s practitioners to adapt rapidly. They cannot be afraid of change.

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