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As hospitals and clinics across the country tried to navigate the early days of the COVID-19 pandemic, so much was happening in such a short time. Pharmacists, including Erin McCreary, a 2015 graduate of Harrison College of Pharmacy, and other healthcare workers have worked tirelessly to identify treatments for struggling patients.
Never one to be afraid of “work, hard work,” McCreary did not sit idly by. Asking questions at a crucial time, she assumed a critical leadership role within the hospital system and became a key resource in pharmacy circles across the country for COVID-19 treatment and protocols.
An infectious disease pharmacist and director of Stewardship Innovation, Infectious Disease Connect with the University of Pittsburgh Medical Center, or UPMC, as well as a clinical assistant professor of medicine at the University of Pittsburgh School of Medicine, McCreary has noticed some trends in orders. the pharmacy. With so much information going through her system, she stepped up and volunteered to coordinate the summarization and cataloging of information going through the pharmacy.
Just by asking the question, she has become a critical leader in the health system’s approach to COVID-19.
“This led to the first draft of our first COVID-19 treatment guideline. We began to implement systems and protocols and IT support across the entire health care system: rural, critical access hospitals, community and academic and urban areas. They were all operating under the same oversight, which was our committee,” McCreary said.
“I went from sort of being a pharmacist in a hospital to being a pharmacist in charge of the system for all COVID-19 therapies, basically asking if someone was writing a basic guideline.”
As pharmacists and doctors learned more about COVID-19 and ways to fight the disease, monoclonal antibodies became an important tool in the treatment of people infected with COVID-19. Designed for use in people who are already infected, the monoclonal antibodies seek out and attach to the spike protein that comes out of the coronavirus that causes COVID-19. When monoclonal antibodies attach to the spike protein, they can block the ability of the virus to enter cells and slow infection.
With this breakthrough treatment, McCreary has once again stepped in to lead the charge and is the lead pharmacist for UPMC’s Monoclonal Antibody Network. When antibody treatments received emergency use authorization in November 2020, McCreary and his team shifted their work from inpatient to outpatient, using their network to treat as many patients as possible.
“Monoclonal antibodies are very effective, but they’re logistically difficult to reach patients, and it takes a whole village of people to coordinate that,” she said.
Their success has not gone unnoticed. Soon the White House called to find out exactly what they were doing at UPMC.
“They said, ‘We’ve invested in all of these drugs, and people aren’t using them and you seem to have figured out how to use them, we want to help you do more,'” McCreary recalled. from an incredible team of people, we were able to go from treating approximately 3% of all eligible patients to 35% of all eligible patients in just a few short months, which is a really, really huge increase. access and something we are very proud of.
The leadership and determination shown by McCreary during such a critical time illustrates why she was selected as the winner of the Young Alumni Achievement Award by the Auburn Alumni Association.
“I’m so humbled and humbled to receive this award, it still doesn’t feel real,” McCreary said. “I am so proud to represent pharmacists and to represent women. Admittedly, it’s a bit strange to celebrate work related to COVID-19 since the pandemic has been such a horrifying experience in so many ways; however, when I step back and reflect more on the systems we’ve built, the ways we’ve collaborated, the patients we’ve helped, and the path for future young female scientists, I’m so proud and this award recognizes a way forward for so many other future leaders to continue this work and make it even better.
McCreary is the first Harrison College of Pharmacy graduate to receive the Young Alumni Achievement Award and the second graduate in as many years to be recognized by the Auburn Alumni Association. Thanks to the valuable contributions of pharmacists, especially in the era of COVID-19, McCreary is pleased to see the spotlight shone on meaningful work within patient healthcare teams.
“Pharmacists are an essential member of every patient care team, regardless of patient location or specialty or medical condition requiring care,” McCreary said. “When we collaborate with our medical, nursing and other healthcare partners, we can truly design trials and create systems that optimize care while making wise use of resources. It’s never too early to work hard and make a difference.
For McCreary, her interest in infectious diseases began during her second year of pharmacy school in Jack DeRuiter’s class.
“Pharmacokinetics and pharmacodynamics fascinate me, and I think one of the best parts of being a pharmacist is diving into that data for different compounds, combining that knowledge with available clinical data, and optimizing the dosage to get the desired effect,” she said. “During our P2 year of ‘insects and drugs’ classes, I realized that antimicrobials were the coolest class of drugs there is. I think it’s fascinating how chemical structures relate directly to their spectrum of activity against various pathogens and adverse events that we see in patients.
Along with DeRuiter, she credits several other members of the Auburn Pharmacy family for helping her through the process. Salisa Westrick taught the optional research course where she learned how to write research papers and apply for grants, and the late Anne Marie Liles was an important faculty mentor who helped McCreary and others get started and grow. the Equal Access Birmingham interprofessional free clinic in Birmingham. She also thanks Courtney Watts Alexander and Kent Owusu, members of the HCOP Class of 2014, who taught her about residencies and involvement in professional organizations.
She also thanks Brent Fox for helping her create her first Twitter account. That account now has a blue tick next to it, boasting nearly 15,000 followers, as it has become one of the nation’s leading voices regarding the COVID-19 treatment.
After leaving Auburn, McCreary completed a two-year residency at the University of Wisconsin Health, specializing in infectious diseases during his sophomore year. Additionally, she was a member of the planning committee of the American Society for Microbiology and chair of the publications committee of the Society of Infectious Disease Pharmacists, or SIDP. She was recently elected to the SIDP Board of Directors and will complete a two-year term from 2021-23.
His practice interests include infectious diseases and antimicrobial stewardship in immunocompromised hosts, antimicrobial resistance, and pharmacokinetic/pharmacodynamic optimization of antimicrobials.
At UPMC, she chairs the COVID-19 Therapeutics Committee, which oversees the writing of guidelines and the development of order sets for all inpatient and outpatient COVID-19 treatments in 35 hospitals and eight patient records. electronic health. She is the pharmacy lead for two large adaptive randomized trials: REMAP-CAP COVID-19 and OPTIMISE-C19 and leads UPMC’s monoclonal antibody outpatient treatment network and 22 Evusheld administration clinics.
With all the data, studies and trials, McCreary is still shocked at how complex and unique COVID-19 is, making it all the more difficult to treat.
“COVID-19 is phenotypically complex, meaning it presents very differently in different patients. We see patients who have absolutely no symptoms and patients who die tragically,” she said. “It also has very heterogeneous sequelae, which means that aside from respiratory symptoms, patients can present with diseases of almost any other organ system that vary in severity.
“Finally, we are only just beginning to understand the terrible consequences of the long COVID and so we will not only try to optimize care for acute illnesses for the foreseeable future, but now we are learning how to manage patients with long illnesses. term. comorbidities associated with their infection.
Still in her first 10 years as a professional, McCreary saw her whole world change in a short time.
“COVID-19 has changed everything. Over the past two-plus years, the majority of my work and the work of many members of my teams has transitioned exclusively to COVID-19,” she said. “We have also had to learn to navigate providing clinical care and collaborating with teams almost exclusively virtually for some time, to appreciate the social and mental challenges we have all faced throughout the pandemic and to work more quickly and more ready to fully rotate plans with more changing information than ever before.
“The silver lining met people across the healthcare system, in a variety of roles, as we all collaborated to improve outcomes.”