World Health Day
Nicole Tsao, PhD, MSc, BSc Pharm
It is exciting and somewhat nostalgic to be invited to write this guest blog post in recognition of World Health Day for the CAPT blog. I must admit, prior to now I had thought little about what World Health Day meant. To me, it was just any other day of the year. Then I realized, this is in fact still true. World Health Day in my ‘world’ as a pharmacist and pharmacoepidemiologist, is every day of the year. Every day I go to work and investigate the safety of medications to strive for ensuring that treatments are keeping us healthy and not causing us harm.
When I was a pharmacy intern in Vancouver, I often saw patients who started new drugs come in days later asking whether a new symptom they are experiencing was due to the medication. In some cases, these symptoms were very common – nausea, diarrhea, your garden variety side effects – but sometimes they could be very odd or potentially dangerous. I think that as a clinician or health researcher, we are taught at early stages of our career that randomized controlled trials are the gold standard. While this remains true under specific contexts, there are many safety outcomes in vulnerable or rare populations where randomized trials of pharmacotherapy are just not feasible.
During my PhD studies from 2014 to 2018 at the University of British Columbia, co-supervised by Dr. Mary De Vera and Dr. Larry Lynd who both introduced me to CAPT, I examined whether biologic drugs, used in a number of rheumatic diseases, are harmful to pregnant women and their fetuses. This was one such scenario where the research questions were only answerable using observational pharmacoepidemiological studies given that pregnant women are routinely excluded from clinical trials.
Before starting my PhD, little did I know that there was a whole community of scientists, academics, clinician-researchers, consultants, who were all just like me. CAPT was where I found like-minded colleagues and a broader research community, which was something I treasured given that I spent most of my time tucked away in the Western-most province of the country. I was the first CAPT board member-at-large student representative and served on the board for years 2015 and 2016. I think that CAPT represents this sweet spot, an intersection between pharmacoepidemiology, health economics, health policy, and clinical decision making. It is not common to have a board, and wider community, composed of individuals from all different sectors, and I think that is what makes CAPT unique. As a student representative, I not only learned a lot but also had a lot of fun. CAPT supported students and postdocs in networking initiatives and social events, which allowed us to get to know not just our fellow trainees but also our mentors.
Since graduating from PhD in August 2018, I have made my way to the East Coast to Boston, Massachusettes where I now spend my days at the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital and Harvard Medical School (www.drugepi.org) It has been an exciting transition to come here for my postdoctoral fellowship, which is supported by the Canadian Institutes of Health Research. Here at Harvard, I continue my work in assessing the safety of chronic disease medications in pregnant women and their offspring, and work with an excellent team in the Harvard Program of Perinatal and Pediatric Pharmacoepidemiology (H4P, www.harvardpreg.org).