PharmSci grad gains range of experiences in pharmacoepidemiology research

Natalia Konstantelos completed a bachelor of science with a specialist in biomedical toxicology in the department of pharmacology and toxicology at U of T. She then started a PhD in pharmaceutical sciences at the Leslie Dan Faculty of Pharmacy with Associate Professor Suzanne Cadarette, where she used health care administrative databases to examine outcomes of osteoporosis medications.

During her time at the Faculty, Konstantelos was involved in student groups, including serving as chair of the Graduate Research in Progress (GRiP) committee and president of the U of T chapter of the International Society for Pharmacoepidemiology.

Konstantelos shared her experiences at the Leslie Dan Faculty of Pharmacy and how her education will help her future career.

Why did you decide to pursue a PhD at the Leslie Dan Faculty of Pharmacy?

During my bachelor’s degree in biomedical toxicology, I learned about the adverse drug events that are identified after clinical trials and once drugs are on the market. Specifically, I remember learning about the famous example of thalidomide, which caused birth defects in the children of women who took it while pregnant. It was really these classes and this program that piqued my interest in the importance of evaluating drug effectiveness and safety even after a medication has been approved by Health Canada. I decided to start a PhD focused on pharmacoepidemiology so that I could eventually pursue a career in this field.

While looking for a PhD supervisor, I became very interested in Professor Cadarette’s research that uses health care administrative data to evaluate the effectiveness of osteoporosis medications. I wanted to learn more about different study designs and methods to evaluate drug safety and effectiveness.

What was your PhD research about?

My PhD research was in pharmacoepidemiologic research methods, specifically looking at using Ontario’s health care administrative data to identify outcomes of osteoporosis medications.

Ontario’s health care administrative data are typically used for billing in our publicly funded health care system, but these health records can also be repurposed to identify drug outcomes of interest in drug safety and effectiveness research. However, there are no standardized definitions to identify fracture outcomes in observational research studies, and using different outcome definitions may impact study results. As such, identifying drug outcomes using valid and accurate definitions is critical.

My PhD research used a cohort of patients at high risk for fracture and aimed to determine whether using different fracture definitions resulted in differences in fracture outcome identification. In the end, I found that the fracture definition used is very important – the number of fractures identified varies greatly depending on the definition used. This may have implications on future osteoporosis medication study results and conclusions. (This research was published in the journal Pharmacy.)

What were some of the highlights of your time at the Leslie Dan Faculty of Pharmacy?

Beyond all the research at the Faculty, some of the most memorable moments included attending our student group seminars and the GRiP Symposium every year. These events were great opportunities to learn about all the amazing and diverse research happening at the Faculty. They also enriched my own work by allowing me to learn about other students’ research.

What have you valued most about your education at the Leslie Dan Faculty of Pharmacy?

Completing my PhD at the Leslie Dan Faculty of Pharmacy provided me with a diverse set of learning and training opportunities. Of course, my PhD thesis set the foundation for my learning, but I also had wonderful opportunities to work with professors and fellow PhD students from other labs within the Leslie Dan Faculty of Pharmacy, including Tara Gomes, Mina Tadrous and fellow PhD candidate Lara Chayab.

By having the opportunity to collaborate and work with other students and professors, I was able to broaden my skillset and learn about additional research areas outside of my own PhD, including access to medications for Hepatitis C across Ontario, impact of COVID-19 on Hepatitis C medication prescribing rates, impacts of drug shortages on drug utilization and the cost-effectiveness of medications for non-small cell lung cancer.

How will your education at the Leslie Dan Faculty of Pharmacy help in your new career?

The education and opportunities I had while at the Leslie Dan Faculty of Pharmacy have provided me with a great foundation for my career. Professor Cadarette is truly a leader in osteoporosis drug effectiveness in Canada and it has been an honour to work with her. Not only did I have an amazing supervisor, but I was also able to work with other professors within the Faculty, which gave me broad exposure to other research areas within pharmacoepidemiology.