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INTRODUCTION

NABP and DOB Data Collection

PULSE: 5/26/2021 - Nonconforming Healthcare: Optimal Drug Dosing and Monitoring for Transgender Patients

QUIZ

EVALUATION

CERTIFICATE

INTRODUCTION

Credit Hours: CME 1.00

Target Audience:

Who should attend:

  • Clinical faculty from the University of Pittsburgh School of Pharmacy
  • Clinical staff pharmacists employed by the University of Pittsburgh Medical Center and deployed throughout the hospital campus in unit based roles and centrally in the department of pharmacy's main pharmacy
  • Student pharmacy interns currently working within the department of pharmacy
  • Certified Pharmacy Technicians

Abstract:
The transgender community is subject to many health disparities due to structural, interpersonal, and individual stigmas. One way to combat the structural and interpersonal stigmas that exist is to enhance healthcare provider awareness of these disparities and provide utmost care to these individuals based on the available data. There is currently much uncertainty regarding drug dosing and monitoring in transgender patients due to the limited information on physiologic and pharmacokinetic changes that occur during the transitioning process. The purpose of this presentation was to review the available data regarding optimal drug dosing and monitoring for transgender patients to help clinicians make informed decisions when providing care to these patients.

Educational Objectives:

Upon successful completion of this continuing pharmacy education program, the participant should be able to:

  • Describe the health disparities present in the transgender community.
  • Explain the changes in pharmacokinetics and pharmacodynamics that can occur during the transitioning process.
  • Discuss the available literature surrounding drug dosing and monitoring strategies in transgender patients.
    • Pharmacy Continuing Education Credits
    In support of improving patient care, the University of Pittsburgh is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
    Pharmacy (ACPE): This knowledge-based activity provides 1.0 contact hours of continuing pharmacy education credit. The assigned universal program number(s) is JA4008223-0000-23-094-H01-P

    .

    Other Healthcare Professionals Other health care professionals will receive a certificate of attendance confirming the number of contact hours commensurate with the extent of participation in this activity. 

Suggested Additional Reading:

  1. Roberts TK, et al. Barriers to quality health care for the transgender population. Clinical Biochemistry. 2014; 47(10):983-987.
  2. Centers for Disease Control and Prevention. Health Considerations for LGBTQ Youth – Terminology. 2021. Available at: Terminology | Adolescent and School Health | CDC
  3. Meerwijk EL, et al. Transgender Population Size in the United States: a Meta-Regression of Population-Based Probability Samples. Am J Public Health. 2017 Feb; 107(2):e1-e8.
  4. American Medical Student Association. Transgender Health. 2021 May. Available at: Transgender Health – AMSA
  5. White Hughto JM, et al. Transgender Stigma and Health: A Critical Review of Stigma Determinants, Mechanisms, and Interventions. Soc Sci Med. 2015 Dec; 147:222-231.
  6. Safer JD, et al. Barriers to Health Care for Transgender Individuals. Curr Opin Endocrinol Diabetes Obes. 2016 Apr; 23(2): 168-171.
  7. UCSF Transgender Care. Transition Roadmap. 2021 Apr. Available at: Transition Roadmap | Transgender Care (ucsf.edu).
  8. Hembree WC, et al. Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2017 Nov; 102(11):3869–3903.
  9. Fernandez JD, et al. Metabolic effects of hormone therapy in transgender patients. Endocr Pract. 2016 Apr; 22(4):383-388.
  10. Chu T, et al. Gender Differences in Pharmacokinetics. US Pharm. 2014;39(9):40-43.
  11. Whitley HP, et al. Sex-Based Differences in Drug Activity. Am Fam Physician. 2009 Dec; 80(11):1254-1258.
  12. Giltay EJ, et al. Effects of sex steroids on plasma total homocysteine levels: a study in transsexual males and females. J Clin Endocrinol Metab. 1998 Feb; 83(2):550-553.
  13. Roberts TK, et al, Interpreting laboratory results in transgender patients on hormone therapy. Am J Med. 2014 Feb; 127(2):159-62.
  14. Webb AJ, et al. Implications for medication dosing for transgender patients: A review of the literature and recommendations for pharmacists. Am J Health-Syst Pharm. 2020 Mar; 77(6):427-433.

Authors:
Erin McMahan, PharmD — PGY1 Resident, UPMC Presbyterian
No relationships with industry relevant to the content of this educational activity have been disclosed.
No other members of the planning committee, speakers, presenters, authors, content reviewers and/or anyone else in a position to control the content of this education activity have relevant financial relationships with any companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

This activity is approved for AMA PRA Category 1 Credit™

The University of Pittsburgh is an affirmative action, equal opportunity institution.