Maurice Alexander

University of North Carolina at Chapel Hill

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Trends

Author Order

Document Type

Co-Authors

J. Ryan Shaw

University of North Carolina at Chapel Hill

Philippe Alliët

Jessa Hospital

Gaston Verellen

Cliniques Universitaires Saint-Luc

Jonathan Ptachcinski

University of North Carolina Health Care

Caroline Artoisenet

CHU Dinant Godinne UCL Namur

Paul M. Armistead

University of North Carolina Health Care

Tatjana Grgic

University of North Carolina at Chapel Hill

Thomas C. Shea

University of North Carolina at Chapel Hill

Denise Deliège

UCLouvain

Marcie L. Riches

University of North Carolina at Chapel Hill

Cooperative Institutions

University of North Carolina at Chapel Hill

University of North Carolina Health Care

UNC Lineberger Comprehensive Cancer Center

University of North Carolina Hospitals

Segeberger Kliniken

Indiana University School of Medicine

Johns Hopkins University

Duke University

Duke Medical Center

Wake Forest University

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Field

Chimeric Antigen Receptor T Cell Therapy: A Comprehensive Review of Clinical Efficacy, Toxicity, and Best Practices for Outpatient Administration

Transplantation and Cellular Therapy (2021)

Maurice Alexander Kathryn A. Culos Julianna Roddy J. Ryan Shaw Christina A. Bachmeier

Chimeric antigen receptor T cell (CAR T) therapy has been integrated into treatment algorithms for acute leukemia, lymphoma, and, most recently, multiple myeloma. The number of clinical trials in both hematologic and solid tumor malignancies for new products and potential indications continues to grow. The clinical toxicities of CAR T therapy include cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome, which often warrant inpatient admission for close monitoring and treatment. Consequently, many centers have built processes around the administration of these cells in the inpatient setting. As new products gain Food and Drug Administration approval with more manageable toxicity profiles, and as institutions gain experience with the management of these toxicities, outpatient administration and monitoring should be expected. In addition, payor reimbursements for inpatient treatment have put the sustainability of inpatient CAR T therapy in jeopardy, especially for centers with a payor mix that includes a high proportion of Medicare patients. This has the serious potential to limit access to care. As the use of CAR T therapy continues to expand, changes in payment models, care settings, or both are needed to ensure the sustainability of safe, efficient, and cost-effective treatment. This review outlines the efficacy and toxicity of currently approved products, as well as best practices to optimize the management of CAR T cell therapy in the outpatient setting.

Cytokine Release Syndrome

10.1016/j.jtct.2021.01.014

Cite

Citations (53)

1122 Work Profile of Belgian Hospital Paediatricians as Assessed by the Head of the Department of Paediatrics

Pediatric Research (2010)

Philippe Alliët Gaston Verellen Maurice Alexander Denise Deliège Caroline Artoisenet

10.1203/00006450-201011001-01122

Cite

Citations (0)

Referral of Dr Peter Mansfield to the GMC

BMJ (2001)

Rebecca Whitmore Maurice Alexander Kalpana Bardhan Ann Manning Glenn Gardner

Medical Council is flawed as he assumes that Worcestershire Health Authority has power in managing its responsibility for a successful public health immunisation campaign. 1It is precisely because the authority is impotent as a public statutory public body that it asked the GMC to intervene.The continuing debate about measles, mumps, and rubella vaccine dents the confidence of many public and professional people, not least because of the assumption that there is no smoke without fire.Majeed's third reference indicates his anxiety despite his initial position statement on the safety of the vaccine.Patients and the media take heed of these different emphases.Maintaining a high level of vaccination cover against diseases that are seen rarely or not at all poses serious difficulties.Majeed's role as an educationalist-a position of power and responsibility-could provide a forum where these difficulties are debated.The role of medical journals and the media should not be ignored in that debate.Their keenness for headlines containing bad news, however misguided or ill informed, while

10.1136/bmj.323.7324.1304

Cite

Citations (2)

Changes to the Administration of Estates Act 66 of 1965 and the Intestate Succession Act 81 of 1987 : practice note

De Rebus (2015)

Maurice Alexander

The Minister of Justice and Correctional Services repealed and confirmed the changes to the amounts in respect of the following sections of the Administration of Estates Act 66 of 1965 - s 18(3); s 80(2)(a); s 80(2)(b); and s 90(1) (see GN R920 GG38238/38238/24-11-2014).

Source

Cite

Citations (0)

Implementation and results of a standardized process for identifying ambulatory pharmacy clinical outcome measures

American Journal of Health-System Pharmacy (2023)

Connor McKay Mary‐Haston Vest Christina T. Doligalski Charles M Summerlin Maurice Alexander

Given the variation in clinical practice, a clinician-centric, standardized process to implement and validate clinical pharmacy outcome measures was developed.Four specialty clinics with embedded clinic-based pharmacists underwent an iterative process to define, refine, and implement the build of electronic health record functionality for outcome measure data collection and reporting. Starting with a list of identified measures, clinic workgroups met to discuss each measure and identify gaps in measure implementation. Information technology experts created electronic documentation forms with discrete data and reports based on criteria specified by the clinic workgroups. Of 32 outcome measures identified as priorities for demonstrating pharmacists' impact in previous research, 29 were implemented for routine monitoring through this project. Implementation strategies included identification through existing reporting, development of discrete documentation tools within the electronic health record, and development of new reporting tools from available discrete data fields. Time to implementation decreased from the first to the last pilot clinic implementation, as demonstrated through a 9-day reduction in electronic documentation form development and 31-day reduction in report development turnaround time.A standardized and reproducible process was developed for the implementation of clinical pharmacy outcomes measures for 4 specialty clinics. The process was successfully utilized to develop measurable outputs for a variety of oncology and nononcology specialty disease states based upon multidisciplinary stakeholder input.

Specialty

Electronic health record

Identification

10.1093/ajhp/zxad056

Cite

Citations (1)

ReCAP: Pharmacists’ Impact in Hematopoietic Stem-Cell Transplantation: Economic and Humanistic Outcomes

Journal of Oncology Practice (2016)

Maurice Alexander Kamakshi V. Rao Tippu Khan Allison M. Deal Maurice Alexander

This study seeks to evaluate the impact of pharmacists' involvement in the care of patients undergoing bone marrow transplantation (BMT).This was a three-phase study. In phase 1, inpatient and outpatient pharmacist encounters were totaled and services provided were translated to revenue generated from prescription revenue and billing charges. In phase 2, pharmacists' activities and interventions were associated with time savings estimated by providers. In phase 3, patients and providers were surveyed to assess their expectations, experiences, and value perceptions of pharmacists.A positive response rate of 80%for each survey item was set as the threshold for high expectations and successful service delivery.In phase 1, after 6 months of data collection, clinical services were provided to 170 inpatients and 290 outpatients. For inpatients, there was an average discharge prescription revenue of $990 per patient through the outpatient pharmacy. In the outpatient clinic, pharmacist visits generated an additional $23,000 in charges (approximately $80 per patient) and an annual prescription revenue of approximately $840,000 through the outpatient pharmacy. In phase 2, pharmacists' activities led to a total time savings of 122 hours. In phase 3, patients and providers met the predetermined 80% positive response rate for most survey items. The item for which patient and provider responses consistently did not meet this threshold related to pharmacists educating patients about their BMT.Pharmacists are valuable resources in the care of patients undergoing BMT, as their care translates to increased revenue, provider time savings, and positive perceptions from patients and providers.

Medication therapy management

10.1200/jop.2015.008797

Cite

Citations (18)

Influence of Germline Genetics on Tacrolimus Pharmacokinetics and Pharmacodynamics in Allogeneic Hematopoietic Stem Cell Transplant Patients

International Journal of Molecular Sciences (2020)

Jing Zhu Tejendra Patel Jordan A. Miller Chad Torrice Mehak Aggarwal

Tacrolimus exhibits high inter-patient pharmacokinetics (PK) variability, as well as a narrow therapeutic index, and therefore requires therapeutic drug monitoring. Germline mutations in cytochrome P450 isoforms 4 and 5 genes (CYP3A4/5) and the ATP-binding cassette B1 gene (ABCB1) may contribute to interindividual tacrolimus PK variability, which may impact clinical outcomes among allogeneic hematopoietic stem cell transplantation (HSCT) patients. In this study, 252 adult patients who received tacrolimus for acute graft versus host disease (aGVHD) prophylaxis after allogeneic HSCT were genotyped to evaluate if germline genetic variants associated with tacrolimus PK and pharmacodynamic (PD) variability. Significant associations were detected between germline variants in CYP3A4/5 and ABCB1 and PK endpoints (e.g., median steady-state tacrolimus concentrations and time to goal tacrolimus concentration). However, significant associations were not observed between CYP3A4/5 or ABCB1 germline variants and PD endpoints (e.g., aGVHD and treatment-emergent nephrotoxicity). Decreased age and CYP3A5*1/*1 genotype were independently associated with subtherapeutic tacrolimus trough concentrations while CYP3A5*1*3 or CYP3A5*3/*3 genotypes, myeloablative allogeneic HSCT conditioning regimen (MAC) and increased weight were independently associated with supratherapeutic tacrolimus trough concentrations. Future lines of prospective research inquiry are warranted to use both germline genetic and clinical data to develop precision dosing tools that will optimize both tacrolimus dosing and clinical outcomes among adult HSCT patients.

Pharmacodynamics

10.3390/ijms21030858

Cite

Citations (18)

Demografie en werkbelasting van kinderartsen in België

Tijdschrift voor Geneeskunde (2011)

Philippe Alliët Maurice Alexander Gaston Verellen Caroline Artoisenet Denise Rott

As in other European countries, Belgian hospitals encounter difficulties in recruiting paediatricians. The task of a paediatrician in the hospital is more diversified than in other specialties. The Belgian Academy of Paediatrics performed a survey in 2007 in order to assess the demographic characteristics and the workload of the hospital paediatricians in Belgium. There is an ongoing feminization among hospital paediatricians. No gender difference could be observed in the time spent in the various types of paediatric medical activity in the hospital. Male paediatricians spend however more than two half-days in clinical activities outside the hospital. Ambulatory care remains important as well in regional as in university paediatric departments. Non-curative tasks form about one third of the working time. The number of days on-call per paediatrician is higher in regional vs university hospitals. The mean size of paediatric regional hospital teams in Flanders is smaller than in French-speaking Belgium (4 vs 8), resulting in a higher on-call activity per paediatrician. In 2007, about 100 vacancies were reported by the heads of the paediatrics department, in three out of four hospitals.

10.2143/tvg.67.12.2000990

Cite

Citations (0)

Nigrostriatal dopamine system dysfunction and subtle motor deficits in manganese-exposed non-human primates

Experimental Neurology (2006)

Tomás R. Guilarte M CHEN Jennifer L. McGlothan Tatyana Verina Derek A. Wong

Human brain

Nigrostriatal pathway

10.1016/j.expneurol.2006.06.015

Cite

Citations (188)

The future of hospital paediatric care in Belgium

Philippe Alliët Gaston Verellen Yvan Vandenplas Chris Van Geet Maurice Alexander

Source

Cite

Citations (0)