14 Oct Donica Janzen
Donica Janzen, BSP, is a PhD candidate at the College of Pharmacy at the University of Manitoba. She obtained her Bachelor of Science in Pharmacy from the University of Saskatchewan in 2011. After graduation, she worked as a pharmacist in northern Manitoba. Later, she decided to pursue graduate training in pharmacoepidemiology at the University of Manitoba in order to bridge the gaps in evidence that she encountered in her work. She started an MSc with Dr. Silvia Alessi-Severini in 2016 and transferred to the PhD program in 2018.
I started out as a pharmacist because I wanted to help others, and that hasn’t changed, even though my career path has. Whether I end up educating the next generation of pharmacists, conducting pharmacoepidemiology research or venturing into pharmaceutical policy, my ultimate goal is to promote safe and effective use of pharmaceuticals in the Canadian population.
Tell us a bit about your background and how you ended up studying in this field.
I obtained my Bachelor of Science in Pharmacy from the University of Saskatchewan in 2011. After graduation, I moved to northern Manitoba to work as a pharmacist. Working in a multidisciplinary health care team, I quickly became aware of the limitations of applying evidence from randomized controlled trials to treat my real-world patients. I valued evidence-based approaches to decision making but found many gaps in the evidence that was available. Recognizing the quality of administrative health data in Canada and its potential to inform clinical decisions, I decided to pursue graduate training in pharmacoepidemiology at the University of Manitoba. I started an MSc with Dr. Silvia Alessi-Severini in 2016 and transferred to the PhD program in 2018.
Give us a short summary of your recent research.
At the start of my PhD program, I was interested in studying the real-world effectiveness of long-acting injectable antipsychotics (LAIAs). However, I quickly realized the importance of first understanding patterns of use and quality of data before undertaking an effectiveness study. The first component of my thesis project was a drug utilization study looking at long-acting injectable antipsychotic prescribing trends and characteristics of users. The second component was a validation study that assessed the validity of using prescription claims from the Manitoba Drug Program Information Network database to measure long-acting injectable antipsychotic exposure. Now, with those foundational studies complete, we can move forward with a population-based cohort study to evaluate the effectiveness of LAIAs.
What excites you the most about the research you are doing or hope to do in the future?
In my pharmacy practice, I saw a number of patients who responded very well to long-acting injectable antipsychotics (LAIAs) and a number of recent pharmacoepidemiology studies have shown them to be very effective. However, LAIAs are only used in approximately 5% of antipsychotic users. I hope my research will strengthen the body of literature on real-world effectiveness of LAIAs and encourage prescribers to consider using LAIAs more widely.
Are there aspects of the work that you find particularly challenging?
My pharmacy background was extremely helpful as I ventured into pharmacoepidemiology research, but I had (and still have!) a lot to learn about biostatistics, observational study designs and administrative health data. As a pharmacoepidemiologist-in-training, I’m very aware of what can go wrong when prescribing decisions are based on poorly designed observational studies. Rigorous pharmacoepidemiology study designs that minimize bias and confounding can be difficult to describe to an audience outside of the field, yet I want to produce research that is relevant to clinicians and patients. It is certainly challenging to communicate research findings in a way that is accessible for a broader audience.
What are your career goals?
I’ve been thinking about this a lot lately, as I hope to complete my PhD soon! I started out as a pharmacist because I wanted to help others, and that hasn’t changed, even though my career path has. Whether I end up educating the next generation of pharmacists, conducting pharmacoepidemiology research or venturing into pharmaceutical policy, my ultimate goal is to promote safe and effective use of pharmaceuticals in the Canadian population.
You’ve only just started with CNODES; how has your experience been so far?
I was introduced to CNODES by my PhD supervisor, Dr. Silvia Alessi-Severini, who has been a co-investigator on several CNODES studies. For the past 2 years, I have had the opportunity to be a peer reviewer for the CNODES Analyst Training Program. In this role, I provided feedback to content developers on topics like administrative health data and propensity scores. I’ve been so impressed with how responsive CNODES is to the needs of trainees across Canada!
How has CNODES impacted your studies or career trajectory?
CNODES has been extremely supportive throughout my graduate training! With CNODES funding, I was able to attend pharmacoepidemiology summer courses at McGill in 2017, the International Conference on Pharmacoepidemiology and Therapeutic Risk Management in 2019, and an ISPOR short course on causal inference in 2020. As I near completion of my PhD and start to think about next steps, it’s exciting to know that, no matter where I go in Canada, I can continue to be involved in CNODES.
Outside of work and studies, what are you passionate about?
I started container gardening this summer, and it’s been wonderful to watch my little seeds grow into big, vegetable-producing plants! I can’t wait to expand my garden next summer.
Selected recent publications:
Janzen D, Bolton JM, Kuo I, Leong C, Alessi-Severini S. Trends in the use of long-acting injectable antipsychotics in the province of Manitoba, Canada. J Clin Psychopharmacol. 2020;40(1):6-13.
Watch for our validation study, currently undergoing peer review.