Wajd Alkabbani

Tell us a bit about your background and how you ended up studying in this field.

Fresh out of high school, I started my Bachelor’s in Pharmacy program in the Faculty of Pharmacy at Kuwait University. During our 5^th and final year of the program, we were required to finish a clinical and a thesis component. My primary supervisor, a few committee members, and our Dean, all went to grad school in Canada! When I expressed how much I have enjoyed the research component and my interest in pursuing graduate training, they all pushed me to consider Canada.

In 2016, a few months after I finished my BSc, I moved to Winnipeg, and I started my MSc program under the supervision of Dr. Christine Leong at the College of Pharmacy at the University of Manitoba. It was a surreal experience, a mix of fear of the unknown with excitement to start this new adventure and meet new people. It turned out to be great! I made amazing friends and professional connections and most importantly, I was introduced to the world of administrative data for clinical research. I was very lucky to use data from the Manitoba Centre for Health Policy to look into the utilization of cannabis-based pharmaceuticals, a timely project that was also related to my BSc thesis in epilepsy.

Early in my MSc, I realized how much I enjoy pharmacoepidemiologic research; however, I wanted to move on from utilization studies and start my training in outcome research. In 2019, I started my PhD program at the School of Pharmacy, University of Waterloo, under the supervision of Dr. JM Gamble, who is also a Pharmacist with graduate training in pharmacoepidemiology.

Give us a short summary of your current or recent research.

The most important part for me was to be able to align my research interest in neuropsychiatric conditions with my supervisor’s expertise in diabetes. Right before I started my PhD, a systematic review and meta-analysis came out in BMJ Open Diabetes Research and Care that discussed the impact of pharmacological treatment of diabetes mellitus on the risk of dementia. This opened my eyes to look more into the current gaps in our knowledge of the relationship between diabetes and dementia. Specifically, my PhD thesis focuses on providing more clinically relevant details on the complex relationship between the two conditions. Although this association has been established, several questions remain regarding the role of diabetes severity, diabetes medications and their side effects. To answer these questions, I will be using administrative data from Population Data BC. My project has been approved and granted the Alzheimer Society Research Program Doctoral award, and I am hoping I can start my data cleaning and analysis this spring.

Currently, I am also working as a research assistant. I am using the UK’s Clinical Practice Research Datalink (CPRD) to conduct a series of cohort studies to assess the comparative safety of the newest class of diabetes medications, the sodium glucose co transporter-2 (SGLT-2) inhibitors. Using results from this project I have presented at the ISPE mid-year conference this past April and will be presenting in several conferences this summer.

Very recently, I have developed an interest in looking more into sources of evidence. These are foundational in the world of evidence-based practice; clinicians, as well as policy makers, rely on the available evidence in the decision-making process. Therefore, it is crucial to make sure that the available knowledge is an output of appropriate and comprehensive evidentiary sources.

What excites you the most about the research you are doing or hope to do in the future?

I really enjoy the freedom that comes with research, and the ability to conceptualize research questions that are both clinically relevant and interesting. I have always been fascinated by the area of neuropsychiatric conditions and medications and have very recently joined the diabetes research club. So, I am very excited to be able to use real-world data to play “clinical detective” and pursue several research investigations that combine both areas. In the past 2 years, I have been more involved in mentoring PharmD students that are trying research for the first time. I often look forward to these meetings and I enjoy seeing students get excited about their projects and results.

Are there aspects of the work that you find particularly challenging?

Using administrative data to study chronic disease pharmacoepidemiology often comes with a set of challenges, such as residual and time-varying confounding, limited data or important variables, and the potential impact of time-trends. Often these can impede the feasibility of an interesting project, or at least complicate it. For example, although 10- or 15-years’ worth of data seem plenty, it might not be sufficient to look at long-term outcomes, such as dementia. Failure to account for these limitations can potentially lead to biased results, therefore extensive methods training needs to accompany clinical experience.

What are your career goals?

My primary career goal is to become a clinician-scientist as a pharmacist and pharmacoepidemiologist. I aspire to combine my clinical skills gained during my Bachelor of Pharmacy program with research skills gained from graduate training. Similar to many clinician-scientists, I foresee myself conducting independent research in an academic setting to answer clinically relevant questions.

Tell us about your experience related with CNODES.

I was first introduced to CNODES through the Manitoba site. Several faculty members are also CNODES members and have regularly presented timely, interesting, and important work in seminars and workshops. Personally, I am also involved as a peer reviewer for the upcoming Analyst Training Program (ATP). For the past 2 years, we have been developing and reviewing content material designed to train CNODES analysts. The training modules cover a wide range of important topics for analysts looking into using administrative data for pharmacoepidemiologic research.

How has CNODES impacted your studies or career trajectory?

CNODES has provided me with several training opportunities since I started my graduate training. This includes financial support to take a pharmacoepidemiology course at McGill in 2017, which helped me strengthen my pharmacoepidemiologic knowledge and meet fellow graduate students doing similar research in Canada and across the world. In 2018, CNODES also provided me with financial support to attend the ISPE mid-year meeting in Toronto, an international meeting that brings together pharmacoepidemiology experts and students from around the world. In fact, I met my current PhD supervisor and a committee member (Dr. Colleen Maxwell) at ISPE 2018! I also often attend the CNODES monthly webinar and CNODES collaborations with DSECT; these sessions help further my understanding of classic and established methods, as well as introduce me to the newest ones. This year, CNODES is supporting me in taking two advances biostatistics courses that will cover specific methods needed for my thesis work.

Outside of work and studies, what are one or two things that you are really passionate about?

I follow politics closely; it is not always the healthiest activity, but I think it is crucial to keep in touch with relevant topics. During the COVID-19 pandemic, I started two new activities, cooking and learning French!

Selected recent publications

Alkabbani W, Pelletier RT, Gamble JM. Sodium glucose co-transporter-2 (SGLT2) inhibitors and the risk of diabetic ketoacidosis: An example of complementary evidence for rare adverse events. Am J Epidemiol. In Press; March 2021. https://doi.org/10.1093/aje/kwab052

Alkabbani W, Marrie RA, Bugden S, Alessi-Severini S, Bolton JM, Daeninck P, Leong, C. Persistence of use of prescribed cannabinoid medicines in Manitoba: a population-based cohort study. Addiction. 2019;114 (10): 1791-1799. https://doi.org/10.1111/add.14719

Alkabbani W, Marrie RA, Bugden S, Alessi-Severini S, Daeninck P, Bolton JM, Sareen J, Leong, C. Pharmaceutical cannabinoid use in Manitoba, 2004/05 to 2014/15: a population-based cross-sectional study. CMAJ Open. 2018;6(4):E637-E642. 9778/cmajo.20180109