Faculty

Betsy Reynolds

PharmD

2027 Sessions

PAWSIC: Deprescribing for Healing: The Pharmacist's Role in the Stalled Wound

Wound care clinicians routinely assess perfusion, pressure, nutrition, and bioburden — yet the medication list is rarely examined as a modifiable cause of delayed healing. In post-acute care, where most patients are older adults with multiple chronic conditions, polypharmacy is the norm, and many commonly prescribed agents act directly on the cellular machinery of repair.

This moderated panel brings two pharmacists with expertise in geriatric pharmacotherapy and post-acute consultant practice into dialogue with a geriatrician and certified wound specialist physician. Panelists will review how specific drug classes impair healing: corticosteroids through suppression of fibroblast proliferation, collagen synthesis, and angiogenesis; anticoagulants through cutaneous necrosis and bleeding risk; proton pump inhibitors through micronutrient malabsorption; and antibiotics through effects on collagen cross-linking and tensile strength when used without confirmed infection. The panel will also address glucose-lowering therapy and the consequences of both inadequate and overly aggressive glycemic management in diabetic foot ulcers.

The session then turns to intervention, describing practical approaches to medication review and deprescribing — including use of the AGS Beers Criteria®, assessment of anticholinergic and sedative burden, and management of drug-drug and drug-disease interactions. Particular attention will be paid to how age-related changes in renal and hepatic function, frailty, and goals of care reshape the risk-benefit calculation for older adults.

Attendees will leave with a structured framework for identifying medication-related barriers to healing and for initiating collaborative conversations with prescribers, consultant pharmacists, and patients.

Co-Presenter

Moderator

Thursday, April 29 2:30–3:30 PM
Faculty

Nicole Brandt

PharmD, MBA, BCGP, FASCP
Professor and Parke-Davis Chair in Geriatric Pharmacotherapy
University of Maryland Baltimore

Dr. Brandt is a professor and Parke-Davis Chair in Geriatric Pharmacotherapy in the Department of Practice, Sciences, and Health Outcomes Research (P-SHOR) and executive director of the Peter Lamy Center on Drug Therapy and Aging at the University of Maryland School of Pharmacy. Dr. Brandt has expanded available geriatric training opportunities, including the geriatrics/palliative care pathway, ASHP-accredited geriatrics residency, and two-year post-PharmD fellowship. She was named the 2019 recipient of the American Geriatrics Society’s (AGS) Dennis W. Jahnigen Memorial Award for her leadership in geriatrics education. She has worked on various interdisciplinary teams across numerous practice settings and is currently leading initiatives to integrate sustainable pharmacist-directed services to help older adults with multiple co-morbidities at the MedStar Center for Successful Aging. Dr. Brandt has been active in promoting optimal care for older adults and has affected this through her educational, clinical, as well as healthcare policy work. She co-led an initiative that led to the University of Maryland, Baltimore and University of Maryland, Baltimore County to become the first universities in the state of Maryland to receive Age-Friendly University distinction. She was a Fulbright Program Specialist from 2023 – 2024 with the University of Helsinki to work on Age-Friendly Care initiatives.  

Faculty

Betsy Reynolds

PharmD
Faculty

Ronald Rosen

MD, CMD, CWSP
geriatrician
Mass General Brigham

Ronald Rosen, MD, CMD, CWSP is a geriatrician and hospice physician with Mass General Brigham, specializing in the care of older adults in skilled nursing and post-acute care settings. He has extensive clinical experience in wound management, skin integrity, palliative care, and the complex medical and psychosocial issues affecting medically frail older adults.

Dr. Rosen is actively involved in professional education and serves on the board of the Post Acute Wound and Skin Integrity Council (PAWSIC). He is also a member of the Post-Acute and Long-Term Medicine (PALTMed) community, a faculty member of their Core Curriculum and contributes to Caring for the Ages, writing on clinical topics relevant to post-acute and long-term care.

In addition to his clinical work, Dr. Rosen is a medical-legal consultant and educator, bringing a practical perspective to the intersection of clinical care, documentation, communication, and patient safety. His presentations emphasize evidence-based practice while incorporating real-world clinical examples, audience interaction, and strategies that clinicians can immediately apply to patient care.

Dr. Rosen is particularly interested in wound care as a multidisciplinary endeavor and in improving outcomes through better clinical reasoning, communication, and collaboration among physicians, advanced practice providers, nurses, therapists, patients, and families.

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