Tyler Gallo, PharmD, Receives ABRC Grant on Heparin-induced Thrombocytopenia

Tyler Gallo, PharmD, an assistant research professor at the University of Arizona College of Medicine – Phoenix, received a research grant from the Arizona Biomedical Research Centre (ABRC). 

The ABRC grant, which is worth $220,000 over the course of three years, will be used to study heparin-induced thrombocytopenia (HIT), a rare immune-mediated reaction to heparin products.

Heparin is an anticoagulant designed to prevent blood clots. In rare immune reactions, though, it can actually cause blood to clot, which may lead to different thrombotic events such as heart attack, stroke or pulmonary embolism.

“About a third of all hospitalized patients receive heparin and are potentially at risk; and detection of HIT can be difficult because there are many different causes of thrombocytopenia,” said Dr. Gallo. 

The goal for the research was to create a tool within the electronic health record that could monitor platelet counts for patients who are on heparin. The system would alert clinicians when there was a platelet count fall consistent with HIT.

“We had a tool running in the background that was the basis for triggering the alert, but we were seeing that there were patients who were at risk who were not being tested,” Dr. Gallo said. “That was a good indicator that there were probably cases of HIT that were going undetected and not receiving the appropriate management.”

Dr. Gallo and his team’s initial study found the HIT clinical decision support advisory fired on 412 patients. Among those who underwent diagnostic testing, 13 patients, or 10%, had HIT. 

Since his studies in pharmacy school, medication safety has always been a focus for Dr. Gallo. During his time there, he did research through CredibleMeds looking at QT prolongation. This exposure to research and medication safety inspired him to pursue it further.

“With technology, we have the opportunity to implement different tools that can optimize prescribing and help minimize risk or ensure early detection of side effects such as HIT,” Dr. Gallo said. “I think that’ a key pharmacist role is to help ensure medication safety.”

After finishing up the initial study, Dr. Gallo said the team will begin studying a pre-intervention period, so they can see how much of the HIT detection is due to the clinical decision support versus the previous baseline.

“The plan is to disseminate these results and show that there is a way to use these tools and technology in other institutions,” Dr. Gallo said. “We have had some interest in others who want to adapt the tools, so this could have a major impact beyond just at Banner Health.”

Dr. Gallo earned his pharmacy degree from the University of Arizona in 2016. Following his graduation, he did a two-year research fellowship in Clinical Data Analytics and Decision Support at the U of A College of Medicine – Phoenix. Since then, he has been employed at the U of A College of Pharmacy and College of Medicine – Phoenix with a focus on medication safety and clinical decision support.