Ewoudt van de Garde appointed Professor of Clinical Pharmacotherapy

Utrecht University has appointed Ewoudt van de Garde as Professor of Clinical Pharmacotherapy. His work focuses on pharmacotherapy, the use of medicines to treat diseases, in hospital settings. In addition to teaching pharmacotherapy to Utrecht students training to become pharmacists, he conducts research into the use and effectiveness of medicines in routine clinical practice. Alongside his academic work, he continues to work as a hospital pharmacist at St. Antonius Hospital.

Van de Garde sees many advantages in combining the roles of lecturer, researcher and hospital pharmacist. “Developments in the field are moving rapidly, and there is a risk that education may fall behind,” he says. “My work as a hospital pharmacist helps me stay up to date with the latest developments and keep the curriculum current. At the same time, my research is focused on shaping the future.”

Focus on education 

Van de Garde spends most of his time at Utrecht University on teaching. He is involved not only in designing and delivering courses for both bachelor’s and master’s students, but also in supervising students during their residencies. 

Students who earn a master’s degree in Pharmacy are qualified to work as pharmacists. During four residencies, they gain practical experience outside the university. “That’s a significant amount of learning time that needs to be spent well, in a strong learning environment,” says Van de Garde. He also supervises student research projects, in which students explore their own research questions.

I believe a strong pharmacy programme teaches students how to deviate from protocols in a well-substantiated way.

Van de Garde is happy to share his practical experience from pharmacy practice with his students. “Students appreciate authentic teaching,” he says. “At the same time, the students also help me, because they often encourage me to consider new perspectives.”

Substantiated deviation

A great deal has changed since Van de Garde began his career as a pharmacist. “Pharmacotherapy has become much more complex. There are more treatment options, and treatments are far more personalised, tailored to the characteristics of individual patients. Patients also have more autonomy these days, and costs and efficiency play a larger role.”

New treatments and medicines are constantly being developed. “In medicine, doctors and pharmacists follow guidelines,” says Van de Garde. “These guidelines are valuable: following them means treating patients according to what the profession considers best practice. However, guidelines often lag behind new developments and insights. If several recent studies point to a new understanding, it can be justified to deviate from the guideline. I believe a strong pharmacy programme teaches students how to deviate from protocols in a well-substantiated way.”

Medicines in hospital practice

Van de Garde’s research focuses on how medicines work in real-world clinical practice. Before medicines are brought to market, they are tested in clinical trials, but these trials are not always representative. “Participants in these studies are often relatively fit, young people. Hospital patients frequently have additional conditions alongside the one the medicine is intended to treat. These patients also want access to new treatments. So it is important to have a clear idea of what these patients can expect.”

It is very helpful for patients to know what they can expect from specific medicines.

Van de Garde collaborates with various hospitals to collect sufficient patient data. “We compare outcomes from clinical trials with those of our hospital patients. Are there differences, and if so, can they be explained by patient characteristics or by the way care is organised? Ultimately, the goal is to better understand what is most likely to work for a patient, so that decisions can be made together with the patient.”

Data-driven pharmacotherapy

For Van de Garde, data on treatments and their outcomes in everyday practice are essential for determining the most appropriate therapy. “Smart algorithms can help us to use this data to estimate which treatment is most likely to contribute to a particular outcome. These insights can then be integrated into the decision-making process for an individual patient. After all, what matters to a patient is highly personal. In conditions with a poor prognosis, such as metastatic lung cancer, an important question is how someone wants to spend the final phase of their life. Side effects and quality of life play a major role, and it is very helpful for patients to know what they can expect from specific medicines.”

Van de Garde previously worked on a decision aid for lung cancer that offers personalised insights into the outcomes of different medicines in the Netherlands. Patients receive an overview based on data from comparable patients in the recent past: how many chose a particular medicine and what were the outcomes? “This allows patients, in consultation with their healthcare providers, to make a better informed decision.”

In his teaching, Van de Garde aims to strengthen students’ understanding of data and AI, so that as pharmacists, using their knowledge of pharmacology and the support of smart technology, they can contribute to optimal pharmacotherapy. Van de Garde: “In this way, the treatment choices made and outcomes achieved in yesterday’s patients help inform appropriate pharmacotherapy for today’s patients.”