POEM: a pharmacist-led plan to optimize liver-bleed HE management
Official title: Improving Hepatic Encephalopathy Through a Pharmacist-Delivered Program to Optimize Encephalopathy Management (POEM): a Hybrid Effectiveness-Implementation Study
Funded at Indiana University Indianapolis · NIH-11342776 · Data updated 2026-11-12
A pharmacist-driven program helps people with hepatic encephalopathy manage lactulose use and safely reduce unnecessary medications to improve thinking and reduce hospital stays.
Quick facts
| Grant type | R01 grant |
|---|---|
| Study type | NIH-funded research |
| Funding institution | Indiana University Indianapolis NIH-funded |
| Lab location | 1 site (Indianapolis, United States) |
| Project start | July 1, 2026 |
| Project end | March 31, 2031 |
| Funding year | 2026 |
| Award (this year) | $805,822 |
| NIH project number | 1R01DK147308-01 |
| Project ID | NIH-11342776 on NIH RePORTER |
Who could benefit from this research
✓Could help
Adults 21 and older with hepatic encephalopathy who are on lactulose and potentially taking medications that may worsen HE.
✕Less likely to help
Patients without HE or those not on lactulose or at risk for PIM-related issues may see little benefit.
What this research studies
This project introduces POEM, a pharmacist-led program that uses a digital monitoring system to improve how lactulose is taken and to deprescribe medications that can worsen hepatic encephalopathy. It combines medication optimization with support from pharmacists to tailor dosing and minimize harmful drugs. The goal is to improve cognition, quality of life, and reduce hospitalizations for adults with HE.
Why it matters
Potential benefit: If successful, it could lead to better thinking, fewer HE-related hospital visits, and easier daily medication routines for patients with HE.
How similar studies have gone: Pharmacist-led interventions have improved medication management in other chronic conditions and deprescribing has reduced PIM use in some populations.
Where this research is happening
-
Indiana University Indianapolis
Indianapolis, United States Active
Researchers
- Principal investigator: Orman, Eric — Indiana University Indianapolis
- Study coordinator: Orman, Eric
Related research
Other NIH-funded projects on the same topics.
-
Cholesterol and brain health in liver cirrhosis leading to hepatic encephalopathy
Researchers will study how cholesterol in the brain may contribute to brain problems seen in people with liver cirrhosis and hepatic encephalopathy.
-
How cholesterol affects brain problems from cirrhosis
This research looks at whether cholesterol builds up in the brain and changes neurosteroids, contributing to hepatic encephalopathy in adults with liver cirrhosis.
-
Investigating how gut bacteria affect brain function in liver disease
This study is looking at how gut bacteria might affect brain function in people with liver disease, specifically those with and without symptoms of hepatic encephalopathy, to find new ways to help improve their health.
-
Investigating how cholesterol affects brain function in liver disease
This study is looking at how cholesterol levels in the brain might affect brain problems in people with liver cirrhosis, hoping to find new ways to help those who are dealing with these serious issues.
-
Coil-assisted small-diameter stent shunt reduction for refractory HE after TIPS
A coil-assisted, small-diameter covered-stent technique is being tested to see if it can safely and effectively reduce shunt flow and lessen recurrent hepatic encephalopathy in people with a prior TIPS.
-
Fecal transplant plus standard therapy for refractory hepatic encephalopathy after TIPS
This study tests whether adding fecal microbiota transplantation to usual medicines helps people with recurrent hepatic encephalopathy after TIPS implant.
About this research
- This is an active NIH-funded research project — typically early-stage science, not a clinical trial accepting patient enrollment.
- Some NIH-funded labs run parallel clinical studies or seek volunteers for related work. To check, contact the principal investigator or institution listed above.
- For full project details, budget, and progress reports, visit the official NIH RePORTER page.