About

Nimish Patel, Pharm.D., Ph.D., AAHIVP, is a Professor of Clinical Pharmacy at the Skaggs School of Pharmacy and Pharmaceutical Sciences. His main research interest involves evaluating clinical outcomes associated with anti-infective medications. His research encompasses three domains: the comparative safety and effectiveness of antimicrobials in real-world settings, predictors and outcomes of patients with contraindicated drug-drug interactions, and pharmacoeconomic strategies of emerging antimicrobial agents that result in cost savings related to toxicities or prolonged hospitalization. Dr. Patel's clinical expertise includes treatment of hospitalized patients with infectious diseases, pharmacokinetic monitoring of antimicrobials, antibiotic stewardship, HIV consult service, and hepatitis C. His current projects include studying the safety and effectiveness of fluoroquinolones versus ceftriaxone/azithromycin for community-acquired pneumonia, predictors of outcomes in diabetic foot infections, and the impact of exogenous hormones on renal function and drug concentrations in transgender patients using pre-exposure prophylaxis.

Research topics

• Medicine
• Internal medicine
• Intensive care medicine
• Computer science
• Surgery

Selected publications

• Comparison of Existing and New Race- and Sex-Free Kidney Function Equations in Transgender Adults without CKD

  Clinical Journal of the American Society of Nephrology · 2025-07-22 · 1 citations

  articleOpen access1st authorCorresponding
  PublisherOA PDFDOI

• Evaluating the relationship between letermovir prophylaxis and medication regimen complexity Index over time in allogeneic hematopoietic stem cell transplant patients

  Journal of Oncology Pharmacy Practice · 2025-05-05

  articleOpen access

  Background The medication regimen complexity index (MRCI) quantifies patient-level regimen complexity, and higher scores are associated with adverse clinical outcomes. Characterization of regimens using the MRCI for allogeneic hematopoietic cell transplant (allo-HCT) recipients remains unexplored. Regimens may include letermovir which is used for cytomegalovirus prophylaxis and may prevent the need for addition of complex preemptive therapies. However, quantification of complexity in patients receiving letermovir has not been described. Objective This study aimed to compare MRCI scores over a one-year period in allo-HCT recipients who received letermovir prophylaxis versus those who did not. Methods A retrospective analysis included adults who underwent allo-HCT from January 1, 2016 to October 31, 2021. MRCI scores were calculated at admission, discharge, day +100, 6 months, and 1-year post-transplant. Results A total of 218 patients were included, with 67 receiving letermovir and 151 not receiving letermovir. Median MRCI scores were comparable at discharge post allo-HCT (23 [10–39] vs 22 [12–37], p = 0.97). However, at day +100, patients in the letermovir group exhibited significantly higher median scores compared to the non-letermovir group (59 [46–74] vs 50 [37–67], p = 0.009). By 1-year post allo-HCT, no significant difference in scores was observed between groups (47 [30–68] vs 41 [27–61], p = 0.12). Conclusion and Relevance This study revealed increased MRCI scores up to one year after transplantation in allo-HCT recipients receiving letermovir. The nonrandomized study design and potential patient differences between groups complicate the interpretation of the findings. Future analyses should aim to account for these differences.

  PublisherDOI

• Relationship Between Opioid Use, Depression, and Quality of Life Among Persons With HIV at End of Life

  JAIDS Journal of Acquired Immune Deficiency Syndromes · 2025-08-04 · 1 citations

  articleOpen access
  PublisherOA PDFDOI

• Assessing the clinical and economic impact of delayed versus early pegaspargase

  Journal of Oncology Pharmacy Practice · 2025-10-30

  articleOpen access

  Background In acute lymphoblastic leukemia (ALL), pegaspargase is included in the backbone of numerous chemotherapy regimens. Treatment-related toxicities can be substantial, often resulting in treatment delays, dose reductions, or early discontinuation. This study aimed to evaluate whether differences in efficacy, safety, and economic outcomes exist between standard dosing and modified approaches involving dose-reduced and delayed administration of pegaspargase. Methods This retrospective, single-center study evaluated hospitalized adult patients who received pegaspargase as part of CALGB 10403 induction course I. Patients were stratified into two groups: 1) full pegaspargase dose 2500 units/m 2 and standard administration on day 4 (Early PEG group), or 2) dose reduced pegaspargase 1000 units/m 2 and delayed administration on day 15 (Delayed PEG group). Results Eight patients (27%) were treated with a reduced dose of pegaspargase on day 15 of induction (Delayed PEG). Median age of the study population was 27 years, and median BMI was 29.6 kg/m 2 . The majority of patients were male (60%), Hispanic (53%), and had a diagnosis of Philadelphia chromosome negative B-ALL (70%). Incidence of grade 3 or higher toxicities was not significantly different between groups. MRD status at the end of induction was similar between groups [Early PEG 12 (55%) vs Delayed PEG 4 (50%), p = 0.51]. Economic outcomes within 30 days were also similar. Conclusion Our study demonstrates comparable incidence of high-grade toxicities and MRD negative status, suggesting that concomitant dose reduction and delay of pegaspargase administration during CALGB 10403 induction does not significantly impact effectiveness, safety, or economic outcomes.

  PublisherDOI

• Predictors of discontinuing injectable cabotegravir/rilpivirine and virologic outcomes after resuming oral antiretroviral therapy

  HIV Medicine · 2025-10-12

  articleOpen access

  OBJECTIVE: Evaluate factors associated with discontinuation of long-acting injectable (LAI) cabotegravir/rilpivirine (CAB/RPV) and describe virologic outcomes in those that returned to oral antiretroviral therapy (ART). METHODS: This is a retrospective cohort study at a single-centre primary care HIV clinic. Included were adults who received at least one injection of LAI CAB/RPV between April 2021 and March 2024. Characteristics were compared between those that continued LAI CAB/RPV and those that discontinued treatment during the study period. HIV viral load (VL) outcomes were evaluated in those that returned to oral ART and included the most recent VL in the range of 1-24 weeks, 24-48 weeks and the most recently documented VL through September 2024. RESULTS: A total of 92 and 346 patients were included in the discontinuation and continuation cohorts, respectively. Being male sex assigned at birth and having psychiatric disease was associated with continuing LAI CAB/RPV, whereas having active substance use and being on a multi-class regimen prior to initiation of LAI CAB/RPV was associated with discontinuation. In those with VL data after resuming oral ART, the percentage of those with HIV VL <50 copies per mL up to 24 weeks (n = 58) was 91.4%, up to 48 weeks (n = 53) was 90.6%, and using the most recent documented VL (n = 74) was 91.9%. CONCLUSIONS: High viral suppression rates were observed in those that returned to oral therapy after discontinuing LAI CAB/RPV. Individuals with substance use demonstrated a higher rate of LAI discontinuation, despite the potential benefit from LAIs in this population.

  PublisherOA PDFDOI

• Trends in outpatient care utilization for patients with established atrial fibrillation before and after the Covid-19 pandemic: a nationwide analysis of claims data

  BMC Research Notes · 2025-11-27

  articleOpen access

  OBJECTIVE: To evaluate trends in outpatient visits among Medicare beneficiaries with established AF before and after the pandemic and to investigate differences in outpatient care utilization patterns based on baseline utilization levels. RESULTS: We analyzed 2018-2022 Medicare data to assess outpatient visit trends among 124,483 beneficiaries with atrial fibrillation (AF), categorizing them into quartiles based on pre-pandemic in-person visit frequency. We found that in-person visits declined while telehealth use increased across all groups during the pandemic. After the pandemic, total visits remained below pre-pandemic levels for higher-utilizing groups after the pandemic.

  PublisherOA PDFDOI

• Information standards for innovative surgery: what patients need to know

  British journal of surgery · 2025-06-21 · 3 citations

  articleOpen access

  BACKGROUND: There are repeated and ongoing failures in shared decision-making and informed consent for innovative surgical procedures. Governments and regulatory bodies internationally recommend establishing information standards to support safe and transparent surgical innovation. The aim of this study was to develop a core information set (CIS) for surgical innovation. METHODS: This was a mixed-method study in three phases: a provisional CIS was generated from multiple data sources (interviews with patients/professionals (44), recorded consultations (34), policy documents (58), and published studies (213)) using qualitative content analysis; the CIS was refined, with input from key stakeholders (patient representatives, surgeon innovators, anaesthetists, lawyers, ethicists, medical directors, academic experts, and regulatory representatives) using a modified nominal group technique; and the CIS was finalized through public consultation. RESULTS: The final CIS comprised seven themes that included: what is 'new' about the procedure; potential conflicts of interest; reasons for the innovation (including why the innovation is believed to be appropriate for the patient); treatment alternatives; unknowns (including uncertain safety/efficacy and that the procedure may be abandoned/modified); expertise with the innovation; and governance, oversight, and accountability (including how safety will be monitored and recompense if anything goes wrong). Two themes require follow-up discussions after the procedure. CONCLUSION: A seven-theme CIS for surgical innovation was co-developed, with input from key stakeholders. International implementation of these information standards may support safe and transparent surgical innovation.

  PublisherDOI

• Multicenter, retrospective cohort study of antimycobacterial treatment-related harms among patients with non-tuberculosis <i>Mycobacterium</i> infections in the United States

  Antimicrobial Agents and Chemotherapy · 2025-03-04 · 4 citations

  articleOpen accessSenior author

  ABSTRACT Non-tuberculosis mycobacteria (NTM) are extensively drug-resistant organisms that require long-term therapy. The study purpose was to quantify the incidence of and risk factors for antimycobacterial-associated adverse drug events (ADEs) in persons with NTM infections receiving outpatient therapy. A multicenter, retrospective cohort was performed of persons with NTM infections who received antimycobacterial treatment from 2013 to 2024. Inclusion criteria were age ≥18 years, ≥1 month of outpatient treatment, and ≥1 follow-up outpatient visit within 3 months of index encounter. Mycobacterium avium complex and Mycobacterium tuberculosis complex were excluded. The primary outcome was development of pre-specified treatment-related ADE or acute kidney injury (AKI), thrombocytopenia, and/or Clostridioides difficile infection (CDI) through 12 months of therapy. Secondary outcomes included therapy discontinuation due to any treatment-related ADEs. Two hundred patients were included: 14% developed a pre-specified ADE. Mycobacterium abscessus (29%) was the most common pathogen; most initial regimens included a macrolide (54%), systemic aminoglycoside (24%), β-lactam (24%), or tetracycline derivative (22%). The most common pre-specified ADEs were thrombocytopenia (9%), AKI (8%), and CDI (&lt;1%). The median (IQR) time-to-ADE was 25 (18–38) days from initial outpatient regimen; patients who received aminoglycoside- or oxazolidinone-based therapies were more likely to develop a pre-specified ADE (adjOR, 3.9; 95% CI, 1.7–9.2). Therapy discontinuation due to any ADE occurred in 35% of patients; the median (IQR) time-to-any ADE was 32 (21–58) days. ADEs in persons with NTM infections are common and occur near the first month of outpatient treatment. Intensified monitoring and/or use of more tolerable antimycobacterial regimens early in treatment may be an appropriate approach to avoid harms. Treatment of non-tuberculosis mycobacteria is complicated by adverse drug events (ADEs). This work quantified the incidence and time course of pre-determined, clinically relevant ADEs (acute kidney injury, thrombocytopenia, and C. difficile infection), which occurred in 14% of patients within 30 days of outpatient treatment.

  PublisherDOI

• Predictors of Injection Visit Adherence in Those Receiving Injectable Cabotegravir/Rilpivirine

  JAIDS Journal of Acquired Immune Deficiency Syndromes · 2024-11-05 · 6 citations

  article

  BACKGROUND: There is limited data evaluating potential predictors of adherence to injection visits and the impact of late injections on viral suppression in those receiving long-acting injectable (LAI) cabotegravir/rilpivirine (CAB/RPV) for the treatment of HIV. METHODS: A retrospective cohort study was conducted among adult people with HIV receiving LAI CAB/RPV for at least 6 months between May 2021 and August 2023. Data collected included demographics, office visit no-shows 1 year before switching to LAI CAB/RPV, injection visit no-shows, injections outside the dosing window, and virologic outcomes. Cox-proportional hazards regression was performed to evaluate predictors of no-show to injection visits or late injections. RESULTS: Included were 287 people with HIV with a median follow-up time (interquartile range) of 450 days (344-548 days). Younger age [HR 0.97 (95% CI: 0.95 to 0.98)] and ≥1 office visit no-show in the year before switching to LAI CAB/RPV [HR 2.03 (1.32 to 3.12]) were associated with having a no-show to an injection visit (32.1%). Male sex assigned at birth [HR 9.18 (1.26 to 66.9)] with a trend toward younger age [HR 0.98 (0.95 to 1.0)] were associated with having a late injection (15.3%). There was no relationship between late injections and having a detectable viral load or virologic failure (n = 3) after switching to LAI CAB/RPV. CONCLUSIONS: Having office visit no-shows before switching to LAI CAB/RPV was associated with missed injection visits, and younger age was associated with both missed injection visits and late injections. Resources to reduce and manage missed injection appointments need to be considered when implementing LAI CAB/RPV.

  PublisherDOI

• No observed bidirectional effect between tenofovir diphosphate concentrations and gender‐affirming hormone concentrations among transgender persons switching from tenofovir disoproxil fumarate/emtricitabine to tenofovir alafenamide/emtricitabine for HIV pre‐exposure prophylaxis

  British Journal of Clinical Pharmacology · 2024-04-22 · 2 citations

  articleOpen access1st authorCorresponding

  AIMS: Many transgender and gender diverse (TGD) individuals have expressed concerns about the potential for oral pre-exposure prophylaxis to affect hormonal concentrations achieved from taking gender-affirming hormone therapy (GAHT). The purpose of this study was to understand the bidirectional effects between hormone and intraerythrocytic tenofovir diphosphate concentrations when switching from tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) to tenofovir alafenamide/emtricitabine (TAF/FTC) in TGD users/nonusers of GAHT. METHODS: The study evaluated stored blood samples and dried blood spot cards from TGD adults without HIV who took ≥12 weeks of TDF/FTC and then switched to ≥12 weeks of TAF/FTC for pre-exposure prophylaxis. RESULTS: Thirty-nine individuals met the study inclusion criteria. Regardless of sex assigned at birth and the use of GAHT, there were no significant differences in hormone concentrations when individuals taking GAHT were taking TDF/FTC and then switched to TAF/FTC. Further, there was no significant difference in intraerythrocytic tenofovir diphosphate concentrations between users and nonusers of GAHT. CONCLUSION: There are no bidirectional effects between hormone and intraerythocytic tenofovir diphosphate concentrations when switching from TDF/FTC to TAF/FTC in TGD users/nonusers of GAHT.

  PublisherOA PDFDOI

Frequent coauthors

• Maneesha

  Synergy University Dubai

  79 shared

• Amrish Thakker

  79 shared

• Navath Kanade

  79 shared

• Tejal

  79 shared

• Giovanni Leone

  University of Padua

  78 shared

• Jaimini Mehta

  78 shared

• Sen Kapadia

  78 shared

• Neelkanth Chhaya

  76 shared

Education

• Ph.D. Epidemiology, School of Public Health

  University at Albany State University of New York

  2015

• M.S. Epidemiology, School of Public Health

  University at Albany, State University of New York

  2010

• Doctor of Pharmacy

  Albany College of Pharmacy and Health Sciences

  2006

Awards & honors

• Faculty Preceptor of the Year at ACPHS (2012)
• Teacher of the Year at ACPHS (2012)
• Society of Infectious Diseases Pharmacists (SIDP) Young Inve…
• Janis V. Giorgi Memorial Award – California HIV/AIDS Researc…