After being discharged, patients often had to wait in line to pick up medications, navigate insurance issues or learn their prescriptions were more expensive than expected. These challenges could delay treatment and add stress during a time when patients should be focused on recovery.

Two years ago, UC Davis Health launched its Meds to Beds program to remove those barriers by delivering discharge medications directly to patients before they leave the hospital.

Since then, the program has become an integral part of the discharge process. It helps patients start their treatment immediately while supporting a safer transition from hospital to home.

“When we deliver medications directly to patients before they go home, we remove one more barrier to their recovery,” said Kevin Lau, manager of retail pharmacy at UC Davis Health. “It's convenient, but more importantly, it helps ensure patients have the medications they need and understand how to take them. That can lead to better health outcomes, prevent complications, reduce hospital readmissions and, in severe cases, save lives.”

How Meds to Beds works

Through the Meds to Beds program, eligible patients are automatically enrolled during their hospital stay. As discharge orders are entered, pharmacy staff work closely with care teams to prepare prescriptions and coordinate bedside delivery before patients leave UC Davis Medical Center.

The service eliminates the need for patients, caregivers or nurses to walk to the pharmacy after discharge paperwork is completed. Pharmacy staff also help navigate insurance coverage, prior authorizations and financial assistance programs when needed, ensuring patients can promptly access the medications prescribed for their recovery.

“Patient care does not end when someone is discharged,” said Cindy Vang, supervisor of the UC Davis Medical Center Discharge Pharmacy team. “We want to make sure patients can continue their care after they leave the hospital, and having medications in hand is a critical part of that.”

Improving outcomes beyond convenience

While the program adds convenience to the discharge process, its impact extends far beyond saving patients an extra stop on their way home.

Research has shown that Meds to Beds type of programs can significantly reduce 30-day hospital readmissions. One study of nearly 40,000 hospital discharges found that patients who participated in a Meds to Beds program were approximately 50% less likely to be readmitted within 30 days than those who did not participate.

The program also helps address a common challenge known as primary nonadherence: when patients never fill a prescription after leaving the hospital. By providing medications before discharge, Meds to Beds removes potential barriers such as transportation challenges, insurance complications and out-of-pocket costs. Studies suggest that up to a third of medication-related readmissions are linked to patients not taking prescribed medications as directed.

“Medication adherence is critical for patients with cardiac conditions who are discharged with new prescriptions,” said Samer Mishriky, pharmacy supervisor at UC Davis Health. “Barriers such as high costs, insurance challenges and lack of transportation can prevent patients from accessing needed therapies, leading to readmissions, higher healthcare costs and poorer health outcomes.”

A collaborative effort across UC Davis Health

While patients experience a seamless bedside delivery, the program is powered by extensive collaboration across the health system.

Pharmacy leaders partnered with nursing leadership, information technology, nurse educators and other key stakeholders to design workflows that integrated smoothly into the electronic health record and existing clinical processes. The program launched as a pilot before gradually expanding across inpatient units.

“We had to build a lot of infrastructure to get the program off the ground,” Lau said. “There were many stakeholders involved, and it was important to make sure the program integrated smoothly into existing workflows without disrupting patient care.”

That collaboration has benefited caregivers as well as patients. Prior to the program, nurses or family members often had to leave patient units to pick up medications, taking time away from patient care. By bringing medications directly to the bedside, care teams can remain focused on their patients while helping facilitate a more efficient discharge process.

The pharmacy team measures performance and identifies opportunities for improvement by tracking key metrics through a dedicated dashboard, including patient capture rates and reductions in medication turnaround times.

National recognition for innovation

The success of the UC Davis Health Meds to Beds program has attracted attention from health systems across the country.

Earlier this year, UC Davis Health was selected to present its innovative Meds to Beds workflow enhancements at Epic’s XGM Conference. Healthcare organizations nationwide learned about the team's automated enrollment processes, chain-of-custody documentation and technology innovations.

Attendees showed particular interest in UC Davis Health’s opt-out enrollment model as an alternative to the commonly used opt-in approach. They were also eager to learn about the organization’s integrated tracking systems, which enhance medication delivery by improving safety and efficiency and minimizing disruption to clinical operations.

Looking ahead

As the program enters its third year, leaders are focused on continuing to expand patient access. Recently, Meds to Beds expanded operations to include weekends and holidays, helping ensure patients can receive medications regardless of when they are discharged.

The team is also exploring opportunities to bring similar services to additional care settings outside the hospital.

For the pharmacy discharge team, the program's growth reflects a simple but powerful goal of ensuring patients have the tools they need to continue their recovery after hospitalization.

“By delivering medications directly to a patient's bedside, we're able to provide both convenience and peace of mind before discharge,” shared Adriana Lepe, discharge pharmacy technician. “My hope is that this service helps make the transition home a little easier by ensuring patients have what they need and one less thing to worry about as they focus on their recovery.”

The biotherapeutic metabolite, 10-hydroxystearic acid (10-HSA), is produced by the beneficial gut bacterium Lactiplantibacillus plantarum. L. plantarum is a common lactic acid bacterium found in many over-the-counter probiotics and fermented foods. It also occurs naturally in the human gut.

The findings were published in Nature Microbiology.

"Current HIV therapies are remarkably effective at controlling viral replication, but they do not fully repair the profound damage HIV causes in the gut," said Satya Dandekar, senior author of the study and a distinguished professor in the Department of Medical Microbiology and Immunology at UC Davis Health. "Our findings suggest that restoring the gut's structural and immune health can enhance antiretroviral treatment and opens an entirely new avenue for achieving more durable control of HIV.”

HIV and the late stage of the infection, AIDS, remain major global public health issues. In 2025, an estimated 40.9 million people were living with HIV, and approximately 1.2 million people acquired new HIV infections. In 2025, around 570,000 people died from AIDS-related illnesses worldwide.

HIV damages gut immune system

Gut-associated lymphoid tissue, the body’s largest immune tissue and key regulator of the body's immune system, is an early target of HIV. The virus severely damages the immune and epithelial cells in the gut’s lining. This damage leads to an inflamed, leaky gut, a weakened defense system and decreased nutrient absorption. The virus also disrupts mitochondrial function (mitochondria are organelles that generate energy within the cells). 

Even with strict adherence to ART, many people living with HIV have persistent gut inflammation caused by the virus. Previous research from Dandekar’s lab showed L. plantarum could quickly heal the chronically inflamed leaky gut associated with HIV.

For this study, the researchers identified metabolites produced by L. plantarum in the virally inflamed gut environment in the non-human primate model of HIV/AIDS. Among the hundreds of molecules created by L. plantarum, one metabolite, 10-HSA, emerged as the strongest candidate for repairing the gut barrier and reducing inflammation.

Using X-ray crystallography to visualize 10-HSA interactions at the atomic level, researchers demonstrated that 10-HSA directly binds to PPAR-alpha, a nuclear receptor that regulates key biological processes.

This binding promoted histone crotonylation, an epigenetic modification that helps regulate gene activity. The resulting cascade of cellular events reprogrammed gene expression to restore mitochondrial function and energy metabolism while supporting repair of the gut lining.

Researchers also found that 10-HSA increased mitochondrial respiration of gut epithelial cells during HIV inflammatory conditions, boosting energy-generating capacity and reducing harmful reactive oxygen species.

Testing the approach in nonhuman primates

To determine whether the benefits of 10-HSA translate to living organisms, the team conducted two independent studies at the UC Davis National Biomedical Research Institute in non-human primates infected with simian immunodeficiency virus (SIV), a close relative of HIV.

• The first study evaluated 10-HSA alone without ART. This led to intestinal repair, improved key markers of gut function, improved mitochondrial health, reduced inflammatory signaling and partially restored the gut microbiota.

• The second study evaluated 10-HSA in combination with ART. Significantly, the combined treatment showed faster clearance of viral burden than ART alone. The combination also promoted faster recovery of gut immune cells, reduced immune activation, restored epithelial barrier integrity and restored beneficial gut microbiota and microbial diversity.

“The findings suggest repairing the tissue damage caused by HIV may be as important as suppressing the virus itself with antiretroviral therapy,” said Dylan Kramer, first author of the study and recent Ph.D. graduate from the Dandekar Lab. “By rebuilding the gut barrier, restoring mitochondrial function and reducing inflammation, 10-HSA helps create conditions that support stronger immune recovery and more effective antiviral therapy for HIV.”

The authors caution that the results are from preclinical models. The studies showed no adverse effects. The research supports testing the safety and effectiveness of 10-HSA in humans.

"Our research shows that host health, microbial health and viral control are deeply interconnected," Dandekar said. She noted that treating the damaged gut ecosystem facilitates recovery of the immune system, leading to regained functions that have been lost during HIV infection. Additionally, treating the damaged gut during HIV infection can improve outcomes beyond what antiviral drugs can achieve alone.

“The restoration of gut barrier integrity and microbial balance through 10-HSA supplementation may represent a promising therapeutic strategy, with implications that extend beyond HIV to other chronic inflammatory diseases of the gastrointestinal tract,” Dandekar said.

A full list of authors appears in the journal article.

This research was supported by funding from the National Institutes of Health (U42OD010990, AI123105, R37 AI 153025, T32 AI060555, P51 OD011107, R01 ES036174) and the UC Davis School of Medicine.

The University of California has filed a patent application related to therapeutic treatment strategies involving 10-HSA.

Resources

Read the study in Nature Microbiology

Mapping the pathway to gut health in HIV and SIV infections

The study, published in The Lancet, found that patients who received deramiocel experienced significantly slower disease progression compared with those receiving a placebo, demonstrating benefits across multiple measures of muscle and cardiac function.

Duchenne muscular dystrophy affects approximately 1 in 3,500 to 5,000 boys worldwide and progressively weakens skeletal, respiratory and cardiac muscles. While advances in care have improved survival, there remains a critical need for therapies to address multiple aspects of the disease, particularly in non-ambulatory patients with advanced disease.

In the HOPE-3 study, 106 participants with advanced DMD were randomized to receive quarterly infusions of deramiocel or placebo over 12 months. Patients treated with deramiocel showed significantly less decline in upper limb function, a critical measure of independence that affects activities such as feeding, grooming and using technology. The treatment also demonstrated advantages on measures of cardiac function and disease-related heart scarring, two major causes of illness and premature death in DMD.

“What makes these findings especially meaningful is that deramiocel demonstrated effects across multiple systems impacted by Duchenne muscular dystrophy,” said Craig McDonald, chair of the Department of Physical Medicine and Rehabilitation at UC Davis Health and lead study investigator. “Preserving arm and hand function is critically important for maintaining independence and quality of life in people living with Duchenne. At the same time, protecting heart function is essential for long-term health. Seeing evidence of the benefit in both areas is a game changer and represents a potentially important advance for patients and families.”

A different approach to treating Duchenne

Unlike therapies that target a specific genetic mutation, deramiocel is designed to address disease processes common to many people with DMD — including inflammation and fibrosis, or scarring — that progressively damages muscles and the heart.

The therapy consists of cardiosphere-derived cells, which are obtained from donated human heart tissue and act through biological signaling mechanisms that help reduce fibrosis and modulate harmful inflammation.

The event celebrated the extraordinary courage of young warriors battling cancer at the cancer center and honored the unwavering love and strength of their families who stand beside them every step of the way.

Since 1998, Hyundai Hope on Wheels has awarded 14 grants to UC Davis Comprehensive Cancer Center, totaling $1,310,000 in funding.

“To me, this is the best thing we do other than selling cars. We want to make sure that someday, kids will be 100% cured. That’s the goal,” said Rajesh Gupta, senior group manager of regional sales for the Western Region at Hyundai Motor America. “Every single dollar helps Dr. Marcio and his team to do what they need to do to make medicine and conduct research for the kids.”

This is the fourth consecutive year that Marcio Malogolowkin, chief of the Division of Pediatric Oncology-Hematology at UC Davis Comprehensive Cancer Center, has received a Hyundai Hope on Wheels grant.

“This will help our kids by improving their lives during therapy and advancing their long-term outcomes, but it will also help us find new modalities, therapies and ways to care for our patients,” Malogolowkin said.

The event began in the cancer center’s auditorium and ended outdoors where attendees dipped their hands in paint and added their handprints to the SUV.

On hand to provide a “high five” and a thank you was 8-year-old cancer patient Alizah. She smiled broadly as she made an indelible memory of the day. 

“UC Davis gave Alizah her childhood back and gave her her voice,” said the girl’s mother, Malia Martinez. “We didn’t get the help we needed until we came here. Thank you.”

“Hey,” Justina Huang asked, “Have you thought about going back to school?”   

By “school,” Huang meant medical school. Zhang had taken the Medical College Admission Test (MCAT) about 13 years earlier and scored well but decided not to apply. 

The question lingered. The desire to become a physician still remained despite years spent building a career and raising a family. This time, Zhang decided to pursue it. She enrolled in online, out-of-state science courses, retook the MCAT and, with the encouragement of her husband, applied to medical school. 

On Saturday, Zhang will officially join the UC Davis School of Medicine as one of 139 first-year medical students. 

“I’m very grateful to be here and I would say it feels surreal,” Zhang said. “But at the same time, I feel like I’m in the right place, like it just fits.” 

The induction ceremony, also known as a white coat ceremony, takes place at the Robert and Margrit Mondavi Center for the Performing Arts in Davis. The new students will receive a warm welcome from deans, be given a stethoscope and hear words of advice from fourth-year students. The 10 a.m. ceremony will be livestreamed on the School of Medicine’s Facebook page. 

Returning to her UC Davis roots 

For Zhang, medical school means returning to the university where she earned her master’s degree in nutritional biology in 2014. 

She has since worked at hospitals in Fairfield, Lodi, and even UC Davis Medical Center during her dietetic internship in 2016.  

She loved her 10-year career as a registered dietitian, which included a stint in private practice where she provided counseling. She especially enjoyed the opportunities to help children develop healthier habits, educate parents about nutrition and see the positive results. 

“I worked with a lot of kids with eating disorders, and it was very meaningful to connect with them and gain their trust,” Zhang said.  

Some of the most memorable chapters of her career have unfolded at Shriners Children’s Northern California, the Sacramento hospital where she has been a clinical dietitian since 2022. The hospital is located across the street from the UC Davis Health building that houses the medical school classrooms, so she can easily meet old friends for lunch. 

Providing nutritional therapy allowed Zhang to appreciate the rich cultural diversity of her patients. She helped some make dietary adjustments without sacrificing dishes that held meaning for their families. 

“Food is so important to your identity,” said Zhang, who was born in New Jersey to Taiwanese American parents and lived most of her childhood in China. “It’s really about enjoying your food and honoring your culture. And I think that’s what medicine should be.” 

The push to become a physician 

When Zhang committed to applying to medical school upon her sister’s suggestion, and husband’s support, she knew the journey would require significant sacrifices. 

Her kids were 1, 3 and 5. Her husband worked a demanding job. When he was traveling, Zhang juggled raising the children and shuttling them to daycare and activities, packing the lunches, doing the laundry and other chores — all while working part time.   

“I was treading water,” she confessed. 

She signed up for online classes, one after the other, to reactivate expired pre-requisite coursework for medical school applications. First chemistry. Then organic chemistry. Biology. Physics. 

While most classmates watched lectures in real time, Zhang squeezed them in whenever she could — late at night after her children went to bed and on weekends. 

Her work ethic will come in handy at UC Davis — and not only for the usual rigors of medical school. Zhang is one of six students enrolled in the ACE-PC pathway, or Accelerated Competency-based Education in Primary Care. The pathway allows students to complete medical school in three years instead of four through a more intensive curriculum focused on primary care. 

Zhang dreams of becoming a family medicine physician and psychiatrist, she says.  

She looks forward to serving on a care team and intervening earlier with nutrition therapy — an opportunity she did not have as a registered dietitian. 

As she begins medical school, Zhang’s thoughts are on the people who helped make the journey possible. 

“I’m thinking about my family: My grandparents were refugees, with very poor health literacy. My parents sacrificed for my education. My sister believed in me and gave me a nudge. I could not have gotten here without the support of my husband, in-laws and friends,” Zhang said. I am investing in myself and modeling being a lifelong learner to my children.” 

The oral medication was approved by the U.S. Food and Drug Administration in 2024 to treat anemia caused by chronic kidney disease in adults. The drug is currently approved for once-daily use.

The new trial evaluated the safety of administering it three times a week rather than daily, aligning treatment with a typical patient’s dialysis clinic visits.

“Offering patients a treatment that aligns with their regularly scheduled dialysis sessions ensures adherence and reduces the burden of managing yet another medication at home,” said Shuchi Anand, a kidney specialist and professor in the Department of Internal Medicine at UC Davis Health.

Anand served on the executive steering committee for the clinical trial, helping to design the study, oversee its implementation and evaluate its outcomes.

Need for new treatment options

Many patients on dialysis develop anemia because damaged kidneys produce less erythropoietin (EPO), the hormone that stimulates red blood cell production. Frequent blood draws and iron loss during dialysis sessions can further lower blood counts. 

Treatment typically includes iron supplementation, EPO-stimulating injections and, more recently, oral medications to help reduce fatigue and prevent complications associated with low red blood cell levels.

“The goal of this trial was to broaden the range of treatment options available to patients,” said Anand. “We haven't seen a new anemia therapy for people on dialysis in more than two decades. That makes it especially important to develop safe and effective alternatives.”

The award will allow McBeth to spend six months on research to improve trauma care in a country she's very familiar with — The Gambia — where she has trained healthcare workers for years. 

Her Fullbright work will support the country's National Trauma Injury Prevention and Management Plan for 2025–2029. The plan was created after a deadly stadium collapse prompted the need for stronger emergency care systems.

Unlike the United States, emergency medicine is not yet recognized as an independent medical specialty in The Gambia and many other low- and middle-income countries. As a result, emergency care is often delivered by physicians from multiple disciplines without standardized emergency medicine training, creating gaps in trauma care, triage and the management of critically ill patients. 

During her six-month Fulbright-sponsored appointment, McBeth will partner with clinicians and health system leaders in The Gambia to develop a longitudinal emergency and trauma care curriculum for medical residents and medical officers. Her research will evaluate best practices for implementing emergency and trauma care systems, including improvements in clinical workflow, patient outcomes, provider knowledge and attitudes and strategies to optimize the transfer of injured patients across the country's healthcare system. 

“I am honored to receive this prestigious award,” McBeth said. “The Fulbright is a meaningful recognition of the work we’ve been doing in The Gambia and the difference it is making. This opportunity will allow us to spend six months focused on improving trauma care, helping us build on our progress and reach more people. I’m grateful for the support and recognition this award provides.”