Update Your ProfileAcademic Title:
Clinical Assistant Professor
Primary Appointment:
Medicine
Additional Title:
Director of Palliative Care for IHV Clinical Programs
Location:
29 S Greene St, Suite 300
Phone (Primary):
(410) 328-7129
Phone (Secondary):
(410) 328-5725
Fax:
(410) 328-4430
Education and Training
- A.B., Randolph Macon Woman’s College, Lynchburg, VA
- M.L.S., University of Maryland, School of Library and Information Science, College Park, MD
- M.D., University of North Carolina School of Medicine, Chapel Hill, NC
- Internship (Internal Medicine/ Primary Care), Medical University of South Carolina, Charleston, SC
- Residency (Preventive Medicine), University of Maryland Hospital, Baltimore, MD
- Residency (Internal Medicine), University of Maryland Hospital, Baltimore, MD
- Fellowship (Oncology), University of Maryland Cancer Center, Baltimore, MD
Biosketch
Dr. Alexander is a physician educator with over 30 years clinical and research experience in delivery of palliative care services for persons with chronic viral illness. She joined the UMB-SOM IHV in 1997 as an Assistant Professor of Medicine and Director of Palliative Care. Currently, she is the Medical Director for the UMMC Midtown Campus Palliative Care Program. Recent educational activities have addressed the End-of-Life and Bereavement needs of family members of persons dying with limited visitation opportunities during the COVID-19 pandemic in Baltimore.
Dr. Alexander is a Fellow of the American Academy of Hospice and Palliative Medicine and an internationally recognized expert for those living with HIV disease. She has focused care, teaching and research upon the early integration of the palliative approach with HIV management. Dr. Alexander has served as Course Master for multiple regional, national and international workshops and conferences regarding implementation of the palliative approach and/or integration of medical and behavioral health care for persons living with HIV disease. She has lectured and/or precepted clinical care throughout North and South America, 11 African countries, Eastern and Western Europe, the UK, Ukraine, Haiti and parts of Asia.
With collaborators in the UK and East Africa, Dr. Alexander completed the first prospective, longitudinal controlled trial comparing pain management and reporting outcomes that evaluated integrated HIV outpatient palliative care in the presence of antiretroviral therapy to substantiate an essential role for Palliative Care alongside HIV treatment, regardless of prognosis. Dr. Alexander, and MPI Dr. Victoria Raveis of the Psychosocial Research Unit for Health, Aging and Community at NYU School of Dentistry, completed a prestigious Patient Centered Outcomes Research Institute (PCORI) contract to translate the African findings into a US setting. The CASA Study, a teaching intervention for staff, was meant to promote HIV disease control for young persons in syndemic environments where social determinants of health impede one’s ability to successfully engage and remain in care. The research team demonstrated the feasibility in the US of delivering concurrent HIV management and a palliative approach in the outpatient setting early in disease management. With the aging of the HIV population, Dr. Alexander has implemented and taught advance care planning for persons who had previously expected to die of their disease. During the COVID-19 pandemic, Dr. Alexander and the clinical team recruited and trained community volunteers to provide virtual support for families facing a loss with infection-control precautions in place.
Dr. Alexander’s National and International Leadership positions include having served as: President of the American Academy of Hospice and Palliative Medicine (2000); Medical Director, National Hospice and Palliative Care Organization (2001-2004); International Medical Director, Foundation for Hospices in Sub-Saharan Africa (2004-2007); Senior Technical Advisor in Tanzania for the AIDSRelief Consortium (2004-2007) to implement all aspects of antiretroviral care and treatment in 4 Regions; then Content Lead for Palliative Care and Support for the UMB SOM IHV International Programs (2008-2013). Her work includes policy, strategy, implementation, evaluation, mentorship and advocacy in resource-constrained settings.
Highlighted Publications
Alexander CS. Terminal Care: Where Does It Fit In Oncology? MD Med J-1989; 38(3):211.
Ross D, O'Mara A, Pickens N, Keay T, Timmel D, Alexander CS, Hawtin C, O'Brien III W, Schnaper D, Hospice and Palliative Care Education in Medical School: A Module on the Role of the Physician in End-of-Life Care. J Cancer Educ 1997; 12(2):152-156.
Ross D., Alexander CS, Management of Common symptoms in Terminally Ill Patients: Part I. Fatigue, Anorexia, Cachexia, Nausea and Vomiting. Amer Fam Physician 2001; 64(5): 807-814.
Harding R, Simms V, Alexander CS, Collins K, Combo E, Memiah P, Patrick G, Sigalla G, Loy G. Can palliative care integrated within HIV outpatient settings improve pain and symptom control in a low-income country? A prospective, longitudinal, controlled intervention evaluation. AIDS Care, 2013; 25(7):795-804. DOI: 10.1080/09540121.2012.736608
Douglas BR, Merlin J, Lum PJ, Ahmed E, Alexander CS, Corbett AH, Foley K, Leonard K, Glenn Jordan Treisman, and Peter Selwyn. "2017 HIVMA of IDSA Clinical Practice Guideline for the Management of Chronic Pain in Patients Living with HIV." Clinical Infectious Diseases 2017; 65(10): 1601-1606.
Alexander CS, Raveis VH, Karus D, Carrero-Tagle M, Lee MC, Pappas G, Lockman K. PharmD MA5, Brotemarkle R, Memiah P, Mulasi I, Hossain MB, Welsh C, Henley Y, Piet L, N’Diaye S, Murray R, Haltiwanger D, Smith CR, Flynn C, Redfield RR, Silva CL, Amoroso A, Selwyn P. A palliative approach can be used early in HIV disease management in the US to improve outcomes: findings and insights about young men who have sex with men in the era of disease control from the Care and Support Access (CASA) Study 2013-2019. Am J Hosp and Pall Med 2020: On-line first 8/27/2020. https://doi.org/10.1177/1049909120951129.
Additional Publication Citations
Keay T, Alexander CS, McNally K, Crusser E, Eger R, Hawtin C, Lowitt NR, Ross D., Adult Education Program Palliative Care for Nursing Facility Physicians: Design and Pilot Test. J of Pall Med (Winter) 2003; 3(4): 457-463.
Keay T, Alexander CS, McNally K, Crusser E, Eger R, Nursing Home Physician Educational Intervention Improves End-of-Life Outcomes. J Pall Med (Spring) 2003; 6(2): 205-213.
Karus D., Raveis V., Marconi K., Hanna B., Selwyn P., Alexander C., Perrone M., Higginson I., Service Needs of Patients with Advanced HIV Disease: A Comparison of Client and Staff Reports at Three Palliative Care Projects. AIDS Patient Care and STDs 2004; 18 (3): 145-158.
Karus D, Raveis VH, Marconi K, Selwyn P, Alexander C, Hanna B, Higginson I, Mental Health Status of Clients From Three HIV/AIDS Palliative Care Projects. Palliative and Supportive Care; (2004); 2, 125-138.
Ross DD, Shpritz D, Alexander CS, Carter K, et al. Development of Required Postgraduate Palliative Care Training for Internal Medicine Residents and Medical Oncology Fellows. J Cancer Educ 2004; 19:81-87.
Bedor M, Alexander C, Edelman Martin. Management of Common Symptoms of Advanced Lung Cancer. Current Treatment Options in Oncology 2005; 6(1): 61-68.
Emanual L, Alexander CS, Arnold R, Bernstein R, Dar R, Dellasantina R, Dykstra L, and Tulsky J. Integrating Palliative Care into Disease Management Guidelines, Palliative Care Guidelines Group Report. J Pall Med 2004;7(6):774-83.
Karus D, Raveis V, Alexander C, et al. Patient reports of symptoms and their treatment at three palliative care projects servicing individuals with HIV/AIDS. J of Pain & Sx Mant. 2005:30(5):408-17.
Royak-Schaler R, Gadalla SM, Lemkau, JP, Ross DD, Alexander CS, Scott D. Family Perspectives on Communication With HealthCare Providers During End-of-Life Cancer Care. ONF 2006; 33(4): 753-760.
Harding R, Powell R, Downing J, Connor S, Mwangi-Powell F, Defilippi K, Cameron S, Garanganga E, Kikule E, Alexander C. Generating an African Palliative Care Evidence Base: The Context, Need, Challenges, and Strategies. J Pain and Symptom Management. 2008; 36 (3):304-309.
Alexander CS, Memiah P, Henley YB, Kaiza-Kangalawe A, Shumbusho AJ, Obiefune M, Enejoh V, Stanis-Ezeobi W, Eze Charity, Odion E, Akpenna D, Effiong A, Miriti K, Adudda S, Oko J, Melaku GD, Baribwira C, Umutesi H, Shimabale M, Mugisa E and Amoros A. Palliative care and support for persons with HIV/AIDS in 7 African countries: implementation experience and future priorities. Am J Hospice & Pall Med, 2012; 29(4); 279-285.
Harding R, Simms V, Alexander CS, Collins K, Combo E, Memiah P, Patrick G, Sigalla G, Loy G. Can palliative care integrated within HIV outpatient settings improve pain and symptom control in a low-income country? A prospective, longitudinal, controlled intervention evaluation. AIDS Care, 2013; 25(7):795-804.
Riedel DJ, Mwangi I, Fantry L, Alexander CS, Hossain, M, Pauza D, Redfield RR, and Gilliam BL. High cancer-related mortality in an urban, predominantly African-American, HIV-infected population. JAIDS 2013 April; 27(7):1109-17.
Alexander CS MD FAAHPM, Pappas G MD PhD, Obiefune M MBBS, Brown-Henley Y RN, CHPN, Kaiza-Kangalawe A BS, Oyebola FO MBBS, DAWACS, MSc, MPhil. Palliative Medicine (UCT), Nwene E MBBS MPH, Stanis-Ezeobi W BSN, Enejoh V MSc, Nwizu C MD, Nwandu A MD, Memiah P DrPH, Oni B MD, Etienne-Mesubi M DrPH, Amoroso A MD, Redfield RR MD Pain management for persons living with HIV disease: experience with interprofessional education in Nigeria. Am J Hosp Pall Care, 2015 Aug; 32(5):555-62. Doi 10.1177/1049909114527153. Epub 2014 Apr 10.
Memiah P, Constance S, Henley Y, Mwakyusa S, Maghimbi A, Komba P, Mlila A, Haule V, Tull T, Stafford K, Etienne-Mesubi M, Alexander C. “Know your CD4 campaign”: 6-year outcomes from a quality improvement initiative to promote earlier initiation of antiretroviral therapy in Tanzania. International Journal of Medicine and Public Health; July-Sept 2014; 4(3):194-199.
Pappas G MD, Yujiang J MD, DrPH, Seiler N JD, Malcarney MB JD MPH, Horton KRN JD MPH, Shaikh I MD PhD, Freehill G MA, Alexander C MD, Akhter MN MD MPH, Hidalgo J ScD MSW MPH. Perspectives on the Role of Patient-Centered Medical Homes in HIV Care. American Journal of Public Health: July 2014, 104, (7):e49-352. Doi: 10.2015/AJPH.2014.302022.
CS Alexander, G Pappas, A Amoroso, M Lee, Y B-Henley, P Memiah, M Obiefune, A Kiromera, F Oyebola, V Tepper, A Kaiza-Kangalawe, L Hachaambwa, R Sheneberger, G Delva, C Nwizu, A Nwandu, E Nwene, V Enejoh, W Stanis-Ezeobi, A Edozien, C Barbwira, D patel, M Etienne-Mesubi, O Babatunji, J O’Neill, O Dix, R Redfield. Implementation of HIV palliative care: interprofessional education to improve patient outcomes in resource-constrained settings, 2004-2012. J Pain and Symptom Management. Sep16; 50(3):350-61. Epub 2015 Jul 16.
Research Interests
Curriculum development for non-palliative specialists to implement palliative skills to improve patient outcomes; Methods for providing support to both HIV patients and health professionals caring for them in the US and in resource-constrained settings; Importance of self-care for physicians and other members of the interdisciplinary care team; Care and support needs of persons dually impacted by cancer and HIV; and furthering the understanding of advance care planning for persons living with HIV disease.
Clinical Specialty Details
Dr. Alexander specializes in HIV/AIDS, hospice and palliative medicine.
Grants and Contracts
Patient Centered Outcomes Research Institute, Inc.
Award IH-1304-7297 2013-2016
Professional Activity
Currently with Dr. Victoria Raveis and colleagues at New York University, Dr. Alexander is finalizing a 3 year study and curriculum for the Patient Centered Outcomes Research Institute, Inc. (pcori.org) relative to the impact of teaching multidisciplinary non-palliative specialists critical elements of palliative care that can be implemented early in chronic illness to engage and retain challenging patients in care. She is Medical Director for the Palliative Care Service at the University of Maryland Medical Center – MidTown Campus and provides outpatient clinical care at the Oncology-Infectious Diseases Clinic in the Greenebaum Cancer Center.