Academic Pharmacy Now: 2019 Issue 5 by AACP

Academic Pharmacy

The News Magazine of the American Association of Colleges of Pharmacy

NOW

Volume 12 2019 Issue 5

Fighting Back Against Chronic Disease Pharmacists can help patients keep their health on track by partnering to manage chronic conditions. 18

Also in this issue: Cannabis in the Classroom 6 Expanding Access to Contraceptives 14

Pharmacists Help People Live Healthier, Better Lives.

who we are @AACPharmacy

Academic Pharmacy The News Magazine of the American Association of Colleges of Pharmacy

Pharmacists Help People Live Healthier, Better Lives.

1400 Crystal Drive, Suite 300 P Arlington, VA 22202 703-739-2330 P www.aacp.org Founded in 1900, the American Association of Colleges of Pharmacy is the national organization representing the interests of pharmacy education. AACP comprises all accredited colleges and schools of pharmacy, including more than 6,600 faculty, approximately 63,800 students enrolled in professional programs and 4,800 individuals pursuing graduate study.

NOW

CEO & Publisher

Lucinda L. Maine Editorial Advisor

Lynette R. Bradley-Baker

Editorial Director

Maureen Thielemans Managing Editor

Letters to the Editor

Jane E. Rooney

We welcome your comments. Please submit all letters to the editor to communications@aacp.org.

About Academic Pharmacy Now

Academic Pharmacy Now highlights the work of AACP member pharmacy schools and faculty. The magazine is published as a membership service.

Change of Address

For address changes, contact LaToya Casteel, Member Services Coordinator, at lcasteel@aacp.org.

Advertising

For advertising information and rates, visit https://www.aacp-mediaplanner.org/ or contact Samantha Roesler, AACP Media & Event Sales, at samantha.roesler@mci-group.com

Editorial Assistant

Kyle R. Bagin

Communications Advisor

Stephanie Saunders Fouch

Art Director

Tricia Gordon Digital Designer

Sean Clark

Freelance Writer

AACP’s Professional Supporter Program Achievement Supporter

Joseph Cantlupe

Promotion Supporter

Freelance Writer

Emily Jacobs

Freelance Writer

Athena Ponushis

Academic Pharmacy NOW  2019 Issue 5

Volume 12 2019 Issue 5

@AACPharmacy a look inside

campus connection

St. Louis College of Pharmacy Faculty Receive $6.3 Million in NIH and Department of Defense Grant Awards

Medical Marijuana Goes Mainstream Pharmacy schools are beginning to offer programs to study medical marijuana as its use expands across the country.

The grant funding will support research related to Alzheimer’s disease as well as musculoskeletal disorders.

community impact

Binghamton University Certified as an Opioid Overdose Prevention Program Site

Pharmacists can help patients keep their health on track by partnering to manage chronic conditions.

The university’s program, which promotes naloxone awareness and use, becomes one of the first public universities to be certified in New York State.

Fighting Back Against Chronic Disease

Prescribing the Pill By expanding access to birth control, pharmacists are improving public health and making the case for provider status.

@AACPharmacy

Don’t Wait: Membership Renewal Now Open 2020 AACP NMA Conference Award Nominations Due December 4

28 February 8–11, 2020 Wyndham Grand Rio Mar Puerto Rico Golf & Beach Resort

Save $150 when you register by December 10!

Academic Pharmacy NOW  2019 Issue 5

community note publisher’s impact

Dear Colleagues: AACP’s newest senior staff member, Dr. Terri Moore, just returned from the meeting of the new Pharmacists Section of the American Public Health Association (APHA) in Philadelphia. While meeting with this highly energized group of public health-oriented pharmacists, Terri had opportunities to both share AACP’s perspective on pharmacists’ impact on public health and learn about the diverse and exciting practice and research efforts of attendees. It is highly significant that APHA now recognizes pharmacists as a section, opening new opportunities to forge connections with other public health leaders. I wish this issue of Academic Pharmacy Now had been in Terri’s hands at the meeting! The stories of our members’ education, research and practice activities in just three key areas under the broad public health umbrella— chronic disease prevention and treatment, cannabis and increasing access to contraceptives—underscore our message that pharmacists, student pharmacists and faculty are key contributors to local, state, national and international public health programs. We all know the immunization story with the expanding empowerment of pharmacists to make life-saving vaccines more broadly accessible in every state and U.S. territory. In reflecting with Terri as she prepared for the APHA meeting, I shared how many in the Academy reacted to the 2004 AACP CAPE Educational Outcomes revision. This was the version of the CAPE Outcomes that essentially characterized the work of pharmacists and the curricular framework in three dimensions: Pharmaceutical Care, Systems Management and Public Health. More than one educator questioned the appropriateness of including public health as one of the three legs on our Pharm.D. education “stool.” This surprised people outside the profession as well. Across the 15 years since that was released, we have truly lived into our contention that there are many ways for pharmacy to contribute to public and population health. Our Pharmacists for Healthier Lives campaign, now in its second year, promotes the accessibility of pharmacists. While current economic disruption places our access somewhat in peril, by fully activating the services profiled in this issue and preparing our graduates to activate critically needed public health services, pharmacists will earn the deserved reputation as the most accessible point of access for primary and secondary prevention. Sincerely,

Lucinda L. Maine, Ph.D., R.Ph. CEO and Publisher

Academic Pharmacy NOW  2019 Issue 5

campus connection

St. Louis College of Pharmacy Faculty Receive $6.3 Million in NIH and Department of Defense Grant Awards The grant funding will support research related to Alzheimer’s disease as well as musculoskeletal disorders. St. Louis College of Pharmacy faculty know is occurring in those suffering In addition, Burris has been awarded conducting research in the Center more than $400,000 from NIH to inves- from the disease.” In addition to new for Clinical Pharmacology have been funding from NIH, college faculty at tigate the role of ROR nuclear receptors awarded more than $6.3 million in grant in regulating critical inflammatory path- the center have received a three-year, funding from the National Institutes of ways in the brain. Burris will collaborate $2.3 million grant from the Department Health (NIH) and the U.S. Department with Dr. Erik Musiek, associate profesof Defense that will support research of Defense to support projects focused focused on the development of therasor of neurology at the Washington on the treatment of Alzheimer’s disease University School of Medicine, to study peutic compounds to treat or prevent and musculoskeletal disorders. The these pathways that are regulated by the overuse and traumatic injuries and NIH has provided more than $4 million inflammasome and have been found to treat musculoskeletal injuries, namely to support two Alzheimer’s-related amongst members of the military. be overactive in those with Alzheimer’s initiatives. The funding includes a $3.7 disease. This knowledge, along with Specifically, the research will focus million grant that will fund research the findings of previously conducted on the creation of drug compounds designed to examine REV-ERB nuclear research that determined ROR nuclear designed to accelerate muscle recovery, receptors and their ability to help rereceptors can be used as drug targets to decrease muscle atrophy and help those duce inflammation of the nervous sysinhibit the inflammasome, will allow rewho are immobilized maintain muscle tem and improve cognitive function in searchers to formulate drug compounds those with Alzheimer’s and, potentially, designed to reduce inflammasome activ- mass. Burris and Dr. Bahaa El-Gendy, assistant professor of medicinal chemother neurodegenerative disorders asity in the brain. istry at the college, will serve as the sociated with neuroinflammation. Dr. principal investigators on the project. “Our Alzheimer’s research is exciting Tom Burris, vice president for research because we are looking at developing and Alumni Chair in Pharmaceutical “This is important research because new and improved drug compounds to Education, is serving as the principal the drug compounds we are developtreat this disease that affects so many,” investigator on the project. ing have the potential to positively Burris said. “While there impact the health and quality of life is no cure for Alzheimer’s of those in the military community by yet, our work will play providing faster recovery times and an important role in the improved treatment options for those creation of drugs that can who are severely injured in combat or reduce or eliminate cogniduring training,” Burris said. “In some tive decline and suppress cases, these drugs have the potential the brain inflammation we to reduce the healing time for severe muscle injuries by 50 percent, and that’s a big deal when it comes to preventing NIH grant funding will support infection and reducing the amount of Alzheimer’s research by Dr. Tom Burris that will lead to creating downtime that our military members drugs that can reduce or elimican face.” P nate cognitive decline.

Academic Pharmacy NOW  2019 Issue 5

campus connection

Medical Marijuana Goes Mainstream Pharmacy schools are beginning to offer programs to study medical marijuana as its use expands across the country. By Joseph A. Cantlupe Ninety years ago, marijuana was widely known as the “evil weed,” prompting the 1936 propaganda film “Reefer Madness” about its dangers. In the ensuing decades, study after study gradually backed off the hyperbole about marijuana, though it is still under a spotlight of continued research. In today’s world, marijuana is sometimes used to treat what ails us. Pharmacy is keeping pace as medical marijuana goes mainstream. Pharmacy schools are offering programs to study medical marijuana not only for student pharmacists but others seeking to learn more about it for myriad reasons, including regulatory or business purposes as well as for improved patient care. As the industry expands, more colleges are adding cannabis or marijuana courses to their portfolio. Medical marijuana is gaining traction in America with more states legalizing its use and more dispensaries opening across the country. Some educators point to the increasing need for medical professionals—including physicians, nurses and pharmacists—to properly advise patients about medical marijuana. At last count, 33 states as well as the District of Columbia, Guam and Puerto Rico have legalized medical marijuana. Three states are already requiring that pharmacists be part of the dispensing process, according to the National Community Pharmacists Association. For instance, New York State requires a pharmacist to be on the premises and supervising the activities within a marijuana dispensing facility. The legalization movement is expected to broaden to more states. “The number is only expected to increase in the future, fueling a demand for an educated workforce that is well-trained in both the science and therapeutic effects associated with this medicinal plant,” said Dr. Natalie D. Eddington, dean and professor at the University of Maryland School of Pharmacy. A 2019 study from the University of Pittsburgh School of Pharmacy found that 62 percent of U.S. pharmacy schools surveyed incorporated medical cannabis into their doctor of pharmacy programs and another 23 percent planned to include courses in their programs in the next 12 months.

Academic Pharmacy NOW  2019 Issue 5

New Horizon The University of Maryland School of Pharmacy has launched a new master of science in medical cannabis science and therapeutics, one of the first in the country to do so. The two-year program is designed for an array of healthcare professionals, scientists, regulators, dispensary owners and staff and anyone interested in the field. The program was developed “because of a knowledge gap (in medical cannabis), particularly for healthcare professionals,” said Dr. Leah Sera, assistant professor in the Department of Pharmacy Practice and Science, director of the school’s new master’s program and a clinical pharmacist. University of the Sciences in Philadelphia has launched a medical cannabis MBA program, specifically targeting the business of cannabis, said Dr. Andrew Peterson, John Wyeth Dean Emeritus and professor of clinical pharmacy and health policy at USciences. Peterson said that the “combination of healthcare, pharmaceutical and cannabis business knowledge and expertise will be incredibly valuable as graduates move forward in their careers.” The USciences courses are provided through the business department in conjunction with the Substance Disorders Institute at USciences and include partnerships with Philadelphia-area cannabis organizations, Peterson said. While pharmacy schools are beginning to tap into coursework for medical marijuana, the University of Mississippi School of Pharmacy has been involved in researching the plant for more than 50 years. A 12-acre farm run by the university has been the sole domestic source of cannabis for government-funded and approved research. Through the National Institute on Drug Abuse (NIDA), the University of Mississippi provides marijuana to researchers across the U.S. under NIDA’s Drug Supply Program. After an open competition among institutions around the country, the University of Mississippi won the first contract in spring 1968 to be the government’s provider for marijuana for research purposes. “During our 50 years of cannabis research we have been involved in a multitude of projects involving the botanical and

campus connection

The University of Mississippi’s 12-acre farm has been the sole domestic source of cannabis for government-funded and approved research.

chemical properties of the plant as well as ongoing development of candidates for new cannabis-based drugs and novel drug delivery systems,” said Don Stanford, assistant director, Research Institute of Pharmaceutical Sciences, which is part of the school of pharmacy. After some legal challenges, the government has now opened the door for more than 30 other organizations to grow cannabis for research, although the process has yet to begin, officials said.

A Complicated Substance While medical marijuana presents many possibilities, the plant itself is extremely controversial with questions over its legality, overall addictiveness and effectiveness. Marijuana use is legal in some states but it’s still illegal from the federal government’s perspective. About 85 percent of Americans support legalizing medical marijuana. Because the marijuana plant contains chemicals that scientists say could help a range of illnesses and symptoms, many people argue it should be legal for medical purposes. The major thrust of medical marijuana has been for pain control. Chronic pain impacts millions of Americans. Marijuana has more than 100 active components. THC, which stands for tetrahyrocannabiniol, is the chemical that ignites the “high” that is linked to marijuana use. CBD,

which stands for cannabidiol, is derived from the hemp plant, a “cousin” of the marijuana plant, according to Harvard Medical School. CBD has been used by patients for a variety of conditions, such as pain relief, or to combat anxiety or insomnia. CBD does not have intoxicating properties (although it is also present in the marijuana variety of Cannabis sativa). The marijuana plant remains classified as a Schedule I substance under the federal Controlled Substances Act. Schedule I substances are considered to have a high potential for dependency and no accepted medical use, making distribution of marijuana a federal offense. The law, however, is generally applied only when people possess, cultivate or distribute large quantities of cannabis, according to Americans for Safe Access, an organization that advances legal medical marijuana therapeutics and research. The Obama administration encouraged federal officials not to prosecute people who distribute marijuana for medical purposes. The Trump administration differs; it has allowed federal prosecutors to decide how to prioritize enforcement of federal marijuana laws. Marijuana dispensaries have grown because federal law prohibits cannabis from being prescribed and filled at pharmacies for medical or recreational purposes. State-regulated dispensaries are designated under regulations for the growth and consumption of cannabis, noted Americans for Safe Access.

Academic Pharmacy NOW  2019 Issue 5

campus connection

The medical cannabis MBA program at University of the Sciences in Philadelphia offers a “combination of healthcare, pharmaceutical and cannabis business knowledge and expertise [that] will be incredibly valuable as graduates move forward in their careers.” — Dr. Andrew Peterson In Maryland, Strategic Advantage As the marijuana industry began expanding, University of Maryland officials believed they needed to initiate a program to give students a “competitive advantage” in pursuing a career in the medical cannabis industry, whether working in healthcare or not. Indeed, the program is specifically designed for students with or without a background in science or medicine, said Sera. The Maryland curriculum includes coursework in “policy and direct patient care,” with a “grounding in the basic science of pharmacology and the development of the formulation and chemistry of different cannabinoids and how we can treat different conditions,” Sera said. For students, the courses also provide a “grounding in the history of cannabis regulation in our country in order to participate in the development of well-informed medical cannabis policy moving forward.” Faculty for the medical cannabis program include instructors from the pharmacy school immersed in the basic sciences, teaching pharmacology and chemistry, as well as clinicians. Besides those working in the medical field, adjunct professors who are knowledgeable in the study of cannabis will be engaged. Sera herself is a specialist in pain medicine and palliative care. At least half of the 150 students who were accepted into the program’s first class, which began in August, have a background in science, chemistry, medicine or microbiology. Others include attorneys, educators and patient advocates, and even an art student. The classes are primarily online with an in-person symposium held once each semester. Neil Leikach, president of a Catonsville-based pharmacy and a BSP graduate of the University of Maryland, is a student in the master’s program and is particularly interested in learning about evolving regulations around cannabis that are impacting pharmacies.

Academic Pharmacy NOW  2019 Issue 5

“This has been a Schedule I drug, and states are looking at this differently. There are many opportunities to help patients,” Leikach said. “States are really catching up on how to help patients with different disease states.” Leikach said he’s attended classes that have focused on regulations and drug interactions with cannabis. He’s pleased with the course offerings. “As pharmacists we need more information, and there is not enough good information out there.”

A Matter of Business in Philadelphia As USciences officials began looking into the academic program for cannabis instruction, they believed that it should examine not only the science of the plants but also something that has not received enough focus: the business of medical marijuana, its marketing and sales. “There are many unique aspects to the medical cannabis and hemp industry,” noted Peterson. As he examined the program and worked with experts in the field, Peterson said he was surprised by the complexity involved in the underlying business of marijuana and the horticulture process. “I learned so much about the science of growing plants,” he said. “The humidity, pest control, so many things.” The legal aspect will also be explored. Students will be asked questions such as “what is the status of cannabis as a controlled substance in the U.S. under federal law as well as state to state?” Peterson said. USciences sought assistance in developing its program through a memorandum of understanding agreement with Franklin BioScience, a Coloradobased cannabis grower and retailer. Franklin BioScience assisted in developing educational programs about the cannabis plant and its medicinal value. Four separate courses are being offered online as part of the Cannabis Industry Masters of Business Administration option under the pharmaceutical and healthcare business curriculum. While any student can take the courses, priority is

campus connection

Photo credit: Matthew Di’Agostino

Attendees at the University of Maryland 2019 fall symposium for the MS in Medical Cannabis Science and Therapeutics Program.

given to MBA students, and there is no certificate for taking cannabis-related electives, school officials said. The courses include introduction to the medical cannabis industry; finance and regulation in the medical cannabis industry; cannabis marketing and sales; and a project-based course where students will work to write a business plan or bring a product to market. Currently 14 people are enrolled; officials are still recruiting for the next cohort, all of them MBA students (some of whom are pharmacists). Like Maryland, USciences does not have an on-site cannabis lab.

Mississippi: Ahead of the Field The University of Mississippi has not offered an advanced degree in medical marijuana despite its research on the substance, officials said. “We could not consider doing so due to our long-standing efforts to develop new cannabis-based therapies as (Food and Drug Administration) approved products, but we are now exploring the possibilities of a cannabis program here,” said Stanford. From 2005 to 2015, the University of Mississippi was involved in discovering 43 new cannabinoids, which are gener-

Academic Pharmacy NOW  2019 Issue 5

campus connection

Researching the Risks and Benefits While much of the academic community is focusing on medical marijuana, many questions remain about the impact of the drug and where it fits into pharmaceutical treatment regimens. That’s where the University of Florida College of Pharmacy is jumping in. The university is leading a statewide consortium studying health outcomes related to medical marijuana by evaluating its benefits and risks. The consortium will tackle safety and effectiveness outcomes but also specific intricacies of medical marijuana inherent in its dosing routes of administration and the effects of smoking versus other methods of consumption, according to Dr. Almut Winterstein, a professor and chair in pharmaceutical outcomes and policy at the University of Florida College of Pharmacy and director of the University of Florida Center for Drug Evaluation and Safety. As the demand grows in the emerging marijuana and cannabis market in Florida, she said there is an “urgent need” for evidencebased studies revolving around medical marijuana. Under the program, the consortium of academic institutions will create a statewide resource for health outcomes research related to medical marijuana, said Winterstein, who was appointed director of the consortium. As Winterstein sees it, marijuana would be put to the test in the same way as any other drug in development. “As with any other medical treatment, providers, patients and regulators need the necessary information to evaluate its benefits and risks,” she said. “At the time of drug approval, we really don’t know much about side effects and how the new drug works in populations with multiple comorbidities” because that’s not the focus of clinical trials. That’s why

Academic Pharmacy NOW  2019 Issue 5

post-marketing safety and effectiveness studies are pivotal, and the same applies to medical marijuana. “Really we know very little about what medical marijuana actually does, and for me this requires basically the same systematic evaluation as is in place for any other drug that is on the market.” While there are similarities with other drugs in studying the impacts of medical marijuana, there is a major difference: for the most part, medical marijuana lacks Food and Drug Administration approval, she noted. As a result, the Florida research “is probably more important because we don’t have approval process on the front end. We really don’t know much about efficacy. And it’s being used by patients who have really serious problems.” If patients who have Parkinson’s disease or multiple sclerosis take medical marijuana, “we don’t know the degree medical cannabis interacts with other drugs necessary to control the disease,” she continued. While the FDA has not approved marijuana as a safe and effective drug for any indication, it has approved a drug that contains purified cannabidiol, one of the more than 80 active chemicals in marijuana, for the treatment of seizures associated with Lennox-Gastaut syndrome or Dravet syndrome in patients two years or older. The FDA also has approved drugs containing a synthetic version of a substance in marijuana. At least 20 marijuana research studies have been initiated in the past five years in Florida, where as many as 200,000 people have been registered to receive medical marijuana, including people suffering from severe and life-threatening health conditions. Researchers have been examining the health benefits and risks of medical marijuana from

different perspectives and include outcomes research related to HIV infection, chronic pain in older adults and cannabinol treatment for children with drug-resistant epilepsy. The university has been involved in a medical marijuana program since 2014. It has extensive research infrastructure and a broad faculty, Winterstein said, and is well positioned to lead the Consortium for Medical Marijuana Clinical Outcomes Research, which comprises public and private universities engaged in research on clinical outcomes of medical marijuana. It will receive $1.5 million in annual recurrent funding from the state to support the research. The university proposes to: • Build a repository known as the Medical Marijuana Clinical Outcomes Repository or MEMORY that can track patient outcomes over time. • Develop a Clinical Research Core that will provide infrastructure support for studies and establish a competitive grants program offering $600,000 annually from the state appropriation to participating institutions. The core will assemble a group of physicians and clinical partners to recruit patients for medical marijuana research studies. In addition, the core plans to conduct a survey of medical marijuana providers in Florida, engage a scientific expert group and provide opportunities for the public and industry to help inform the most urgent clinical research priorities, according to the university. The repository will be available to researchers within the consortium and create a statewide resource for realworld health outcomes research related to medical marijuana.

campus connection

ally considered the most pharmacologically active compounds in the plant, according to the university. “Our contributions to the understanding of the chemical makeup and biological properties of the Cannabis sativa plant has spanned several decades,” Stanford said. “The longtime use of cannabis for the treatment of glaucoma is another example of how we have been involved in the search for new cannabis therapies.” Photo credit: Matthew Di’Agostino

In the early 1970s, studies in both humans and animals indicated that smoking marijuana might provide relief for the intraocular pressure in the eyes, according to Stanford. Taking that a step further, the University of Mississippi conducted studies and provided the standardized cigarettes used in the studies conducted in the U.S. This evidence “led to one of the earliest expanded access programs by the FDA that allow patients access to unapproved treatments,” he said. The university’s research efforts also explored cannabis-based therapies for dry eye, macular degeneration and diabetic retinopathy.

The University of Maryland’s program provides a “grounding in the history of cannabis regulation in our country in order to participate in the development of wellinformed medical cannabis policy moving forward.” — Dr. Leah Sera (above)

Although the University of Mississippi was the sole contractor with the government for all these years, other researchers are seeking to grow marijuana for contracts now that the process is going to open to more than 30 other organizations and academic institutions. “The University of Mississippi applies for the contract just like everyone else,” said Dr. Mahmoud ElSohly, director of the university’s Marijuana Project and professor of pharmaceutics. “Our research capability, our expertise, our knowledge in the areas of cannabis chemistry and production our personnel and facilities—everything is in place to make us very competitive.” The Drug Enforcement Administration said it “anticipates that registering additional qualified marijuana growers will increase the variety of marijuana available for these purposes.” P Joseph A. Cantlupe is a freelance writer based in Washington, D.C.

Welcoming Our New Dean on November 1, 2019 Jayanth Panyam, PhD Celebrated Research Scientist and the University of Minnesota College of Pharmacy’s Former Endowed Professor of Targeted Drug Delivery and Head of Department of Pharmaceutics

Academic Pharmacy NOW  2019 Issue 5

community impact

Binghamton University Certified as an Opioid Overdose Prevention Program Site The universityâ&#x20AC;&#x2122;s program, which promotes naloxone awareness and use, becomes one of the first public universities to be certified in New York State. By Emily Jacobs As substance misuse and opioid overdoses persist across the nation, many states and communities have launched overdose prevention programs. These programs often seek to prevent opioid overdose fatalities by training first responders, medical professionals and the general public to recognize overdose symptoms and to administer naloxone. Since April 1, 2006, New York State has allowed non-medical persons to administer naloxone to prevent fatal opioid overdose. Further supporting the cause, the state has increased access to the lifesaving medication through standing orders at pharmacies, the Naloxone Copayment Assistance Program (N-CAP) and Opioid Overdose Prevention Pro-

Student pharmacists participate in an event to educate community members about appropriate naloxone use.

Academic Pharmacy NOW ď&#x201A;§ 2019 Issue 5

grams. The New York State Department of Health (NYSDOH) furnishes naloxone to each registered opioid overdose program that educates its target population in recognizing opioid use disorder and appropriate naloxone use. Dr. Bennett Doughty, clinical assistant professor of pharmacy practice at Binghamton Universityâ&#x20AC;&#x2122;s School of Pharmacy and Pharmaceutical Sciences, saw an opportunity for the university to leverage this state support in creating its own program. Last spring, Binghamton became one of the first universities to be certified by NYSDOH as an Opioid Overdose Prevention Program site. Although naloxone dispensing has increased in recent years, it continues

to be underutilized. Per the CDC, while 2018 saw 38.4 million high-dose opioid prescriptions dispensed, there were only about 556,847 naloxone prescriptions dispensed. In other words, about nine naloxone prescriptions were dispensed for every 200 patients who were prescribed high-dose opioids in 2018. Because of their diverse student bodies and community involvement, college and university campuses have enormous potential to help increase awareness of naloxone and reduce opioid overdose fatalities. Doughty pointed out that opioid overdoses continue to rise in central New York, with the fastest increases found among college-age students. Despite this, few universities

community impact

“It’s of the utmost importance that pharmacists, being the most accessible healthcare profession, really are able to talk with community members about what [naloxone] does, that it applies to everyone and the associated stigma.” — Dr. Bennett Doughty

and colleges have their own opioid overdose prevention programs.

Empowering the Community to Take Action Doughty worked with Dr. Richard Moose, medical director of the Decker Student Health Services Center, to develop Binghamton University’s Opioid Overdose Prevention Program. The program developed its policies and registered with the state during the spring 2019 semester. Now officially launched, the program is seeking additional trainers as well as opportunities to partner with community organizations and participate in community events to expand naloxone awareness and use. Most naloxone programs are aimed at first responders and other medical professionals. In developing the educational curriculum for Binghamton University’s Opioid Overdose Prevention Program, Doughty and his partners endeavored to provide education geared toward community members “to make sure that we created a program that is of importance and of understanding to the general community member,” he said. Doughty has begun a research phase with Dr. William Eggleston, also of the School of Pharmacy, and Dr. Sarah Young, of the university’s Department of Social Work. Both Eggleston and Young are helping to assess the

program’s effectiveness in educating participants and empowering them to use naloxone appropriately. Assessing their program can be a challenge, Doughty noted, because there is no validated standard program that can be used as a control. Instead, his team is working to demonstrate that their curriculum is unique, effective and applicable to the average community member and can be adapted and individualized to different audiences. Data will be collected at multiple checkpoints using both validated and qualitative measures, including the Opioid Overdose Attitudes Scale (OOAS) and the Opioid Overdose Knowledge Scale (OOKS), to show efficacy in both the short and long term. This measures respondents’ knowledge and confidence in recognizing an opioid overdose and using naloxone. Each checkpoint has been scheduled to match the standard schedule of a Binghamton student, with trainings set for targeted student groups about once every semester (i.e. residential life). Doughty and his partners began the program among the school’s Residential Life communities, with plans to expand to other groups within the university. He also worked with several secondyear student pharmacists on the program. These students were able to

practice background research, engage with university administration staff and launch their own research projects. Doughty said that learning to communicate with the general public is an important skill for student pharmacists, as conversations with community members can help reduce the stigma associated with naloxone use and opioid use disorder. “It’s one thing to just dispense it or offer it, but another thing to take it a step further and say, ‘Let’s talk about this,’” he said. “[Naloxone] shouldn’t be a stigmatized area but it is. So it’s of the utmost importance that pharmacists, being the most accessible healthcare profession, really are able to talk with community members about what it does, that it applies to everyone and the associated stigma. If we just teach people how to use naloxone, we ignore the fact that community members may not truly understand the importance/ applicability of it. Even if community members are experts in administering the product, if they don’t perceive naloxone as important and necessary, they may never even carry it. This is why our developed curriculum focuses very heavily on exploring this stigma and how the disease impacts the community at large.” P Emily Jacobs is a freelance writer based in Toledo, Ohio.

Academic Pharmacy NOW  2019 Issue 5

community impact

Prescribing the Pill By expanding access to birth control, pharmacists are improving public health and making the case for provider status. By Athena Ponushis Contraception has been named by the Centers for Disease Control and Prevention (CDC) as one of the 10 greatest public health achievements of the 20th century, yet access to contraception can be challenging, even today. In 2016, Oregon and California implemented groundbreaking laws authorizing pharmacists to prescribe hormonal contraceptives—pills, patches, injection and rings—removing one obstacle for women: making an office visit to obtain a physician’s prescription. Other states followed suit. Presently, 10 states have given pharmacists this authority and more are considering the move, aspiring to make access to birth control easier, as states continue to grapple with high rates of unintended pregnancy. The CDC reports that nearly half (45 percent) of all pregnancies in the United States are unintended. Expanding the role of pharmacy to include contraception allows pharmacists to help women avoid unintended pregnancies and live healthy, satisfying lives. Pharmacists are accessible; 93 percent of Americans live within five miles of a community pharmacy. By prescribing hormonal contraceptives, pharmacists are helping the women who need it the most, those living in underserved communities who may not have the means of getting birth control any other way. Practicing pharmacists and student pharmacists are being trained and colleges of pharmacy are doing the research to show the extent of their reach. Dr. Allie Jo Shipman, director of state policy for the National Alliance of State Pharmacy Associations, sees this progress as pivotal. “We know this is a public health issue and that access to hormonal contraceptives is a problem in a lot of states. Being able to show that pharmacists are not just in the store to help you with your chronic medications

Academic Pharmacy NOW  2019 Issue 5

but that they can expand access to care for patients is significant, because it shows that pharmacists really can impact public health,” Shipman said.

Proof of Impact Oregon pharmacists have written 10 percent of all new birth control prescriptions in the Medicaid population within the first two years the state gave pharmacists prescriptive authority. Researchers estimate that by prescribing contraceptives, pharmacists in Oregon were instrumental in averting more than 50 unintended pregnancies, saving the state approximately $1.6 million. Dr. Lorinda Anderson, clinical assistant professor at Oregon State University College of Pharmacy (OSU) and an author on these recent studies, was tasked with creating pharmacyspecific training for prescribing contraception for the state. Anderson sat on a committee formed by the Oregon Board of Pharmacy to help set the rules and regulations that would ultimately be adopted in the new law, and her training program, currently the only one approved by the Oregon board, received editing support from OBGYNs who wanted to see the policy succeed.

community impact

“Access to hormonal contraceptives is a problem in a lot of states. Being able to show that pharmacists are not just in the store to help you with your chronic medications but that they can expand access to care for patients is significant, because it shows that pharmacists really can impact public health.” — Dr. Allie Jo Shipman

“I have had a chance to talk to faculty in other colleges of pharmacy across the country who, even if their state doesn’t allow it yet, want to start teaching [how to prescribe hormonal contraception] in their schools,” Anderson said. Specifically, Oregon has a “standard procedure algorithm” and “self-screening risk assessment questionnaire,” which walk pharmacists through the process, laying out the steps of a pregnancy screen, medication screen, blood pressure screen, patient history evaluation and counseling for the chosen contraception. Oregon’s documents have been picked up by other states implementing similar programs (https:// www.oregon.gov/pharmacy/Pages/ContraceptivePrescribing. aspx). “There is no copyright on the documents, so they are free to duplicate,” Anderson said. “Some have exact duplications—Colorado and Utah come to mind—and others have used them as a starting template.” Shipman sees the OSU studies and others as crucial because the data help move practice forward. When pharmacists can say, ‘Look, here’s the good we did. We increased access to care, we reduced the burden on the state, we are seeing better health outcomes for our constituents in our state because we are allowing pharmacists to do this,’ then it makes a compelling case for expanding the scope of practice in other areas. Now that pharmacists can be involved in prescribing contraception, Shipman said they need to get involved. In states where laws have already passed, pharmacists must complete whatever training may be required, implement the service at their practice site and advertise the service to their community. Schools must prepare students, even if pharmacists in the state do not presently have prescriptive authority. That could change in a few years, or students could practice in a state that does allow independent prescribing of contraceptives by pharmacists. “I don’t see this slowing down at all, and in my opinion, it’s always better to be prepared for where practice is going than to try to play catch-up,” Shipman said.

Filling the Gap Dr. Amy Bachyrycz, clinical assistant professor at the University of New Mexico College of Pharmacy and practicing pharmacist, has heard patients express satisfaction, with comments such as, ‘I can finally have birth control while waiting for my appointment,’ or ‘I am so grateful pharmacists can do this.’ Seeing the benefit, she urges schools of pharmacy to do the work to show that by prescribing contraception, pharmacists are preventing unintended pregnancies and preventing abortions. Showing that impact in numbers could persuade more states to take similar strides. “I want every state to do this because this is a skill set we can own. We know the mechanism of action of these drugs, we have the patient relationships where we can provide contraception in a safe and effective way,” Bachyrycz said. “We have national guidelines from the CDC for contraceptive use (https://www.cdc.gov/reproductivehealth/contraception/contraception_guidance.htm). With just a little bit of training, plus our effective communication skills that we are so good at as a profession, I think pharmacists could really make a difference with this particular public health concern.” Bachyrycz has embedded training regarding how to prescribe contraception into her curriculum. Students see the material multiple times, in therapeutics and in lab. Plus, students take a refresher course prior to graduation, which covers all the prescriptive authorities pharmacists have in New Mexico. “The American Pharmacists Association came out with national hormonal contraceptive training but ours was developed before theirs and it really meets the needs of New Mexico. We have quite a few on Medicaid and we have a lot of rural areas where there’s a lack of provider access, so our training focuses on our state,” Bachyrycz said. At OSU, Anderson teaches hormonal contraception in live lectures and practice labs, running through numerous

Academic Pharmacy NOW  2019 Issue 5

community impact

“We’ve identified gaps in care, such as a patient who comes in with no refills and she’s not able to see her doctor for three months. Having the ability to fill that gap is huge for a community pharmacist.” — Dr. Amy Bachyrycz cases to talk through the points of prescribing. She has her students download an app developed by the CDC (it can be found in any app store by searching “US MEC” or “US SPR”) to use alongside her questionnaires. Oregon law requires training for practicing pharmacists. Although the law does not specify that graduating pharmacists will have the training, graduates still need to take the approved training in order to prescribe contraception, so all OSU graduates are gifted access to the course. Bachyrycz leads the training classes for practicing pharmacists in New Mexico. She says pharmacists are eager to do this. They see the need and want to help. “We’ve identified gaps in care, such as a patient who comes in with no refills and she’s not able to see her doctor for three months. Having the ability to fill that gap is huge for a community pharmacist. A patient does not have insurance. She’s going to apply for insurance, which can take 30 days or more. Again, that’s a gap we can fill,” Bachyrycz said. “Identifying patients who don’t even have a medical home. For instance, I’m going to work with a patient and say, ‘I’ll prescribe for six months but you work on finding a doctor and getting an appointment.’ It’s like a collaboration with a patient, because I’m not their primary care provider and I don’t want to be, but I do want to get them in and help them so they can have a medical home going forward. So it’s been really helpful to meet the needs of community pharmacists.”

Time and Money Dale Tinker, executive director of the New Mexico Pharmacists Association, agrees that pharmacists are enthusiastic about expanding their role to prescribe contraception, but they really can’t move forward if they are not getting paid to do it. “Pharmacists are very excited about it. The problem is that payers are not, so the health insurance plans are not reimbursing pharmacists to do that critical care service, and obviously, if you can’t get paid to do it, you’re probably not going to focus on it because you’ve got to make a living,” Tinker said. So while pharmacists are being trained, some pharmacy chains are not allowing them to perform this

Academic Pharmacy NOW  2019 Issue 5

service because it’s time consuming. Counseling for most prescriptions takes pharmacists a few minutes, but the clinical services for determining what contraception to recommend to a patient takes more than a minute or two. In order for pharmacists to offer those clinical care services, payers are going to have to be willing to reimburse them. Pharmacy schools can take steps on a state level to push payers to pay pharmacists for clinical care services so public health measures, like prescribing contraception, might reach their full potential. Schools can partner with state pharmacy associations to help move practice forward, but Tinker said administrators can also take every opportunity to talk about the extraordinary level of training their pharmacists receive and how their talents are underused relative to their training. “Our dean and two assistant deans at the University of New Mexico wrote an op-ed, which was published in the Albuquerque Journal a few months ago, that talked about the capabilities of pharmacist clinicians in New Mexico. Our cabinet secretary for Health and Human Services had a copy of that article when we met with him a few weeks ago,” Tinker said. “Our meeting was to discuss how we can work with Medicaid to get their participating MCOs (managed care organizations) to reimburse pharmacists for providing clinical services. Medicaid has a mechanism to reimburse pharmacist clinicians in the fee-for-service program.” In his 31 years working for the state pharmacy association, Tinker has lobbied to give pharmacists prescriptive authority for hormonal contraception, tobacco cessation, vaccinations, naloxone, emergency contraception and tuberculosis testing. “We really need to get the federal law changed to allow pharmacists reimbursement under the Social Security Act,” Tinker said. “There’s a bill in the Senate, there’s a bill in the House…more than half of Congress endorses or has cosponsored that legislation,” but there’s no movement. If pharmacists really engage in prescribing contraception, they will strengthen the case for provider status. P Athena Ponushis is a freelance writer based in Ft. Lauderdale, Florida.

community impact

Predict student academic performance Ensure you’re recruiting the best candidates!

The upward trend of the pharmacy industry

We understand there are several factors affecting why schools may adopt test-optional admission policies — especially in these challenging market conditions. However, those factors are not necessarily about the predictive value of quantitative measures such as the PCAT. The PCAT remains one of the most reliable predictors of student academic performance in pharmacy programs.

Pharmacy retains a moderate future employment outlook despite challenging market conditions.

Why risk it? Let’s work together to ensure you’re recruiting the best candidates!

Employment (2016) 313,000 employees

Visit PearsonAssessments.com/PCATvalue to read the white paper Test-Optional Admission Policies and the Value of Quantitative Measures or speak to a consultant at 800.622.3231 800-622-3231

Pharmacist Wages & Employment Trends* Median wages (2018) $60.64 hourly, $126,120 annual

Projected growth (2016–2026) Average (5% to 9%) Projected job openings (2016–2026) 15,300 Top industries (2016) Retail Trade Health Care and Social Assistance

PCATweb.info

*Source: Retrieved from O*Net on May 1, 2019. Original source: Bureau of Labor Statistics 2018 wage data and 2016-2026 employment projections. Copyright © 2019 Pearson Education, Inc. or its affiliates. All rights reserved. Pearson and PCAT are trademarks, in the US and/or other countries, of Pearson plc. CLINA21556 SR 10/19

Academic Pharmacy NOW  2019 Issue 4

community impact

Academic Pharmacy NOW ï&#x201A;§ 2019 Issue 5

community impact

Fighting Back

Against Chronic Disease

Pharmacists can help patients keep their health on track by partnering to manage chronic conditions. By Jane E. Rooney

Academic Pharmacy NOW ď&#x201A;§ 2019 Issue 5

community impact

Chances are you know someone who suffers from a chronic disease. Six in ten Americans live with at least one chronic disease, like heart disease, stroke, cancer or diabetes, according to the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). These and other conditions (such as Alzheimer’s disease, epilepsy and chronic lung disease) are the leading causes of death and disability in America, and they are also a leading driver of healthcare costs. The American Public Health Association (APHA) indicated that the five most costly and preventable chronic conditions cost the United States nearly $347 billion— 30 percent of total healthcare spending—in 2010. NCCDPHP data show that 90 percent of the nation’s $3.3 trillion in annual healthcare expenditures are for people with chronic and mental health conditions.

According to the APHA, the U.S. could decrease treatment costs by $218 billion per year and reduce the economic impact of disease by $1.1 trillion annually by investing in prevention and treatment of the most common chronic diseases. Pharmacists are ideally positioned to help patients navigate chronic disease prevention and management. In addition to assuring the accurate filling of prescriptions and medication orders, pharmacists can provide key screenings and immunizations, determine which medications are best and talk through medication requirements with patients and their caregivers, ultimately improving health and lowering costs. “Pharmacists’ involvement can increase access to patient care services and improve health for patients. There are data to back that up,” said Dr. Kelly Ragucci, vice president of professional development at AACP. “There is a recognition of the importance of preventive medicine and getting pharmacists integrated into primary care physician offices as part of a healthcare team.” As part of his pharmacy practice transformation efforts as AACP president, Dr. Todd Sorensen has set a goal to have 50 percent of primary care offices engage in a formal relationship with pharmacists by 2025. “Team-based care is emerging as a key strategy in delivering better care in value-focused payment systems,” Sorensen said in his opening remarks at the AACP Annual Meeting in July. “Creating these partnerships will open up new employment opportunities for pharmacists—whether directly within medical practices or through other collaborative arrangements that improve chronic care management.”

Academic Pharmacy NOW  2019 Issue 5

Prioritizing Prevention and Wellness “Pharmacists are uniquely qualified to serve as part of the interprofessional medical team. We are physician extenders. There is still a shortage of primary care physicians, and pharmacists can help close the gap,” said Dr. Seena Haines, professor and chair, Department of Pharmacy Practice, The University of Mississippi School of Pharmacy. “I can speak to the role that pharmacists can have as part of a primary care team: to have prescriptive authority, see patients, review labs and make adjustments to pharmacotherapy. Pharmacists can pursue several specialties through board certification. The care plan for patient and caregiver needs that pharmacists are qualified to address relative to chronic disease is significant. As artificial intelligence continues to grow I see that impacting dispensing needs across diverse settings. It creates a significant opportunity in the community setting to offer enhanced clinical services. There are community-focused initiatives underway nationwide to help educate and train pharmacist directed clinical services.”

community impact

One example, Haines continued, is the Community Pharmacy Enhanced Services Network, which includes 33 states in networks across the country. North Carolina was one of the first states to align chain and independent pharmacies into partnerships through a mentorship model and coaching network to help shift practice models and workflow toward enhanced clinical services. She also sees pharmacists stepping up efforts when it comes to preventing chronic diseases. “We’ve engaged in annual wellness visits across the country,” Haines pointed out. “We are working with insurers on health and wellness coaching benefits. We are uniquely qualified to assist in those areas. It really does align with our education and training. We’ve seen some national traction with the National Academy of Medicine and other pharmacy associations trying to combat stress and burnout. We know the role that stress plays in the burden of chronic disease. I absolutely think we can provide patients with health and wellness strategies and consult routinely toward the achievement of health and wellness goals.” She believes that a transdisciplinary approach, working with government as well as non-government sources, can position pharmacists to help prevent chronic diseases, such as diabetes and obesity, and prevent worsening or onset of disease. More than ever, pharmacists must be trained to meet the needs of an aging population. “We want to think about that prevention side more and gain better control of disease states such as cardiovascular disease at younger stages in life so the impact is less as we age.” Dr. Lourdes Planas, associate professor, department of pharmacy: clinical and administrative sciences, University of Oklahoma College of Pharmacy, and current chair of

“Team-based care is emerging as a key strategy in delivering better care in valuefocused payment systems. Creating these partnerships will open up new employment opportunities for pharmacists—whether directly within medical practices or through other collaborative arrangements that improve chronic care management.” — Dr. Todd Sorensen

AACP’s Social and Administrative Sciences Section, conducts research around the pharmacist’s role in medication therapy management services in community pharmacy settings and ambulatory care clinics. “When pharmacists have been involved with patients with chronic conditions, particularly hypertension and diabetes, when pharmacists educate patients on their disease states and how to take their medication and how to self-monitor, such as checking blood pressure and blood glucose, we found that patients improve in several different clinical outcomes for their conditions,” Planas noted. “We were able to show more of an improvement for patients who were seeing pharmacists,” she continued. “It’s not just about educating the patient; a big part of it is looking for medication-related problems such as sub-optimal therapy—doses that are too low and a pharmacist recommending to a physician that those doses be increased. First it’s about making sure the patient is taking the prescribed dose. Sometimes the education component helps patients to understand. If adherence is not an issue, pharmacists can work with a physician to recommend a different dose or additional medication.” In some cases, patients’ drug regimens are not optimal according to clinical standards for their condition (for example, some patients with diabetes need to be on an ACE inhibitor for renal protection). “Many community pharmacies offer convenient and accessible opportunities for patients to check their blood pressure,” Planas said. “Hypertension is one of those diseases that if patients aren’t regularly going to a doctor’s office, they might not be

Academic Pharmacy NOW  2019 Issue 5

community impact

PATIENTS Program participants take part in a National Night Out event.

Patient-Centered Care Informs Research At the University of Maryland School of Pharmacy, a five-year, $5 million infrastructure development grant from the Agency for Healthcare Research and Quality led to The PATIENTS Program, which aims to address health equity and improve major chronic conditions for every American, with a particular focus on underserved populations. “We want to transform the way research is done to be more patient-centered,” explained Dr. C. Daniel Mullins, PATIENTS program director and professor and chair, department of pharmaceutical health services research. “The traditional model on an academic medical campus is there’s a hospital and some clinics in the surround-

Academic Pharmacy NOW  2019 Issue 5

ing neighborhoods that provide care and number of partners outside the school, then there’s a research center. Sometimes including healthcare provider communithose things remain quite separate. We ties and research institutions. really embrace the idea that without “As clinicians work with us they begin to talking with patients and those providing see that the way we do research is the patient care, can we really do research way healthcare is provided,” Mullins said. that will ultimately impact human health? “If someone has diabetes, you ask the We shouldn’t keep them separate, but we patient how things have been going. With need to look at how care is being proresearch, we often don’t ask patients if vided in order to do research to continue they think the research is going well. The to improve care.” way we improve healthcare is by listenThe program is part of a campuswide ing to what patients are saying so in the infrastructure. The entire school of pharcontext of research we can make it more macy is involved as well as all of the health patient-centered.” professional schools at the University of The program supports both local and Maryland. Mullins said they also have a larger national clinical trials. Mullins would

community impact

getting their blood pressure checked, or maybe they get it checked at the pharmacy in between doctor’s visits. Hypertension is a silent disease so people often don’t even feel any different.” Helping patients manage chronic conditions enables pharmacists to prevent medication-related harm and minimize complications.

Curricular Changes Address Chronic Conditions With the ACPE standards calling for a bigger focus on public health over the past decade, Planas said schools are increasingly training student pharmacists in chronic disease prevention. Several students at Oklahoma’s College of Pharmacy who take classes in entrepreneurship and must develop a business plan as part of their coursework have proposed wellness pharmacies. “A lot of our students have proposed weight clinics to work with patients to lower their weight because that has been linked to so many chronic conditions,” she said. “Many of our graduates have started to work with protein-rich diets. Students on rotation are getting exposure to these things, primarily in independent pharmacies.”

“When pharmacists have been involved with patients with chronic conditions, particularly hypertension and diabetes, when pharmacists educate patients on their disease states and how to take their medication and how to self-monitor…we found that patients improve in several different clinical outcomes for their conditions.” — Dr. Lourdes Planas

The college offers integrated modules where the students receive instruction on a combination of pharmacotherapy, medicinal chemistry, pharmacology and pathophysiology. “In the general health module they learn a lot about the influence of obesity on chronic conditions,” Planas noted. “Through their co-curricular plan, our students participate in a lot of health fairs and have opportunities to interact with members of the public. Often students will check BMI and talk with patients about lowering their risk for chronic diseases. The overwhelming majority of patients our students interact with are overweight or obese. Those experi-

like to see more research being done in community pharmacy settings. “Increasingly the way we do research isn’t just in academic medical centers,” he pointed out. “It’s in community centers. We could really gain knowledge about patients in the community rather than doing research in the traditional hospital or clinical setting. That’s where I would love to see an expansion of research. Part of the way we learn is by using community pharmacies more in that research process.”

munities and where patients learn from providers how to live a healthy lifestyle. The model relies on bi-directional learning and data and knowledge. “Thinking about a learning healthcare community has a lot of implications for community pharmacy,” Mullins said. “Some community pharmacies may not be attached to a larger healthcare system but every single one is part of improving the health of the nation. How can community pharmacies be active participants?”

Recently, the PATIENTS program developed the Learning Health Care Community model, which envisions a community where healthcare providers learn from patients what issues matter in their com-

He added that to prepare student pharmacists to communicate with patients about treatment and quality of life, the curriculum could be expanded to explore shared decision-making in the context of

healthcare. “Sometimes we act as if the healthcare provider has all the relevant information and just communicates that with patients,” he noted. “The patient is the one who knows how they feel and they can express preferences for treatment. Sometimes we don’t ask about that. The best decisions for treatment could be different for two people with the same disease. Only when we begin to understand that there is that shared decisionmaking process can we really be patientcentered. Explaining what we know in our current environment on best practices and how to prepare future pharmacists for that is an area for growth.”

Academic Pharmacy NOW  2019 Issue 5

community impact

ences interacting with patients are very rewarding for our students because they get a chance to practice what they’ve learned.” Haines pointed out that the revised ACPE standards elevate the need for interprofessional education and that curricular reform is occurring. “Some schools are structuring selective school experiences,” she said. “Students can deepen their didactic knowledge and experiential learning through courses in specialty areas such as infectious diseases, cardiovascular disease, diabetes and community pharmacy. We are also seeing curricular emphasis related to rural health/telehealth, health disparities and underserved populations as well as more interprofessional coursework across the entire curriculum.” She added that pharmacy schools are trying to prepare learners to perform and leverage themselves for positions that don’t exist yet. “Specialty pharmacy is on the rise. Student pharmacists need to take every opportunity to further their education after graduation and through these individualized learning tracks we’re seeing. I think certificate programs play an important role in providing focused training. [It’s crucial to] continue with professional development and maintaining credentials; to provide a high level of clinical care and expertise is really essential. We continue to expand our practice roles in direct patient care and furthering our engagement in population and public health initiatives.”

Academic Pharmacy NOW  2019 Issue 5

AACP’s Ragucci agrees that signs point to pharmacy schools making changes to the curricula. “Schools and colleges are incorporating more team-based learning, simulations and interprofessional experiences for students,” she noted. “Diabetes and immunization certifications are also offered in addition to unique electives such as MTM. Preparing students for the current workforce and understanding the importance of practice transformation is particularly important.” Ragucci sees telehealth as a new frontier for pharmacists reaching out to patients. “Telehealth is a huge opportunity for pharmacists to get more involved with chronic disease state management and prevention,” she said. “Patients who tend to get admitted to the hospital over and over often don’t have access to primary care services. You can reduce those ER visits and costs if you can improve access to healthcare, and telehealth is one of those ways. It also allows faculty to have more access to both students and residents on rotation and use that technology to communicate.”

community impact

“Some schools are structuring selective school experiences. Students can deepen their didactic knowledge and experiential learning through courses in specialty areas such as infectious diseases, cardiovascular disease, diabetes and community pharmacy.” — Dr. Seena Haines

Team-Based Care Is the Future The next step is getting a payment structure in place and trying to get pharmacists reimbursed, Ragucci said. “We know we can improve patient health, but convincing [physician offices] and other employers to pay for medication therapy management is another thing.” Said Haines, “We have an opportunity ahead of us to change the paradigm in community practice and change the scope in direct patient care activities across settings. We have an opportunity to expand our role and have a seat at the table. The provision of provider status is important. Equally important is what happens at the state level. The provision of provider status and compensation recognizing pharmacists for clinical services is critical to move us forward.”

Planas said she hopes to see a greater focus on weight and nutrition since obesity and poor eating habits are big contributors to chronic disease. “The more that pharmacists are in positions where they are able to assess how patients are doing in those areas, the better they will be equipped to make recommendations. And having the ability to do screenings [is crucial]. Because of their accessibility, a pharmacy could be the first place a patient finds out his or her blood pressure is high. In pharmacy schools we develop those skills in our students of recognizing the importance of those types of screenings and following through with offering programs or knowing referral sources in the community.” She added that if a patient is obese and has high blood pressure and high blood glucose, ideally the pharmacist should know a local nutritionist who can help. “We know it’s not going to be just one healthcare provider. It’s a team effort: a physician, a nutritionist, a pharmacist. For some patients there might even be a physical therapist involved. It’s about interprofessional education—that emphasis is going to benefit not only our profession but all professions.” P Jane E. Rooney is managing editor of Academic Pharmacy Now.

Attendees at a PATIENTS Program stakeholder meeting focused on a Learning Health Care Community study.

Academic Pharmacy NOW  2019 Issue 5

@AACPharmacy

Academic Pharmacy NOW ï&#x201A;§ 2019 Issue 5

@AACPharmacy

Set Your Sights on Career Development in 2020 Don’t Wait: Membership Renewal Now Open! Renewing today ensures your benefits won’t lapse. Take advantage of all the professional development opportunities AACP has to offer in 2020: •

Join discussions relevant to your field. Collaborate throughout the year with faculty, administrators and staff via AACP Connect. More than 2,400 discussion posts and 1,000 resource documents have been posted this past year!

•

Access valuable resources. Learn from your peers in members-only Special Interest Groups or Sections. Numerous programmatic Webinars, including those with CE credit, allow members to take advantage of professional development resources and opportunities.

•

Stay up-to-date on news and opportunities. Explore valuable content in publications such as Academic Pharmacy Now, American Journal of Pharmaceutical Education and AACP electronic newsletters.

•

View industry trends by accessing institutional research data, including the Profile of Pharmacy Faculty report.

•

Bolster your career development. Immerse yourself in a year-long leadership experience through AACP’s Academic Leadership Fellows Program (ALFP).

Renew your membership today: http://bit.ly/AACPmembership

/ NMA

Nonprescription Medicines Academy

2020 AACP NMA Conference Learn, Grow, Connect and Flow May 28–30, 2020 The 19th AACP Nonprescription Medicines Academy (NMA) Conference is an opportunity for pharmacy faculty to engage and collaborate in the self-care and non-prescription medicine arena. Programming integrates current trends and scholarly activities in self-care relevant to education and practice. Visit http://bit.ly/AACPNMA2020 for more information on conference objectives, an agenda and the application and submission process.

Nominations for the Chalmers, Dawson, Volwiler and Lifetime Achievement Award Due December 4th Learn more about AACP’s top awards: http://bit.ly/AACPawards Robert K. Chalmers Distinguished Pharmacy Educator Award: Recognizing outstanding achievements as an educator and mentor in pharmacy education. Paul R. Dawson Award for Excellence in Patient Care Research: Recognizing an active scientist as a leader in the broad range of research related to health services delivery directly affecting patient outcomes. Volwiler Research Achievement Award: Recognizing an individual as one of the leading research workers in a given area of the pharmaceutical and clinical sciences, pharmacy practice and the social and administrative sciences. Lifetime Achievement Award: Recognizing an individual who has made a significant contribution to AACP and to pharmacy education through instruction, leadership/service and research/scholarship over a minimum of 25 years.

Academic Pharmacy NOW  2019 Issue 5

Pharmacists Help People Live Healthier, Better Lives.

1400 Crystal Drive, Suite 300 P Arlington, VA 22202 703-739-2330 P www.aacp.org

Gain New Perspectives on Leadership Development February 8–11, 2020 Wyndham Grand Rio Mar Puerto Rico Golf & Beach Resort

Save $150 when you register by December 10! Being an effective leader means adapting to change, communicating efficiently, broadening your outlook and so much more. At INsight 2020, Feb. 8–11 in Puerto Rico, you’ll learn from experts in areas critical to leadership development and collaborate with peers who are experiencing the same challenges and successes. Whether you are a clinical or basic scientist, faculty member or dean, you will leave INsight 2020 with new perspectives and enhanced skills to help you prepare for transformation in pharmacy education and practice.

Add to Your Registration: Research Symposium on Feb. 8 Join researchers and research leaders from across the Academy at the 2020 Research Symposium on Saturday, Feb. 8. This one-day meeting will focus on maximizing your institution’s potential to support and sustain high-impact research by fostering interdisciplinary collaboration and faculty development.