ARRX Spring 2019

Second Quarter 2019 Award-Winning Quarterly Publication of the Arkansas Pharmacists Association

BACK IN SESSION 92nd General Assembly Brings Patient and Pharmacist Victories

THE GIFT OF GIVING A Life-Changing Event from APA Member Emily Wilson

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APA Staff John Vinson, Pharm.D. Executive Vice President and CEO John@arrx.org

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Jordan Foster Director of Communications Jordan@arrx.org Susannah Fuquay Director of Membership & Meetings Susannah@arrx.org Lauren Jimerson, Pharm.D. Executive Fellow Lauren@arrx.org Celeste Reid Director of Administrative Services Celeste@arrx.org Debra Wolfe Director of Government Affairs Debra@arrx.org Office E-mail Address Support@arrx.org Publisher: John Vinson Editor: Jordan Foster Design: Gwen Canfield - Creative Instinct

CONTENTS

Arkansas Pharmacists Association 417 South Victory Street Little Rock, AR 72201-2923 Phone 501-372-5250 Fax 501-372-0546

4 Inside APA: Catching Fire

20 FEATURE: The Gift of Giving

5 From the President: Looking Back and

22 2019 Calendar of Events

AR•Rx The Arkansas Pharmacist © (ISSN 0199-3763) is published quarterly by the Arkansas Pharmacists Association, Inc. It is distributed to members as a regular service paid for through allocation of membership dues ($5.00). Non-members subscription rate is $30.00 annually. Periodical rate postage paid at Little Rock, AR 72201. Current edition issue number 86. © 2019 Arkansas Pharmacists Association.

POSTMASTER: Send address changes to AR•Rx The Arkansas Pharmacist 417 South Victory Little Rock, AR 72201 Opinions and statements made by contributors, cartoonists or columnists do not necessarily reflect the attitude of the Association, nor is it responsible for them. All advertisements placed in this publication are subject to the approval of the APA Executive Committee. Visit us on the web at www.arrx.org.

Forging Ahead

7 Member Spotlight:

Brittany Sanders, Pharm.D. The Pharmacy at Wellington

8 FEATURE: Back in Session - the 92nd

Arkansas General Assembly

13 Safety Nets: Continue to Carefully

Examine All Prescriptions

15 New Drugs: FDA Approved Record

Number of Drugs in 2018

16 UAMS: UAMS Programs Impacting

Pharmacists Around the State

17 UAMS College of Pharmacy 2019

Graduates

18 Harding University: Pharmacists, Take

the Wheel

19 Harding University College of

Pharmacy 2019 Graduates

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Cover Photo Courtesy Arkansas Secretary of State

23 APA 2019 Annual Convention 30 Legislator Profile: Representative

Fredrick Love, Little Rock

31 AAHP: Hospital Medication Safety 32 Compounding Academy: You Can't

Always Get What You Want

33 Staff Spotlight: Lauren Jimerson,

Pharm.D., APA Executive Fellow

34 APA Hosts Legislative Day ADVERTISERS 2 Pharmacists Mutual 5 EPIC Pharmacies 6 Retail Designs, Incorporated 6 Arkansas Pharmacy Support Group 12 Pharmacy Quality Commitment 14 2018 Bowl of Hygeia Award Recipients 22 UAMS College of Pharmacy 29 Biotech Pharmacal, Inc. 32 Law Offices of Darren O'Quinn Back Cover: Smith Drug Company

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APA Board of Directors 2018 - 2019 Officers President – Stephen Carroll, Pharm.D., Benton President-Elect - Dean Watts, P.D., DeWitt Vice President – Kristen Riddle, Pharm.D., Greenbrier Past President – Lynn Crouse, Pharm.D., Lake Village

Regional Representatives Region 1 Representatives Dylan Jones, Pharm.D., Fayetteville Spencer Mabry, Pharm.D., Berryville Lacey Parker, Pharm.D., Charleston Region 2 Representatives Max Caldwell, P.D., Wynne Greta Ishmael, Pharm.D., Cherokee Village Region 3 Representatives Brandon Achor, Pharm.D., Sherwood Clint Boone, Pharm.D., Little Rock Lanita White, Pharm.D., Little Rock Region 4 Representative Betsy Tuberville, Pharm.D., Camden Region 5 Representative James Bethea, Pharm.D., Stuttgart At Large Representatives Stacy Boeckmann, Pharm.D., Wynne Yanci Walker, Pharm.D., Russellville Arkansas Association of Health-System Pharmacists David Fortner, Pharm.D., Rogers Academy of Compounding Pharmacists Tyler Shinabery, Pharm.D., Sherwood Academy of Consultant Pharmacists Larry McGinnis, Pharm.D., Searcy

Ex-Officio APA Executive Vice President & CEO John =, Pharm.D., Benton AR State Board of Pharmacy Representative John Kirtley, Pharm.D., Little Rock Board of Health Member Marsha Boss, P.D., Little Rock UAMS College of Pharmacy (Interim Dean) Schwanda Flowers, Pharm.D., Little Rock Harding College of Pharmacy (Dean) Jeff Mercer, Pharm.D., Searcy Legal Counsel Harold Simpson, J.D., Little Rock Treasurer Richard Hanry, P.D., El Dorado UAMS COP Student Cortni Hicks, Little Rock Harding COP Student Jacilyn 4 McNulty, Searcy

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INSIDE APA

Catching Fire

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a c k country hiking is one John Vinson, Pharm.D. of my favorite APA Executive hobbies.

Vice President & CEO Connecting with nature helps me to gain perspective, to feel alive and find peace. John Muir, my favorite naturalist, gave great advice when he said “keep close to Nature's heart...and break clear away, once in awhile, and climb a mountain or spend a week in the woods. Wash your spirit clean.” Spending a week or several days in the woods can certainly wash your spirit clean and reinvigorate your life.

Preparing for a trip like this also requires careful planning and preparation. Most importantly, you have to have a map for finding your way and survival tools for access to food, water, fire, and shelter.

Fire can be optional for periods of time, depending on the circumstances, but it is also my favorite. It has many uses for continuing life. Fire can be used to boil water, cook food, provide warmth, scare dangerous predators away, smoke out mosquitos and other biting insects, and provide light in the darkness of night. Every fire requires a spark to start and fuel to burn. In the profession of pharmacy, we also need a spark, fire and fuel for both survival and for us to thrive in providing the best care for our patients.

I have been involved in leadership with the Arkansas Pharmacists Association since 2002 as a volunteer member of the Board of Directors and most recently as a staff member leading the organization through the 2019 Arkansas legislative session.

Our office and team over the years have continued to receive increasing amounts of calls, emails, complaints, social media outreach, and texts about serious threats to their professional practice and businesses. The most frequent theme of these enormous challenges has been stories and data about the anticompetitive and unfair business practices of pharmacy benefit managers.

When I first joined the staff and heard these stories, my understanding of what the Arkansas Pharmacists Association

could do about these issues was to advocate and share the story with those who would listen and try to help put fires out on the day to day issues that threaten our profession’s existence.

I see it differently now. I think back to my time in the woods and I see what we are currently doing as starting and building a fire rather than putting fires out. I see our pharmacy profession in Arkansas as a spark, a fire, and rays of light for the rest of the nation in the quest for reform of pharmacy benefit managers and their health plan partners. The healthcare and the community pharmacy market need the fire to grow to burn down what is wrong with the broken market in wildfire fashion so that sunlight can reach the new growth in the forest and the flowers can bloom.

Your stories, advocacy, membership in the Arkansas Pharmacists Association, grass roots with the governor, state and federal legislators, interactions with the Arkansas Insurance Department, and financial support to the Arkansas Pharmacists Political Action Committee (AP-PAC) are vital fuel for the fire.

I would also ask each of you to think about other sparks in your practice setting that set a fire and what fuel is needed for new growth and innovation.

Pharmacists should be paid from the medical benefit of health plans for their professional services. Organizations like the Community Pharmacy Enhanced Services Network are seeking out these opportunities. There are also innovations in health plan design in the self-insured employer marketplace in Arkansas that produce cost savings by reducing administrative burden rather than paying providers below their cost to operate safely. There are emerging technology solutions that allow for population health management and documentation of community pharmacy interventions in an e-Care plan tied to new payment for improved patient outcomes. Many of these opportunities will be discussed in detail at the Arkansas Pharmacists Association annual meeting June 6-8, 2019, in Little Rock. I hope to see you there. It is vital for us to organize and keep the fires burning. § AR•Rx

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THE ARKANSAS PHARMACIST

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FROM THE PRESIDENT

Looking Back and Forging Ahead

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ow quickly a year can go by. This will be the last time I have the opportunity to write to you as President of the Arkansas Pharmacist Association and I want to look back at the past year of incredible accomplishments and look forward at what is to come.

I mentioned in a previous article about the strength of APA membership, but I can’t understate the impact that a strong membership has on an organization’s success. For the second year in a row, the APA membership was crucial in another landmark legislative victory when SB520 (Act 994 of 2019) was passed with unanimous support in both chambers of the legislature. Act 994 was not a legislative goal at the APA Board of Directors Retreat last year, but it became very apparent in the first few months of 2019 that the PBM Licensure Act needed some clarifications as well as additional language. APA staff along with input from members went to work drafting language that would further strengthen the PBM Licensure Act as well as improvements to the MAC bill that was signed into law in 2015.

In addition, APA supported two scope of practice initiatives originated by other organizations that were successful in the legislative process. These efforts were built strongly on facts and data with the assistance of APA members.

I do not believe that this is the end of the road with PBMs. The transparency that is now available to the Arkansas Insurance Department will allow the State of Arkansas to fully understand where healthcare dollars reside in pharmacy costs. It will also improve patient access to pharmacy services in Arkansas

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communities. We must continue to provide facts to allow everyone to see where healthcare dollars spent Stephen Carroll, Pharm.D. on pharmacy are going. This cannot President come from the efforts of only some of our pharmacies; in the coming years, it will take greater participation from all members of our association to ensure that the voice of pharmacists is heard. We must not forget what work was done to get us here and work to educate our patients, legislators, as well as our local businesses.

While I am proud of the accomplishments that have guided our profession to this point, I see more opportunities that we must work toward. It will not be easy or without great challenges. Innovation in pharmacy practice will be key along with working with other healthcare professionals to improve patient health. Our focus should continue to be on advocacy efforts to ensure that our patients are taken care of with the highest level of service. We must continue to collaborate with physicians and other healthcare professionals to ensure that pharmacists are part of the healthcare team and are allowed to use our skills to improve patient health.

I want to end by thanking all our members for your support and efforts over the past year. It has been such an honor to serve and lead the Board of Directors of this great organization. I am excited to support APA leadership in the coming years. The future of pharmacy is in our hands and we continue to have opportunities to lead the nation in advancing our profession. §

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THE ARKANSAS PHARMACIST

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MEMBER SPOTLIGHT

Brittany Sanders Pharm.D. Pharmacist/Owner The Pharmacy at Wellington

Pharmacy School & Graduation Year: UAMS, 2005 Years in business: I worked at Walgreens initially as a

pharmacist then went into the store management side. I worked as a front-end store manager for several years before returning to the pharmacy after the birth of my youngest child.

I worked as a pharmacy manager for six years before leaving to open The Pharmacy at Wellington in 2015. The Pharmacy at Wellington has now been open for about 3.5 years.

Favorite part of the job and why: I truly enjoy the patient interactions and coming to work every day knowing that I have the ability to make a positive impact on someone's life.

Being able to precept students and teach them as well as learn from them is something I really enjoy as well!

Least favorite part of the job and why: Battling the PBM's,

Recent reads: Do the books I've read to help my children with book reports count? Kidding! I've recently completed a Bible Study with my D-Group at Fellowship over the book "Freedom in Christ" by Neil Anderson and Steve Goss.

Favorite activities/hobbies: Spending time watching my

kids participate in one of the many activities that they are involved in. I have two children of my own and one foster child and amongst the three, we participate in dance, basketball, baseball, football, and wrestling. We are very involved all year around and it keeps us on the go, but I wouldn't have it any other way!

Ideal dinner guests: All of my extended family! We are all

spread across the country, so it is a very rare occasion that we are all around the same dinner table at this point in life.

no doubt! It's hard to face every day knowing that you're entering a battlefield against someone who has a leg up against you, but it is also a motivator to keep pushing me forward every day to make my pharmacy successful.

If not a pharmacist: I honestly can't imagine having any

What do you think will be the biggest challenges for pharmacists in the next 5 years? I think we will still be

APA serves as a strong voice in support of the profession of pharmacy, especially during times as critical as the most recent legislative session. It is extremely important to be an active member of professional organizations and stay active in the profession of pharmacy so that you can stay involved, continue learning, and make connections with other pharmacists. The APA serves as an organization to unify pharmacists across multiple practice settings to advocate for the good of the profession. ยง

facing the challenge of PBM's. We are making history in the world of pharmacy currently and jumping great lengths to fight the battle against PBM's, but I don't think the battle will be short lived. PBM's are smart, we have to give them that, but they are also sneaky. I think this is going to be an ongoing battle that we must stay strong and fight through to come out on top, but I am confident that the profession of pharmacy will prevail.

career other than pharmacy, but I could see myself teaching.

Why should a pharmacist in Arkansas be an active member of the Arkansas Pharmacists Association? The

Oddest request from a patient/customer: To deliver a

Starbucks croissant to their home or to deliver cigarettes to their home. While we do deliver some strange things, we do not usually deliver items we do not carry in store.

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92nd General Assembly Brings Pharmacist Victories

BACK IN SESSION T

he Berra

By APA Director of Communications Jordan Foster

inimitable once

Yogi said,

“it’s like déjà vu, all

over again.” Though originally referencing legendary Yankees players Mickey Mantle and Roger Maris, some quotes are so well-crafted they capture the essence of events decades later. For APA, pharmacists, and state legislators, the 92nd Arkansas General Assembly was a lesson in déjà vu as the capitol halls once again echoed with the words "pharmacy benefit managers" just one year after a wildly successful 2018 special session put Arkansas on the pharmacy map.

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Photo Courtesy Arkansas Secretary of State ARRX 2nd Quarter Jordan Edits.indd 9

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BACK IN SESSION: THE 92nd ARKANSAS GENERAL ASSEMBLY

With the Arkansas General Assembly rapidly approaching, APA leadership EVP & CEO John Vinson, Director of Government Affairs Debra Wolfe, and President Stephen Carroll spent the final months of 2018 ironing out legislative priorities and developing a strategy for the follow-up to the 2018 special session that saw the creation of one of the most restrictive PBM regulatory laws in the country. As they anticipated the coming 2019 legislative session, Arkansas pharmacists anticipated the January 1 implementation of the 2018 PBM law that would require pharmacy benefit managers to be licensed and regulated by the State Insurance Department in order to operate in Arkansas.

Pharmacists pack the room at a House Committee meeting. Governor Asa Hutchinson and several legislators made

special comments during the legislative session that pharmacists' passion and keen legislative strategy were well Work continued into January as APA known around the capitol and contributed to legislative victories. collaborated with legislators on bills to authorize pharmacists to initiate tobacco cessation therapy, to allow pharmacists to provide The bill clarified the insurance department's regulatory and immunizations to patients from seven years old to eighteen, enforcement authority concerning PBMs and modified the PBM and to require mandatory electronic prescribing for controlled Licensure Act by: substances. Weeks after most bills had been introduced and committee meetings were in full swing, a path presented itself • prohibiting spread pricing; to shine more light on the PBMs and pull back the Rx curtain • prohibiting payment reductions due to GERs, BERs, and even further. APA leaders worked with Senator Kim Hammer other aggregate level methodologies from PBMs and health and Representative Michelle Gray to introduce SB520, a plans that create unfair market conditions and dangerous comprehensive bill intended to strengthen the PBM Licensure patient care environments; Act of 2018 and address tactics and loopholes that PBMs have • setting a payment floor for ingredient cost payment to been taking advantage of. pharmacies that is not less than NADAC or WAC (when no

“This is why we ended up with #BehindtheRxCurtain… and I can’t wait until we pull that curtain back and see who all of y’all are holding hands.”

– Senator Jason Rapert, referring to insurance and PBM representatives in a Senate Insurance & Commerce Committee meeting

APA Executive Vice President & CEO John Vinson and Senator Kim Hammer testify before the Senate Insurance and Commerce Committee.

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NADAC exists); • requiring quarterly rebate reporting by PBMs to the Arkansas Insurance Department of all rebates, all payments from pharmaceutical manufacturers to PBMs, and what is passed through to community pharmacies; • closes loopholes on the definition of Maximum Allowable Cost, to include all drugs and all payment methodologies; • and clarifying in law that Medicaid managed care programs and PBMs are regulated by these statutes and that the statutes are enforceable by the Arkansas Insurance Department.

SB520 faced fierce opposition from entities that have benefitted from the models that cripple pharmacies. That opposition came out full force with communications sent to members of the House of Representatives and insurance representatives across the state, spreading misinformation about the bill. However, for the second year in a row, pharmacists banded together, educated their legislators, and stood united at the state capitol, speaking with one loud, clear voice in support of SB520. The result: through the Senate Insurance and Commerce Committee, to the Senate floor, to the House Insurance and Commerce Committee, and through the House of Representatives, SB520 found universal support with not a single no vote and Arkansas found itself back in the national headlines as a leader in the pharmacy world. § AR•Rx

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THE ARKANSAS PHARMACIST

5/24/19 11:04 AM

BACK IN SESSION: THE 92nd ARKANSAS GENERAL ASSEMBLY

Arkansas 92nd General Assembly - Regular Session 2019 Pharmacy Related Acts HB 1801 - Act 856 (Representative Lee Johnson and Senator Missy Irvin): An act to require the Arkansas Medicaid program to cover an additional albuterol inhaler for certain Medicaid beneficiaries

INSURANCE, PHARMACY BENEFIT MANAGERS, AND MEDICAID SB 520 - Act 994 (Senators Kim Hammer and Ronald Caldwell and Representative Michelle Gray): An act to clarify the state insurance department’s regulatory and enforcement authority concerning pharmacy benefits managers; to modify the Arkansas Pharmacy Benefits Manager Licensure Act SB 480 - Act 734 (Senator Missy Irvin and Representative Mark Lowery): An act to establish the Healthcare Contracting Simplification Act; to allow pharmacists and other providers to accept contracts on a case by case basis and not be forced to accept bundled contracts that could be a mixture of both good and bad terms

SB 446 - Act 699 (Senator Greg Leding and Representative DeAnn Vaught): An act concerning step therapy requirements for certain prescription drugs to treat metastatic cancer SB 472 - Act 589 (Senator Bruce Maloch): An act to require a health insurer to contract with a licensed healthcare provider if the healthcare provider is permitted to participate in Medicare, Medicaid, or any other federal health benefit plan

SCOPE OF PRACTICE

SB 527 - Act 706 (Senator Cecile Bledsoe and Representative Deborah Ferguson): An act to require a healthcare payor to disclose on a member identification card whether a health benefit plan is insured or selffunded HB 1555 - Act 959 (Representative Andrew Collins and Senator Missy Irvin): An act to increase coverage for medications approved by the United States Food and Drug Administration for tobacco cessation in the Arkansas Medicaid Program

HB 1263 - Act 651 (Representative Les Eaves): An act to amend the definition of “Practice of Pharmacy” to authorize a pharmacist to initiate therapy and administer or dispense, or both, certain types of nicotine replacement therapy; to authorize a

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HB 1269 - Act 637 (Representative Stephen Magie): An act to allow pharmacists to make biological product substitutions SB 174 - Act 447 (Senator Kim Hammer and Representative Justin Boyd): An act to require mandatory electronic prescribing for controlled substances

REGULATORY

HB 1278 - Act 652 (Representatives Jimmy Gazaway and Robin Lundstrum): An act to amend the definition of “Practice of Pharmacy” to allow vaccines and immunizations to be given to a person from seven (7) years of age to eighteen (18) years of age under a general written protoco

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physician to administer or dispense, or both, certain types of tobacco cessation

HB 1518 - Act 504 (Representative Justin Boyd and Senator David Wallace): An act concerning hempderived cannabidiol to match state law to federal law (2018 Farm Bill).

HB 1763 - Act 910 (Representative Andy Davis and Senator Bart Hester): An act to create the Transformation and Efficiencies Act of 2019; to establish cabinet-level departments; to transfer state entities; to amend portions of the Arkansas Code resulting from initiated Act 1 of 1914, initiated Act 4 of 1948, and initiated Act 1 of 2000

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THE ARKANSAS PHARMACIST

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UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES COLLEGE OF PHARMACY

Melanie Reinhardt, Pharm.D. Eddie Dunn, Pharm.D.

Continue to Carefully Examine All Prescriptions This issue of Safety Nets illustrates the potential hazards associated with poorly handwritten prescriptions. Thank you for your continued support of this column.

CASE ONE

The e-prescription illustrated in Figure 1 was transmitted from a prescriber's office to a community pharmacy in Central Arkansas.

The pharmacist verified the prescription for Humulin® 70/30, but immediately realized there were two problems: the quantity of Humulin® 70/30 to dispense and the patient directions. The pharmacist realized to fill the order as written, ten vials would be required - an unusually large amount. In addition, there were two separate patient directions in the Sig. field - "30 units twice a day" and "30 units in the morning and 20 units in the evening". The pharmacist telephoned the prescriber's office for clarification. A nurse listened to the pharmacist's concerns - and frustration - about the order. The nurse addressed the insulin quantity (i.e. 100 mL) by replying "Give him a month supply." When asked about the patient directions the nurse said, "It clearly states 30 units in the morning and 20 units in the evening." When the pharmacist asked why "30 units twice a day" was included in the order, the nurse ended the conversation. After this, the pharmacist entered the prescription information into the computer as Humulin® 70/30, quantity 20 mL (two vials for a month supply), with patients directions of "inject 30 units in the morning and 20 units in the evening. Record fasting and 10 p.m. blood sugar." The prescription was filled and placed in the "will call" bin for patient pickup.

Figure 1

to paper prescriptions, e-prescribing improves safety along with prescribing accuracy and efficiency". Unfortunately, e-prescribing has created new types of medication errors which would have been extremely unlikely to occur with traditional handwritten prescriptions.

In the first case, would a prescriber actually handwrite two, separate patient directions in the Sig. field that contradict each other? In the second, it would be possible for a prescriber to unintentionally write "mL" instead of "unit" but unlikely to completely spell out the word milliliter. Clearly, the e-prescriptions illustrated in these cases do not "improve safety along with prescribing accuracy and efficiency." § Figure 2

STUDENT SPOTLIGHT

HPV Vaccine: To Give or Not To Give Tammir Marshall Human Papillomavirus, or HPV, is a cancer-causing infection that affects millions of young Americans every year.

While most types of HPV are harmless, some have the ability to cause cancer or genital warts.

CASE TWO

The e-prescription illustrated in Figure 2 was transmitted to a community pharmacy in Northwest Arkansas. A technician entered the prescription information as Novolin® R 100 units/mL, quantity 90 mL, with patient directions of "inject 25 - 30 milliliters three times daily." The same technician filled the order and placed it in line for pharmacist verification and counseling. During verification, the pharmacist realized the technician had entered the patient directions exactly as they appeared on the E-prescription (i.e. inject 25 - 30 milliliters three times day) without first consulting a pharmacist. At this point, the pharmacist explained correct insulin dosing to the technician. The technician re-entered the directions as "inject 25 30 units three times a day." After this, the order was correctly filled and the patient appropriately counseled.

Over 70% of U.S. physicians utilize e-prescribing. The Health Resources and Services Administration (HRSA) states "compared WWW.ARRX.ORG

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HPV types 16 and 18 are most likely to result in cancer and are called high-risk HPV. Types 6 and 11 lead to the majority of genital warts cases and are called low-risk. Cervical cancer is the most common cancer associated with HPV in women. It has also been known to cause other genital and oropharyngeal cancers.

These cancers and warts are avoidable if individuals between ages 9 and 26 receive the HPV vaccine. People over 26 should be regularly screened, as the vaccine is not an effective option.

The younger the person, the more effective the vaccine. Efficacy increases even more if the vaccine is administered before sexual activity begins.

In my opinion, all school-aged children should be required to be vaccinated for HPV. It is the only vaccine that protects against HPV types 6, 11, 16, and 18 as well as five other types that can lead to some sort of cancer. This directive will result in fewer cases of HPV infections as well as multiple forms of cancer. Pharmacists and other healthcare professionals should strongly advocate for the administration of the HPV vaccine as it is beneficial to individual and overall population health.

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THE ARKANSAS PHARMACIST

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FDA Approved Record Number of Drugs in 2018

T

he FDA had a banner year in 2018 for a record number of drug approvals. The 59 drug approvals in 2018 are the most in more than 10 years, including 34 novel drugs for rare diseases, 19 first-in-class agents, and a record 7 biosimilars.

Of these novel drugs, 73% had priority review, 41% were fast tracked, and 24% were designated as breakthrough therapies. However, so far in the first quarter of 2019, drug approvals have been about as rare as a day without rain in Arkansas. Nonetheless, the few that have been approved represent a variety.

Acute Care: Recently, to help reduce opioid overdose deaths, the

FDA took unprecedented steps to fast-track availability of OTC naloxone. Two model drug facts labels have been developed, for nasal spray and auto-injector formulations, and this is the first time the FDA has proactively tested such labeling to support OTC product development. Egaten™ (triclabendazole) became the only drug approved in the US for fascioliasis (liver fluke infestation) and is currently the only treatment recommended by the World Health Organization (WHO).

Chronic Care: Spravato™ (esketamine) nasal spray is

being hailed as a potential game changer for treatmentresistant depression, although its distribution is restricted under a REMS program. Vaxelis™ (diphtheria, tetanus, pertussis, poliomyelitis, hepatitis B, and Haemophilus influenzae type B) is a 6-in-1 IM vaccine for children age 6 weeks through <5 years to reduce the number of injections.

Motegrity™ (prucalopride) a 5-HT4 receptor agonist was approved for chronic idiopathic constipation.

Oncology: Although a number of drugs were approved for

new indications, only a couple of new molecular entities were approved including Asparlas™ (calaspargase pegol-mknl) as an orphan drug component of a multi-agent chemotherapy regimen for acute lymphoblastic leukemia. Xospata®

(gilteritinib), along with a companion diagnostic LeukoStrat® CDx FLT3, was fast-tracked through priority review as an orphan drug to treat patients with refractory acute myeloid leukemia with the FLT3 mutation. Elzonris™ (tagraxofusperzs) received priority approval as a breakthrough orphan drug as the first treatment for the aggressive but rare blastic plasmacytoid dendritic cell neoplasm.

Specialty: Ultomiris™ (ravulizumab), as a priority orphan

long-acting complement inhibitor that prevents hemolysis, will change the way patients are treated with the rare lifethreatening paroxysmal nocturnal hemoglobinuria. Cablivi® (caplacizumab-yhdp), in combination with plasma exchange and immunosuppressive therapy, received priority orphan drug review as the first targeted treatment that inhibits the formation of blood clots in patients with acquired thrombotic thrombocytopenic purpura. Esperoct® (turoctocog alfa pegol), an extended half-life glycopegylated factor VIII, was approved for hemophilia A, but cannot be marketed until 2020 due to third-party intellectual property agreements.

Jeuveau™ (prabotulinumtoxinA-xvfs) is the first aestheticonly neurotoxin approved in the US, used for the temporary improvement in the appearance of moderate to severe glabellar lines associated with corrugator or procerus muscle activity (those vertical lines that form between your eyebrows when you frown).

New Dosage Forms: Significant new dosage forms approved

this quarter include: Lonsurf® (trifluridine/tipiracil, tablet) as a new combination for metastatic gastric adenocarcinoma; Gloperba® (colchicine, oral solution) for gout; Tosymra™ (sumatriptan, nasal spray) for acute migraine; Ontruzant® (trastuzumab-dttb) as a biosimilar to Herceptin®; and ProAir® Digihaler™ (albuterol) as the first digital inhaler with a built-in sensor that connects to a companion mobile app to monitor usage. §

AAHP Board

Arkansas State Board of Pharmacy

Executive Director............Susan Newton, Pharm.D., Russellville

President..................................Lenora Newsome, P.D., Smackover

President-Elect............Erin Beth Hays, Pharm.D., Pleasant Plains

Member..........................................Steve Bryant, P.D., Batesville

President..................................David Fortner, Pharm.D., Rogers

Immediate Past President.........Brandy Owen, Pharm.D., Conway

Treasurer...........................Kendrea Jones, Pharm.D., Little Rock Secretary..................................Melissa Shipp, Pharm.D., Searcy

Board Member at Large.....Kimberly Young, Pharm.D., Little Rock Board Member at Large........Chad Krebs, Pharm.D., Little Rock

Board Member at Large...........Joy Brock, Pharm.D., Little Rock

Technician Temple, CPhT, Pine Bluff W W W . A Representative.....BeeLinda RRX.ORG

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Vice President/Secretary...............Debbie Mack, P.D., Bentonville Member..................................Lynn Crouse, Pharm.D., Lake Village

Member...........................Rebecca Mitchell, Pharm.D., Greenbrier Member....................................Ken Lancaster, P.D., Arkadelphia

Public Member........................................Carol Rader, Fort Smith

Public Member............................................Amy Fore, Fort Smith 15

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UAMS SCHOOL OF PHARMACY

Schwanda Flowers Pharm.D. Dean and Professor

I

UAMS Programs Impacting Pharmacists Throughout the State

n thinking about subjects for messages like this one to Arkansas pharmacists we often focus on various achievements by our students and faculty within the college.

There is so much great work happening at the UAMS College of Pharmacy, so I think it's only natural that we like to boast about these achievements!

pharmacy implementation research network (AR, AL, MS, NC, SC).

In the last 4 years, under the leadership of Dr. Curran the CIR has supported pharmacists in Arkansas through the completion of projects such as, exploring decision-making and practices around dispensing opioids for chronic noncancer pain, documenting barriers to and facilitators of That said, one area that tends to get overlooked are the things being done that impact you directly. As a college, we offering advanced clinical/cognitive services in independent have committed significant resources community pharmacies, and evaluating to do just that, so I decided to use this implementation strategies designed to opportunity to let you know about some increased completion rates of MTM in We are grateful for the of this exciting work. community pharmacies. support of innovative

Arkansas pharmacists whose

In addition, Dr. Megan Smith and Dr. Leading the way in this area is the work contributions to our college being done through our Center for Rachel Stafford have been affiliated with make all of this possible Implementation Research (CIR) program many of the CIR projects and have played through participation, led by Dr. Geoff Curran. Partnering with a key role in developing partnerships for philanthropy and pharmacists throughout the state, Dr. these initiatives. Dr. Smith has led the collaborative partnerships.

Curran and his core team, including efforts for the Community Pharmacy Dr. Jeremy Thomas and Dr. Ben Teeter, Enhanced Services Networks (CPESN) focus on exploring and implementing in Arkansas. This has been a remarkable a range of innovative services in community pharmacy and year for the formation of the Arkansas CPESN. Under the primary care settings, particularly in rural and underserved umbrella organization, CPESN USA, the network has grown in operations to support local networks and is dedicated to areas of our state. Once the services are identified and implemented, the effectiveness and impact of these services providing medication optimization and working collaboratively on patient care and health outcomes are evaluated. The use with patients and the healthcare team to provide enhanced of technology has aided in offering these enhanced services pharmacy services for Arkansans. The Arkansas CPESN is that allow pharmacists to practice at the top of their license to one of 5 networks with greater than 100 pharmacies, with a meet the patient needs of their communities. These projects membership of 117 across our state. address the issues pharmacists are now facing, such as the opioid crisis and offering immunizations. Many of these The UAMS College of Pharmacy and the Center for Implementation Research continues to support pharmacy projects are federally funded by the National Cancer Institute, The National Institute on Drug Abuse, and the Agency for practice in Arkansas through a wide variety of projects aimed Healthcare Research and Quality. at positioning the pharmacist to be a valuable and needed member of the patient’s healthcare team. We are grateful The CIR is currently developing and testing implementation for the support of innovative Arkansas pharmacists whose strategies to support the delivery of clinical pharmacy contributions to our college make all of this possible through services via telehealth, prescribing of naloxone by community participation, philanthropy and collaborative partnerships. I pharmacists, providing HPV vaccinations, delivery of point of want to sincerely thank all of our friends of the college and care testing in community pharmacies for acute conditions I look forward to working with you on these and many other projects. § such as strep and flu, and creating a five-state community

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HARDING UNIVERSITY REPORT

Pharmacists, Take the Wheel

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f you serve as a preceptor or have attended any national Jeff Mercer, Pharm.D. pharmacy meetings over the last Dean couple of years, you are likely familiar with the Pharmacists’ Patient Care Process (PPCP) for pharmacy practice. The PPCP was published by the Joint Commission for Pharmacy Practitioners (JCPP) in 2014 as a consensus approach and best practice for pharmacists to deliver effective patient care. Thirteen well-known national pharmacy organizations, including the American Pharmacists Association, American Society for Health-System Pharmacists, and National Community Pharmacists Association, among others, united together in support of the PPCP as a standard of care for pharmacists. That’s really saying something. This unprecedented agreement from so many influential pharmacy organizations acknowledges the importance and applicability of the process across a wide-range of patient-care settings.

For those who do not know of the PPCP, or if you need a short refresher, it is a five-step process illustrated by a colorful “wheel” graphic that describes the framework for delivering patient care services in any practice setting. The steps in the PPCP are “Collect, Assess, Plan, Implement, and Follow-up.”

Look familiar? It’s really not that new. Discerning pharmacists will recognize the PPCP as a contemporary take on the traditional pharmaceutical care model that has been the basis of pharmacy education for many years. What has changed is the consensus-based approach to how this process is supported, taught, and now practiced.

Harding University College of Pharmacy has taught the general principles of pharmacist-delivered patient-centered care throughout the history of our program. However, in 2015, we began a steady transition to emphasize the Pharmacists’ Patient Care Process throughout our didactic and experiential curricula. Our goal is to educate students for current practice expectations and to therefore prepare our graduates to utilize the PPCP in collaboration with other health care providers to optimize medication use and overall health outcomes of the patients they serve. Students begin learning about the PPCP “wheel” early in the first professional year and reinforce that learning

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over subsequent pharmacy practice and pharmaceutical science courses. Outside the classroom, we encourage students to practice the PPCP through co-curricular activities and dedicated pharmacy practice experiences. Though the foundations of patient care are still rooted in the pharmaceutical care model of yesterday, the new PPCP model gives our students and graduates the contemporary methodology and confidence to accept the responsibility for patient outcomes associated with coordinated and consistent delivery of patient care, regardless of the practice setting.

As I mentioned at the outset, most preceptors are already aware of the Pharmacists’ Patient Care Process model and the importance of utilizing it for training students during introductory and advanced pharmacy practice experiences.

To support preceptor development and preparation in applying the PPCP during experiential teaching, we have inserted the “wheel” into each experiential syllabus and provided foundational information in our Pharmacy Practice Manual as well as our website. Preceptors also have access to targeted development through our experiential office by participating in continuing education courses and utilizing the APhA guidebook on implementing the PPCP in your practice.

Whether you are a preceptor or not, all active pharmacy practitioners should be aware of the Pharmacists’ Patient Care Process. If you are interested in learning more about this model for your practice or have general questions about the process, please reach out to us at Harding University College of Pharmacy. We would love to hear from you! §

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The Gift of Giving

By Emily Wilson, Pharm.D.

CALL TO ACTION

I always knew I wanted to serve people, but I never imagined making an impact before graduating pharmacy school. Each season of life has prepared me for the next, and it is this building of skills, this testing of beliefs and values that prepared me for the opportunity of a lifetime – the opportunity to save a life.

My first year of pharmacy school I faced a seemingly insignificant choice: begin studying after class or stop by the DKMS bone marrow donor drive on UAMS campus. I chose the latter and was recruited as a newly registered donor and pledge of the oldest and largest pharmaceutical fraternity, Kappa Psi. I gained a pharmacy brotherhood while joining the fight to save lives.

Two years later the call came. It felt like a movie moment where you remember everything - where you were, what you were wearing, what you were thinking, and what you were feeling in that moment when another human life is suddenly placed upon your shoulders; your mind processing the options while your heart swells with selfless compassion for a stranger, all in the muted silence of a moment - the moment that you realize our decisions ripple far beyond our own pond.

Emily Wilson on donation day.

year waiting for a match on the kidney transplant list. Peritoneal dialysis was losing effectiveness and the stress of end-stage renal disease was taxing on her ailing body; she was running out of time.

My mother was admitted to the ICU, and I returned to UAMS to begin my final (and busiest) didactic semester as a student I can still picture that day: Rochester, Minnesota, at the Mayo pharmacist. The semester was packed with coursework, Clinic Starbucks, ordering a venti salted caramel mocha, wearing additional electives, projects, and teams. a green V-neck sweater, anxious as I waited Due to my match’s condition, the scheduled for my mother’s parathyroid surgery followdonation date was pushed back twice; up, and uneasy when my phone rang with I remember looking back yet, my commitment to the 9-year-old an unfamiliar New York number that I almost at the excitement and boy never wavered. I shouldered school didn’t answer. It was a snowy Minnesota optimism I had in being commitments and family responsibilities, day in late December when I answered a part of something bigger never losing sight of the fact that I was in call that would change my life. a unique position: I was a family member A 9-year-old boy with acute lymphoblastic than myself, but I never waiting for the call on a donation match, leukemia (ALL) needed a bone marrow could have anticipated I while simultaneously being the match for transplant to save his life – and I was a was about to begin the most a person in need. match. “YES,” I remember answering the challenging year of my life. call to action confidently, my salted caramel DONATION mocha growing cold and unclaimed on the DKMS orchestrated every detail of the Starbucks counter. “When can I start?!” I donation process: flights and hotel stays, remember looking back at the excitement and optimism I had even transportation to and from facilities. Prior to donation, DKMS in being part of something bigger than myself, but I never could performed an extensive donor physical to ensure I was healthy have anticipated I was about to begin the most challenging year enough to donate and educated me on what to expect as a donor. of my life.

PREPARATION

After spending Christmas at the Mayo Clinic in Minnesota, 2018 began in an Arkansas emergency room. My mother had the flu and developed a secondary bacterial pneumonia infection. In 2010, she lost her kidney function to a misdiagnosed autoimmune disease and was given a 5 to 10-year prognosis. This was her 8th

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There are two ways to donate: non-surgically via peripheral blood stem cell (PBSC) collection or surgically via bone marrow donation. PBSC donations (75% of cases) collect blood stem cells through the bloodstream. My match required the more invasive donation method: collecting marrow cells from the back of my hip bones.

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THE GIFT OF GIVING

During the donation, I was under anesthesia and didn’t feel any pain. A unit of my own blood was set aside 2 weeks before the donation to help minimize anemia during recovery. After the procedure, I woke up to a care package full of snacks, a “Hero” t-shirt, and sweet handwritten notes from the hospital staff.

Donating bone marrow was such a JOY to be a part of and something I would do again in a heartbeat!

IMPACT

A year has passed since my donation date: March 1st, 2018. All that’s left from this day is the t-shirt, the memories, and two tiny, pink scars on my lower back. Scars I wear proudly that I hope never fade. Scars that gave the gift of life.

My mother also has a scar. Just two months later, on May 17th, 2018, she received a lifesaving kidney transplant after waiting eight years on the transplant list. My mother has a second chance at life thanks to the selfless gift of an organ donor. God bless organ donors!

Sadly, not all stories have a happy ending. Acute lymphoblastic leukemia robbed my match of his childhood, and ultimately, his life. Despite the outcome, I would still donate again. I had many reasons to say “no” – my mother was in the ICU, I had additional electives and weekly pharmacy school exams, and my business team was creating a nationally competitive business plan – yet, the worst possible outcome of these events could never compare to the value of a human life. How do we know what we truly value?

By the choices we make.

contributions and time invested by volunteers. Even if you don’t match, patients are helped by more than marrow. Advocacy, prayers, donor drives, financial contributions, swab parties, newly registered donors, awareness – more than marrow.

Will you join me in the fight to save lives and beat blood cancer? YOU could be the match that saves a life.

More Than Marrow DKMS Virtual Donor Drive page: https://dkmsgetinvolved.org/virtualDrive/5cbf034ced019 056b83c2f82 Register to be an organ donor: https://registerme.org/ Instagram: @morethanmarrow

Emily and her mother

The call will interrupt your life. The call will ask more of you than you may expect, but when the call comes, you have a choice.

The 9-year-old boy with leukemia who depended on a stranger for a lifesaving bone marrow transplant did not. Cancer does not give choices; cancer takes.

BE A HERO

A bone marrow donation gave my match a choice, a choice to fight blood cancer with every option available. Every three minutes an American is diagnosed with blood cancer, yet only thirty percent of patients find a compatible donor in their family. Unfortunately, most patients (sixty percent) are unable to find a compatible match.

Annual Kappa Psi Bone Marrow Donor Drive

My match lost his fight to blood cancer shortly after a bone marrow transplant. To honor him, I am hosting a virtual donor drive in his memory. He may have lost the fight to blood cancer, but his legacy lives on in every person who reads this article, in every donated dollar and new donor that joins the registry, and in every patient’s life that will be saved.

MORE THAN MARROW

According to the Institute for Justice, only two percent of the population is on the national registry for bone marrow and only one percent of registered donors will match a patient in need.

These numbers need improving!

I matched a patient in need, but a bone marrow transplant wouldn’t have been possible without the generous financial

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`

2019 Calendar of Events

JUNE ———————————­ June 6-8 - Little Rock APA 137th Annual Convention Doubletree by Hilton

June 8-12 - Boston, MA American Society of Health-System Pharmacists Summer Meeting

JULY ———————————

APA Board Retreat and Committee Chair Orientation - TBA

AUGUST & SEPTEMBER ———— August 27-31 / September 5-26 Around the State APA District Meetings

OCTOBER —————————

NOVEMBER ————————

October 20* APA Board Meeting Conference Call

DECEMBER ————————

October 3-4 - North Little Rock AAHP Fall Seminar Wyndham Riverfront

October 26-29 - San Diego, CA National Community Pharmacists Association Annual Convention October 31* - Little Rock APA Golden CPE Hosto Center

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December 1* APA Committee Forum - TBA December 1* APA Board Meeting - TBA

December 8-12 - Las Vegas, NV American Society of Health-System Pharmacists Midyear Clinical Meeting

* Subject to change

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November 7-10 - Grapevine, TX American Society of Consultant Pharmacists Annual Meeting and Exhibition Gaylord Texan Resort

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LEGISLATOR PROFILE

Representative Fredrick Love LITTLE ROCK

District: 29 Represents (Counties): Part of Pulaski County

Advice for pharmacists about the political process and working with the Arkansas Legislature:

Years in Office: 9

Have your local pharmacist reach out to their legislators. It means more when your constituents contact you with an issue.

Occupation: Director of Community Services for Pulaski

Your fantasy political gathering would be: A weekend with

What do you like most about being a legislator? Being able to lead on issues that impact the quality of life for my constituents and the citizens of Arkansas

Hobbies: Watching movies, board & card games, and

What do you like least about being a legislator? The

and provide my community with quality of life essentials that were missing. §

County Government

cynicism the public has towards politicians and the political process

all living Presidents at Martha’s Vineyard volunteering

Why did you run for office? I wanted to make a change

Most important lesson learned as a legislator: Don't take it personally!

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ARKANSAS ACADEMY OF HEALTH-SYSTEM PHARMACISTS

Hospital Medication Safety David Fortner, Pharm.D., President

P

harmacists in hospitals and healthsystems across our state continue to work daily to provide the best possible care for the patients we see in our facilities and clinics. I continue to be encouraged by the stories I hear around new and creative ideas to expand the pharmacy footprint and seek more opportunities to impact patient care.

As opportunities increase, we do see additional increasing pressures as well. You could likely run through a list of concerns like increasing drug cost, continued shortages, and staffing challenges that present significant financial concerns for your operation.

Even though we feel this pressure, we obviously do not lose sight of our most important objective: safe, quality care for our patients.

Many of you likely saw a recent story of a former nurse at Vanderbilt that was involved in a tragic medication error involving a neuromuscular blocker.

The Institute for Safe Medication Practices (ISMP) has detailed information surrounding this error and the subsequent events impacting the nurse involved. If you have not seen this information, I would encourage you to explore the ISMP website and ensure you have the safeguards they recommend in place to prevent this type of situation in your own facility. While this is a scary occurrence, it should also be viewed as another opportunity.

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We have opportunity in Arkansas to help each other with these efforts as well. If you believe AAHP can do something to help your hospital and/or organization to improve medication safety, please reach out to let us know. Additionally, if you have examples or ideas from a medication safety perspective that will benefit others, please let us know that as well. AAHP is working to identify current practices around the state for some of these important efforts.

We have opportunity in Arkansas to help each other with these efforts... If you believe AAHP can do something to help your hospital and/or organization to improve medication safety, please reach out to let us know.

Other recent examples of medication safety issues are the continued challenges around the opioid crisis, safe administration of IV push medications, formulary decisions related to injectable promethazine, and again, issues that arise from shortages where optimal medications or dosage forms are not available.

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be leading efforts around safe use of all medications and continuing to work with other disciplines to ensure our efforts produce positive results. Certainly, groups like the Joint Commission expect hospitals to routinely evaluate medication events and organize interdisciplinary groups to address concerns. Pharmacists can and should continue to be the voice leading the discussion in this area.

Just as we see with most challenges, we are better when we work together toward a common goal. It goes without saying that medication safety is fundamental to who we are as pharmacists. This discussion also provides another opportunity for us to positively impact patient care. ยง

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COMPOUNDING ACADEMY REPORT

Tyler Shinabery, Pharm.D. Compounding Academy President

You Can’t Always Get What You Want

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reetings! I wanted to continue my series of articles of the updates to USP 795 with regard to changes in nonsterile compounding. As most of you know, this document is currently under revision, and I want to highlight some of the changes you should consider for your compounding facilities if the language in the revision holds true at the time of the writing of this article (Spring 2019). As you review the current USP 795 document vs. the proposed revision, I would implore you to set both copies side-by-side in order to easily see the new interpretation of the standard.

In this issue I wanted to discuss updates to training of compounding personnel in the non-sterile setting. Many of the tenets remain the same. For example, you are required to have a written and skills portion of all aspects of the compounding process. The trainee must first read chapter 795 as well as any other applicable chapters to your facility. The trainee would

then need to read all SOPs in your facility with regard to the facility, equipment, personnel, actual compounding, evaluation, packaging, storage, and dispensing of compounded products.

The compounder must then demonstrate the hands-on skills required to the trainee followed by observation of the trainee performing said skills without assistance. And of course, document, document, document!

There is some new language that isn’t as explicitly discussed in the current version regarding hand hygiene procedures and personnel preparation. Once again, many of these principles will be familiar to those performing sterile compounding.

There are explicit instructions to quarantine workers from the direct compounding area if they exhibit physical signs of illness such as rash, oozing sores, respiratory infections etc.

The lab manager would then have to determine whether the individual should be allowed to operate in the compounding environment or be placed elsewhere in the store until normal health resumes. The guidance also discusses the explicit ban of outer garments such as hats, coats, & scarves, among other things. Nails and fingers must be neatly trimmed, and there is no use of headphones allowed. Hand hygiene is also more explicitly defined, with an actual step-by-step process in the document. Hands must be washed initially upon entering the compounder area and re-entering after a break. Specific guidelines for timing, detergents, and drying of hands are also defined. This garbing and handwashing procedure would also need to be demonstrated, independently observed, and documented in the trainee’s employee file.

In summary, it is important to review the new revision of USP 795 since there are some significant procedural changes from the document currently in use. This only touches the surface of the changes to USP 795. Constant review of SOPs is no pharmacy operator’s favorite task, but diligence in paperwork will always pay dividends for protecting your pharmacy from operational liabilities. Until next time, another quote from the annals of classic rock:

"I went down to the Chelsea drugstore to get your prescription filled. I was standing in line with Mr. Jimmy and man, did he look pretty ill….you can’t always get what you want, but if you try sometimes, you just might find, you get what you need.” §

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STAFF SPOTLIGHT

Lauren Jimerson, Pharm.D. 2018-2019 APA EXECUTIVE FELLOW

Hometown: I am proud to be from Searcy, Arkansas, a city of 23,916. Fun fact: Searcy was recently selected to be Small Business Revolution: Main Street’s Season 4 winning town and will be featured on Hulu in October 2019.

Education: I completed my pre-pharmacy course requirements

and earned a BA in General Studies from Harding University in Searcy, Arkansas in spring of 2014. I earned my Doctor of Pharmacy from Harding University College of Pharmacy in May of 2018.

Career background: Since my senior year of high school, I

Katherine. We have two family pets that we love very much, our dog, Abbie and our cat, Sweetie.

Most unusual/interesting job: My favorite job was during college and pharmacy school when I worked as a barista and shipping specialist at Mr. Postman Expresso in Searcy, AR. My boss Allison became a mentor to me and entrusted me with a lot of responsibilities that taught me about running a small business and providing excellent customer service. I even had the opportunity to help create and name a drink that is still featured on the menu.

knew I wanted to pursue pharmacy. Prior to my fellowship at the Arkansas Pharmacists Association, I worked as a pharmacy intern for four years at Walgreens alongside a great pharmacy team.

Working as a pharmacy intern helped me discover my passion for building relationships with patients, helping them understand their medications, and empowering them to take ownership of their health.

Best vacation: Throughout my many travels across the US, one trip stands above the rest - an annual family-friends beach trip to Panama City Beach, Florida where we watched a beautiful July 4th fireworks display on the beach. We also took a pontoon boat to Shell Island (one of my favorite places I've ever visited) and spent the entire afternoon collecting sand dollars, seashells the size of my hand, and avoiding a shark.

Personal goal for APA: One personal goal I have for APA is to

Favorite meal: My favorite meal is my dad’s fried chicken,

foster a greater student involvement. Working at APA, I have seen firsthand the pivotal role students play in membership.

Best part about working at APA: My favorite part about working

at APA is interacting with our members and hearing their stories.

I've been able to learn about the pharmacy profession from a completely different angle, and I have learned that everyone has a story to be told. I love to learn of pharmacists varying career paths all while gaining insight and seeking their wisdom.

Dream job: If I would have pursued anything other than pharmacy,

it would have been interior design. I love watching HGTV, seeing how they renovate, restore homes, and recreate spaces.

Family: Family is very important to me. I am very close to my family and I enjoy spending time with them. My family consists of my dad, Tim, my mom, Kim, and a younger sister, WWW.ARRX.ORG

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homemade dressing, green beans, and rolls at Thanksgiving.

He knows it is my favorite so sometimes he makes it for my birthday in June.

Favorite quote: “The future belongs to those who believe in the beauty of their dreams.” - Eleanor Roosevelt

Recent Reads: As a recent pharmacy graduate, naturally I

am currently reading two pharmacy books both written by pharmacists: Seven Figure Pharmacist and How to Build a Pharmacy Consulting Business.

You are happiest when: I am happiest when I am laughing.

Favorite hobbies and why you like them: In my spare time I enjoy yoga. I began practicing yoga while in pharmacy school as a way to stay active and relieve stress. § 33

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APA Hosts Legislative Day APA’s 2019 Legislative Day and Reception brought together pharmacists and legislators for a day of discussing important topics relevant to pharmacy in Arkansas. Pharmacists started the day being formally recognized in both the Arkansas Senate and House of Representatives. Attendees then convened at the Old Supreme Court room where APA Executive Vice President & CEO John Vinson provided a look at legislation being introduced during the 2019 session and Arkansas Insurance Commissioner Allen Kerr discussed the implementation of 2018’s landmark PBM bill. The pharmacists also earned three hours of CPE before joining legislators for the Legislative Reception at Trapnall Hall in Little Rock.

Representative Clint Penzo and Spence Mabry

Brandon Achor and Tanner Rogers

Karen Cree, Representative Grant Hodges, and Nicki Hilliard Representative Jay Richardson, Jennifer Johnson, Representative Lee Johnson, and Senator Mathew Pitsch

Representative Bruce Cozart, Brittany Sanders, Susan Schee, and Lelan Stice

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James Bethea, Representative Cameron Cooper, and Scott Stanley

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Pharmacists were formally recognized with a resolution in the House of Representatives recognizing the important role they have in the health of every Arkansan.

Representative Deborah Ferguson, Representative Dan Douglas, Lindsey Tankersley, and John Vinson

Connor Reed, Kyler Vaughn, Amelia Whitkanack, Rodney Richmond, Tanner Rogers

Arkansas Insurance Commissioner Allen Kerr discusses the landmark 2018 PBM bill and its implementation.

APA wishes to thank all of the legislators, pharmacists and other participants who attended our 2019 Legislative Day! Arkansas House of Representatives votes on the pharmacist resolution sponsored by Representative Justin Boyd.

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