ARRX Summer 2017

SUMMER 2017 Award-Winning Quarterly Publication of the Arkansas Pharmacists Association

A Different Approach Lynn Crouse, Pharm.D. 2017-2018 APA President

OPIOID ABUSE ROUNDTABLE Three Pharmacists in the Fort Smith Area Take Action

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APA Staff

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Scott Pace, Pharm.D., J.D. Executive Vice President and CEO Scott@arrx.org John Vinson, Pharm.D. Vice President of Practice Innovation John@arrx.org Jordan Foster Director of Communications Jordan@arrx.org Susannah Fuquay Director of Membership & Meetings Susannah@arrx.org Elisabeth Mathews, Pharm.D. Executive Fellow elisabeth@arrx.org

Debra Wolfe Director of Government Affairs Debra@arrx.org Office E-mail Address Support@arrx.org Publisher: Scott Pace Editor: Jordan Foster Design: Gwen Canfield - Creative Instinct Arkansas Pharmacists Association 417 South Victory Street Little Rock, AR 72201-2923 Phone 501-372-5250 Fax 501-372-0546 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 80. © 2017 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.

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CONTENTS

Celeste Reid Director of Administrative Services Celeste@arrx.org

4 Inside APA: Healthcare Reform Back

on the Agenda in Washington

5 From the President: We Are Still Here 7 Member Spotlight: Jon Martin,

Pharm.D., Bryant Family Pharmacy

8 FEATURE: A Different Approach -

Lynn Crouse, Pharm.D. 2017-2018 APA President

12 2017-2018 New APA Board Members 12 Arkansas Pharmacists Association

Welcomes New Executive Fellow

13 Safety Nets: Archaic Terms and

Abbreviations Can Lead to Confusion

14 2017 Calendar of Events 15 New Drugs: A Dramatic Rebound

Quarter for New Drug Approvals

16 Compliance Corner: What’s Next for

Medical Marijuana?

17 Member Classifieds 18 FEATURE: Opioid Abuse Roundtable 21 Prescription Drug Abuse Prevention:

As a Pharmacist, Let Your Voice Be Heard

22 Harding & UAMS:

Arkansas College of Pharmacy Graduates Salary Survey 2017

26 APA Consultants Academy Report:

The Med-Pass Tip Sheet

27 Compounding Academy Report:

Five Steps to USP <800> Compliance

28 Legislator Profile:

Senator Jason Rapert

29 AAHP: Focusing on Coming Year with

New Board Members

30 2017 Regional Meetings 31 2017 APA Annual Convention

Exhibitors and Participants

38 2017 APA Annual Convention Award

Winners

42 Staff Spotlight: Susannah Fuquay ADVERTISERS 2 Pharmacists Mutual 6 Retail Designs, Incorporated 6 Arkansas Pharmacy Support Group 11 Pace Alliance 14 Law Offices of Darren O'Quinn 25 UAMS 25 EPIC Pharmacies 43 Pharmacy Quality Commitment Back Cover: APA Honors CardinalHealth

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APA Board of Directors

INSIDE APA

2017 - 2018 Officers President - Lynn Crouse, Pharm.D., Lake Village President-Elect – Stephen Carroll, Pharm.D., Benton Vice President – Dean Watts, P.D., DeWitt Past President – Eddie Glover, P.D., Conway

Regional Representatives Region 1 Representatives - Dylan Jones, Pharm.D., Fayetteville - Spencer Mabry, Pharm.D., Berryville - Lacey Parker, Pharm.D., Centerton Region 2 Representatives - Max Caldwell, P.D., Wynne - Darla York, P.D., Salem Region 3 Representatives - Brandon Achor, Pharm.D., Sherwood - Clint Boone, Pharm.D., Little Rock - Lanita White, Pharm.D., Little Rock Region 4 Representatives - Betsy Tuberville, Pharm.D., Camden Region 5 Representatives - James Bethea, Pharm.D., Stuttgart At Large Representatives - Amber Bynum, Pharm.D., Little Rock - Yanci Walker, Pharm.D., Russellville Academy of Compounding Pharmacists Becca Mitchell, Pharm.D., Greenbrier Arkansas Association of Health-System Pharmacists Brandy Owen, Pharm.D., Conway

Ex-Officio APA Executive Vice President & CEO Scott Pace, Pharm.D., J.D., Little Rock Board of Health Member Gary Bass, Pharm.D., Little Rock AR State Board of Pharmacy Representative John Kirtley, Pharm.D., Little Rock UAMS College of Pharmacy Representative (Dean) Keith Olsen, Pharm.D., Little Rock Harding College of Pharmacy Representative (Dean) Jeff Mercer, Pharm.D., Searcy Legal Counsel Harold Simpson, J.D., Little Rock Treasurer Richard Hanry, P.D., El Dorado UAMS COP Student Meghan Petersen Harding COP Student Chithien Le 4

Scott Pace, Pharm.D., J.D. Executive Vice President & CEO

Healthcare Reform Back on the Agenda in Washington

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as it really been seven years since the last healthcare reform debate occurred in Washington, D.C.? The first year and three months of the Obama administration brought debate and ultimately the passage of the Affordable Care Act (ACA), which created mandates on employers and individuals to purchase healthcare insurance. It also created the opportunity for states to expand their Medicaid programs to individuals making slightly above the poverty level.

These changes altered the fabric of healthcare in America by establishing minimum standards for insurance policies, instituting required medical loss ratios, eliminating coverage for pre-existing conditions, eliminating lifetime caps on coverage and a host of other provisions.

Seven years after its passage, more than twenty million Americans have healthcare coverage that did not have it prior to the ACA.

of the Republicans have also expressed concerns. Even Governor Hutchinson has made public comments expressing concern over funding to the states regarding Medicaid expansion. Medicaid expansion is important to the Governor’s Arkansas Works program, which currently provides healthcare coverage to upwards of 300,000 of Arkansas’s working poor, individuals with incomes of 101-138% of the federal poverty rate.

At the time this article was written, 10 Republican Senators are opposed to the Senate Bill. Some because it will ultimately eliminate Medicaid expansion, which is covering millions of people throughout the country; and others believe that Obamacare should be fully repealed with a replacement plan to come later.

Today, the new Congress and new President have vowed to “repeal and replace” the ACA. The U.S. House of Representatives debated the American Health Care Act (AHCA) in the Spring and narrowly passed the bill 217-213 in May. All four of Arkansas’s U.S. Representatives voted for the AHCA.

Change will likely happen, and APA has been encouraging members to advocate for three additions to the bill that would help patients and pharmacists. The first is transparency in the Pharmacy Benefit Manager marketplace and no mandatory mail order for all federally-funded plans, including Medicare Part D and Tricare.

This will reduce cost of these taxpayer funded plans and provide patients choice. The second addition we would like to see is the elimination of DIR or direct-indirect remuneration fees in the Medicare Part D plans. These fees are felt by both the patients and the pharmacists and ultimately harm patient access. The final addition we would like to see is the inclusion of pharmacists as healthcare providers in the Social Security Act or getting “provider status.” This would finally open up the ability for pharmacist to bill Medicare Part B for our non-dispensing professional services.

Over the Summer, the U.S. Senate has been creating and debating their own healthcare bill. The Democrats all seemingly oppose the Senate bill and many

Big changes in federal healthcare law do not happen often, so we must seize the opportunity to make sure pharmacy’s voice is heard. §

Despite the massive changes and dramatic increase in the number of covered Americans, the ACA (also known as Obamacare) created a rallying cry for political parties and interest groups that opposed the original bill. This led to a dramatic shift in party control of both houses of Congress in the 2010 elections and was a factor in the election of President Trump last year.

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THE ARKANSAS PHARMACIST

FROM THE PRESIDENT

We Are Still Here Lynn Crouse, Pharm.D. President

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o all Arkansas pharmacists – I share your fears and But after all that, we must never forget that the success frustrations. A lot of tough mandates have been imposed of our efforts rests squarely on the shoulders of YOU, the upon us and a lot of even tougher issues ahead cause us to individual pharmacist. It is not in any dues you pay, or PAC donations you contribute, or question so much of our profession and self-worth. Yet, we are still here. meetings you attend, or offices We work every day in the face of ever you hold. It depends solely on the "Our future has and always will lowering third party reimbursement, impact you have on the lives you rest on each of us doing this one their dysregulation, and their evertouch. Our future has and always thing. Listen to their needs. Be narrowing networks. Yet, we are will rest on each of us doing this honest in your diligence to find one thing. Listen to their needs. Be still here, individually serving our patients, aiding in their health and honest in your diligence to find their their answers. Continue to learn. well-being, and professionally answers. Continue to learn. Take Take care of your patients’ health." care of your patients’ health. positioning our pharmacists to better serve our communities at the point of the healthcare team.

I love what I do because of who I do it for. I am proud to be a part of the community we call Arkansas. I am so very proud to serve those people as a Our APA Board of Directors this upcoming year is a perfect pharmacist. We are still here and we will be here. § example of the profession in Arkansas as each one brings diversity and brilliance from the area each represents. Our Executive Committee is also very strong in leadership for the coming year and for years to come. I am so honored to be associated with such great talent and people.

AAHP Board

Arkansas State Board of Pharmacy

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

President.......................................Tom Warmack, P.D., Sheridan

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

Vice President/Secretary..................Steve Bryant, P.D., Batesville

President-Elect.....................David Fortner, Pharm.D., Sherwood

Member..........................................Debbie Mack, P.D., Bentonville

Past President...................Kendrea Jones, Pharm.D., Little Rock

Member...................................Lenora Newsome, P.D., Smackover

Treasurer...........................Kendrea Jones, Pharm.D., Little Rock

Member...........................Rebecca Mitchell, Pharm.D., Greenbrier

Secretary..................................Melissa Shipp, Pharm.D., Searcy

Member....................................Ken Lancaster, P.D., Arkadelphia

Member-at-Large........Erin Beth Hays, Pharm.D., Pleasant Plains

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

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

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

Technician Representative.....Holly Katayama, CPhT, Little Rock

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MEMBER SPOTLIGHT

Jon Martin, Pharm.D. Pharmacist / Owner, Bryant Family Pharmacy

Pharmacy school and graduation year: UAMS 2010 Years in business/years teaching: 4 Favorite part of the job and why: I love getting to know

my patients, learning about them, what interests we share, and how they are all connected to one another. It seems like every patient is someone's brother, aunt, or best friend and I enjoy getting to make those connections

Least favorite part of the job and why: I dislike having to

constantly be on guard for fraudulent or early prescriptions.

I don't know if any of us truly realize how much time we use to check out the PMP, fill history, and duplications of therapy for the patient that is getting one opioid prescription that could be used to better educate the patient that is newly diagnosed with diabetes.

What do you think will be the biggest challenges for pharmacists in the next 5 years? The biggest challenge

do, declining reimbursements on them will force us to find new ways to prove our value to healthcare and in turn find ways to make it profitable for PBMs as well as pharmacist.

Oddest request from a patient/customer: I'm pretty sure I had a customer try to get me to help him steal a car once.

He knew I was into old cars and told me he knew where a '62 Corvette was that the people moved away and left the car. Supposedly they left the title with it too and if I helped him load it up he would sell it to me.

Fun activities/hobbies: I love old cars, enjoy tinkering on them, and driving them around.

If not a pharmacist thenâ&#x20AC;Ś: Strangely enough, a mechanic.

I actually thought about getting a part time job at a garage somewhere just to learn more about it, but who am I kidding.

I'm at Bryant Family Pharmacy pretty much every day. §

in my opinion for retail pharmacy will be a transition from a fee for product model to a fee for service model. While medication dispensing will always be a large part of what we

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A DIFFERENT APPROACH Lynn Crouse, Pharm.D. 2017-2018 APA President

By Jordan Foster

“So much of the mainstream wants us to manage disease. I don't want to manage disease. I'd rather manage people.”

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ard work and a drive to succeed are things APA President Lynn Crouse is very familiar with. From the time he was a young boy working in his dad’s pharmacy and running his own lawn care and janitorial businesses to his current role as pharmacist and owner of eight pharmacies in South Arkansas and Mississippi, Crouse's persistence and dedication to rolling up his sleeves and getting to work have transformed from an inward drive for personal success to an outward motivation to see his community rise up and take control of their health and wellness. Now, he’s made it a personal mission to see that all his patients take responsibility for their lives through unconventional methods.

Starting Out

Born in Pine Bluff, Lynn remembers at a young age his father’s decision to go to pharmacy school, a decision that would eventually change Lynn’s life by introducing him to the world of pharmacy and sparking an interest that would become his career. As a child, he spent afternoons at his father’s store, Hunter’s Pharmacy in Lake Village, growing up behind the counter. “As a child, that wasn’t always something I wanted to do,” Lynn says. “I wanted to be out having fun, but if I didn’t have something else to do I had to go to the store.”

As Lynn grew up, his entrepreneurial spirit flourished as he began mowing yards, raising chickens, and began his own janitorial service where he would clean bathrooms, vacuum, and take out the trash. By the time high school came around and he added athletics and student council, Lynn learned quickly how to juggle responsibilities and always have a few things up in the air at the same time.

He attended the University of Arkansas, earning a Bachelor of Science in microbiology and Louisiana State University, where he earned a Bachelor of Science in medical technology.

His path was leading him towards a PhD program for clinical pathology at the University of Tennessee when he got a voicemail from Karrol Fowlkes that altered his trajectory – he had been accepted into the UAMS College of Pharmacy.

After graduation, Lynn started his career in community pharmacy working for Don Curran at Harp’s in Springdale.

“Don is probably one of the most wonderful people I’ve ever met. He gave me a chance. His patients love him. He’s a great example and I’m proud to say he hired me.” Years later, after a move to USA Drug, Lynn and his wife Michelle felt drawn back home to Southeast Arkansas. “We always knew we wanted to go back to Lake Village. We had been in Little Rock for college and Northwest Arkansas working, but there was always that pull to go back home.” After years of being way, the Crouses made their way back to Lake Village and soon bought Eudora Drug Store. Within a year, Lynn’s influence in Arkansas pharmacy had caught the eye of then APA CEO Mark Riley, who persuaded Lynn to get involved with the Association. Lynn and Michelle would go on to buy stores in Crossett, Monticello, Warren, Portland, and across the border in Mississippi.

The Year Ahead

Now a major voice in Arkansas pharmacy, Lynn has seen

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“APA is a platform for pharmacists. When we meet, it’s a sharing of information and knowledge, we are all audiences to different venues of information... It’s a collective knowledge. APA means I’m not fighting this fight alone.” healthcare change in the past twenty years, but has also seen pharmacists evolution somewhat stunted by doubt. “I think we are much more connected to the matrix than we used to be.

We graduate pharmacy school with a wonderful education, great knowledge about systems in the body. But now you pass the NAPLEX and you get connected to a computer and you forget about serving your patients’ needs and their health. So much of the mainstream wants us to manage disease. I don’t want to manage disease, I’d rather manage people. When a patient comes in and says ‘How can I change my cholesterol numbers? How can I lower my blood pressure? How can I get off this proton-pump inhibitor?’ we should be able to help them. If we are truly the drug experts, we should be helping them get off medicine.” Doubt, he adds, is threatening the relationship between the pharmacist and the patient, a crucial part of the success and health of a community. “One of the most important issues facing pharmacists today is our own perception of self-worth and what type of impact we can have.

We are all too ready to sell ourselves short. We can help people change their lives if we just look up from the computer and listen to them.”

Using his voice to help other pharmacists is a key reason Lynn ran for president and one that he intends to do in his year-long term. “I want to get pharmacists thinking about what they can do in their practices that doesn’t take a legislative action or a board approval, something that only takes that pharmacist trying a new idea. I think I’ve got some good ideas, so do other pharmacists. We just need to get those ideas out there.

Often we’re talking about what the patient needs. You can educate people all day long about what they need, it doesn’t

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LYNN CROUSE, PHARM.D. - 2017-2018 APA PRESIDENT

Lynn, Michelle, and the staff at Hunter's Pharmacy.

mean they’re going to change. We have to endear ourselves to the patients.”

In addition to therapeutic modification, Lynn also focuses on drug-induced nutritional depletion with his patients, educating them about how taking some prescriptions will naturally deplete their bodies of a much needed nutritional element which should Part of getting his message out to pharmacists across the state is using his position in APA to recruit. He says that it’s be supplemented. “We have to remember that we know the important to remember to reach out to younger pharmacists body and that we have to modulate these things. For instance, if you take 100 people on metformin and ask them to participate because sometimes that’s all they need – trying to keep their blood sugar low, having someone they look up to thirty percent of those people, their “The goal is for not only our patients but ask them to get involved. “APA is a bodies will stop making B12. That other members of the healthcare team to platform for pharmacists. When we might not sound that bad, but if look at us as more than just a healthcare meet, it’s a sharing of information you remove metformin from those provider or disease state manager. They people that have stopped making and knowledge, we are all audiences should look to us as providers of health.” to different venues of information.

B12, fifty percent of those thirty Maybe you’ve been giving out a people will never make B12 again. medication forever and then you B12 goes on to make serotonin, find out there’s a pharmacist over here that has a kernel of which is what all the anti-depressants try to regulate. Serotonin goes to melatonin, which regulates your sleep. Nobody is really information that reminds you of something you forgot or teaches teaching this and in reality, not knowing these things can create you something new. It’s a collective knowledge. APA means I’m a domino effect for the patient’s health.” not fighting this fight alone.”

Providers of Health

Functional medicine might not be a term that many pharmacists are familiar with, but at Lynn’s stores, it’s a discipline that is leading patients to take back the reins of their health and ask more questions about their treatment. The Crouses use therapeutic lifestyle changes as a template of what to do to prevent a patient from going on a drug.

“There is a period of time between when the doctor thinks something may be going on and when you start taking a drug that you’re supposed to be doing diet and lifestyle modifications.

The National Institute of Health recommends 12 weeks of lifestyle modifications. What we do, and what I think pharmacists should do, is take that 12 weeks to help the patient prevent themselves from having to go on this medication. All it takes is giving patients time to explain what’s going on and then giving them time and helping them figure out what the answer is.”

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Lynn admits it may sound tangential and on the edge of medicine now, but the links between functional medicine/therapeutic lifestyle changes and the health of his patients has begun to pay off. “We’ve started to see tremendous changes in our patients’ health. We have three to four diabetics a year come off their medications. We’ve had five times that amount correct their lipid panels. Michelle has been working to correct thyroid problems in her patients and seen success. We’ve had people come off PPIs in as little as three months, but typically it’s six months to a year.”

He encourages pharmacists across the state to advocate for their patients and learn about new methods for improving the health of their communities. “Look at your own practice and your own patients and figure out what you can do to help. The goal is for not only our patients but other members of the healthcare team to look at us as more than just a healthcare provider or disease state manager. They should look to us as providers of health.” §

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2017-2018 New APA Board Members Region 1 Representative

At Large Representative

Berryville

Little Rock

Spencer Mabry, Pharm.D.

Amber Bynum, Pharm.D.

Region 2 Representative

AAHP President

Brandon Achor, Pharm.D.

Brandy Owen, Pharm.D.

Sherwood

Conway

Region 2 Representative

Lanita White, Pharm.D. Little Rock

Returning Board Members

Region1 - Dylan Jones Region 1 - Lacey Parker Region 2 - Max Caldwell Region 2 - Darla York Region 3 - Clint Boone

Region 4 - Betsy Tuberville Region 5 - James Bethea At Large - Yanci Walker Compounding Pres. - Becca Mitchell Vice President - Dean Watts

Announcement

Arkansas Pharmacists Association Welcomes New Executive Fellow APA Executive Vice President and CEO Scott Pace has named Elisabeth Mathews, Pharm.D., as the Association’s inaugural fellow for the APA Executive Fellowship in Association Management.

“Growing up on a chicken farm in Madison County, I experienced first-hand what it means for a community to be medically underserved,” Mathews said. “I saw the important role pharmacists can play in rural communities given their accessibility and expertise. I’m excited for the opportunity to work for the pharmacists of our state in furthering the impact our profession can have in advancing the health and wellbeing of every Arkansan.”

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Mathews earned a B.S. in chemical engineering from the University of Arkansas, Fayetteville and recently graduated from the University of Arkansas for Medical Sciences with a doctorate of pharmacy. As a student, Mathews was active in the American Pharmacists Association – Academy of Student Pharmacists, serving as president of the UAMS chapter, chairing the national nominating committee, and serving on an advisory committee to the national academy president.

She joins the APA staff for a one year fellowship, developing her skills in association management and working with the Association to advocate for Arkansas pharmacists and patients. The Executive Fellowship is being funded jointly by the UAMS College of Pharmacy, the Harding University College of Pharmacy, and the Arkansas Pharmacists Association. §

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THE ARKANSAS PHARMACIST

UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES COLLEGE OF PHARMACY

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

Archaic Terms and Abbreviations Can Lead to Confusion Welcome to another issue to Safety Nets. Thank you for your continued support of this column.

A

pharmacy technician received the original, handwritten prescription illustrated in Figure One. The prescription was written by a veterinarian for a dog diagnosed with Type 1 Diabetes. The technician entered the information into the computer as Novolin N, 100 units/mL, quantity 10 ml, with directions of "Give 16 units four times a day". The order was then transferred from the input queue to the pharmacist verification queue in the computer. The pharmacist immediately questioned the "four times daily" dosing interval and telephoned the veterinarian for clarification. The veterinarian said he had prescribed Novolin N at a dosing interval of once daily. He explained he had written the prescription abbreviation "s.i.d." not "q.i.d." The pharmacist stated she had never heard of "s.i.d." The veterinarian said "s.i.d." means once daily and apologized for using this seldom used abbreviation. After this, the prescription was correctly filled and the dog's owner appropriately counseled.

Figure 1

question the "four times daily" dosing interval rather than mindlessly verifying the order in a robotic fashion. It is important that pharmacists treat each order as a unique entity, instead of "just one more" or "a problem" that will interrupt workflow.

This case also illustrates the hazards associated with prescription abbreviations, especially archaic ones like "s.i.d.".

If the veterinarian had simply written "Give 16 units once daily", the order would have been crystal clear. In the interest of patient safety, words should be completely written - never abbreviated. § STUDENT SPOTLIGHT

Empathy in the Pharmacy - Marie Ponnath We all have â&#x20AC;&#x153;those patients.â&#x20AC;?

Visualize these individuals that just popped into your mind.

Are they troublesome to you because they blame your for a copay increase, prior authorizations, working too slow, or not getting the e-script or fax fast enough?

This prescription is unique in that the prescriber wrote the abbreviation "s.i.d." which stands for "semel in die" or "once per day". Its use is particularly hazardous because "s.i.d." is virtually unknown outside of veterinary medicine. Its persistence in veterinary medicine is puzzling, given its use in medical practice has disappeared.

The pharmacist and technician in this case were unfamiliar with "s.i.d." and initially interpreted the abbreviation as the more familiar "q.i.d." or four times daily. In fact, at first glance, the abbreviation more closely resembles "q.i.d." than "s.i.d.". If this initial interpretation had gone undetected, the Novolin N vial would have left the pharmacy with a label instructing the owner to administer a four-fold overdose. People trust the information contained on their medication labels. This could have resulted in the dog's owner questioning her understanding of the veterinarian's verbal instructions provided during the dog's examination.

Fortunately for the dog's owner (and the dog!) the error was detected during verification. The pharmacist took time to WWW.ARRX.ORG

It is easy for us to quickly judge people when we know nothing of their story. We are usually clueless what their day had been like moments before they entered our pharmacy. One may have just learned troubling lab results, while another is recently unemployed and is now uninsured. None of us like to be yelled at or blamed for something over which we have no control.

However, when confronted with these situations, we must maintain our composure and handle the situation in a professional manner.

Is this easy? No - it's hard. Fortunately, pharmacy school prepares students from the very beginning to handle difficult situations and remain patient-centered.

Pharmacists must strive to provide patients with safety and comfort - not inflame the situation through verbal retaliation. We must demonstrate we care about our patients; we must empathize with them. Our ability and dedication to show empathy is crucial in maintaining a positive patient-provider relationship, thus allowing further opportunities to provide the best healthcare possible.

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2017 Calendar of Events AUGUST

Region 5 Tuesday, September 12 Monticello Country Club Monticello, AR

Region 5 Thursday, September 21 Grand Prairie Center Stuttgart, AR

Region 1 Thursday, September 14 Lake Point Conference Center Russellville, AR

Region 4 Tuesday, September 26 Embassy Suites Hot Springs, AR

Region 2 Monday, September 18 Vada Sheid Community Development Center- ASU Mountain Home Campus Mountain Home, AR

Region 2 Wednesday, September 27 St. Bernard Conference Center Jonesboro, AR

OCTOBER

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Region 1 Tuesday, September 19 Doubletree by Hilton Bentonville, AR

October 5-6 AAHP Fall Seminar Wyndham Riverfront Little Rock

Region 3 Thursday, September 7 Chenal Country Club Little Rock, AR

Region 1 Wednesday, September 20 Hard Scrabble Country Club Fort Smith, AR

October 14-18 National Community Pharmacist Association Annual Convention Orlando, FL

______________________________ August 3-5 APA Board of Directors Retreat Tunica, MS

APA Regional Meetings: Region 4 Tuesday, August 29 Camden Country Club Camden, AR Region 2 Thursday, August 31 Harding University Founders Room Searcy, AR

SEPTEMBER

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October 26* APA Golden CPE Hosto Center Little Rock, AR

NOVEMBER

______________________________ November 3-5 American Society of Consultant Pharmacists Annual Meeting and Exhibition Kissimmee, FL

DECEMBER

______________________________ December 3-7 American Society of Health-System Pharmacists Orlando, FL December 2* APA Committee Forum TBD December 3* APA Board Meeting TBD *Dates have not been finalized.

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A Dramatic Rebound Quarter for New Drug Approvals This column, presented by the Harding University College of Pharmacy, aims to briefly highlight information on new molecular or biological entities, new indications, or significant new dosage forms recently approved by the FDA.

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he FDA has approved 16 new drugs or chemical entities so far this second quarter of 2017—nearly the same number of drugs approved in all of 2016. Keeping with the trend over the past 5-years, approximately one-third (29%) of the drugs approved this quarter were chemotherapeutic or immunological agents aimed at cancer-related diagnoses.

This remains consistent with previous years when oncology drugs grabbed the lion’s share of new drug approvals, including 2016 (27%), 2015 (31%), 2014 (22%), and 2013 (33%). Also of note, the FDA approved the marketing of 23andMe Personal Genome Service Health Risk tests. These are the first direct-to-consumer tests authorized by the FDA for providing information on the genetic predisposition to certain diseases or conditions, which may inform lifestyle choices or discussions with healthcare providers.

Oncology: Alunbrig™ (brigatinib) was granted accelerated

approval through priority review for the treatment of metastatic anaplastic lymphoma kinase-positive non-small cell lung cancer. Bavencio® (avelumab) received accelerated priority approval as orphan breakthrough therapy as the first drug to treat metastatic Merkel cell (skin) carcinoma. Imfinzi™ (durvalumab) was also designated as a breakthrough therapy with accelerated priority review for the treatment of locally advanced or metastatic urothelial carcinoma.

Kisqali® (ribociclib) was approved in combination with letrozole (Femara®) as targeted therapy for advanced or metastatic HR-positive, HER2-negative breast cancer in postmenopausal women. Rydapt® (midostaurin) received fast-track priority review as breakthrough therapy, combined with the diagnostic LeukoStrat® CDx FLT3 mutation assay, as the first targeted treatment for newly diagnosed acute myeloid leukemia with the FLT3 gene mutation. Zejula™ (niraparib) was approved on the fast-track as orphan breakthrough therapy for maintenance treatment to delay cancer growth in adults with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer.

osteoporosis in post-menopausal women, but it carries a boxed warning for potential dose-dependent osteosarcoma noted in laboratory animals. Xadago® (safinamide) is an MAO-B inhibitor approved as add-on therapy in Parkinson’s disease for patients taking carbidopa-levodopa and experiencing “off” episodes.

Specialty Drugs: Austedo™ (deutetrabenazine) is the

first deuterated product approved by the FDA and received orphan drug status to treat Huntington’s disease-associated chorea. This product carries a boxed warning for risk of depression and suicide. Brineura™ (cerliponase alfa) is an enzyme replacement therapy receiving priority review as a breakthrough orphan drug for a rare pediatric disease to treat a form of Batten disease. It is the first approved treatment for slowing loss of ambulation in patients >3 years. Ocrevus™ (ocrelizumab) was granted fast-track priority, breakthrough therapy review as the first drug approved to treat primary progressive multiple sclerosis and other relapsing forms of MS. Radicava™ (adaravone), developed in Japan, received orphan drug status to treat Lou Gehrig’s disease.

New Dosage Forms: Significant new dosage forms approved

this quarter include: Minolira™ (minocycline, extendedrelease tablet) for acne; Noctiva™ (desmopressin, nasal spray) for nocturnal polyuria; Qtern® (dapagliflozin/ saxagliptin, tablets) new combination for type 2 diabetes; Rhofade™ (oxymetazoline, cream) for rosacea-related erythema; RoxyBond™ (oxycodone, abuse-deterrent immediate-release tablets) for severe pain; Xatmep™ (methotrexate, oral solution) for pediatric acute lymphoblastic leukemia and juvenile arthritis; Renflexis™ (infliximab-abda, biosimilar for IV infusion) for multiple indications. §

Chronic Care: Dupixent® (dupilumab) was approved as a

priority breakthrough therapy for moderate-to-severe atopic dermatitis (eczema). Ingrezza™ (valbenazine) was fasttracked as breakthrough therapy as the first drug to treat tardive dyskinesia; notably, the drug is shown to prolong the QT interval. Kevzara® (sarilumab) is approved as self-injection for moderate-to-severe rheumatoid arthritis in patients who are non-responsive or intolerant to other DMARD drugs. Symproic® (naldemedine), a Schedule II controlled-substance structurally related to naltrexone, was approved to treat opioid-induced constipation in adults with chronic non-cancer pain. Tymlos™ (abaloparatide) is the first anabolic therapy approved in 15 years to treat WWW.ARRX.ORG

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What’s Next for Medical Marijuana?

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ver since Issue 6 legalized medical marijuana in November of 2016, medical marijuana has been a frequent topic of conversation in the pharmacy community.

The discussions have only intensified since the passage of Act 1024 of 2017, which requires dispensaries to designate a pharmacist consultant. This column will take a closer look at the structure of the dispensary operation and the role of a pharmacist consultant in that structure.

The Arkansas Medical Marijuana Commission (MMC) will initially license 32 dispensaries, with 8 dispensary licenses held in reserve to address demand or diversity goals. The MMC has divided the state into 8 geographical regions and intends to license 4 dispensaries in each region. The dispensaries will be awarded by geographical zone and, once awarded, can only be operated in the zone authorized.

These dispensaries will be chosen through a merit-based application process, which includes extensive meritbased criteria. This criteria is intended to assess the applicant’s suitability to run a dispensary and includes questions regarding: (1) general experience in running a business and any specific experience in a regulated, highsecurity or agricultural industry; (2) the operational plan for operating the facility; (3) a timeline for opening a facility; and (4) proof of financial stability and resources. The MMC may also award “bonus points” to applicants with: (1) an affiliation with a physician or pharmacist (in addition to the pharmacist consultant); (2) proof that the facility will positively impact the economy or diversity of an area; or (3) proof that the facility will benefit the community through substance abuse or compassionate care plans, plans for research and education or percentage of ownership by Arkansas residents.

Dispensaries will have broad authority on the retail side of medical marijuana, with the ability to “acquire, possess, manufacture, process, prepare, deliver, transfer, transport, supply, and dispense marijuana, marijuana paraphernalia, and related supplies and educational materials to a qualifying patient or designated caregiver.” Dispensaries are also authorized to engage in wholesale sales of marijuana to cultivation facilities and other dispensaries as well as retail sales to patients.

Issue 6 explicitly allows any kind of medical marijuana or product to be sold and permits any method of consumption.

However, this wide-open product market proved to be a focus of the recently-concluded legislative session and,

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as a result, the agency rulemaking has incorporated some limits on smoking marijuana and on the type, shape and flavor of products which may be sold.

Act 1024, which created “pharmacist consultants,” also limited the range of materials which may be sold by dispensaries. Although Issue 6 allows the sale of unprocessed marijuana flower buds for consumption by smoking, Act 1024 prohibits dispensaries from selling any paraphernalia requiring combustion to be properly utilized. Although none of the bills banning edible forms of marijuana ultimately became law, the General Assembly’s concern over any product which might appeal to children was incorporated into the agency rules, which prohibit any marijuana item with a shape or design likely to appeal to minors, including anything modeled after an item primarily consumed by or marketed to children, products in an animal, vehicle, person or character shape, products that closely resemble familiar food or drink items, including candy, or any product that is made by applying extracts to commercially available candy, food or drink. The ABC’s final version of the proposed rules also prohibits items which resemble cookies or brownies.

In order to become a qualifying patient, a patient over eighteen must present an Arkansas driver’s license or photo ID, submit “written certification”—not a prescription—from a physician establishing that the patient has a qualifying medical condition and pay a fee of $50. For a minor, the patient’s parents or guardians must give written consent to the use of medical marijuana and register to become the minor’s designated caregiver. Because there is no requirement for a recommendation from a physician or any medical guidance regarding the use of medical marijuana, Act 1024’s pharmacist consultant will play a very important role in the day to day work of a dispensary.

The pharmacist consultant will be responsible for developing educational materials, procedures and policies and conducting training of the dispensary staff, as well as be available by telephone or videoconference consultations with staff or patients. Specifically, the Act requires the pharmacist consultant to: • Develop and provide training to other dispensary agents regarding the risks benefits and side effects of medical marijuana, the signs and symptoms of substance abuse, and guidelines for refusing marijuana to an impaired individual;

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COMPLIANCE CORNER

• Assist in the development and implementation of processes for patient education and support; • Provide oversight for development of education materials regarding: side effects and contraindications, guidelines for notifying the physician of side effects, descriptions of the potential effects of different strains and products, information about drug interactions, techniques for the use of paraphernalia, and information about different methods of administration; • Provide oversight for systems to document symptoms of the patient, including a logbook, a rating scale and selfassessment; • Provide oversight for policies and procedures to refuse medical marijuana to an individual who is impaired or abusing medical marijuana; and • Be accessible by phone or video conference for consultation by dispensary staff and patients during all operating hours.

Member Classifieds

There is no doubt that the pharmacist consultants will help to bridge the large gap for patients between simply having a qualifying condition and having expert advice on what type and how much medical marijuana to try for relief of symptoms. It may prove to also provide an interesting opportunity for pharmacists who enjoy exploring a new field of study.

________________________________________________________________ Erika Gee is a partner at Wright Lindsey Jennings, a member of the firm’s Government Relations Practice and a former Chief of Staff and Chief Deputy in the Arkansas Attorney General’s Office. She focuses her practice on administrative and regulatory law, government investigations, legislative drafting and lobbying.

Member Classifieds are free to APA members and $65 per issue for nonmembers. Contact communications@arrx.org for more information.

LEED Certified Pharmacy Fixtures and Shelving for Sale.

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Cantrell Drug Company in Little Rock is currently seeking applicants for Aseptic Compounding Pharmacist position in 503B Outsourcing Facility with the hours of 3pm – 12am.

The Aseptic Compounding Pharmacist will be involved in day to day manufacturing operations at the facility and perform the duties and responsibilities in a manner consistent with Cantrell Drug Company values and commitment to quality.

For more information, please email lwilson@cantrelldrug.com.

Jefferson Regional Medical Center is currently seeking a Staff Pharmacist for a full-time opportunity: Job Description: Staff Pharmacists at JRMC are required to verify physician orders for accuracy and appropriateness.

Also, they are responsible for having a working knowledge of all areas of pharmaceutical services provided including drug distribution systems, central operations, and IV admixture.

Shift: 8:30AM – 7PM (some variance) Scheduled Hours per 2-week Pay Period: 80 Weekends Required: Every Other Contact Mark Porter (PorterM@JRMC.org) for more information.

Pharmacist-Part time, (M-F) 12-5PM. CHI St. Vincent Hot Springs Rehabilitation Hospital, an affiliate of HealthSouth is growing and looking for a part time pharmacist. Hours are

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• Importantly, this Act also specifically provides that pharmacists will not be subject to prosecution or discipline, including discipline by the State Board of Pharmacy, for performing duties as a pharmacist consultant.

Monday through Friday from noon to 5pm, with the potential to increase as we continue to grow. If you enjoy pharmacy, contributing to excellent patient outcomes and serving on an amazing team, we may be just what you are looking for.

Pharmacist with 30 plus years experience seeks one solid day per week in Central Arkansas Region. Effective professional and communicator with patients, customers, and staff. Proven track record. Use my current clients as references. Please review my LinkedIn profile for full CV under Timothy Lacey PD. Contact by email at timothylacey@msn. com or 501-231-1130.

Cantrell Drug Company has a new opening for Director of QA/QC. Master’s Degree in Life Sciences or Doctor of Pharmacy preferred. Interested applicants should contact Leslie Wilson at lwilson@cantrelldrug.com.

Premier Pharmacy Care is looking for highly motivated individuals to work in a growing, fast past Long Term Care Pharmacy.

Full-Time Positions available in Sherwood, AR Pharmacist: Mon-Fri 1330-2200 every 3rd Sat Pharmacy Technician: Mon-Fri 1300-2200 every 3rd Sat Pharmacy Technician: 7on/7off Thursday through Wednesday 2100-0800 Full-Time Positions available in Springdale, AR Pharmacy Technician: Mon-Fri 1030-1900 every 3rd Sat Pharmacy Technician: Mon-Fri 1300-2130 every 3rd Sat Fax (501) 992-1013 or e-mail resume to rstudent@ ppcsherwood.com 17 17

Opioid Abuse Roundtable THREE PHARMACISTS IN THE FORT SMITH AREA TAKE ACTION AGAINST A DEADLY PROBLEM

By Jordan Foster

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t comes as no surprise to pharmacists, but the United States is in the midst of an opioid epidemic. According to the CDC, since 1999, the number of prescription opioids sold in the U.S. has almost quadrupled, as has the number of overdose deaths involving opioids. The CDC estimates that 91 Americans die from an opioid overdose (prescription opioids and heroin) every day. Arkansas has not been immune to this dark national trend and many communities and families here at home have been ravaged by opioid abuse.

Now, three pharmacists in the Fort Smith area are taking action against this deadly problem and uniting to protect their patients and their communities. Keith Larkin, Pharm.D., owner of Medi-Sav pharmacies and John Hall, P.D., owner of Health Depot pharmacies, have gone from friendly competitors to teammates in a fight against a plague that is sweeping across Arkansas. Along with Taylor Franklin, Pharm.D., Clinical Coordinator for Health Depot, Medi-Sav, and Coleman’s pharmacies, the three are leading the charge to help their patients and inspire pharmacists across the state to take action.

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The opioid epidemic is not something that happened overnight, when did you first notice that there was a problem?

Keith Larkin: We have known for a long time, because we see those prescriptions that come across. Of course, PMP has come along, and that’s brought more attention to it, but now the physician world is understanding, and so we’re getting to be able to work with them to reduce this.

John Hall: Physicians are now required, or they will be soon required, to check the PMP prior to any narcotic dispensing, not just suggested. It will be a requirement of theirs. I think it is just things like that which have kind of nudged us in that direction saying, “If we don’t get involved, if we don’t do this, before long it will be mandated.” So, we need to get out in front of it and make sure our patients are covered as best as we can and give them as much notice up front as we can before these things are required.

Taylor Franklin: I was surprised when I got out of pharmacy school at just the volume of prescriptions of opioids we were seeing. So now, I feel like we finally have good guidelines

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OPIOD ABUSE ROUNDTABLE

from the CDC. We’ve got something concrete we can work with and we’ve got better numbers on the type of damage these drugs are doing to our community. So, it’s easier to see where we should be drawing that line and what we should be helping people work towards now that we have concrete guidelines to go by.

Keith: And like anybody, it depends on what our legality is. We have to protect our patient. We have to protect ourselves, our business, our profession, likewise. So, those all come into play.

You all have your own stores in your own communities.

How did you decide to unite and work together to fight this problem?

Keith: We are friendly competitors. We already lean on each other as far as trying to take care of supplies, not just controlled substances but any medication, and we exchange ideas and meet socially. It was easy for me, because I know they have better ideas than I do. That’s the key is the friendly competition - we work together, we belong to the same buying groups, and with those established relationships, and the Association, it’s easier. Retail pharmacy as a whole, especially independent retail, they know what the other person’s going through. So, they relate, and consequently, they depend on each other.

John: I would agree. I think that over the years, we had what used to be called the “hotline.” If you had a forged prescription, you would pick up the phone and call around to say, “Hey, you guys be on the lookout for this. We saw this today.”

Over time, that’s kind of grown into other ideas, so we decided let’s just get together and take this to the next logical phase, and we’ll go ahead and implement a plan to start doing something instead of just talking about it.

Taylor: It’s helpful, too, to have several different business locations presenting on a united front on this and everybody’s getting the same message so we can kind of set a standard for our community of what pharmacies should be doing.

How does the program work?

John: The CDC guidelines basically suggest that pain management starts at about 50 morphine milligram equivalents, and as it progresses up to 90, they don’t see any benefit occurring, really, above 90. The liability for

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addiction and overdose ramps up drastically above 90, and the benefit of any additional pain relief is just not there to offset that risk. So, what we did is we came up with a program where we are going to get in front of the patient, give them their calculated morphine milligram equivalents, show them the CDC guidelines, overdose percentages, death rates, and give them something that they can talk about with their physician to say, “Hey, I’m concerned. The pharmacy has explained this to me, and this is something that I’m worried about now.” Then, we are going to give them 90 days to work towards getting reduced to a reasonable level, or if the physician wants to get involved and say, “Hey, this person is on way too much to reduce down in 90 days. Can we work on this for 6 months as long as we are working towards it?” I think as much as anything to just educate the patient on the risk, and then have them get involved and realize what the risks are there, and then start reducing them down to a more reasonable number.

Taylor: We’re doing a lot of patient education and counseling and then also laying out the expectations for what we are going to do for them and what we expect from them to talk about with their doctors going forward. There’s a false perception, I think, that this is safe just because the doctor’s prescribing it and the pharmacy is filling it that however much of it you’re getting is safe, but I think that this education that we’ve been doing with this has, like John said, opened a lot of people’s eyes to the dangers of using this even if they’re using it just the way the doctor has prescribed it. They’re at a high risk of overdose and opioid-abuse disorder and a lot of other things.

I think as much as anything to just educate the patient on the risk, and then have them get involved and realize what the risks are there, and then start reducing them down to a more reasonable number.

- John Hall, Pharm.D.

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John: That being said, a key part of this program is potentially decreasing your script count. When we’re fighting for every dollar that they’re clawing back for DIR fees, it means something for us to come together and say, “Ok, let’s turn away “X” number of hundreds or even thousands of prescriptions because it’s the right thing to do.” It is the right thing to do. It’s the right thing for our patients.

It’s the right thing for our communities.

But it’s still a difficult time for us to do that. It took a lot of thought for us to agree and realize that this just has to be done.

Once this program is up and running and off the ground, a year or two years down the road, do you see maybe sharing this program and the packet with other pharmacies? Is that something that could potentially be in the future?

A lot of patient counseling and education are what we’ve been doing and I think all pharmacists are capable of that.

Pharmacists are the experts on this, so read up and learn what you need to know about it so that you can be that resource for your patients and for their prescribers.

- Taylor Franklin, Pharm.D.

John: Absolutely. I don’t think it’s going to be a year or two years down the road. We’re seeing this thing roll quicker than that. I think all the involvement of the various states, the state Medicaids, these other things, I think that it’s going to push it forward a lot quicker. I don’t think that it’s going to take two years to get some real numbers out there.

Taylor: Anyone who would like information and help doing this, we would be happy to work with them.

What do you think other pharmacies that have not put anything into place can do? What can they learn from what you’re doing to help other parts of the state?

Taylor: The CDC has a great resource page on all of this, so get familiar with the guidelines and the numbers when you look at the problems that people are facing because of this.

You see some of the risks to your patients, and you’re able to better counsel and better educate them on what a safe dose of this type of medication is. A lot of patient counseling and education are what we’ve been doing and I think all pharmacists are capable of that. Pharmacists are the experts on this, so read up and learn what you need to know about it so that you can be that resource for your patients and for their prescribers.

John: If you don’t get involved, if you don’t get out in front of it, it’s just going to steamroll you. CDC has put the guidelines

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out there. A lot of these different companies are choosing to be a little more realistic and not just say that 90 is the number, because they realize that people are up in the 400s or more.

So, Medicaid is starting at 250 and reducing it by 50 every 6 months. They’re going to work towards getting them down to that 100 or 90 number. Some of the Medicare Part D plans are starting at 120. Some are starting at 100, but they’re all starting somewhere. You just have to start somewhere. Some doctors are going to want you to go at a certain pace for this patient and another pace for another patient. As long as they’re working towards it, we’re willing to work with them.

I think we’re still trying to get the same end result; we’re still trying to get the same goal. §

Resources: • CDC's website: https://www.cdc.gov/drugoverdose/ prescribing/resources.html • Patient fact sheet: https://www.cdc.gov/ drugoverdose/pdf/guidelines_factsheet-patients-a.pdf • Calculating dose in MME: https://www.cdc.gov/ drugoverdose/pdf/calculating_total_daily_dose-a.pdf • CDC's mobile app: https://www.cdc.gov/ drugoverdose/prescribing/app.html

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THE ARKANSAS PHARMACIST

PRESCRIPTION DRUG ABUSE PREVENTION

As a Pharmacist, Let Your Voice Be Heard

By Vic Snyder, M.D.

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n 2016, Arkansas Blue Cross Blue Shield processed claims for 599,455 opioid and combination prescriptions. This number includes 125,553 prescriptions for tramadol. During this same time period, we processed a total of 32 prescriptions for naloxone, less than 100 statewide for an entire year. That’s one naloxone prescription for every 19,000 opioid or tramadol. I don’t know what the appropriate ratio ought to be, but surely 1/19,000 leaves an unknown number of Arkansans at risk for overdose and death.

During last year’s excellent Arkansas Attorney General Prescription Drug Abuse Prevention Summit, one of the speakers represented DEA. He advised the many pharmacists in the room to pick up the phone and push back on prescribers if something about the prescription history or the customer doesn’t seem to be consistent with good medical practice. As someone who practiced medicine for quite a few years, I know how cantankerous we physicians can be when confronted by someone, even someone as well trained as a pharmacist, who appears to be criticizing how we practice. I never had to make those kinds of phone calls, but a recommendation from a pharmacist that results in naloxone also being considered may keep the patient safer as well as send a not-so-subtle message that the amounts, dosages, or drug interactions may be putting the patient at risk and need to be reviewed.

We all know America including Arkansas is in the middle of an opioid abuse/misuse epidemic. For the past few years we have been learning together through initiatives such as Patient Centered Medical Home that our patients get the best care when medicine is delivered by a group of people who work together for the best quality care. Pharmacists are an essential part of that team. I encourage you to make those professional recommendations you believe to be appropriate even if you sometimes seem to collide with a grouchy provider. _______________________________________________ Vic Snyder, M.D., J.D. is the Corporate Medical Director for External Affairs of Arkansas Blue Cross Blue Shield.

He is a former U.S. Representative for Arkansas’s 2nd congressional disctrict, serving from 1997 to 2011.

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HARDING & UAMS SALARY SURVEY

2017 Survey Presents Positive View of Market for Pharmacists

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n behalf of the UAMS and Harding University Colleges of Pharmacy, we offer our sincere congratulations to the Arkansas Pharmacy Classes of 2017. As they take the NAPLEX and start their new jobs or postgraduate work, we certainly wish them all the best.

As in previous years, we appreciate the students’ willingness to complete a salary survey during the week of graduation.

We also thank Dr. Schwanda Flowers and Dr. Sarah Griffin for compiling the data. The information indicates the job market for our 2017 Arkansas pharmacy graduates is good.

Overall, the average salary is $118,385 (a 0.6% decrease from 2016). Of the 172 students who completed the survey prior to graduation, 75% had already accepted a position and the majority (54%) characterized the position opportunities as excellent or good. Some trends from previous years have

Jeff Mercer, Pharm.D. Dean

Keith Olsen Pharm.D., FCCP, FCCM Dean and Professor

remained relatively constant. Fifty-two percent of the students accepted a position at a place where they had served as an intern or spent time during an experiential rotation. The majority (63%) accepted positions in a community/retail setting, 28% have accepted residency/fellowship positions, and 10% plan to own a pharmacy in the future.

Eighty-four percent of graduates have student loans. The average amount of debt decreased to $137,356 after a steady climb from $138,725 in 2014 and $145,000 in 2015 to $147,017 last year.

In summary, our graduates continue to have many opportunities for employment at the time of graduation.

We share their excitement as they begin their professional careers!

Arkansas College of Pharmacy Graduates Salary Survey 2017 *Note: data compiled from separate but structurally similar survey instruments

Summary

• 172 AR Graduating pharmacy students completed the survey (UAMS (n=119); Harding (n=53)).

• 75% of respondents have accepted a position.

• 54% of respondents believe the position opportunities available were excellent or good.

• 63% of those who have accepted a position did so in a community/retail setting.

• 28 students have accepted a residency/fellowship position.

• 25% were offered a sign-on bonus and the average reported sign-on bonus is $16,837.

• Overall, 33% of all students accepting positions will practice pharmacy in central Arkansas. Excluding residencies and graduate programs, 33% of the students accepting positions will practice pharmacy in central Arkansas.

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• Overall, 27% of all students accepting positions will practice pharmacy or do a residency out-of state. Excluding residencies and graduate programs, 17% of the students accepting positions will practice pharmacy out-of state.

• Top benefits include: paid vacation, health insurance, paid holidays, and retirement plan, which are similar to the top benefits in previous years.

• Average salary for a graduating pharmacy student from an Arkansas College of Pharmacy (excluding residency) position is $118,385; a decrease of $680 (0.6% decrease) from 2016.

• Approximately 10% plan to own a pharmacy in the future.

• Approximately 84% of AR graduates have student loans, with an average amount of $137,356.

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COLLEGE OF PHARMACY GRADUATES SALARY SURVEY 2017

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APA CONSULTANTS ACADEMY REPORT

The Med-Pass Tip Sheet

A

s a long-term care facility consultant, there will always be value when we assist the staff with med-pass. It does not come as a big surprise that a medication error rate of 5% or greater and/or one that includes a significant medication error is in the top ten issues seen in the state of Arkansas during survey.

Anthony Hughes, P.D. President

There are more times than I would like to admit that we get the response from staff, “Are you sure?”

Unless you live on the other side of the world in long-term care, everybody knows John Tipton the senior pharmacist with the office of long-term care. John has been a surveyor with that agency for almost as many years as I have been consulting. That, my friends is longer than John and I would like to admit sometimes. If you can assure the facility that your statement is correct, plus that statement is what John says too, then everyone is on the same page and the ultimate winner is the patient.

Just over a year ago, John put together a tip sheet with 48 items that provide guidance during the med-pass to ensure it is done correctly. In this list are items that he has observed repeatedly during the med-pass observations in the survey process.

I would like to share a sample of these points from John’s list. Remember, he did not have to do this; he did it to ensure the patient is provided their medications correctly and the facility does well on their survey. Bottom line, I say a big thank you for John.

Number 3 - Psychotropic: Chart behaviors by exception

(when that behavior is observed). There is no regulation for using actual behavioral monitoring sheets. Don’t forget to chart side effects of the drug. Documenting side effects comes under F-Tag 272 Assessment and F-tag 329 Monitoring.

Number 5 - Insulin: Multidose vials can be used for more than one resident. Remember to date the vial when opened and that it is only good for 30 days once opened in most cases.

Number 8 - Read your labels. Effexor XR is not the same as

Effexor tablet. One is extended release, the other is not. This is a medication error. Another example is metoprolol, is it the tartrate or succinate?

Number 10 - If you are going to give something later

(example: updrafts or eye drops) let the surveyor know so that they know you are aware and did not just forget to give it. They will come back and watch since they must observe multiple routes of medications.

Number 15 - Narcotics: Keep your narcotic book with you.

Sign out the medication as soon as you take it out of the drawer or when you sign off your MAR. Not later. If you go on to the next resident without signing the narcotic book, then it can be a tag under clinical records.

Number 21 - Missing Narcotics. Complete the missing narcotic form and DMS-7734 (Incident and Accident rep) and DMS-762. (Investigation rep)

Number 28 - Keep records of pharmacy notifications for 15 months (order sheets, delivery sheets, etc.)

Number 29 - If a medication dosage is decreased (example: Ativan 1mg changed to Ativan 0.5mg) they must destroy the other half of the pill. You cannot re-tape it into the card and use it. If the drug is a narcotic, then 2 nurses must witness the destruction.

Number 33 - If a resident expires, the medications do not go

with the family, even if they are privately paid. The medications can only be given to the one they are prescribed for.

Number 42 - Potassium: Give with 4-8oz of fluids.

Number 46 - ER Box: While the box is actually owned by

the pharmacy, the narcotics in it must be stored and counted just like the other narcotics. You cannot change the ER Box med sheet without approval from the Board of Pharmacy and the Medical Director. The medications and dosages on the approved sheet must match the medications in the box.

You must replace used drugs from the ER Box within 72 hours of use.

Number 48 - Just read and use common sense.

Again, I want to thank John for his time and efforts by putting such a list together. If you wish to have the list of all 48 items please drop me an e-mail at TXH4110@aol.com and I will send it back a quickly as possible. §

Number 9 - During the survey med pass, the surveyor must

see the bottle, box, or card because they must make a note of the actual drug you are giving.

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COMPOUNDING ACADEMY REPORT

Five Steps to USP <800> Compliance

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t’s hard to believe, but we are a mere eleven months from the GO LIVE date for Becca Mitchell, PharmD, FIACP compliance with USP <800>.

If you aren’t already compliant or well on you way to compliance, DO NOT PANIC. There’s still time, but you may be wondering, “Where do I start?” In this short article, I will summarize helpful tidbits from some recently published articles on USP <800> as well as give some best practice recommendations – italics are used to distinguish between the “must do requirements” and the “should do tips”. A list of references is also provided at the end, as I am standing on the shoulders of giants here and do not claim to be an expert … yet. Hopefully come July 1, 2018 we will ALL be experts in USP <800> and ALL compliant to the Arkansas Board’s satisfaction. Let’s dive in!

Background: USP <800> Hazardous Drugs – Handling in

Healthcare Settings applies to all healthcare facilities, including retail and hospital pharmacies, who handle hazardous drugs (“HDs”). Compliance will be enforced by the Arkansas State Board of Pharmacy and OSHA starting July 1, 2018.

IMPORTANT NOTE: USP <800> is HD handling – not just compounding – so EVERY pharmacy who handles HDs in any way is expected to document a risk assessment and have HD handling procedures that comply with this new chapter.

Step 1: Build a Hazardous Drug Library. See References

below for the most useful items.

Step 2: Designate a Hazardous Drug Compliance Officer (“HDCO”). Responsibilities for the HDCO will be creating and implementing SOPs, ensuring the annual SOP review is performed, monitoring compliance, and operator competency and training. Tip: Choose a senior technician with administrative strengths or who has leadership potential and has expressed the desire to grow professionally.

Step 3: Conduct a Risk Assessment. There are a number of tools available to aid in performing this step and documenting it in a simple, easy to use format (see References) and an article comparing some of those tools as well. The general process should start with creating a list of hazardous drugs and a list of tasks where exposure potential exists (receipt and storage, compounding, labeling and packaging, administration, etc.).

After identifying the route of administration (oral, inhalation, dermal) of potential exposure, you will choose a severity classification based on probability and impact.

Step 4: Identify and Resolve Deficiencies in Facility and Equipment. The PCAB/IACP Consensus Statement is very helpful for outlining MUST vs. SHOULD and giving examples of various options that comply with USP <800>. Most pharmacies will likely implement the use of a BSC, and if you are already doing so you will need to check its ventilation for compliance.

Remember that in addition to facility design you also need to consider Personal Protective Equipment, including masks, gloves, and smocks. Tip: Invest in a good consultant and make sure the consultant and contractor/installer have good communication. This will save you time, money, and headaches.

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Step 5: Use your Risk Assessment to Develop SOP’s for

Hazardous Drug Handling. Your Risk Assessment will help you understand what you should be doing (before July 1, 2018!) so the draft SOP’s may not be effective until you complete any necessary facility changes. Tip: Again, here is a great place for a senior technician or pharmacy intern to assist the pharmacist.

Empower your team to own this program by involving them in this process.

Some, but not all, of the items you need to have covered in procedures include: • General Hazardous Drug Program (list of HD’s, references, reproductive hazard) • Personal Protective Equipment Required • Use of Facility and Equipment • Compounding Techniques • Garbing and De-garbing • Personnel Competency – Qualification and Requalification • Deactivation, Cleaning, and Disinfection • Managing Spills • Labeling, Packaging, and Dispensing • Administration • HD Destruction/Waste Disposal As with all major changes, managing the new processes can seem daunting. Your best opportunity for success starts with creating an organized plan.

Here are a few final best practice tips I’ve gleaned from colleagues around the country: • Give your Hazardous Drug Compliance Officer the ability to assign specific topics to other personnel and encourage them to become your pharmacy’s expert on that singular topic.

• Make a detailed task list and set goals for major and minor timelines. Examples might be “hire a consultant by August 31, obtain three construction/equipment bids by September 31, and complete construction/installation by end of Q1 2018.”

• Have every member of your staff read the PCAB/IACP Consensus Statement or another summary reference. § References: 1. Eberwein S, Amerine L. Comparison of USP <800> Gap Analysis Tools. Pharmacy Purchasing and Products, April 2017; 12-13.

2. Mansur J, Kienle P, Kastango E. Self-Assessment of Safe Handling Practices for Hazardous Drugs Survey. Joint Commission Resources. https://hazmedsafety.com/. Accessed June 12, 2017.

3. Kastango E, Douglas K. The 2017 USP <800> Compliance Study: A National Study of Hazardous Drug Compounding Practices Gap Analysis Tool. Critical Point, LLC. www.800gaptool.com.

Accessed June 12, 2017.

4. USP <800> Hazardous Drugs – Handling in Healthcare Settings Gap Analysis Survey. Int J Pharm Compounding. https://compoundingtoday.com/compliance/uspgap.cfm. Accessed June 12, 2017.

5. Dillon L, Cabaleiro J, Chamallas S, et al. Consensus Statement on the Handling of Hazardous Drugs per USP Chapter <800>. Hazardous Drug Consensus Group. PCAB/IACP, March 2017.

6. United States Pharmacopeial Convention, Inc. <800> Hazardous Drugs – Handling in Healthcare Settings. United States Pharmacopeia 39 – National Formulary 34. Rockville, MD: US Pharmacopeial Convention, Inc, 2016.

7. NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings. Dept of Health and Human Services, 2016.

8. American Society of Health-System Pharmacists (ASHP). ASHP Guidelines on Handling Hazardous Drugs.

9. Controlling Occupational Exposure to Hazardous Drugs. OSHA Technical Manual, 1995.

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LEGISLATOR PROFILE

Senator Jason Rapert DISTRICT 35

Represents: City of Conway, portions of Faulkner and Perry

Counties

Years in Office: 7 years Occupation: Financial Services and Non-profit management What do you like most about being a legislator: I enjoy

working with colleagues to help make Arkansas a better place to live, work and raise all our families through public policy. I also enjoy helping people get things done when they call on me with an issue or challenge that I can help them address.

What do you like least about being a legislator: I am

disappointed with the hateful tone of politics in our nation and the lack of civility used by some in the process. I try my best to encourage civility and mutual respect between everyone in our political process whether they agree or disagree.

Most important lesson learned as a legislator: Every issue is unique and every vote counts.

Most admired politician: George Washington was a true

model of courage, faith, perseverance and leadership as one of our founding fathers, commander of the Continental Army and the first president of the United States.

Advice for pharmacists about the political process and working with the AR Legislature: We sincerely want to hear

from those affected by public policy decisions that live in each of our districts. Never hesitate to contact your legislator and let them know how you feel about an issue that comes before the legislature.

Toughest issue of the session: Legislation dealing with the

enactment of rules and regulations dealing with Issue 6 medical marijuana.

Hobbies: I'm a fiddle player and love playing bluegrass and

gospel music with my band Living Grace. I grew up hunting with my family and enjoy doing that every chance I get.

You are set to become president of the National Conference of Insurance Legislators in November. How do you plan to use your position to help Arkansans and other Americans? It has been my honor to serve as an officer

of the National Conference of Insurance Legislators and I am humbled to serve as president of the organization during 2018. Legislative leaders that serve around the country in the various states are members of NCOIL. We study all issues pertaining insurance and financial services that come before legislative bodies in our individual states when we meet throughout the year. Whether it is passing a model law or a resolution, NCOIL is diligent to bring expertise, experience and knowledge together to promote good policies that can be implemented in our states to address important issues.

NCOIL is dedicated to ensuring the state based insurance regulatory system is properly maintained to ensure the best interests of citizens are served in every jurisdiction around the country. We often handle issues that are extremely important to the pharmacy community including opioid abuse, the cost of pharmaceuticals and healthcare reform. §

Your fantasy political gathering would be: George Washington, Abraham Lincoln, Gov. Winthrop Rockefeller, Daniel Webster, Winston Churchill

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ARKANSAS ACADEMY OF HEALTH-SYSTEM PHARMACISTS

AAHP Focusing on Coming Year with New Board Members Brandy M. Owen, Pharm.D., BCPS President

H

ello AAHP members! It is such an honor to be your 2017questions we will be asking ourselves and our councils in 2018 AAHP President. I think I had been a pharmacist the coming year. for about 5 minutes when I volunteered to help with exhibit What about you? What are you focusing on this year? Would booths at Fall Seminar. I wasn’t exactly sure what I was getting you like to become more involved with AAHP? Not everyone myself into, but I have always been nosey, wanting to be in wants to be an officer or even a major player organizing big on the action, and probably (to be totally honest) wanting to impress my new employer too. That small volunteer job jobs like Fall Seminar. We totally get that. Ever thought about eventually led to a few different terms as Board Member-atmicrovolunteering?

Large and Fall Seminar Chair. I’ve basically been in the mix Technically, it means freely offering of hospital pharmacy association to help, but on a very small scale. “stuff” for about 15 years. I love We can ALWAYS use help making this group of professionals. I love being a part of an organization that name tags for Fall Seminar, "I love this group of watching over the silent auction, values and respects those that professionals. I love being a came before us, while supporting judging posters, etc. Please reach part of an organization that and celebrating the new members out to myself (brandy.owen@ eager to come aboard. baptist-health.org) or another values and respects those AAHP board member if you’d like that came before us, while As we move into the summer, to help in any way, big or small. for many this is the beginning We’d love to have you. supporting and celebrating of the year. New officers with the new members eager to associations, new graduates Finally I cannot say thank you starting job or residencies, and enough to Kendrea Jones, your come aboard."

2016-2017 AAHP President. She new opportunities for everyone to refocus on goals. For AAHP, we will has worked tirelessly for you and start off this year doing just that. your organization all year, and it We will have an officers’ retreat to has been such a pleasure for me focus in on our long term goals and really drill down into to work with her and get to know her as a professional and the details of how to achieve them. We will tackle many friend. Thank you Kendrea for being a great mentor and issues, like membership value, provider status, advocacy, role model. I would like to thank Rob Christian and Marsha continuing education, innovative social media usage, Crader for their tremendous hard work and dedication antibiotic stewardship initiatives, and technician utilization. while on the board of AAHP, as well as Kevin Robertson for None of these are particularly new issues, but we have new his hospital pharmacy representation on the AR Board of leaders bringing fresh ideas to the table. We will continue Pharmacy. Kevin, we wish you all the best in your new role. to strive to increase membership and improve the value of Finally, I would like to welcome your new President Elect that membership. What do our members want? How can we David Fortner and new Board Member-at-Large, Joy Brock.

AAHP is truly blessed to have you both in these roles. § provide better continuing education at a convenient location?

How can we improve our communication to our members?

We want to keep you abreast of work from a newly formed AAHP Antibiotic Stewardship Task Force. How can we be a good resource for stewardship and new antibiotic initiatives?

We will be updating our web presence. How can we best utilize our website, FaceBook, and Twitter? What’s the latest with Provider Status for pharmacists? How can we best mobilize our members for advocacy for this important piece of legislation? Who is struggling with 797 regulations? Ok, who isn’t? How can we as AAHP be a source of truth for our pharmacists and technicians? These are just some of the

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2017 Regional Meetings (Formerly District Meetings)

8/29/2017 (Tuesday) Camden Country Club Camden, AR

9/14/2017 (Thursday) Lake Point Conference Center Russellville, AR

9/20/2017 (Wednesday) Hard Scrabble Country Club Fort Smith, AR

8/31/2017 (Thursday) Harding University Founders Room Searcy, AR

9/18/2017 (Monday) Vada Sheid Community Development Center- ASU Mountain Home Campus Mountain Home, AR

9/21/2017 (Thursday) Grand Prairie Center Stuttgart, AR

9/7/2017 (Thursday) Chenal Country Club Little Rock, AR 9/12/2017 (Tuesday) Monticello Country Club Monticello, AR

9/26/2017 (Tuesday) Embassy Suites Hot Springs, AR

9/19/2017 (Tuesday) Doubletree by Hilton Bentonville, AR

9/27/2017 (Wednesday) St. Bernard’s Auditorium Jonesboro, AR .

To register for a Regional Meeting, check out www.arrx.org/regional-meetings.

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Thank You to Our 2017 APA Annual

Convention Exhibitors and Participants!

P

harmacists from across the state and across the pharmacy spectrum gathered at the 2017 APA Annual Convention in Little Rock this June to earn CPE hours, network with other pharmacists, learn about practice updates, and try their hand at winning $20,000. The three day event kicked off with a presentation on medical marijuana that packed the house. During the convention, awards were presented to some of the stateâ&#x20AC;&#x2122;s leading pharmacists and convention attendees played for big prizes at the Backyard Bingo social event. Thank you once again to all our attendees, sponsors, and exhibitors!

AmerisourceBergen

Mark and Brenda Riley

Sen Jim Hendren speaks to the crowd during the Arkansas Pharmacists Political Action Committee breakfast.

APA welcomed 43 exhibitors from the pharmacy field to talk to convention attendees about new products and services to help pharmacists serve their patients more effectively and efficiently.

APCI

Arkansas CPESN

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Arkansas Foundation for Medical Care

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Bio-Tech Pharmacal

CBI Team

Cardinal Health

Convention By The Numbers

3 350 15.5

DAYS ATTENDEES CPE HOURS

15 PRESENTERS 43 EXHIBITORS 11 AWARD WINNERS Chartwell Financial Group

DataRx

ECCHIC Group

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Convention kicked off with a full house for Kari Franson’s presentation on medical marijuana.

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EPIC Pharmacies

First Community Bank

Equashield

Harding University College of Pharmacy

During the convention, awards were presented to some of the stateâ&#x20AC;&#x2122;s leading pharmacists and convention attendees were entertained at the Backyard Bingo event.

HD Smith

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Attendees enjoy a delicious dinner and time to speak to exhibitors during the Exhibit Hall Opening Reception.

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IPC

Janssen Pharmaceuticals

Kedrion Biopharma

Lilly USA

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APA Regional Representative Lanita White and APA CEO Scott Pace call Bingo numbers with the help of Scott’s son Carter.

Liberty Software

MassMutual Dallas-Fort Worth

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McKesson

Merck Vaccines

Thank You to Our 2017 APA Annual Convention Exhibitors and Participants!

Morris & Dickson

Octapharma

Novo Nordisk

Otsuka

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Parata

PBA Health

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Pharmacists Mutual Companies

PharMEDium

Retail Designs

PioneerRx

RxMaster Pharmacy System

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QS1

Roberts Remodeling

RxSystems

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The new 2017-2018 APA Board of Directors takes the oath of office.

Andrew Mize tries to crack the APA vault to win $20,000.

Smith Drug

Southern Pharmacy Cooperative

SpartanNash

Joe Moose gives his presentation on community pharmacy enhanced services networks.

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UAMS College of Pharmacy

Stone Bank

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2017 APA Annual Convention Award Winners 2017 Pharmacist of the Year – Laura Lumsden, Pharm.D. Laura Lumsden, Pharm.D., was awarded the 2017 Pharmacist of the Year Award. This award recognizes a pharmacist for his outstanding contributions to the profession of pharmacy and activities in the advancement of pharmacy during the year.

“I love helping and making things better. My life’s mission is to ‘make a difference.’ As a pharmacist, I get to do that every single day.” After graduating from UAMS College of Pharmacy, Laura dedicated her career to community pharmacy, working for Petty’s Drug, Super D Drug, and USA Drug before opening her own store, Remedy Drug, with business partner Philip Way. “Laura is the best I’ve ever seen at customer care,” Philip says. “She sets no limits when it comes to taking care of ANY patient regardless of who they are or where they come from. I’ve had the pleasure of working beside her for 10 years now and get to witness daily what a community pharmacist is intended to be.”

The spirit of service that has guided Laura’s career is also present in her personal life. She volunteers for AARP, the American Lung Association, and The Association for the Blind and Visually Impaired, as well as being a guest contributor on local radio and television stations to discuss health-related issues.

She also serves as the Communications Committee chair for the Arkansas Pharmacists Association and is a member of the UAMS College of Pharmacy Assessment Committee, the UAMS College of Pharmacy Alumni Association, and NCPA.

Bowl of Hygeia Award – Sue Frank, PD Sue Frank, PD was awarded the 2017 Bowl of Hygeia Award. The Bowl of Hygeia Award is sponsored by the American Pharmacists Association Foundation and National Alliance of State Pharmacy Associations, with premier support from Boehringer-Ingelheim. This award was established to honor pharmacists who have compiled an outstanding record of community service.

Sue completed her pre-pharmacy work at ASU in Jonesboro and graduated from UAMS College of Pharmacy with a Pharmacy BS. She went on to have a successful career working as a retail pharmacist, a staff pharmacist at the Arkansas Department of Health and for Merck as an Executive District Manager. In 2008, after 28 years working for Merck, Sue decided it was time to retire and set her sights on helping her community.

Sue has served in various roles volunteering for Arkansas Children’s Hospital, St. James United Methodist Church, and UAMS College of Pharmacy Alumni Association, and in just nine short years has received several Volunteer of the Year awards for her dedication to these organizations. She serves on multiple committees, councils, and boards for UAMS, St. James United Methodist Church, Arkansas Children’s Hospital, and is the only woman to serve on the Merchants and Farmers Bank Board of Directors in the bank’s 108 year history.

Distinguished Young Pharmacist of the Year – Josh Bright, Pharm.D. Josh Bright, Pharm.D. was awarded the 2017 Distinguished Young Pharmacist Award. The APA Distinguished Young Pharmacist Award is given annually to an outstanding young pharmacist who has been out of pharmacy school less than ten years and who has demonstrated leadership among his or her peers.

Working in the pharmacy environment as a teen solidified Josh’s decision to pursue a career in the field. “I loved the people, the interactions, I loved the feeling that I was making a difference in my community, and that’s been a common thread throughout my professional development – giving back to my community.”

Now less than ten years out of pharmacy school, Joshua serves as the Director of Pharmacy Services at the North Arkansas Regional Medical Center. He serves on the Board of Directors for the North Arkansas Partnership for Healthcare Education and is a participant in Arkansas Association of HealthSystem Pharmacists’ Practice Advancement Initiative.

Joshua graduated from Arkansas Tech University with a Bachelor of Science degree in 2004 and graduated UAMS College of Pharmacy in 2008. He is a member of the Arkansas Pharmacists Association, the American Pharmacists Association, the American Society of Health-System Pharmacists, the Arkansas Diabetes Advisory Council, and a founder of the Boone County Diabetes Collaborative.

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Cardinal Health Generation Rx Award – Rob Christian, Pharm.D. Rob Christian, Pharm.D. was awarded the 2017 Cardinal Health Generation Rx Award. This award honors a pharmacist who has demonstrated outstanding commitment to raising awareness of the dangers of prescription drug abuse among the general public and among the pharmacy community.

The award is also intended to encourage educational prevention efforts aimed at patients, youth, and other members of the community.

Rob attended LSU and UALR for his pre-pharmacy course work and graduated from UAMS College of Pharmacy in 2000. During his time in pharmacy school, he worked as a pharmacy intern at Baptist Health Medical Center in North Little Rock, which transitioned into a 17-year career at Baptist Health. After graduating, he took a position there as staff pharmacist and went on to become Pharmacy Coordinator and Pharmacy Supervisor. From there, he transitioned to Baptist Health Information Systems, serving as Ambulatory Manager for Epic, a comprehensive electronic medical records system, and undergoing a two-year effort configuring, educating and working through the regulatory process to get Baptist Health equipped for the DEA’s Electronic Prescriptions for Controlled Substances program, allowing controlled substances to be prescribed electronically.

“This is a huge honor for me, I’m very humbled by it. I worked with a lot of different people from a lot of different areas within our organization and I’m proud that this award means that Baptist is being recognized as well.”

NASPA Excellence in Innovation Award – Jody Smotherman, Pharm.D. Jody Smotherman, Pharm.D. was awarded the 2017 Excellence in Innovation Award. This award was established in 1993 by the APA in cooperation with the National Alliance of State Pharmacy Associations to annually recognize a pharmacist who has demonstrated a prominent spirit of innovation and entrepreneurship in the practice of pharmacy.

A native of Oil Trough, Arkansas, Jody attended Lyon College and UAMS College of Pharmacy, where he graduated with a Doctor of Pharmacy in 1997. During his time at Lyon, he was first attracted to a career in pharmacy when he worked for a local pharmacist in Batesville. “I began working at a local pharmacy and came to know the owner Charles Hon really well. I admired him not just as a healthcare professional, but as a leader and business owner. I also admired the kind of work, which made me realize pharmacy would be a good career for me to pursue.”

Though he began working in community pharmacies, Jody soon branched out from behind the counter and saw his career advance as Director of Pharmacy, Director of Hospital Medicine, and now Associate Administrator of Graduate Medical Education at White River Health System, a role that has allowed him to develop physician residency training programs for internal and family medicine.

“I feel very fortunate to be where I am today at White River Health System. There are very few pharmacists that have taken their career in this direction because it’s so different from what most pharmacists do.”

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2017 APA Annual Convention Award Winners Guy Newcomb Award – Senator Jason Rapert and Representative Clint Penzo Senator Jason Rapert and Representative Clint Penzo were awarded the 2017 Guy Newcomb Award.

The APA Board of Directors created this award to recognize individuals who, by their legislative influence and leadership, have distinguished themselves as political friends of Arkansas pharmacy.

Senator Jason Rapert

Senator Jason Rapert represents Senate District 35, comprised of Faulkner and Perry counties. Serving in the Senate since 2010, he is chairman of the Insurance and Commerce Senate Committee, co-chair of the ALC-Higher Education Subcommittee, vice-chair of the ALC-Peer Committee, and serves on the Joint Budget Committee, the Arkansas Legislative Council, the Senate Revenue and Tax Committee, and the Joint Public Retirement and Social Security Programs Committee, among many others.

In the 91st General Assembly, Senator Rapert was a sponsor on Senate Bill 721, the companion bill to HB2190, that would require all marijuana dispensaries to appoint a pharmacist consultant and he led the charge of shepherding HB2190 through the Senate to ultimately become Arkansas law.

Senator Rapert is a member of Rotary International, Gideons International, and serves on the boards of Conway Christian School Foundation, Conway Area Chamber of Commerce, and Conway Symphony Orchestra. Professionally, he is a financial advisor and co-owner of Rapert & Pillow Financial and the president and founder of Holy Ghost Ministries, Inc. He and his wife Laurie have two daughters

Representative Clint Penzo

Representative Clint Penzo is serving his first term in the Arkansas House of Representatives. He represents District 88 which is comprised of Washington County. Penzo serves on the House Public Transportation Committee and the House Aging, Children and Youth, Legislative and Military Affairs Committee.

In the 91st General Assembly, Representative Penzo was a sponsor HB2190, now Act 1024, that requires all marijuana dispensaries to appoint a pharmacist consultant.

Representative Penzo is a member of the Knights of Columbus, the Rotary Club, Springdale Chamber of Commerce, and the National Association of Realtors. Professionally, he works as a realtor for Re/ Max Associates.

The Charles M. West Leadership Award – Meggan Edmondson Meggan Edmondson was named winner of the 2017 Charles M. West Student Leadership Award. This award was established in 2004, honoring former APA and NARD (now NCPA) Executive Vice President Charles M. West. The award recognizes a student that demonstrates outstanding potential in pharmacy and leadership.

Meggan is a member of Phi Lambda Sigma National Leadership Society, Christian Pharmacist Fellowship International, Kappa Epsilon Alpha Theta Chapter, National Community Pharmacy Association, and the American Pharmacist Association – Academy of Student Pharmacists. She has served as treasurer and Vice President of Kappa Epsilon and P1 Liaison, Treasurer and President of National Community Pharmacist Association. Meggan completed her prepharmacy curriculum at University of Central Arkansas.

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UAMS Endowed Scholarships – Mary Bradley and Ahmed Salem Mary Bradley

Mary has served as chair and as a member of the National Policy Standing Committee for the American Pharmacists Association - Academy of Student Pharmacists (APhA-ASP), the Chapter President and Vice-President of Policy for the UAMS chapter of APhA-ASP, the Student Director of External Events for the 12th Street Health and Wellness Center, and the Childhood Education Committee Chair for the UAMS Chapter of the Student Society of Health-System Pharmacy. Mary completed her pre-pharmacy curriculum and obtained a Bachelor of Science from the University of Arkansas at Little Rock.

Ahmed Salem

Ahmed Salem is a member of the National Community Pharmacy Association, Kappa Psi Fraternity, ASHP Student Societies of Health-Systems Pharmacy, Student National Pharmacist Association, and the American Pharmacist Association – Academy of Student Pharmacists. He has served as the APhA Vice President of Finance, Kappa Psi Secretary, and is the lead student coordinator for the Multi-Mini Interview admissions process. Ahmed Salem completed his pre-pharmacy curriculum at the University of Arkansas in Fayetteville, Arkansas where he earned a degree in Psychology and Business Administration.

The Arkansas Pharmacy Foundation Award – Schrell Crockett Schrell Crockett was awarded the 2017 Arkansas Pharmacy Foundation Award. The award was established in 2014 to honor a Harding University College of Pharmacy student who demonstrates outstanding potential in pharmacy and leadership.

Schrell is a member of American Pharmacists Association (APhA)-Academy of Student Pharmacists (ASP) – Harding University Chapter, National Community Pharmacists Association (NCPA)-Dr. Mark S. Riley Student Chapter, Arkansas Pharmacist Association (APA), Arkansas College of Clinical Pharmacy (AR-CCP), Rho Chi Society, Delta Omicron Chapter and Alpha Chi Honor Society, Arkansas Eta Chapter She has served as a committee member for Ronald McDonald House of Charity and as an academic tutor for Rho Chi Society.

Her volunteer activities at Harding College of Pharmacy include MTM support for local independent pharmacies, medication take-back programs, Ronald McDonald House, River Valley Christian Clinic, Christian Health Ministry Clinic, Arkansas Minority Health and Wellness Screening and A Day of Caring.

Schrell received her Bachelor of Science degree at Philander Smith College in Little Rock, AR.

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STAFF SPOTLIGHT

SUSANNAH FUQUAY Director of Membership and Meetings Hometown: Cleburne, TX Education:

BSE in Recreation/Event Management, University of Arkansas

Career Background:

Mount Sequoyah Conference and Retreat Center, Event Manager; Arkansas Department of Parks and Tourism, Group Travel Manager; Aristotle Inc. Interactive Agency, Project Manager; Rogers-Lowell Chamber of Commerce, Director of Special Events

Personal goal for APA: It is my desire to continue to grow the membership of the APA through creative and innovative approaches that encourage new memberships and maintain all present memberships. We must maintain and grow by being attentive to the needs in both of these areas.

Best part about working at APA: I also enjoy planning the APA events for the membership and getting to meet the members during our annual meetings around the state. It is rewarding for me to hear that a member has really enjoyed an event and will be back again next year.

Dream job: Event Planner for a Professional Sports Team Family: I’ve been married 6 years to Tommy Fuquay and continue to spoil and love our 13-year-old mutt, Guinness!

Tommy is employed by Best Western International and covers an eight-state area as part of their Worldwide Sales team.

Most unusual/interesting job: In college, I bid on the City

of Fayetteville's Parks and Recreation Concession Stands.

I became the proud owner of Oh, Susannah's Concessions for the 4 years that I was in Fayetteville! I recruited all my sorority sisters and guy friends to work night and weekend shifts, The Concession Stands included the Fayetteville city pool, Lake Fayetteville baseball facilities, Lewis Soccer Field, and the Gary Hampton Baseball Complex. Needless to say, I became an expert at making bank deposits from a gallon bubble gum bucket, early morning runs to SAMS, making hot dogs, and nachos, and most importantly...a connoisseur of all concession candies such as Now or Laters and Airheads.

Best vacation: First trip to NY my senior year in high school.

All I wanted to do was go to Coyote Ugly...so we did. I have a photo that was taken in front of the Statue of Liberty with the skyline of NY that included the Twin Towers in 2000... The next year they were not there.

Favorite meal: Chicken fried steak, mashed potatoes with gravy, and my Dad's cream corn!

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Favorite quote: "Do to others what you would have them do to you." Matthew 7:12 NIV

Recent Reads: People Magazine!

People would be surprised to find out that you: I love

sports! I am a huge college football fan. I try to travel to one away Razorback football game a year. I only have two more SEC stadiums to visit—South Carolina and Florida!

You are happiest when: Shopping, crafting and spending time with my family.

Favorite hobbies and why you like them: Football...I win!

Fantasy

Best piece of advice you’ve ever received: "Better to

ask for forgiveness than permission." §

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