ARRX - The Arkansas Pharmacist Winter 2016

WINTER 2016 Award-Winning Quarterly Publication of the Arkansas Pharmacists Association

AppointmentBased Medication Synchronization: New Study Links ABMS with Increased Adherence

New UAMS Dean Returns to Arkansas to Lead COP Mark Riley Bids Farewell to APA

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THE ARKANSAS PHARMACIST

2/6/16 10:21 AM

Dear Colleague, I want to first thank you all for the warm wishes and words of congratulations that I have weeks as I have started my new received over the last few role as CEO of the APA. It is an honor that I treasure, and it is tireless efforts on your behalf. a job that will earn my You deserve it. You are the med ication experts in Arkansas’s my staff and I will never forg health care system and et or lose sight of our priority to work our fingers to the bon in Arkansas. e for all of the pharmacists

I hope you are proud of the national reputation that the Ark ansas Pharmacists Association state pharmacy associations. has as a leader among I will work hard to build on this strong reputation and to take strong voice for pharmacists us to the next level. A at the state and national leve l is more important now than encourage you to be an active ever, and I want to personally member of APA.

Membership in the Arkansas Pha rmacists Association connects you to a network of pharmacy for the future of pharmacy. Bein leaders that are fighting g involved with an organization that is dedicated to fighting for primal way to protect your inte your career is the most rests, your livelihood, and you r future. After all, before you speak up. can be heard, you have to

2015 was a critical year for Ark ansas pharmacies in the state legislature as the APA advanc of legislation that protect pati ed three important pieces ents and create a more fair playing field with the pharma process and control much of cy benefits managers that the prescription drug marketp lace. The legislation address remittances, PBM regulations, ed the issues of negative and maximum allowable cost lists, and created accountabi prescription drug pricing. lity in the establishment of

In addition to fighting for pha rmacists before the Arkansas legislature, the APA provides e-newsletter on industry cha InteRxActions, a weekly nges and trends, AR•RX The Arkansas Pharmacist, a qua features on topics affecting the rterly journal with in-depth pharmacy world, and more than 20 hours annually of Continuing with numerous networking opp Pharmacy Education ortunities.

APA’s clinical programs continu ed to be successful in 2015.

The award-winning Pharmacist provided immunizations and s Immunization Program CPR training for APA member s and provided free promotiona patients to receive their flu, l materials encouraging pneumonia, shingles, and who oping cough vaccines from launched a new MTM certifica their pharmacist. We also te training program.

For the past decade, I have wor ked within this organization to fight for pharmacists across the to the many challenges facing state and to find solutions the pharmacy profession and the healthcare industry. As a pharmacy owner, APA member, pharmacist, community and now CEO, I will continue to hold high the values of Ark work together to further inco ansas pharmacists as we rporate pharmacists as the med ication experts in Arkansas’s healthcare system.

Membership in the APA is a small investment that can hav e an enormous impact on you pharmacy. Please join the Ark r future and the future of ansas Pharmacists Association and invest in the path to that exceptional future.

If you ever have a question that needs to be addressed, feel free to contact me on my person 690-8735. al cell phone at 501-

Sincerely,

Scott Pace, Pharm.D., JD Executive Vice President & CEO 417 South Victory Street | Littl

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APA Staff

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Scott Pace, Pharm.D., J.D. Executive Vice President and CEO Scott@arrx.org Jordan Foster Director of Communications Jordan@arrx.org Susannah Fuquay Director of Membership & Meetings Susannah@arrx.org Celeste Reid Director of Administrative Services Celeste@arrx.org Debra Wolfe Director of Government Affairs Debra@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 74. © 2016 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.

CONTENTS

Office E-mail Address Support@arrx.org

6 Inside APA: Moving Forward in a

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FEATURE: The Same River Twice: Dean Keith Olsen

7 From the President: Leaving A

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UAMS: Point-of-Care Testing by Pharmacists

9 Member Spotlight: Rick Rogers,

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Harding: Harding Graduates Pursuing Residencies Search for Their "Match"

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AAHP: Training for Your Career is A Lifelong Effort

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APA Consultants Academy: Vitamin D: Should We Put It In the Water?

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Leaving a Legacy: Mark Riley Retires As APA CEO (2003 – 2015)

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Member Classifieds

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2016 APA Awards Solicitation

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2015-2016 APA Board of Directors

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Call for Board Nominations

Value-based World Legacy

Don's Pharmacy, Little Rock

10 FEATURE: Life In Sync:

The Effects of Medication Synchronization on Patient NonAdherence

13 Legislator Profile: Representative

John Eubanks - District 74

15 New Drugs: FDA Has A Banner

Quarter to Finish Out 2015

17 Safety Nets: Legible Doesn't Always

Mean Correct

18 Compliance Corner: Checks and

Balances

19 2016 Calendar of Events

DIRECTORY OF ADVERTISERS 4 8 8 14 16 23

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Pace Alliance Law Offices of Darren O'Quinn Retail Designs, Incorporated Pharmacists Mutual Pharmacy Quality Commitment EPIC Pharmacies

23 Arkansas Pharmacy Support Group 27 Save the Date: APA Annual 2016 Convention 33 Cardinal Health 36 UAMS 37 Save the Date: 2016 CPE in Paradise Back Cover: APA Honors Pharmacy Partners of America

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APA Board of Directors

INSIDE APA

2015 - 2016 Officers

INSIDE APA

President - John Vinson, Pharm.D., Bryant President-Elect - Eddie Glover, P.D., Conway Vice President - Lynn Crouse, Pharm.D., Eudora Past President - Brandon Cooper, Pharm.D., Jonesboro

Moving Forward in a Value-based World

Area Representatives Area I (Northwest) Michael Butler, Pharm.D., Hot Springs Area II (Northeast) Brent Panneck, Pharm.D., Lake City

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

Area III (Central) Clint Boone, Pharm.D., Little Rock

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Area IV (Southwest/Southeast) Dean Watts, P.D., DeWitt

District Presidents District 1 - Denise Clayton, P.D., Mayflower District 2 - Max Caldwell, P.D., Wynne District 3 - Chris Allbritton, Pharm.D., Springdale District 4 - Betsy Tuberville, Pharm.D., Camden District 5 - James Bethea, Pharm.D., Stuttgart District 6 - Stephen Carroll, Pharm.D., Arkadelphia District 7 - C.A. Kuykendall, P.D., Ozark District 8 - Darla York, P.D., Salem Academy of Consultant Pharmacists Anthony Hughes, P.D., Little Rock Academy of Compounding Pharmacists Lee Shinabery, Pharm.D., Jonesboro Arkansas Association of Health-System Pharmacists Rob Christian, Pharm.D., Little Rock

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) Julie Hixson-Wallace, Pharm.D., Searcy Legal Counsel Harold Simpson, J.D., Little Rock Treasurer Richard Hanry, P.D., El Dorado UAMS COP Student Elisabeth Mathews, Little Rock Harding COP Student Meredith Mitchell, Searcy

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Find the APA on Facebook, or visit our website at www.arrx.org

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he notion of a “value proposition” may seem foreign to us in healthcare. As pharmacists, we rarely have to articulate, demonstrate, or track improvements in the care that we bring to the patients that we treat. However, the concept of paying for health outcomes and not just the provision of care or a product is quickly becoming a reality in the U.S. healthcare system. The concept, in fact, is spreading rapidly.

How do we move from a mindset of being paid for a service/product combination towards a payment model that is outcomes and value-based?

We may need to take one step back to move two steps forward.

Patient-Centered Medical Homes are quickly becoming a standard for many commercial health plans, Medicaid, and the patients they serve. Medicare Part D has famously been assigning Star Ratings to Part D plan sponsors for some time.

Hospital pharmacists face a growing challenge of keeping readmission rates low for patients with chronic diseases or face financial penalties for the bad outcomes. Regardless of the model, these all represent some form of valuebased healthcare payment.

So how do we move from a mindset of being paid for a service/product combination towards a payment model that is outcomes and value-based?

We may need to take one step back to move two steps forward. First, we need to redefine the current community-based reimbursements for our products and services. The old formulas of Average Wholesale Price minus a percentage plus a dispensing fee or Maximum Allowable

Cost plus a dispensing fee are outdated.

The dispensing fees are not remotely representative of what our professional services cost or are worth. Likewise, the ingredient reimbursement portion is so opaque that no one can make a reasonable business decision on what they will truly be paid for providing a service.

Let’s fix this piece of our problem once and for all by bringing a national, transparent model to the table using National Average Drug Acquisition Cost or NADAC. NADAC must be combined with an adjustment to traditional dispensing fees based on the real cost of dispensing and a nominal profit.

Industry adoption of NADAC plus a true and accurate, survey-based dispensing fee can bring a resolution to a twentyyear problem of lack of transparency plaguing both public and private sector purchasers of pharmaceuticals and pharmacists-services.

By solving the product and dispensing fee issue, this will provide pharmacists in all practice settings the appropriate incentives and business certainty. It will provide the freedom to participate further in exciting value-based care where the pharmacists’ role as the medication experts can grow to the next level of helping patients, payers, and other providers administer the best possible outcomes at the best possible costs.

I am confident that the professional knowledge of Arkansas’s pharmacists can continue to grow our medication adherence, medication therapy management, and immunization roles.

We will find exciting new roles within Patient-Centered Medical Homes. It is time to utilize the medication expertise that we all possess to play an even more important role in the health of our patients. § AR•Rx

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FROM THE PRESIDENT

FROM THE PRESIDENT

Leaving A Legacy

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John Vinson, Pharm.D. 003 seems like only yesterday. Professionally, my career membership the most during his President path began to unfold as I started my clinical rotations tenure. in my senior year of pharmacy school. I could finally see the light at the end of the tunnel. This was also the year of One of the most memorable events was the development of the Space Shuttle Columbia disaster, the invasion of Iraq a strong relationship between APA, Arkansas pharmacists and capture of Saddam Hussein, the completion of Human and the Arkansas state employee benefits division. This Genome Project, and launch of MySpace.com, leading the department oversees the prescription drug program for way for the social media era. Impacting pharmacy more Arkansas teachers and state employees covering over directly was The Medicare Prescription Drug, Improvement, 150,000+ people. and Modernization Act (MMA) of 2003. This was the largest overhaul of the Medicare program in 38 years. The MMA Mark’s approach with then Director Sharon Dickerson was established an entitlement program for Medicare prescription to develop a dialogue that could lead to pharmacy solutions that would both save the state money and continue to drug coverage called the Medicare Part D program. Medicare Part D later went into effect on January 1, 2006. The MMA pay pharmacists fairly at the same time. Many of the also required that Part D collaborative solutions Medicare plans support were very successful in saving millions of dollars for an “electronic prescription Many APA members and friends of pharmacy the state without provider program” and pharmacists have told me that Mark has been the “Face of fee cuts to pharmacists. saw tremendous growth in Arkansas Pharmacy” for the last 13 years. electronic prescriptions after Mark recalls that it takes 2008. a minimum of six months of building trust through Over the last 13 years, technological advances have brought a process of relationship building, telling the truth, and products and features that have changed our lives daily educating. This blueprint led to many other success stories including collaborating with Governor Huckabee and finding including cellphones with cameras, the invention of the an important solution for the early Medicare and Medicaid iPhone and ensuing generation of smartphones, and the mainstream explosion of high-speed mobile broadband, text Part D crisis for Arkansas pharmacists of 2006. Mark and APA messaging, and civilian GPS. In the world of healthcare, we also had a high success rate in the legislature with victories have seen the development of the first HIV cocktail dosed in significant pharmacy benefit manager (PBM) legislation, as a single pill daily, the first vaccine that prevents cancer, audit protection, a pharmacist practice act change to allow growth in the use of laparoscopic surgeries, and widespread pharmacist therapeutic substitution, and a pharmacy act implementation of smoke-free laws. We also are currently change to allow pharmacist-provided immunizations for seeing the implementation effects of the federal Affordable children and adolescents down to age seven. Mark also Care Act of 2010 and the implementation of the Arkansas noted that development of a written long-term collaborative Private Option in the Medicaid program. agreement with the Arkansas Association of Health System Pharmacists and the growth in pharmacist delivery of immunizations were key successes for our membership July 1st 2003 was Mark Riley’s start date as Executive Vice President and CEO at the Arkansas Pharmacists Association. during his time with APA. Many APA members and friends of pharmacy have told me that Mark has been the “Face of Arkansas Pharmacy” I would like to add that Mark worked closely with the Arkansas State Board of Pharmacy, UAMS College of Pharmacy and for the last 13 years. As the leader of the largest Arkansas pharmacy professional organization, Mark saw and heard built collaborative relationships with the newest College firsthand how Arkansas pharmacists were impacted both of Pharmacy in Arkansas at Harding University. He also positively and negatively by the events discussed above. represented Arkansas well at the national level as President Focusing on positives, I had an opportunity to visit with of NCPA and testified before Congress in Washington D.C. Mark in January to discuss his thoughts on key events as about unfair practices of pharmacy benefit managers. well as accomplishments at APA that directly benefited our (continued)

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FROM THE PRESIDENT

Mark Riley’s retirement from APA was official on December 31st, 2015. We will certainly miss seeing Mark in the office and around the state.

Our profession and world continue to evolve. One key evolution in healthcare is the projected change in volumebased payments to value-based payments for individual and population outcomes. Physician shortages are also a growing concern for many and pharmacists need to make sure they’re at the table when the solutions to these challenges are crafted. As the healthcare world continues to evolve, an exciting future is underway at APA with Dr. Scott Pace at the helm. Through his fresh leadership and our fervent support, Scott’s new role as the “Face of Arkansas Pharmacy” will lead to a strong future for the APA and pharmacists throughout the state. §

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THE ARKANSAS PHARMACIST

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MEMBER SPOTLIGHT

Rick Rogers, P.D. Co-Owner, Don's Pharmacy - Little Rock

Pharmacy/academic practice: Retail, Don's Pharmacy Graduate pharmacy school and year: North East Louisiana,

Oddest request from a patient/customer: I was asked to

help change a colostomy bag.

1975

Recent reads: Killing Lincoln

Years in business/years teaching: 40

Fun activities/hobbies: Horse racing, hunting, traveling

Favorite part of the job and why: The customers. I love

Ideal dinner guests: My parents & my family at the round

coming to work every day and talk to the customers. Many of them have become good friends of mine.

Least favorite part of the job and why: Insurance. Enough

said! When I started we didn't have to deal with insurance, those were the good ole days.

What do you think will be the biggest challenges for pharmacists in the next 5 years? Cash flow. With the cost

table at Graffiti's.

Tell me a little about your retirement: It just began, but so far it's been great. No set schedule. I still come down to Don's everyday to talk to the customers, pay bills and to eat lunch with my brother. With Oaklawn starting up, that will keep me busy for awhile. ยง

of doing business increasing every year you have to increase your profits by the same margin just to break even. PBMs putting a limit on our profits directly affects the cash flow and makes it tougher than it is already.

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LIFE IN SYNC:

The Effects of Medication Synchronization on Patient NonAdherence

By Jordan Foster

As pharmacists, it’s easy to understand the importance of staying adherent to a prescription therapy plan.

It’s also easy to see the detrimental effects nonadherence has on patients, the healthcare system, and the general health of the country. It’s been estimated that hundreds of billions of dollars are spent annually on the added costs to the healthcare system caused by patient non-adherence and non-persistence.1 What can pharmacists do to change that?

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THE ARKANSAS PHARMACIST

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LIFE IN SYNC: MEDICATION ADHERENCE

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n 2015, the National Community Pharmacists Association, in cooperation with the Arkansas Pharmacists Association and with support from Pfizer, published the study “Addressing Medication Non-Adherence through Implementation of an Appointment-Based Medication Synchronization Network,” examining the effect that appointment-based medication synchronization (ABMS) has on medication adherence. A similar study published in 2015 examined ABMS implementation in a single pharmacy chain consisting of 71 pharmacies in 20 Ohio counties and concluded that an ABMS program led to significantly better adherence and persistence in observed pharmacy patients. However, with thousands of independent pharmacies utilizing ABMS across the country, there was little research of the ABMS success rate among independent pharmacies.

The authors of the study, Jacob T Painter, Pharm.D., MBA, PhD; Gary Moore, M.S.; and Bri Morris, Pharm.D. initiated the study with a goal of determining if a concerted effort of a single monthly appointment to refill maintenance medications and a scheduled interaction with a pharmacist could improve patient medication adherence and persistence, both of which are critical to positive patient outcomes. With so many Americans suffering chronic diseases and on complex medication therapy plans, the threat of non-adherence can and does result in an incredibly steep and avoidable burden on the healthcare system.1 The study seeks to determine if independent pharmacists could provide an ABMS service that would improve the health of a patient and reduce financial burden to the healthcare system.

To begin, the authors considered some foundational statements that the study would expand upon: 1. A patient’s personal connection with a pharmacist or pharmacy staff is the number one predictor of medication adherence.2 2. Simplifying a pharmacy’s workflow leads to more time for a pharmacist to provide valuable patient interactions and other services that help improve health outcomes.

3. Medications are most effective if taken at appropriate doses in correct quantity and at appropriate time intervals.

4. Taken together, non-adherence and non-persistence result in excess costs to the health care system that total in the hundreds of billions of dollars each year.1 The study measured the impact of ABMS on medication adherence and persistence rates across 82 independentlyowned pharmacies geographically dispersed throughout the state of Arkansas. Despite the pharmacies operating on 13 unique pharmacy management systems (PMS), a common synchronization platform, PrescribeWellness, was utilized to both facilitate the delivery of ABMS in a

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Can independent pharmacists provide an ABMS service that would improve the health of a patient and reduce financial burden to the healthcare system?

standardized fashion across multiple PMSs and collect data to measure the impact on medication adherence rates.

Starting in 2014, patients were approached by a pharmacy staff member and given information about the ABMS study and the opportunity to opt-in if they were at least 18 years old and had at least two fills for 30 days or more of a chronic medication in one of 13 classes (antiretrovirals, beta blockers, biguanides, calcium channel blockers, dipeptidyl peptidase [DPP]-IV inhibitors, meglitinides, incretin mimetics, non-warfarin anticoagulants, reninangiotensin system [RAS] antagonists, sodium glucose transporter-2 [SGLT2] inhibitors, statins, sulfonylureas, and thiazolidinediones). Patients were then divided into two groups: an ABMS group that would receive medication synchronization therapy and a control group that received no therapy and would serve as a comparison group.

Patients enrolled in the study were matched with up to five other comparison patients based on medication class, pharmacy urbanicity, follow-up time, age, and sex allowing the authors to compare similar patients receiving a medication in the same class from a pharmacy in a similar setting.

As part of the study, participating pharmacies employed an ABMS program developed by the National Community Pharmacists Association called Simplify My

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LIFE IN SYNC: MEDICATION ADHERENCE

Meds and a medication synchronization software from PrescribeWellness. The programs allowed pharmacies to: • • • • •

synchronize refills for the patient on a single ‘appointment day’ contact the patient 7-10 days prior to the appointment day to review his/her medications review the orders one-day before the appointment day to resolve any clinical issues remind the patient of their appointment one day prior to their appointment day meet with the patient on the appointment day to discuss any outstanding issues, provide counseling, or patient services (MTM, immunizations)

Between May 7,2014 and May 31, 2015, data was collected from 82 pharmacies with 7,378 ABMS-enrolled patients and 608,479 control patients. A patient’s adherence was determined based on the proportion of days covered (PDC), the measurement period that a patient had a day’s supply of a medication according to their prescription fill record. Non-persistence was determined using the date the patient stopped taking the medication for more than 30 days.

After analyzing the data from all 82 pharmacies for the year-long study period, the authors found statistically significant results. To be consistent with similar studies, a PDC threshold of 0.8 was chosen as the line between adherent and non-adherent.3,4 Adherence when measured

by PDC showed that enrollees within the program were 86% adherent (calculated by an average proportion of days covered of 0.86) while enrollees in the control group were 73% adherent (average proportion of days covered was 0.73). Overall adherence among the groups showed that 75% of the ABSM patients were adherent while only 54% of the control group was adherent. The study also calculated the measure of association between an exposure and an outcome, known as an odds ratio. A positive association between the exposure and the outcome is signified by an odds ratio greater than one. An overall odds ratio for the ABMS study was calculated at 2.57, signifying that enrollees in the program were 2.57 times more likely to be adherent than their peers in the control group.

on multiple PMSs can still offer a program to improve medication adherence, which is a large component of the Medicare Part D Star Ratings program. As the health care system continues to focus on outcome measures and valuebased payment models, it’s particularly important that the study demonstrated that independently-owned community pharmacies can provide a standardized approach to improving medication adherence and persistance. The authors concluded their study by identifying these key points of interest from the project: •

• •

Innately different community pharmacies can come together to form a virtual adherence network by utilizing a common technology to standardize the delivery of ABMS. Data accessibility across all pharmacies should be a primary consideration for future endeavors.

Active pharmacy involvement including recruitment of patients is essential to the success of ABMS across a network.

The effects of non-adherence and non-persistence continue to be a burden on the healthcare system. The NCPA/APA study demonstrates that a network of independentlyowned pharmacies can unite with the common goal of improving adherence and relieving some of that burden.

No matter the practice setting or geographic region, pharmacists can have an impact on patient outcomes and population health through the use of an appointmentbased medication synchronization program. § 1. Viswanathan M, Golin CE, Jones CD, et al. Interventions to improve adherence to selfadministered medications for chronic diseases in the United States: a systematic review. Annals of Internal Medicine. 2012;157(11):785-795.

2. National Community Pharmacists Association. Medication Adherence in America: A National Report Card http://www.ncpa.co/adherence/AdherenceReportCard_Full.pdf. Accessed October 6, 2015.

3. Holdford D, Inocencio T. Appointment-Based Model (ABM) Data Analysis Report. Prepared for Thrifty White Pharmacy. Virginia Commonwealth University.

4. Holdford D. Simplify My Meds Appointment-Based Medication Synchronization Pilot Study Report. Prepared for National Community Pharmacists Association. http://www.ncpa.co/pdf/ ncpa-abms-report.pdf.

4. Holdford D, Inocencio T. Appointment-Based Model (ABM) Data Analysis Report. Prepared for Thrifty White Pharmacy. Virginia Commonwealth University.

5. Holdford D. Simplify My Meds Appointment-Based Medication Synchronization Pilot Study Report. Prepared for National Community Pharmacists Association. http://www.ncpa.co/pdf/ ncpa-abms-report.pdf.

As demonstrated throughout the study, with a 13% improvement in PDC scores and an odds ratio of 2.57, community pharmacies from across the state operating

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LEGISLATOR PROFILE

Representative Jon Eubanks DISTRICT 74, Paris, AR

District: 74 Represents (Counties): All of Logan and parts of Franklin,

Sebastian and Scott.

Years in Office: 5 Occupation: Cattle farmer Your hometown pharmacist: Medi-Quik What do you like most about being a legislator:

Constituent services is probably the most rewarding part of the job of being a legislator. That can entail everything from helping someone maneuver through bureaucratic red tape to getting a bill filed and passed, yet very often it is as simple as taking the time to return a call, listen to them, and hopefully be able to get them an answer to their question.

What do you like least about being a legislator: Lack of privacy

Most admired politician: Ronald Reagan

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

My advice to pharmacists would apply to everyone that needs to work with the legislature. Make contact early, long before the session begins, and develop relationships based on candor, honesty, and the willingness to compromise.

Your fantasy political gathering would include: George Washington, Thomas Jefferson, Abraham Lincoln, Teddy Roosevelt, John Kennedy, Ronald Reagan.

Toughest issue of the past session: In less than 90 days, the 90th General Assembly passed 1,228 pieces of legislation impacting everything from taxes to technology.

It is difficult to point to just one issue, but certainly the Religious Freedom Act and the legislation regarding PBMs were the ones that come to mind as issues that divided members. The former was an emotionally charged issue which made the process more difficult.

What do you do for fun: Play cards, read, go to good

restaurants, visit grandkids, and go to the gym, though not necessarily in that order. ยง

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FDA Has a Banner Quarter to Finish Out 2015 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 finished out 2015 on a high-note with the approval of 26 new molecular or biological entities and a bevy of significant new drug formulations.

New Dosage Forms: Significant new dosage forms that were approved this quarter include: GenVisc 850® (sodium hyaluronate, injection) for osteoarthritis; Ryzodeg® 70/30 (insulin degludec/aspart, injection) for diabetes mellitus; Dyanavel™ XR (amphetamine, extended-release suspension) for ADHD; Basaglar® (insulin glargine, injection) as a less-expensive biosimilar to Lantus; Narcan® (naloxone, nasal) for suspected opioid overdose; Onivyde™ (irinotecan, liposome injection) for advanced pancreatic cancer; Utibron™ Neohaler® (indacaterol/glycopyrrolate) combination anticholinergic/long-acting beta-agonist for COPD; Seebri™ Neohaler® (glycopyrrolate) anticholinergic for COPD; Durlaza™ (aspirin, extended-release capsule) for secondary prevention of cardiovascular events; Enstilar® (calcipotriene/betamethasone, topical foam) for plaque psoriasis; Belbuca™ (buprenorphine, buccal film) for chronic pain; MorphaBond™ (morphine, extended-

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release) for chronic pain; Tolak™ (fluorouracil, cream) for actinic keratosis; Ultravate® (halbetasol, lotion) for plaque psoriasis; and Vivlodex™ (meloxicam, capsules) low-dose for osteoarthritis.

Withdrawals: The FDA withdrew approval for Elepsia™ XR (levetiracetam) due to manufacturing-related regulatory issues.

Losing Patent in 2016: Looking forward to 2016 several highly profitable drugs are going off-patent. Some of the drugs to anticipate include the therapeutic areas of CNS (Intuniv®, Nuvigil®, Seroquel XR™), cardiovascular (Azor®, Benicar®, Crestor®, Tribenzor®, Zetia®), and infectious disease (AmBisome®, Epivir-HBV®, Tygacil®, Epzicom®, Trizivir®, Norvir®, Kaletra®), among others (Aciphex Sprinkles, Advair Diskus, Enablex). § Contributing Authors: Jimmy Skaggs, PharmD Candidate Harding University College of Pharmacy

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THE ARKANSAS PHARMACIST

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UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES COLLEGE OF PHARMACY

Legible Doesn't Always Mean Correct Welcome to another issue of Safety Nets. This issue of Safety Nets highlights the potential hazards associated with E-prescriptions. Thank you for your continued support of this column.

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elcome to another issue of Safety Nets. This column once again examines the potential hazards associated with electronic prescriptions or E-prescriptions. Thank you for your continued support of this column.

The prescription illustrated in Figure One was electronically transmitted from a prescriber's office to a community pharmacy in Eastern Arkansas. The pharmacist who examined the Topamax โ ข (topiramate) prescription Figure One was confused by the patient directions of "take one and onehalf tablet (50 mg) by mouth at bedtime."

The pharmacist immediately telephoned the prescriber's office for clarification. The nurse informed the pharmacist the patient was to administer 50 mg of topiramate in the morning and 75 mg at bedtime. When the pharmacist questioned the nurse how this confusing Sig on the transmitted prescription could occur, the nurse replied "sometimes we just have trouble using this." After this, the pharmacist changed the Sig to read "take one tablet (50 mg) by mouth in the morning and one and one-half tablet (75mg) at bedtime." The prescription was then filled and placed in the patient "will call" bin. Later that day, the pharmacist counseled the patient making certain the patient's understanding of the topiramate dose was identical to the one relayed by the nurse.

Electronic prescriptions are a human invention, and will always be as error-prone as the writers and the users. E-prescriptions have been touted by some to be much safer than traditional handwritten prescriptions.

In some cases - such as preventing look-alike, soundalike medication errors - this may prove to be true. In other cases, it is not. In fact, electronic prescriptions that contain confusing patient directions - as in this case -

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have resulted in numerous medication errors. The type of Sig illustrated in this case would have been extremely unlikely in a traditional handwritten prescription. A prescriber would never write this Sig to mean 50 mg of topiramate in the morning and 75 mg at night. This prescription would have been strengthened by including the topiramate indication. Considering this medication has several indications, including this information is clearly important. The pharmacist would clarify the indication during counseling, but a prompt in the medication order itself would guide the process. It would also be important to ascertain whether this is an initial trial of topiramate, or whether it represents a dose adjustment.

The use of E-prescriptions continues to become more widespread. Unfortunately, in some cases, this type of prescription may actually increase the risk of error compared to a traditional handwritten order. How is this possible? It is possible because pharmacy staff may assume the neatness and legibility of the electronic prescription means it must be error-free. Nothing could be further from the truth! In the author's opinion, electronic prescriptions should be as carefully scrutinized as handwritten prescriptions that are not completely legible.

Legible does not mean correct!

No matter how carefully a prescription is scrutinized, sometimes errors lurking in a prescription will not be detected during the filling process. Is there one last safety net pharmacists can use to ferret out such hard-to-detect errors? Yes - patient counseling. This last safety net is required by the Board of Pharmacy. It is also required for patient safety. It remains our last - and best - safety net to prevent medication errors from reaching our patients. ยง

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Checks Conduct and Balances Wrongful Rule

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ver the last three issues of Compliance Corner, we have taken an in-depth look at all of the different steps a pharmacist can take to prevent diversion of controlled drugs and to quickly detect diversion when it happens. We all know that pharmacists—especially PICs and permit holders—bear a heavy responsibility to keep controlled drugs controlled. Over my years representing the Board of Pharmacy, I have seen and heard from many pharmacists who feel that the task is nearly impossible because diversion is so widespread and, after all, no one can watch everything and everyone all of the time.

However, there are some effective ways to keep diversion to an absolute minimum and to catch it quickly when it does happen. To demonstrate, this issue will examine case studies from real-life diversions to illustrate how putting these tips into practice would have prevented a lot of heartache for permit holders and PICs. Before we turn to the examples, let’s recap the ideas from the previous installments. In the Spring 2015 issue, we discussed physical site security, including controlling the keys and passwords, installing an effective camera system and using alarm systems properly. In the Summer 2015 issue, we tackled what is in my opinion the most crucial aspect of preventing and detecting diversion— appropriate policies for ordering, receiving and tracking controlled drugs. The last issue, Fall 2015, focused on managing your human capital by hiring the right people and giving them the right training. After all, you will have no effective security if your employees don’t follow your policies and procedures.

Now on to the real-life examples. In most of the diversion cases I prosecuted before the Board, there was one key mistake made by the PIC—the failure to have strict controls on ordering and receiving controlled drugs. In the most common scenario, a busy PIC had a trusted technician who had worked in a pharmacy for years. The PIC had come to rely upon the tech over the years and there had never been any issues with theft, but something in the tech’s circumstances changed—maybe a spouse lost their job or they became friends with a different crowd—and they could no longer resist the temptation to take a few pills here and there and easily make several hundred dollars. Once the tech started down that road, the pressure would build to find creative ways to divert even more, like entire bottles. Almost every time, they followed the same path to increase their diversion of drugs to almost unimaginably-high levels—they were the ones to submit the controlled drug order and to check in 18

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the delivery. In that way, they added extra bottles on to the order and diverted them before the order ever made it into the pharmacy inventory.

In some cases, the employee was only occasionally able to manage it so they could both order and receive and the overall volume was relatively low. In others, the arrangement was so routine that it went on for years and hundreds of thousands of pills or gallons of syrup were diverted without notice. In one case before the Board, the diversion started small and ended with entire 1000-count bottles of hydrocodone disappearing several times a week. In either scenario, the single mistake of allowing the same person to fill both roles is what made large-scale diversion possible. And make no mistake— although many diversion cases involved technicians, pharmacists can and do divert too. The important point is to treat controlled drugs as you would $100 bills, because that is what they are worth out on the street. In order to keep your drugs controlled, you must keep checks and balances by dividing responsibility for different aspects of the inventory process.

In most of the cases at the Board, the discovery of the diversion was entirely random and accidental. The PICs involved usually checked the invoices from their wholesaler but really only looked at the bottom line numbers. Because the most commonly-diverted drugs are relatively inexpensive, the overall increase in the volume ordered was virtually unnoticeable over time if cost was the only item tracked. This is why a “shrink report,” or tracking system that measures the quantity ordered versus quantity dispensed, is an indispensable tool for a PIC or permit holder to be able to find diversion before it can progress to a large scale. In each of these cases, a shrink report would have quickly uncovered the diversion and, many times, pinpointed the person who was responsible.

I hope that the suggestions and tips in this series have demonstrated that, with a little effort on the front end, most serious diversions of controlled drugs can be stopped before they ever start. § ________________________________________________________

About the author: Erika Gee represents clients in government relations, regulatory and compliance matters at Wright, Lindsey & Jennings LLP. She previously served as general counsel to the Arkansas State Board of Pharmacy for 6-1/2 years and as Chief of Staff and Chief Deputy Attorney General for Attorney General Dustin McDaniel. She uses her experience as general counsel for state agencies and licensing boards to assist clients to resolve regulatory and disciplinary disputes with state government.

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2016 Calendar of Events FEBRUARY

JUNE

February 26 CPE at the Races Oaklawn Gaming and Racing Hot Springs, AR

June 23-25 APA 134th Annual Convention Hot Springs Convention Center/ Embassy Suites Hot Springs, AR

February 24-27 International Academy of Compounding Pharmacists Educational Conference San Diego, CA

MARCH

March 4-7 American Pharmacists Association Annual Meeting & Exposition Baltimore, MD March 13 APA Board Meeting Hosto Center Little Rock, AR

APRIL

April 14 Arkansas Pharmacy Foundation Golf Tournament Tannenbaum Golf Club, Drasco

MAY

Dates TBD National Community Pharmacists Association Legislative Conference Washington, D.C. May 7 Harding College of Pharmacy Commencement Searcy, AR May 21 UAMS College of Pharmacy Commencement Little Rock, AR

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June 11-15 American Society of HealthSystem Pharmacists Summer Meeting Baltimore, MD

JULY

July 28-30 APA Board Retreat Mount Magazine Paris, AR

SEPTEMBER

All of September APA District Meetings Around the State

OCTOBER

October 15-19 National Community Pharmacists Association Annual Convention New Orleans, LA October 16 * APA Golden CPE Hosto Center Little Rock, AR

NOVEMBER

November 4-6 American Society of Consultant Pharmacists Annual Meeting and Exhibition Dallas, TX *Dates not finalized

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The Same River Twice KEITH OLSEN Pharm.D., FCCP, FCCM Dean - UAMS College of Pharmacy

By Jordan Foster

“

NO MAN STEPS IN THE SAME RIVER TWICE, FOR IT’S NOT THE SAME RIVER AND HE’S NOT THE SAME MAN. -HERACLITUS, Greek Philosopher

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”

ver two decades ago, UAMS College of Pharmacy Dean Keith Olsen stepped onto the UAMS campus for the first time and immediately felt a connection to the faculty and the vision of the school, but ultimately was drawn away.

Now Olsen returns to UAMS a changed man, wiser and more experienced, charged with leading an established institution in the shadow of his predecessor, stepping back into a river that has changed dramatically in the past 22 years.

Taking A Leap

Raised in small town Nebraska, Olsen learned many life lessons from his father who owned a butcher shop, but two lessons would prove invaluable to him when he eventually made his way to Arkansas: how to skin a buck, and the importance of small businesses. “I always thought one thing

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that Arkansas always did better than other states was that entrepreneurial attitude of growing and being successful and not just waiting to see what would or might happen. That’s what I’ve always admired about Arkansas pharmacists, they are proactive and they don’t sit around and let other people dictate. Arkansas pharmacists are a model, there are a lot of states that wish they would have done the same thing.”

Self-discipline and goal-setting were instilled at an early age as Olsen became active in football and basketball in school, but soon it was the appeal of an often overlooked sport that captured his attention and his competitive drive. “I had a friend whose brother was a pole vaulter in high school so we ended up building our own pole vaulting box in the alley behind my house, we came up with our own standards, and used the bamboo tubes out of carpet rolls at the local hardware store,” Olsen said. “There weren’t any camps or video tutorials available like there are today, and none of the coaches I had knew anything about vaulting. I just had to do it over and over until I got it right. Ultimately, I learned more about it; I only wish I had coaches that were able to correct some of my techniques that were wrong. I ended up having

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THE SAME RIVER TWICE: DEAN KEITH OLSEN

a coach that told me ‘Just remember, pole vaulting probably isn’t going to put any bacon on the table.”

Although vaulting didn’t pay the bills, it did open doors for Olsen, whose high school record still stands, when he was recruited to vault at Wayne State College. A science enthusiast from a young age, he was initially pushed towards x-ray technology by his mother before exploring medical technology, a field for which the college was acclaimed. One semester later, Olsen was again looking for a new career direction when a professor recognized his penchant for chemistry.

“I sat in his office and he said, ‘What are you going to do when you graduate?’ I told him I had an internship in medical technology lined up but I just couldn’t do it. So he said, ‘What about pharmacy?’” Unsure of what direction to take, Olsen talked to local community pharmacists and ultimately decided there was one career that met at the crossroads of his love for science and his passion for helping the people of his community. “I went back to my professor and asked him to write me a letter of recommendation for pharmacy school.

Before he could even write it, I was accepted to the University of Nebraska Medical Center (UNMC) College of Pharmacy.”

drugs, become one of the first pharmacists to be named a fellow in the American College of Critical Care Medicine, and serve at an executive level within that organization.”

The Path Forward

Bridging the gap between two leaders can be difficult – differences in leadership style, adjusting the culture of the workplace, and sometimes, change for the sake of change.

New leaders often create ways to leave their signature on the workplace when there isn’t necessarily a need for it. However, what Dean Olsen recognized when he returned to UAMS to interview for the dean’s position was that the college didn’t need change, it needed the continued leadership of someone with the same vision as previous leaders to continue the college’s successful trajectory.

“The pharmacy school was in a great position when Dean Gardner transitioned to the Provost’s office. The college has undergone tremendous growth and has a greater national stature than it did when I left 22 years ago. You mention Arkansas on a national level and we are known for not only what our faculty have accomplished through scholarship but also for what our students have done in organizational leadership and the awards they’ve won. I didn’t have any preconceived notions of wanting to change this or that, I’m more interested in how we can get better, how we can advance our mission as a college, and how we can continue to cultivate our core values of teaching students, serving the profession, and remaining engaged in scholarship and

Upon graduating from pharmacy school, more decisions needed to be made. Although for the first three years of pharmacy school Olsen thought he would end up at a local pharmacy owned by a neighborhood family, an internal medicine rotation and a residency led him to his first job at Southwestern Oklahoma State University. “I had always had that connection to community pharmacy and I never lost that passion, even though I stayed in academia.” Four years later, it was again time for a change. “I wanted to go to a better pharmacy program that was more progressive, that had its sights on growing and getting better, and UAMS was that program.

I must have called ten times before being asked to interview; during my visit I instantly connected with the pharmacists and physicians here at UAMS.” Although his time at UAMS provided many opportunities for research and growth, including becoming the first pharmacist at UAMS to work in a critical care unit, his father’s health issues pulled Olsen back to Nebraska where he spent 22 years at UNMC. “I accomplished things that I never would have if I had stayed, the research opened doors for travel across the US and around the world, and the research opportunities were Dean Olsen discusses the week's events with his assistant. abundant, allowing me to develop

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discovery. I envision this college as a national leader, and in certain aspects we were 22 years ago, but now we are a significant player nationally. The faculty and Provost Gardner’s leadership have to be given the compliments for doing that.”

Olsen acknowledges the unique situation of working for someone who previously had his position, but said his relationship with Provost Gardner stretches beyond that.

“I was on the search committee when we asked Stephanie Gardner to come to UAMS and interview 24 years ago. We were colleagues for several years before I left and I always felt connected. When I interviewed for the position of dean, I tried to explore the idea of ‘Can you work for someone you helped hire?’ but she’s been great. Stephanie helped to lead the college to where it is today and she wants to see it succeed. She shares that passion for pharmacy.”

in assisting and promoting community pharmacy from that view, I think as a college we will say that we are successful.”

At Home

While Dean Olsen has dedicated his career to serving others, the most important people in his life have always been his family. Spending time with his wife Theresa, five children, and seven grandchildren continue to be a priority for Olsen, along with running four marathons, hunting, riding his bike, and cheering on the Razorbacks and Huskers. §

Opportunity for Growth

Though he continues to devote his time to academia, Olsen is occasionally reminded of the small town family-owned pharmacy in Nebraska that could have been his postgraduation landing pad. “Even though I stayed in academia, I never lost my passion for community pharmacy.” That passion translated into a point of care testing program Olsen developed with former colleagues. Together, they had a vision to create a certification program to train pharmacists on dealing with infectious diseases in community pharmacies.

This vision evolved into a pilot program with several small chain pharmacies in Michigan implementing CLIA waived point of care ranging from acute therapy of strep A (strep throat) and influenza to screening for Hepatitis C and HIV. “We would teach pharmacists how to perform the tests and how to develop a business model because we weren’t in the business of giving the services away. As the program progressed, we received feedback from patients that not only were they very satisfied, but they were willing to pay for the service.”

A pharmacist working for the National Association of Chain Drug Stores noticed the program and provided Olsen and his colleagues with the means to extend the program nationwide, culminating in a 12 city launch across the country. “We think this is a fantastic opportunity for pharmacists not to replace the drug product, but to expand the business model in community pharmacies, especially in smaller communities where pharmacists might be the only healthcare provider serving the entire area. It’s only a matter of time before we get provider status and that’s going to have significant benefit in the community pharmacy. It will open doors to new revenue streams, more opportunities for MTM, and to be adequately reimbursed for those services. I believe point of care testing will be a part of that. As a college, I want us to be in a position to work with APA to pilot and justify some of these services in community pharmacy and help build reimbursable models, with sustainable business plans; not just give these services away. Ten years from now, if we are reasonably successful

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Dean Olsen and his wife, Theresa

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UAMS REPORT

Point-of-Care Testing by Pharmacists

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oel is a 25-year-old patient who comes to your pharmacy looking for an over-the-counter (OTC) cough-cold product. His symptoms are a sore throat that developed within the last 24-hours, cough, headache and fever. What do you do?

Should you point him to the OTC cold section; refer him to his doctor; ask him some questions about his symptoms then direct him to the cold section; or conduct a point-ofcare test (POC) in order to make a more informed treatment recommendation?

Keith Olsen Pharm.D., FCCP, FCCM Dean

A common question about point-of-care (POC) is, “can pharmacists legally perform disease screening with POC tests?” The answer is generally ‘yes’ as long as they obtain a CLIA waiver and it is not prohibited by their state pharmacy practice act, (it is not in Arkansas).

Our patient likely has streptococcal pharyngitis. Every year 1.8-3.6 million cases of strep throat are diagnosed in the United States with 5-10% of adults and 20-30% of children being affected. Although the mortality of strep throat is extremely low, the economic burden for the treatment of disease is substantial — $224-539 million USD. Like so many infectious diseases, early recognition of the disease and treatment intervention can reduce the likelihood of experiencing complications, stop transmission, and reduce missed days at work or school.

Community pharmacy is a formidable presence with an estimated 225,000 pharmacists, and 59,000 to 67,000 community pharmacies. Almost all Americans live within 2 miles of a pharmacy. Community pharmacies are in rural 24

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towns, urban neighborhoods, and just about everywhere.

A group of faculty from UAMS, University of Nebraska and Ferris State University have developed a certification course for pharmacists conducting POC. With a physician collaborative practice agreement, the pharmacist with this certification is then able to provide immediate, definitive therapy in cases like Joel’s. If you think about it, community pharmacies are the only health care providers where you can go in and talk to a pharmacist during most hours and most days of the week for FREE. Not only are we available and accessible, but we are paid to be there, so our overhead is covered by other activities. This is not the case with other healthcare sites! The average emergency room visit costs $406 and physician office visit $89, without any additional tests or prescription medications.

A common question about POC is, “can pharmacists legally perform disease screening with POC tests?” The answer is generally ‘yes’ as long as they obtain a CLIA waiver and it is not prohibited by their state pharmacy practice act (it is not in Arkansas). There are over 100 CLIA approved tests that could be conducted in a community pharmacy setting. The POC certification program focuses on 4 infectious diseases: streptococcal pharyngitis, influenza, hepatitis C, and human immunodeficiency virus (or HIV). The business case for providing POC testing is to provide the testing for a profit. Through initial studies and follow-up with patients, pharmacists have determined that patients are extremely satisfied with the POC service and willing to pay an amount that results in a sustainable business model. The POC certification program discusses the development of the business model and the importance of the “business case” for providing a service.

In the spring 2015 AR•Rx The Arkansas Pharmacist issue, President Dr. Brandon Cooper discussed practicing at the top of your license. POC testing is an example, with the right training, where a pharmacist can practice at the top of their license, doing so within a sustainable business model. POC testing is an opportunity for community pharmacists not to replace dispensing medications, but to build another revenue stream while offering a needed service to their patients. If you desire more information regarding POC testing in your pharmacy, please contact me at UAMS College of Pharmacy. We are available to help build POC testing and other patient-care services into routine practice. Remember as pharmacists, we are trusted, accessible, and knowledgeable. In the case of Joel, his pharmacist, with a collaborative practice agreement, could provide a strep POC test, and if positive, provide appropriate antimicrobial therapy. §

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HARDING UNIVERSITY REPORT

APA HOSTS LEGISLATIVE DAY JANUARY 28

Harding Graduates Pursuing Residencies Search for Their "Match"

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recently returned from New Orleans, LA where I was attending the American Society of Health-System Pharmacists Midyear Clinical Meeting (ASHP MCM) that was celebrating its 50th anniversary this year. The ASHP MCM is the largest meeting of pharmacists in the world attended by over 22,000 individuals from around the globe. For the first time, Harding hosted a reception during the MCM for friends and alumni of the college. The reception was held at the Olde NOLA Cookery on Bourbon Street and was attended by approximately 50 individuals. It was great to see alumni from each of our four graduating classes, previous faculty, as well as numerous current students who attended the meeting seeking preparation for or application to residency training. We look forward to hosting a similar event at the ASHP MCM in Las Vegas, NV in 2016.

Julie Hixon-Wallace Pharm.D., BCPS Dean

The ASHP MCM has become increasingly student-centric over the years with a focus on preparation for a career in health-system pharmacy. For many students, this means completion of a post-graduate residency program.

Residency programs are divided into post-graduate year one (PGY1) and post-graduate year two (PGY2) programs with PGY1 residencies generally being in pharmacy practice and PGY2 residencies being in specialty areas such as pediatrics, oncology, infectious disease, pharmacokinetics, geriatrics, etc. In 2015, a total of 5,360 individuals enrolled in the residency matching program, often referred to simply as “The Match.” Of these, 4,358 were seeking a PGY1 position with the remaining candidates seeking a PGY2 position. A total of 3,987 residency positions were available nationally in 2015, up from 3,386 in 2013 (an increase of 18%), but you can see there is still a bit of a mismatch between the number of individuals seeking residency and the number of residency positions available. When the match was completed, a total of 3,605 applicants, up from 3,096 in 2013, matched with a residency program.

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There were approximately 14,000 pharmacy graduates in 2015. If you do the math, about 28% of the graduates in 2015 could have been accommodated in ASHP-accredited residency programs. The administration of ASHP hosts an annual deans’ update during the ASHP MCM and provides academic pharmacy with data from the most recent match cycle. In the 2015 match cycle, Harding had 13 of its 40 graduates register for the PGY1 match, 11 who submitted rank lists, and eight who matched with an ASHP-accredited PGY1 residency program. One additional student also secured a position in a residency program outside of the match and one applied for and secured a PGY2 position.

We are very pleased with the number of Harding students (33% of the class of 2015) who are seeking residency training. This is just one career path pharmacy students today may choose to pursue. While ASHP is the official accrediting agency for residency programs, they work very closely with other professional pharmacy organizations in developing standards for community pharmacy residency and managed care residency programs. The American Pharmacists Association (APhA) helps develop and monitor community pharmacy residency programs while the Academy of Managed Care Pharmacy (AMCP) assists with managed care residency program guidelines. No matter in what arena one wishes to practice, a residency program is an excellent place to start. As the subject of pharmacist credentialing becomes ever more discussed, residency training and specialty pharmacy board certification are sure to be part of the conversation. Certainly one of the beauties of our profession is the variety of positions and opportunities available to pharmacists and residency training is just one avenue making the way better paved for potential job seekers.

On behalf of the faculty, staff, and students of the Harding University College of Pharmacy, I wish you all a very happy new year! §

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ARKANSAS ACADEMY OF HEALTH-SYSTEM PHARMACISTS

Training for Your Career is a Lifelong Effort

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or those of you that attended Fall Seminar in October, this will be a repeat, but the reason I decided to share portions of my speech from that event was due to several individuals’ feedback during and after the meeting. My hope is that this message will now reach a larger audience, and encourage even more people.

Rob Christian, Pharm.D. President

As some of you know, I enjoy spending a decent amount of any free weekend on a road bike, either on the River Trail or riding to a nearby destination. As I thought about the activities that are involved with cycling, I started drawing similarities of our professional lives, as well as this organization. Over the next few paragraphs I will focus on three concepts, that I feel can make a difference If you are all trained for all of us.

areas, and take our patient care abilities to the next level.

Now even if we as cyclists do not desire to finish in first place, or be the fastest person on the road, we still have to keep our ‘base’ strong. To do this, we get up early during the week and ride a stationary bike, or ride 10-15 miles after work, just to keep our miles up, and make sure that come the next weekend ride we are ready. I liken this to our constant need to stay abreast with the most recent journal articles, and continuing education offerings throughout the year. Again, without this base training we can find ourselves ineffective, or at a minimum, falling behind our fellow clinicians.

Next let’s focus on the ride itself, the fun part for most cyclists, where we actually go out on the trail or on the road, and execute these up, and ready to put skills we have honed over the your skills to work, we definitely can find previous weeks and months.

The first concept we will Since not everyone is familiar a group for you to plug in to. Whether with a ride, let me give you discuss is training. Since you are a new graduate, current resident, cycling can be strenuous, and a little context to what this recently licensed technician, or seasoned many organized rides can be looks like. Generally, cyclists clinician, every additional individual fairly long with distances of have a riding group, and the 40, 50 and even 100 miles, group consists of multiple makes our overall organization and our one obviously has to do quite riders that have similar riding profession stronger. a bit of preliminary work abilities and interests. The to attain the strength and group rides in a pace line stamina to complete one of (single file), and the lead rider these longer rides. Now, we as professionals are obviously has the hardest job, as they are having to cut through the familiar with training, as most of you completed formalized wind so that each of the subsequent riders have more and training in the way of a degree program at a College of more of a draft effect. I am sure this makes perfect sense to Pharmacy. This is what we as cyclists would call ‘base’ NASCAR fans. The other key is that you only ride in the lead training, and it would prepare us to go out and ride around position for short periods of time, and then you fall to the town at a leisurely pace, but in no way would prepare us back of the line, and let the second position rider become to truly compete in a major race or finish an organized ride the lead and ‘pull’ the group. So I explain all of this about cycling because my next statement is the real take away that in record time. With this said, if we really wish to compete at this higher level as cyclists, we must put in extra time, I hope you remember. The real reason we ride as a group and specialized training like hill work, speed work, etc., to is because as a group we all become stronger riders. You see, as the group, we can all go farther, faster and more hone those skills and become stronger in our weaker areas. efficiently than any one of us can ever ride individually. It Before I go any further I will make a personal disclosure that is my personal belief that this same concept holds true for I am in no way a competitive cyclist, but instead just a guy each of you reading this, whether we are referring to you who enjoys riding recreationally. At this point, the concept of as a clinician, to your individual practice setting, or to our specialized training is probably sounding familiar to many of profession as a whole. We are going to be able to move all of you, as you understand that we as a profession, are finding these farther, faster, and most efficiently if we work together it ever more valuable to expand on our base training, in the as a group, and help each other during the ‘ride’. It is for this way of Residencies, BCPS certification, MTM certification, and as technicians, PTCB certification, as well as specialized very reason that AAHP exists, and why everyone that serves IV training. This is all evident in national data, and it validates on the Board or as a member of a Council volunteers his or her time and energy. We all have the belief that when we the trends and work we are doing here in Arkansas. Again, like specialized cycling training, these additional educational collaborate we take the best of each individual and combine opportunities allow us to strengthen our skills in specific their talents to achieve great things. I hope it is why you

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ARKANSAS ACADEMY OF HEALTH-SYSTEM PHARMACISTS

choose to be a member of the organization. So now let’s refer back to our cycling analogy, and take it one step further. If AAHP is likened to my weekend riding group, when my group participates in a sponsored ride, we ride alongside other ‘weekend’ groups. As we travel down the road, we find other groups with similar abilities, and in many instances, skills that exceed our group’s. When we find these groups, we quickly see that the basic principles described above still apply, but now with the two groups combined, we gain even more efficiency and speed. This is where I think AAHP too has found itself during the ‘ride’ over the past roughly 60 years.

We have taken the strengths of our group, and combined them with the APA, the Colleges of Pharmacy, the ASBP, and many other healthcare related groups. Most recently one of our major focuses that is showing great results, is our collaboration with the Arkansas Hospital Association on reducing ADE’s, and now the work that is focusing on Antibiotic Stewardship. Again, each group separately is able to achieve many goals, but our abilities are exponentially increased, when we join one or more of these individual groups, and work toward a common goal.

Now to our third and final point, and that is the period that comes after each of these long rides, and it is called ‘recovery’.

So as it sounds, after all the exertion of being on a bike for many miles, usually in the heat, the body naturally needs time to heal. I liken this to the period in our professional lives when we have just completed a major project, certification, or perhaps an appointment on a board or committee. And while these activities, just like crossing the finish line of a

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long ride, leave us with a feeling of great accomplishment, they also many times leave us feeling extremely taxed. So the point I want to make here, is that just like with a ‘recovery’ period in cycling, where we may not ride for several weeks or months, it is okay to take some time off from pushing yourself professionally. Very few people can go non-stop, 24/7, for an extended period of time without burning out, and never returning to whatever activity they were so heavily engaged in.

So with this in mind, I will close with these last few thoughts.

If you are all trained up, and ready to put your skills to work, we definitely can find a group for you to plug in to. Whether you are a new graduate, current resident, recently licensed technician, or seasoned clinician, every additional individual makes our overall organization and our profession stronger.

The key to longevity is to find your own work life balance. So if you have been heavily engaged in helping our profession along, it’s okay to take some time to recover. It is because we are a group, and have strength in numbers, that someone else that is ‘trained up’ can ‘pull’ the group for a while. After you have time to recover, you can get back out on the road, and take your turn at ‘pulling’. In closing, as we look down the road to the next hill on the horizon, and maybe that hill is provider status or tech check tech, let’s all keep in mind that just like the cyclist that never believes they can complete a 100 mile ride, or make it to the top of the mountain, anything is possible if you have the appropriate training, and we remember to work as a group. §

Join us in America’s oldest national park for the 2016 APA Annual Convention, to be held June 23-25 at the Embassy Suites Hotel and Convention Center in Hot Springs. APA will offer 15 hours of continuing pharmacy education (CPE) relating to pharmacy practices.

Members and guests will be able to learn about the latest product trends in pharmacy from more than 40 exhibitors who will showcase new products to potential customers while working to maintain and strengthen relationships with existing customers.

Embassy Suites Hotel / Convention Center Hot Springs, Arkansas WWW.ARRX.ORG

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Social events to mingle with fellow pharmacists, colleagues, and friends are planned as well as the annual golf tournament on Wednesday afternoon, June 22. Convention registration will open shortly so stay tuned for more information through InteRxActions and at www.arrx.org/annual-convention.

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APA CONSULTANTS ACADEMY REPORT

Vitamin D: Should We Put It in the Water?

Anthony Hughes, P.D. President

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question for you: how many of you believe that most older individuals sit outside in the sunshine sipping milk and eating salmon or tuna? Not many you say? Well then, it should not surprise you that about 36% of the population are vitamin D deficient. In the older population it could be even higher.

By checking 25-hydroxyvitamin D we can determine if that person is deficient. If that result is <20ng/ml then that person is deficient. This suggests this person is at a higher risk of falls and fractures.

There are studies that suggest that vitamin D supplementation can reduce the risk of falls by as much as 20%.

We all know the relationship of vitamin D and calcium absorption. Many do not know that vitamin D is linked to muscle weakness and with proper levels may also directly improve muscle strength and balance. Vitamin D receptors are found in the muscle and muscle weakness is a symptom of vitamin D deficiency. This includes the truncal muscles that assist us when we become off center and we right ourselves like a gyroscope. By impacting the muscle strength and balance we have a direct relationship to falls and fractures.

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So do we supplement vitamin D2 or D3? Both vitamin D2 and D3 are effective for raising serum vitamin D. Vitamin D3, cholecalciferol, is synthesized in the skin and at high doses Vitamin D3 seems to be almost twice as potent as vitamin D2.

What is the dose? To prevent falls most studies suggest a daily dose of at least 800IU is required.

About 36% of the population are vitamin D deficient. In the older population it could be even higher.

There are studies that suggest that vitamin D supplementation can reduce the risk of falls by as much as 20%.

Hip fracture is one of the most serious consequences of an elderly person falling, as it can lead to long-term disability, untimely nursing home admission, and premature mortality. One study suggested that falls lead to 40% of all nursing home admissions. Other factors that decrease the vitamin D level include advanced age, malabsorption due to inflammatory bowel disease, and the administration of anticonvulsants, glucocorticoids, antifungals, cholestyramine, or HIV antivirals. So this may suggest a consulting tip of checking the 25-hydroxyvitamin D level if that patient is on anticonvulsants.

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Studies show that with an average serum level greater than 25 ng/mL, that falls and fracture rates were significantly reduced. They also have stated vitamin D [25(OH) D] serum concentration of 30 ng/mL was safe and would ensure the full benefit of vitamin D.

There is limited evidence that 90% of normal-weight older adults (BMI < 25) will achieve recommended serum levels with 1600 to 2000 IU daily supplements from all sources.

Overweight and obese adults require higher daily supplements â&#x20AC;&#x201D; up to 4000 IU daily to achieve serum levels of 30 ng/mL. The Institute of Medicine (IOM) determined that a 4000 IU daily for supplement is safe and can be given without risk of toxicity.

Vitamin D supplementation weekly, biweekly, monthly and up to every 3 months is acceptable. To maximize absorption, the vitamin D supplements should be taken with meals that provide some fat or oils. So by checking the 25-hydroxyvitamin D levels and adjusting the dose to a goal of 25-30 ng/ml we can make a major impact on falls and fracture. §

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THE ARKANSAS PHARMACIST

2/6/16 10:21 AM

Leaving a Legacy: Mark Riley Retires As APA CEO (2003 – 2015)

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riends, family, and colleagues joined former APA CEO Mark Riley at the Little Rock Marriott in December to congratulate him on his retirement and celebrate his illustrious career and his lifetime commitment to improving pharmacy in Arkansas.

While at APA, Mark fought in the legislature for fair laws that would protect Arkansas pharmacists and used his position as a platform to educate both state and US legislators and business leaders about PBMs, MAC pricing, and the pharmacy profession.

Mark retired at the end of 2015 after serving as CEO for 12 years at the Arkansas Pharmacists Association, capping decades of involvement within the association.

Mark and Brenda Riley

“Mark gave over a dozen years of both his time and his talent to the Arkansas Pharmacists Association. His immense contribution to the profession cannot be overstated and our future success will be due to the strong foundation that he built.”

— Scott Pace, New APA Executive Vice President & CEO

Mark Riley, Scott Pace, and Gayle Fowlkes

Mark Riley and Gary Fancher

Lana Riley, Sarah and John Vinson

Wayne Padgett and Richard Hanry

Courtney Sheppard and Lynn Crouse

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Mike Smith

Gayle Fowlkes and CA Kuykendall

Mark Riley and Representative Justin Boyd

Eileen and Steve Denne

Mark Riley and Representative Julie Mayberry

Tery Baskin

"Mark Riley has accomplished a great deal for the profession of pharmacy, Arkansas pharmacists, and the APA during his years at the helm of the APA. One of Mark's outstanding characteristics is to show respect for everyone and to take into consideration viewpoints from all sides. This contributes significantly to our organization's strength and leadership position in American pharmacy." â&#x20AC;&#x201D; Tery Baskin, RxResults Founder, President and CEO

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THE ARKANSAS PHARMACIST

2/6/16 10:21 AM

John Vinson and Mark Riley

Riley Family

“I was very grateful to have the opportunity to work collaboratively with Mark over the past 12 years.

Having the APA, the colleges, and the Arkansas State Board of Pharmacy working in sync on behalf of the profession is invaluable. Mark has been a great friend to the profession and to me.”

— Stephanie Gardner, UAMS Provost and Chief Academic Officer

Maggie Williams

Charles West

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Mark Riley

Percy Malone

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Leaving a Legacy: Mark Riley Retires As APA CEO (2003 – 2015)

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THE ARKANSAS PHARMACIST

2/6/16 10:21 AM

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THE ARKANSAS PHARMACIST

2/6/16 10:21 AM

Member Classifieds

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

Pharmacy tech needed in NWA. United Medical Home Infusion in Fayetteville is looking for a full-time pharmacy tech for a M-F 8am-5pm position. Certified techs preferred.

Contact Neil at 479-973-4889 or nbarker@live.com Unguator e/s Electronic Mortar and Pestle with mixing blades for sale $1800. EXAKT 50 three roll ointment mill for sale $3200. Call Kenny at 501-580-1895 or email kenny-h@sbcglobal.net (1/18/16) Omnicare, a CVS Health company, is hiring for a Pharmacy Manager/Pharmacist in Charge in Jonesboro. Contact michelle.buckley@omnicare.com for more information, or www.omnicare.com/careers to apply directly. (1/15/16) Omnicare, a CVS Health company, is hiring Pharmacists and Pharmacy Technicians for our Little Rock, AR pharmacy. Contact douglas.wedig@omnicare.com for more information, or www.omnicare.com/careers to apply directly. (1/15/16) Pharmacy Technician Needed. Immediate opening at independent pharmacy in Marmaduke, Arkansas.

Established pharmacy needing to hire a 32 hour per week Pharmacy Technician. Looking for someone who is responsible, personable, and organized. If you are interested, please email your resume to "eddingtonpharm@ yahoo.com" (1/15/16) Independent Retail Pharmacy in Jonesboro, AR is seeking full-time pharmacist. Experience required,

duties will include the normal staff pharmacist duties as well as helping with MTM consulting, immunizations, etc.

Store hours are Monday-Friday 9 am-6 pm and Saturday 9am-1pm. Send resume to pharmacist@exiee.com or fax 870-935-4027. (1/13/16) PRN Pharmacy Technician needed at the North Metro Medical Center in Jacksonville, AR. Weekday shifts as needed (10 or 11 hour days), every 4th weekend. If interested or have questions please contact Paige Ballard at pballard@northmetromed.com (1/7/16) Pharmacy Technician job opening at Veterans Healthcare System of the Ozarks in Fayetteville, AR. Please see the following link for all information regarding applying for this position. Deadline to apply is 1/18/16. https://www.usajobs.gov/GetJob/ViewDetails/425121800 (1/6/16) Experienced Pharmacist seeks 2 to 3 days per week.

Contact at 501-231-1130 ortimothylacey@msn.com (1/4/16) Part-Time Pharmacist Needed: Retail pharmacy in the River Valley area is currently seeking a pharmacist to work 2 to 3 days per week. If interested please email cfpharmacy@hotmail.com or call (479)647-3138. (12/7/15) For Sale: Parata Pass 208 for LTC or adherence business. Mint condition. $80,000. Purchased in 2013, balance of maintenance contract in place. Contact Mark at 501-650-4709 for more details. (11/12/15)

AAHP Board Executive Director . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Susan Newton, Pharm.D., Russellville President . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Rob Christian, Pharm.D., Little Rock President-Elect. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Kendrea Jones, Pharm.D., Little Rock Past President . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Marsha Crader, Pharm.D., Jonesboro Treasurer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Rayanne Story, Pharm.D., Searcy Secretary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Wendy Jordan, Pharm.D., Jonesboro Member-at-Large . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Brandy Owen, Pharm.D., Conway Member-at-Large. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Niki Carver, Pharm.D., Jonesboro Member-at-Large . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Erin Beth Hays, Pharm.D., Pleasant Plains Technician Representative . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Holly Katayama, CPhT, Little Rock

Arkansas State Board of Pharmacy President . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Lenora Newsome, P.D., Smackover Secretary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Stephanie Oâ&#x20AC;&#x2122;Neal, P.D., Wynne Member . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Steve Bryant, P.D., Batesville Member . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Tom Warmack, P.D., Sheridan Member . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Kevin Robertson, Pharm.D., BCPS, Little Rock Member . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cheryl Bryant, Pharm.D., Little Rock Public Member. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Carol Rader, Fort Smith Public Member. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . James Burgess, DDS, Greenwood

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2016 APA Awards Solicitation AWARD NOMINATIONS Each year APA encourages members to submit the names of individuals who are deserving of special recognition for their professional activities during the past year. Any active APA member is eligible to nominate a person for the awards. Award recipients are chosen by an APA committee following a review of all nominees. Nominations are now being accepted for the following annual awards to be presented by the Association. Nominations will close at 4:30 p.m., April 1, 2016.

Please mark your nomination with an X. If you have more than one nomination, please feel free to copy this form.

Pharmacist of the Year _______

The Pharmacist of the Year Award was established in 1959 to honor an individual who â&#x20AC;&#x153;should possess professional standards beyond reproach, a record of outstanding civic service in the community, and as a member of the APA, who has contributed efforts toward the progress of the association.â&#x20AC;? Previous recipients include: 2015 Wayne Padgett, Glenwood 2014 Michelle Crouse, Lake Village 2013 Carl Collier, Fayetteville 2012 Charles Born, Little Rock 2011 Don Johnson, Little Rock

Bowl of Hygeia Community Service Award _______

In 1958 E. Claiborne Robbins of the A.H. Robbins Company established the Bowl of Hygeia Award. The purpose of the award is to encourage pharmacists to take active roles in the affairs of their respective communities. Previous recipients include: 2015 Nicki Hilliard, Little Rock 2014 Eric Shoffner, Newport 2013 Vicki and Karrol Fowlkes, Little Rock 2012 Sparky Hedden, Sheridan 2011 Tom Warmack, Sheridan

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. Previous recipients include: 2015 Aduston Spivey, Hot Springs 2014 Denise Robertson, Little Rock 2013 Lelan Stice, White Hall 2012 Dennis Moore, Batesville

Distinguished Young Pharmacist of the Year _______

The nominee must have an entry degree in Pharmacy, received nine or fewer years ago, and be a member of the APA. Nominee must be in the active practice of pharmacy in the year selected, and actively involved in the profession of pharmacy, displaying an interest in the future of the profession.

Previous recipients include: 2015 Rachel Stafford, North Little Rock 2014 Stephen Carroll, Arkadelphia 2013 Zach Holderfield, Fayetteville 2012 Clint Recktenwald, Gassville 2011 Cheryl Bryant, Little Rock

Excellence in Innovation Pharmacy Practice Award _______

This award was established in 1993 by the APA in cooperation with the National Council of State Pharmacy Associations and DuPont Pharmaceuticals to recognize, annually, a pharmacist who has demonstrated a prominent spirit of innovation and entrepreneurship in the practice of pharmacy. Previous recipients include: 2015 Taylor Franklin, Fort Smith 2014 Marcus Costner, Fayetteville 2013 Lanita White, Little Rock 2012 Melissa Brown, Fayetteville (continued) 2011 Eric Crumbaugh, Benton WWW.ARRX.ORG

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2016 APA Awards Solicitation (continued) Guy Newcomb Award _______

The APA Board of Directors created this award in 1997 to recognize individuals who, by their legislative influence and leadership, have distinguished themselves as political friends of Arkansas pharmacy. This award is named in memory of Dr. Guy Newcomb of Osceola. Dr. Newcomb was a pharmacy leader who understood, appreciated, and enthusiastically participated in the political process. Previous recipients include: 2011 Johnny Key, State Senator, Mountain Home 2009 Allen Maxwell, State Representative, Monticello 1999 Larry Teague, State Representative, Nashville 1998 Tim Hutchinson, U.S. Senator, Bentonville

Percy Malone Public Service Award _______

This award was established in 2009 by the Arkansas Pharmacists Association in honor of former state senator Percy Malone, P.D. The recipient must have made a contribution to public service by being elected to any public office and by displaying an interest in the people of Arkansas. Previous recipients include: 2015 Lenora Newsome, Smackover 2011 Gene Boeckmann, Wynne 2009 Percy Malone, Arkadelphia Name of Nominee________________________________________________________________________________________ Address_________________________________________________________________________________________________ City/State/Zip ____________________________________________________________________________________________ Phone___________________________________________________________________________________________________ Reasons for selecting nominee: Attach one page with description of reasons and/or the individual nomineeâ&#x20AC;&#x2122;s resume.

Nominatorâ&#x20AC;&#x2122;s Name: __________________________________Phone____________________________Date________________ Fax or email written nomination form and material to: Awards Committee, Arkansas Pharmacists Association; jordan@arrx.org; Fax 501-372-0546. Please submit by 4:30 p.m., April 1, 2016.

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2015-2016 APA Board of Directors

President John Vinson, Pharm.D.

President-Elect Eddie Glover, Pharm.D.

Vice President Lynn Crouse, Pharm.D.

Past-President Brandon Cooper, Pharm.D.

Area I Representative Michael Butler, Pharm.D.

Area II Representative Brent Panneck, Pharm.D.

Area III Representative Clint Boone, Pharm.D.

Area IV Representative Dean Watts, Pharm.D.

District 1 President Denise Clayton, RPh

District 2 President Max Caldwell, Pharm.D.

District 3 President Chris Allbritton, Pharm.D.

District 4 President Betsy Tuberville, Pharm.D.

District 5 President James Bethea, Pharm.D.

District 6 President Stephen Carroll, Pharm.D.

District 7 President C.A. Kuykendall, P.D.

District 8 President Darla York, P.D.

Health-System Academy President Rob Christian, Pharm.D.

Compounding Academy President Lee Shinabery, Pharm.D.

Consulting Academy President Anthony Hughes, Pharm.D.

Board of Health Member Gary Bass, Pharm.D.

UAMS College of Pharmacy Dean, Keith Olsen, Pharm.D., FCCP, FCCM

Harding College of Pharmacy Dean, Julie Hixson-Wallace Pharm.D., BCPS

UAMS Student Member Elisabeth Mathews

Harding Student Member Meredith Mitchell

State Board of Pharmacy John Clay Kirtley, Pharm.D.

General Counsel Harold Simpson, J.D.

Treasurer Richard Hanry, P.D.

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

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THE ARKANSAS PHARMACIST

2/6/16 10:22 AM

Call for Board Nominations Take advantage of the opportunity to give back by serving on the APA Board of Directors. We are seeking nominations for enthusiastic and energetic individuals who want to make an important contribution to the pharmacy profession. APA Board membership requires the flexibility to meet in Little Rock during the week and on two Sundays during the year. ________________________________________________________________________________________________________

APA Board of Directors Call for Nominations

Nominations are invited for each of the following positions on the Arkansas Pharmacists Association Board of Directors.

Brief job descriptions follow.

Vice President of APA • • • • •

Statewide (Serves four one-year terms as Vice President, President-Elect, President, and Past President, four total years as Board Member) Attends all board and executive committee meetings Serves on the executive committee Assumes responsibilities of the chair in the absence of the board president or president-elect Participates as a vital part of the board leadership

Area II Representative • • • •

Attends all board meetings and conducts the affairs of the association Maintains knowledge of the organization and personal commitment to its goals and objectives Appoints an executive committee and other committees and delegates to the executive committee power and authority of the board of directors in the management of the affairs of the association Recruits new members; participates in APA membership drives

Area II – Northeast Districts (Four-year term) Northeast Counties: Fulton, Izard, Stone, Van Buren, Cleburne, White, Woodruff, Jackson, Independence, Sharp, Randolph, Lawrence, Clay, Greene, Craighead, Mississippi, Poinsett, Cross, Crittenden, St. Francis, Lee, Phillips

District President • • • • • •

Holds meetings and makes recommendations to the Board as deemed necessary by the District Attends all board meetings and conducts the affairs of the association Maintains knowledge of the organization and personal commitment to its goals and objectives Serves as master-of-ceremonies for the APA District Meetings Serves as board liaison to an APA committee as designated by the president Recruits new members; participates in APA membership drives

District 3 President

Northwest District (Two-year term) Northwest Counties: Benton, Washington, Madison, Carroll, Boone, Newton, Searcy, Marion, Baxter

District 6 President

West Central District (Two-year term) West Central Counties: Johnson, Pope, Conway, Perry, Yell, Montgomery, Garland, Hot Springs, Pike, Clark

District 7 President

Western District (Two-year term) Western Counties: Crawford, Franklin, Logan, Polk, Scott and Sebastian

District 8 President

White River District (Two-year term) White River Counties: Fulton, Izard, Stone, Van Buren, Cleburne, White, Woodruff, Jackson, Independence, Sharp

APA OFFICERS AND BOARD OF DIRECTORS

Requirements- The requirements for nominees of the APA Officers are as follows: Arkansas licensed pharmacist who has been a member of this Association in good standing for the past three (3) consecutive years. No elected member of the APA Board of Directors shall serve for more than eight (8) consecutive years for more than two (2) consecutive terms in the same capacity.

If interested in nominating yourself or another individual, please contact APA Executive Vice President Scott Pace (scott@arrx.org) at 501-372-5250. Nominations will close at 4:30 p.m., March 25, 2016.

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