The Georgia Pharmacy Journal: June 2009

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The Official Publication of the Georgia Pharmacy Association

June 2009

GPhA President 2009-2010 Eddie M. Madden, R.Ph. Volume 31, Number 6

www.gpha.org


NEW PLANS – BETTER RATES – MORE BENEFITS in 2009

Look what’s NEW in 2009... Reduced Rates Prescription Drug Coverage Dental and Orthodontic Benefits Guaranteed Issue Term Life Insurance... up to $150,000 with no underwriting requirements

Call or e-mail TODAY to schedule a time to discuss your health insurance needs.

Trevor Miller – Director of Insurance Services 404.419.8107 or email at tmiller@gpha.org Georgia Pharmacy Association Members Take Advantage of Premium Discounts Up to 30% on Individual Disability Insurance Have you protected your most valuable asset? Many people realize the need to insure personal belongings like cars and homes, but often they neglect to insure what provides their lifestyle and financial well-being - their income! The risk of disability exists and the financial impact of a long-term disability (90 days or more) can have a devastating impact on individuals, families and businesses. During the course of your career, you are 3½ times more likely to be injured and need disability coverage than you are to die. (Health Insurance Association of America, 2000) As a member of the Georgia Pharmacy Association, you can help protect your most valuable asset and receive premium discounts up to 30% on high-quality Individual Disability Income Insurance from Principal Life Insurance Company.

For more information visit www.gphainsurance.com. * Association Program subject to state approval. Policy forms HH 750, HH 702, HH 703. This is a general summary only. Additional guidelines apply. Disability insurance has limitations and exclusions. For costs and details of coverage, contact your Principal Life financial representative.

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Departments

Eddie Madden, R.Ph. GPhA 2009­2010 President Preserving the Triad

12 13 14 15 23 27 29 30

GPhA Member News New Members UGA News Mercer University News CE Notice Pharmacy News GPhA-ASP Update GPhA Board of Directors

FEATURE ARTICLES

Advertisers

10 11 13 16 18 22

Pharm PAC: New Beginnings Pharmacy Time Capsules Tech Bit 1 The Role of Pharmacists Within a Community Physician’s Off ice

2 2 7 7 9 11 12 21 23 31 32

The Insurance Trust Principal Financial Group PharmStaff Toliver & Gainer Pharmacists Mutual Companies PQC Michael T. Tarrant AIP Melvin M. Goldstein, P.C. PACE The Insurance Trust

A Shot to the Bottom Line 10 Myths About Dieting

COLUMNS

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President’s Message Editorial

For an up­to­date calendar of events, log onto

www.gpha.org.

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PRESIDENT’S MESSAGE Robert Bowles, Jr. , R.Ph., CDM, CFts GPhA President

The GPhA President’s Report s I stand before you today, I can truly say that serving as President of the Georgia Pharmacy Association has indeed been a privilege and one of the most rewarding times in my professional career. The events of this year have indeed created in me a much deeper appreciation for those who have served before me. Thank you to each person who has previously served as President of the Georgia Pharmacy Association. I have truly been blessed to serve as the 134th President of GPhA.

Committee for your friendship, support, and guidance.

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The GPhA staff is truly incredible. At our monthly meetings in Atlanta, the Executive Committee always parks at the rear of the building. There is always a warm and friendly smile as someone opens the door to let us in. Ruth Ann McGehee is responsible for taking care of the immediate needs and the travel of your Executive Committee. Four years ago, I told my wife that it was unbelievable just how much Ruth Ann does in preparation for the Executive Committee to serve. This year, I have been made even more keenly aware of Ruth Ann’s assistance as she has kept me focused on meetings, deadlines, and travel. Thank you, Ruth Ann, for all you do in keeping the Executive Committee focused on the tasks at hand. During this year, Stuart Griffin has served as our Director of Government Affairs. Stuart brings with him a passion for the political process and a deep understanding of the need to develop relationships with those involved in the process. This year has also seen the addition of Kelly McLendon as Director of Public Affairs. Kelly’s bright smile and strong leadership have attributed to a positive increase in GPhA memberships. Finally, as with anything that we do in life, there are times when we feel overwhelmed. Our Executive Vice President and CEO, Jim Bracewell, has been an encourager to me when those times have occurred and has offered solutions to get me through those times. To each of you who has served as a Region President, a Standing Committee Chair, an

As I have traveled our state and our nation, I have been privileged to meet with old friends and make many new friends. I have been able to learn a great deal from each encounter—both professionally and personally. You have given me the opportunity to see things through a different set of eyes. None of my experiences this year would have been possible without the love and support of my dear wife, Judy. Thank you, Judy, for your patience and support throughout this busy year. I would like to thank the GPhA Executive Committee for their support. Jack Dunn, Jr., R.Ph.; Dale Coker, R.Ph.; Eddie Madden, R.Ph.; and Sharon Sherrer, Pharm.D., CDM, have encouraged and supported me every step of the way. This year has validated for me the importance of serving on the Executive Committee for 5 years. Becoming President of the GPhA is truly a process and not an event. Thanks to each of you on the Executive The Georgia Pharmacy Journal

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Academy Chair, or a member of the Board of Directors, I thank you. Your leadership is vital to the success of GPhA. Lastly, in my inaugural speech, I commented that my serving on the Executive Committee would not have been possible without the support of the staff in my pharmacy. Certainly, this year has made me even more keenly aware of their support in order for me to serve as your President.

The process of updating all GPhA bylaws continued throughout this year and is almost totally completed. I remind each of you that there is a need for this to be an ongoing project. In August, I had the privilege of talking with Senator Johnny Isakson when he came to Thomaston. This provided an opportunity for me to share with him the concerns that pharmacists have on a national level. August also was a time for our Strategic Legislation Planning Session. This year the session was held in Savannah. This is a great opportunity for the pharmacist legislators, the State Board of Pharmacy, the Georgia Drugs and Narcotics Agency, and the elected leadership and staff leaders of GPhA and GSHP to get together and discuss issues affecting our profession in the upcoming legislative session. This time is crucial to our legislative success. GPhA was significantly involved in helping elect former GPhA Executive Vice President, Rep. Buddy Harden, Jr., R.Ph., to the Georgia House of Representatives. I would like to thank the pharmacist legislators: Rep. Buddy Carter, R.Ph.; Rep. Buddy Harden, Jr., R.Ph.; Rep. Bobby Parham, R.Ph.; Rep. Butch Parrish, R.Ph.; and Rep. Ron Stephens, R.Ph., These individuals tirelessly give of themselves and are truly the backbone of our legislative approach. We all owe them a debt of gratitude for their efforts on behalf of pharmacy.

“The mission of the Georgia Pharmacy Association shall be to promote and enhance the profession of pharmacy and the practice standards of its practitioners. Further, the Association shall endeavor to heighten the public’s perception of the profession of pharmacy and pharmacists, and to promote the value of pharmacy services to the health and welfare of the general public.” I could have never anticipated the imminent need for me to appoint an immunization task force so that pharmacists could continue to provide influenza vaccine under a physiciandirected protocol. Thank you, Sharon, for chairing this task force. During this process we began establishing and cultivating a professional relationship with the Medical Association of Georgia and the Georgia Composite Medical Board. Both of these groups were supportive of the physician-directed influenza protocol legislation. The Governor has signed the “Access to Flu Vaccines Act.” Now it is time for each immunizing pharmacist to ensure that they are registered with G.R.I.T.S., the Georgia Immunization Registry. It is very important for us to continue to build and strengthen our relationship with each of these groups.

In September, I had the privilege of meeting with Senator Saxby Chambliss while he was in Thomaston. This provided yet another opportunity to share the concerns that pharmacists have on a national level. Later in September, we held our standing committee meetings at the Atlanta campus of Mercer University. This allowed members from all practice settings to be an integral part in the decisions that are made throughout the year for your Association.

July also was the time for the annual GPhA Executive Committee retreat, a time when we could reflect on the past year and look ahead to the issues that are now facing pharmacy and the Association. While at our retreat, we had the opportunity to have dinner with GSHP leadership. Thank you to Don Davis, R.Ph., President of GSHP, for his leadership as our two organizations continue to work together to benefit the profession of pharmacy and the citizens of Georgia.

October found us kicking off our region meetings. This provided a venue for us to share our upcoming legislative agenda. This is always a special time as I travel all of Georgia and renew old friendships while making new friendships that will last a lifetime. Once again in October, I had the opportunity to meet with Senator Saxby Chambliss as he visited Thomaston. Later in the month, the annual NCPA Convention was held in Tampa. Your Executive Committee attended this meeting and was able to gain additional knowledge of issues that are facing pharmacy. At this meeting, I had the distinct honor of

In August, your Executive Committee attended the Southeastern Officer’s Conference meeting in Mississippi. The time that is spent annually at this meeting provides an opportunity for us to monitor and learn from things that are happening in other state associations. I assure you that your Association is well respected across this nation.

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nominating John Sherrer for a three year term on the NCPA Executive Committee. John continues to tirelessly give of himself to the profession of pharmacy.

During this year, we have developed requests for proposals in seeking and engaging an audit firm for all of the GPhA entities to ensure that your Association is in full compliance with the new IRS 990 guidelines. Additionally, we developed requests for proposals in seeking and engaging a new banking partner for all GPhA entities. Both of these decisions have proven to be wise and productive in our goal to ensure the compliance of GPhA with these guidelines and the continued viability of our Association.

The Georgia Pharmacy Foundation sponsors the Southeastern PRN (Pharmacists’ Recovery Networks) Conference held each November at Simpsonwood. Regena Banks serves as Director of the Foundation and is responsible for organizing this conference. Attendees come from many states as this is a well respected conference throughout the nation. Thank you, Regena, for making this possible. During November, your leadership continued to meet with leadership from the Medical Association of Georgia to foster and strengthen our relationship.

I would be remiss if I did not thank Kelly McLendon for her leadership in taking our website to a new level. Kelly has indeed put a new face on GPhA in the digital age. Now on this website, you can register for events and make payments online for events and membership dues. Additionally, Kelly has initiated the GPhA Journal online as well as continuing the hard copy of the Journal. I hope that you have already noticed that GPhA is on Facebook. If not, I hope that you will take advantage of this means of communication.

The Georgia General Assembly began the 2009 session on January 12. Budget concerns proved to be a primary focus during this year’s session. GPhA continued to host a weekly caucus lunch meeting with our five pharmacist legislators, GPhA, GSHP, and the respective lobbyists for

We must continue to have the courage to change as we embrace new opportunities in immunizations, medication therapy management, adherence, and compliance for our patients. these organizations. As in the past, this proved to be very beneficial in bringing our team together to get the most out of our collective efforts. We reinstituted the Pharm-OGram weekly e-news during the legislative session and continued to host a weekly legislative conference call for the Board of Directors and other key legislative leaders in the Association. As I mentioned earlier, GPhA led the passage of legislation to positively affirm the right of certified pharmacists to deliver influenza vaccine under a physician’s protocol. Also, GPhA led the passage of legislation to license PBMs under the State Insurance Commissioner; however, this legislation was regrettably vetoed by the Governor.

Thank you to Trevor Miller who serves as Director of the Insurance Trust. The Trust developed a strategic plan that took effect in January and has proven to increase the number of insured lives in this self-funded health insurance program. In February, almost 300 pharmacists and students put on their white coats and made the trip to the Georgia Capitol for “Very Involved Pharmacist” day at the Capitol. Their efforts proved to members of the General Assembly how committed pharmacists are and how much they care about their patients and their profession. We must continue to share our passion for our patients and our profession.

The January Leadership Conference brought together the leadership of GPhA from across the state for a retreat at Lake Lanier Islands. The standing committees continued their focus on issues within our Association, and the Board of Directors held its third meeting of the GPhA fiscal year.

The Georgia Pharmacy Journal

Eddie Madden and I represented GPhA at the American Pharmacy Association in San Antonio. During the APhA Convention, GPhA and the three Colleges of Pharmacy in Georgia hosted a reception for all Georgia pharmacists and students attending the APhA Convention. April

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continued to be a busy time as we hosted region meetings for all 12 GPhA regions. The Georgia Pharmacy Foundation and Merck sponsored the annual New Practitioner Leadership Conference at St. Simons. This provides a venue for 20 practitioners who have graduated from pharmacy school within the past 10 years to develop leadership skills. This also affords these new practitioners the opportunity to meet the GPhA leadership. Thanks to John T. Sherrer, R.Ph., and Regena Banks for organizing and hosting this event. Toward the end of April and with the developing swine flu issues, Sharon Sherrer, Jim Bracewell, and I met with Dr. Patrick O’Neal, Director of Office of Preparedness and Anasa Johnson, Coordinator of Pharmacy Services. We will continue to foster these relationships in the future.

In May, the Executive Committee and many pharmacists from across Georgia attended the National Community Pharmacists Association Legislative Conference in Washington, DC. During this time we were able to meet with the staff of both Senator Saxby Chambliss and Senator Johnny Isakson. Also, we had the privilege of meeting with Senator Isakson and Rep. Nathan Deal who were both speakers at the NCPA Legislative meetings. June completes my year as President. Thank you for allowing me to serve you this past year. The theme for my year as President has been “Courage to Change,” We must continue to have the courage to change as we embrace new opportunities in immunizations, medication therapy management, adherence, and compliance for our patients.

YOU’VE FOUND IT!

Regardless of your practice setting – independent, chain, health system, long term care, or industry setting, we can make a contribution to our profession and the communities in which we serve. I thank Sharon Sherrer for these past 5 years of outstanding service to our Association. Sharon, you have been a source of inspiration and encouragement. While you will no longer be on the Executive Committee, I still have your telephone number so that I can get advice. Most of all thank you for your friendship. The future of GPhA is extremely bright under the upcoming leadership of my friend and colleague Eddie Madden. I look forward to working with Eddie and each one of you as we seek to “Preserve the Triad.”

Lawyer and Pharmacist Leroy Toliver, Pharm.D., R.Ph., J.D. • Professional Licensure Disciplinary Proceedings • Medicaid Recoupment Defense • Challenges in Medicaid Audits • OIG List Problems • SCX or Other Audits

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EXECUTIVE VICE PRESIDENT’S EDITORIAL Jim Bracewell Executive Vice President / CEO

2009 Healthcare Reform Urgent Acton Needed n May 11, 2009, President Obama called representatives to the White House to hear from physicians, hospitals and big PhRMA for solutions to reduce the cost of health care in America. He heard from two providers, medicine and hospitals and one provider of product PhRMA. That is, at best, an interesting threesome, but most disturbing is the fact that pharmacy was conspicuously not included in the meeting.

willing to invest two to three hours of one day in late June to join us for breakfast, lunch, an in office, or a visit in a local pharmacy with your U.S. Congressman?

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Are you ready to be a member of the world changing effort for pharmacy? Then email Stuart Griffin, our Director of Government Affairs at sgriffin@gpha.org and put your name in the group. Stuart will be setting up these meetings. He will contact you to confirm your attendance. Stuart, Jeff Lurey, members of the GPhA Executive Committee, and I will attend each meeting.

How do we get pharmacy a seat at the table and off the menu of a carved up new health care reform? One way is by taking action like your GPhA leadership is doing as depicted by the photo at the bottom of this page with U.S. Senator Johnny Isakson. But that is not enough.

These meetings are our opportunity to influence health care reform legislation for 2009. If we do not step up to the plate, others will write health care reform for you us. Don’t be absent from the health care reform table. You are invited by GPhA.

During the Congressional recess from June 27 to July 5, GPhA will host in person meetings with each of Georgia’s 13 congressional representatives. Georgia pharmacists must personally advocate for pharmacy to be a part of health care reform. Are you interested in having your voice heard? Are you

GPhA Executive Committee and members discuss health care reform with U.S. Senator Isakson. The Georgia Pharmacy Journal

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Pharm PAC: New Beginnings by Stuart Griffin, Director of Government Affairs - sgriffin@gpha.org

Pharm PAC would like to encourage you to make a contribution today and help pharmacy look forward to a bright future in the state of Georgia.

eginning July 1, 2009, Pharm PAC will be changing. GPhA has incorporated a new PAC with the official title “Georgia Pharmacy Association Political Action Committee, Inc.” The political action committee will still be known in short as Pharm PAC.

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The purpose of the makeover is to hopefully breathe new life into an aged and often complicated process. Our goal was to streamline the different levels of contributing so they would be conducive to maximizing fundraising efforts in the future. It was obvious that something had to be done to stimulate Pharm PAC fundraising. Influential health care groups in Georgia like the Medical Association and the Trial Lawyers Association were contributing $125,000 $140,000 annually while the Pharmacy Association was expecting to compete in the same arena by only contributing in the annual range of $45,000 - $50,000. Pharmacy will not be able to survive in the political arena at these levels. We must change our thinking. We have made huge efforts to transform our government affairs department and we are sure that we can reach the next level of success if we begin to contribute financially at the same levels as other influential groups in health care. We have set a goal to raise $125,000 between July 1, 2009 and July 1, 2010. This is only $250.00 spread amoug 500 pharmacists - $62.50 per quarter. In early July you will receive a letter from the chairman of Pharm PAC, Mr. Bruce Broadrick, R.Ph. In this letter there will be an explanation of the different contribution levels available. Please keep our goal in mind and contribute to Pharm PAC accordingly.

Name: __________________________________________ Address: __________________________________________ __________________________________________ Phone Number: __________________________________________ Email Address: __________________________________________ Pledge: $___________________________________ (Circle the Pledge Level to which you wish to belong.) $1 - $250 - Patriot $251 - $500 - Representative $501 - $1000 - Senator $1001+ - Governor’s Circle

Sustainers Circle: When you check this box and provide valid credit card information you are making a 5 year commitment to make the same contribution for the next 5 years. Your credit card will automatically be charged annually on the date of your initial contribution. Contributions or gifts to Pharm PAC are not deductible as charitable contributions for Federal income tax purposes. Name on the Credit Card: __________________________________________ Credit Card Number: __________________________________________ CSV#: ________ Expiration Date: _________________ Signature: __________________________________ Detach this form and complete it and return it to:

The most successful fundraising occurs when a group of individuals hold one another accountable. Please call your peers around the state to make sure they have sent in their $250.00 check to Pharm PAC.

The Georgia Pharmacy Journal

Pharm PAC, 50 Lenox Pointe, NE Atlanta, GA 30324 10

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Pharmacy Time Capsules 2009 (Second Quarter) 1984—Twenty-five years ago: • At least 38 infant deaths were linked to E-Ferol Aqueous Solution. It was later determined that the product had not been approved by the FDA. • “The Controlled Substance Registrant Protection Act of 1984” authorized federal backup to the states. Department of Justice intervention is triggered in the cases of armed robberies of pharmacies when more than $500 of drugs or bodily injury or death occur. 1959—Fifty years ago • J&J acquired McNeil Labs • From 1959 to 1961 Lawrence Brock, a 1929 graduate of the University of Nebraska College of Pharmacy, served in the U.S. House of Representatives. When not re-elected he was appointed administrator of the Farmers Home Administration. 1934—Seventy-five years ago • There were 67 colleges of pharmacy – 42 states and D.C. mandated graduation from a recognized college of pharmacy as a prerequisite for licensure in place 1909—One hundred years ago • There were 75 schools of pharmacy granting the 2-year PhG diploma. Only 3 states – NY, PA, and RI – mandate pharmacy college graduation as a prerequisite for licensure. • Oklahoma passed state pharmacy act 1884—One hundred and twenty-five years ago • Two new colleges of pharmacy started – Purdue University and Ohio Normal University (now Ohio Northern) By: Dennis B. Worthen Lloyd Scholar, Lloyd Library and Museum, Cincinnati, OH One of a series contributed by the American Institute of the History of Pharmacy, a unique non-profit society dedicated to assuring that the contributions of your profession endure as a part of America's history. Membership offers the satisfaction of helping continue this work on behalf of pharmacy, and brings five or more historical publications to your door each year. To learn more, check out: www.aihp.org

“We implemented PQC in our pharmacy four months ago – it was easy. I have noticed an enhanced effort from the staff to work together to avoid and eliminate quality-related events.” Pharmacy Quality Commitment® (PQC) is what you need! PQC is a continuous quality improvement (CQI) program that supports you in responding to issues with provider network contracts, Medicare Part D requirements under federal law, and mandates for CQI programs under state law. When PQC is implemented in your pharmacy, you will immediately improve your ability to assure quality and increase patient safety. Do you have a CQI program in place?

Call toll free (866) 365-7472 or go to www.pqc.net for more information. PQC is brought to you by your state pharmacy association.

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GPHA MEMBER NEWS

National Association of Boards of Pharmacy (NABP) introduced the North American Pharmacist Licensure Examination (NAPLEX) Review Committee. William A Hopkins, Jr., Pharm.D., of Big Canoe will be one of the committee members. Bradley G. Phillips, Pharm.D., BCPS, Professor and Head, Clinical and Administrative Pharmacy, moderated the Scientific Paper Platform Presentation, “The Great Eight,” at the American College of Clinical Pharmacy/European Society of Clinical Pharmacy International Congress on Clinical Pharmacy, and announced the Best Scientific Paper Award with co-chair Professor J.W. Foppe van Mil. Kalen B. Porter, Pharm.D., Clinical Assistant Professor, presented a poster presentation: “The use of azithromycin for the treatment of pediatric acute asthma exacerbations’ at the American College of Clinical Pharmacy/European Society of Clinical Pharmacy International Congress on Clinical Pharmacy in Orlando, Florida, with Caity Bowers, Pharm.D. student. The Coastal Bank recently elected state Rep. Buddy Carter, R.Ph. to serve on its board of directors.

The Georgia Pharmacy Journal

William Berry Ivey, Pharm.D., of Lakeland was recipient of the Durward N. Entrekin Pharmacy Student Leadership Award. Elizabeth Wright McCormick, Pharm.D., of Woodstock, and Natalia Aleksandrovna Rozenberg, Pharm.D., of Lawrenceville received the Merck Awards for academic excellence. The GlaxoSmithKline Patient Care Award was given to Robyn Lindsay Keen, Pharm.D., of Jonesboro for exemplary performance during clinical rotation. The Mylan Pharmaceuticals Inc. Excellence in Pharmacy Award for high academic achievement and professional motivation was awarded to Jenna Briann Luedtke, Pharm.D., of Lilburn. Aaron Blake Atkins, Pharm.D., of Huntsville, AL, received the Perrigo Award of Excellence in Non-prescription Medication Studies. Vinh Hgoc Do, Pharm.D., of Athens, received the Redfearn Award for professionalism and community service. Andrea Michelle Albritton, Pharm.D., of Columbus, received the TEVA Pharmaceuticals USA Outstanding Student Award for excellence in the study of pharmacy. 12

If you have an item that you would like included in the GPhA Members in the News section of The Georgia Pharmacy Journal please email the item of news to Kelly McLendon at kmclendon@gpha.org or fax it to her attention at 404.237.8435.

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June 2009


Welcome to GPhA! The following is a list of new members who have joined Georgia’s premier professional pharmacy association! Ashish A. Advani,Pharm.D., Atlanta Evan Anderson, Athens Jose M. Arencibia, O.D., Hiawassee George Brown, Pharm.D., Braselton Marguerite Elizabeth Bryan, St. Simons Island Cassie Butler, CPT, Kennesaw Laura Susan Cain, R.Ph., Columbus Will Coley, Pharm.D., Leesburg Katlynd Contrael, Athens Don R. Dye, O.D., Elberton Robin D-O Findlay, Pharm.D., Savannah Edward R. Ford, O.D., Kennesaw Jennifer Fries, Athens Marsha Gilbreath, Pharm.D., Atlanta Katie Smith Glover, Pharm.D., Smyrna Christopher R. Haire, Athens Lilly Lien Hilding, Athens

Abigail Hobbs, Watkinsville Christopher Johnson, Augusta Melinda Clair Kezer, Augusta Emily Knowles, Pharm.D., Dublin Neva Lamascus, C.Ph.T., Kennesaw Sarah Lobello, Athens Shanna Martin, C.Ph.T., Canton Tammy Lynn McLellan, Pharm.D., Ocala, FL Mandy Mock, Pharm.D., BCPS, Phenix City, AL Devera Moeller, Pharm.D., Canton Christopher M. Saliba, Savannah DeRoyce Simmons, Pharm.D., Norcross Jason Waller, Savannah Angela Williams, Athens Linda J. Wilson, Blairsville Patricia Lea Wooley, R.Ph., Lake Park

Tech Bit 1 100 million hard drives fail every year. I’ve had my share, including one last Christmas Eve. When was the last time you backed up your notebook? Your home desktop? Your work PC? 500 gigabyte external USB drives are selling for $99 to $129 on sale. That’s enough to back up a notebook and most people’s desktop(s). My favorite backup software is CMS Products’ BounceBack Professional ($79, www.cmsproducts.com). While Windows has a built in backup program, BB Pro can create a backup drive that can be simply installed to replace a failed drive (obviously you can’t put a 3.5” hard drive into a notebook). What I really like about BB Pro is it’s the ultimate “nagware.” You tell it how often you want to back up and it will nag you to plug in that external drive and do your backups. So really, when was the last time you backed up? Gregg Marshall, CPMR, CSP, is a speaker, author and consultant. He can be reached by email at gmarshall@repconnection.com, or visit his website at www.repconnection.com.

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THE UNIVERSITY OF GEORGIA NEWS n May 2, 2009, The University of Georgia College of Pharmacy graduated 133 Doctor of Pharmacy and nontraditional Doctor of Pharmacy students. They are as follows: Andrea Michelle Albritton Heidi Allison Kirk Almeter Philip John Almeter Katie Marie Blalock Candace Wanda Boatright Emily Lynn Sprayberry Burg Benjamin Adam Butts Erin Marie Cain Kelly Beth Wrick Cain Christine Elizabeth Carbonell Irina Cedeno Jeffrey Norman Champine Kara Marie Church Thomas Gene Clement Melissa Kay Cohen Marie Danielle Dabbs Tracy Nell Dabbs Millie Camille Dalton Chelsea Melinda Davis Jordan Bradley Davis Nancy Rebecca Davis Rachana Suresh Dhruva Andrea Nicole Diaz Nicole Janette diMonda Eunha Do Vinh Ngoc Do Jackson Guy Dove Jenna Leigh Evans Keith Alan Ferris Brian Christopher Ferslew Kevin Miller Florence Rebecca Lee Foreman Abraham Thompson Funk James Kennith Gable Hannah Elizabeth Gilmore James Lee Goodson Brett Ryan Hall Calvin White Hancock, III Sarah Te-Yi Hao Amy Leigh Harlen Stephanie Nicole Harrell

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Matthew Kearney Hebbard Kevin Lewis Hempe Samuel James Henderson, Jr. Philip Eugene House Erin Melinda Innis William Berry Ivey Kimberly Lynn Jakaitis Joseph Donald James Amy Marie Johnson Vincent Paul Jones Aasif Abdulqader Kazi Robyn Lindsay Keen Holly Kathryn Kincaid Zerine Susan Kurian Clay Andrew Lewis Kathryn Elizabeth Lewis Bing Liao Richard H. Lo Emilie Farr Lobeck Matthew Mark Luce Jenna Briann Luedtke Yen Kim Mach Stephanie Louise Markov Jemique Lauryn McCalley Elizabeth Wright McCormick Scott Thomas McDowell Jason Stewart McNeely Thomas Lamar McNeil, III Melissa Johnson Medders Adam Todd Mills Ashlie Nicole Morgan Robert Douglas Murry Allison Shea Musick Hillary Ndeh Nchotu Melissa Anne Nestor Duong Thuy Nguyen Kimberly Thanh Nguyen Min Hwan Oh Michael Allan Olsommer Jeffrey Brandon Padgett Jaina Jagdish Patel Puja Shailesh Patel Seema Vallabhbhai Patel Pana Veronica Perron Quynh Diem Thuy Phan Matthew Gordon Post Casey Deann Reese

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Andrew Lee Rogalski Reah Irene Rogers Natalya Aleksandrovna Rozenberg Sara Lynne Sawyer Lauren Therese Schoenbachler James D. Scoggins Nicole Leigh Shirah Megan Leigh Sightler Jonathan Lee Sinyard Jonathan Clark Slone John Joseph Small Lindsay Paige Smith Gregory Scott Snyder Steven Dennis Stockdale Melissa Faith Sumner Adrian Penny Sykes Thomas Henry Teasley Ryan Michelle Tharp Justin William Thomas Stephanie Erin Thomas Stephanie Brooke Thompson Adam Joseph Toenes Clinton Thomas Tucker Preeti Dhirajlal Vallabh Kevin James VanLandingham Veronica Dawn Vazquez Alex Harrison Ward Melissa Aysen Amerson Webber Jennifer Lauren Smith Wells Kyle D. Wilbanks Laurie Marie Wyatt Amir Yavari Nontraditional Graduates Christa Bailey Karen Cucina Leann Evans Anthonia Fregene Marcia Fye Larry Guthrie Donna Lackey Radhaica Parmer Tony Payne Elaine Reifinger Roxanne Smith Una Snyder Robin Townsend

June 2009


MERCER UNIVERSITY NEWS n May 9, 2009, Mercer University College of Pharmacy and Health Sciences graduated the Doctor of Pharmacy students. They are as follows: Liju Abraham Ronald Acoff, Jr. Oluwayemisi Adeyefa Anita Aiken Ruaa Al-Baldawi Kimberly Michelle Allen Mollie Starkie Allen William Andersen Laura Anderson Dayana Atallah Nadeje Aurubin Amanda Bates Jessica Beal Jill Bennett Kelly Blanchfield Ebony Blue Cynthia Bowers Katie Bozeman Sophia Braun Monikka Brown Timothy Burns, II Jennifer Canipe Tanea Chane Melissa Martin Chesson Billy-Clyde Childress Elyn Choa Tan Michael Clark Jenna Cleaveland Ryan Manning Clements Crystal Cooper Z. Shaden Dadashnejad Whitney Deal Hauser Jennifer DeJames Daniel Diaz Diana Diaz Tina DiTizio Brittany Dixon Cortney Donovan Amber Sandlin Draper Patrick Durham Lauren Kate Fernald

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Tara Fisher Adrienne Fitzpatrick Kristen McCarthy Dana Flores Joaquin Garcia Mondonna Ghazi Tiffany Gibson Bryan Goodman Jonathan Gordon Kari Grier Katharine Hall Hannah Head Mary Hendy Beth Hiett Laura Hill Carly Hingson Rebecca Hoelker-Tran Cortney Holland Matthew Hurd Jade Huynh Tobin Jacob Karen Jacobs Rhondolyn Jones Amanda Page Brian Keys Matthew Kiger Cimeon Koebel Dana Lacy Keeyeon Lee Jin Brian Lewis Layne Littlejohn Joy Locklear Ashley Sherwood London Setor Lotsu Hannah Luck Andrea Maxfield Ginny Maxon Dominic McCormick Amy Alread McCready Sheldon McDonald Diane McNeil Bhavi Mehta Fabian Mejias Paul Micheletto Karen Miller Joshua Morgan Karrie Mosby

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Dana Mullis Cory McDonald Lilian Ndehi Ashley Neu Michael Nguyen MyHang Nguyen Quynh Nguyen Evan Nix Jennifer Norman Ashley Parker Paige Parsons Katie Patel Khilna Patel Pratik Patel Sonal Patel Jenna Patteson Clara Pham Sarah Phanco Derek Polly Devan Pressley James Prues, Jr. Carolyn Ragsdale Lindsay Raines Scott Raiser Kimberly Richardson Tamara Riggleman Amanda Roland Lynn Hunter Amanda Scott David Scott Laura Sherman Jaime Slapkus Luke Sowards Erin Spivey Jennifer Spry Melisa Sutton Kayla Strack Jonathan Styles Brian Swierczek Jeremiah Taylor Miheret Tesfaye Sy Quoc Tran Ubong Umoren Lauren Ward Bess Richard Joseph Yonkofski, Jr. Sheida Rose Zelaya

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Pharmacy News Ryan Tharp & Jason M. VanLandingham, PharmD, BCPS

The Role of Pharmacists Within a Community Physician’s Office new movement in health care is taking place. Small, efficient clinics are becoming more prevalent and the local pharmacy is increasingly becoming a place for patients to obtain routine immunizations, have conditions monitored, and address minor health concerns. This is appealing to many patients because a pharmacy is often faster than waiting in a doctor’s office and appointments are not necessary. Also, the pharmacist is a highly accessible member of the health care team. A patient can simply drive to the neighborhood pharmacy to ask questions and discuss medications, a service that is unheard of in a doctor’s office. In deciding whether or not to have pharmacists and physicians working alongside one another, it is important to examine their individual roles, satisfaction of all members of the team, patient satisfaction, and how this affects therapeutic outcomes.

for evaluation and treatment. Another role in which pharmacists could be involved is drug interactions. A simple glance down a patient’s medication history could tip off a pharmacist to potential interactions between drugs, foods, or even herbal supplements the patient purchases with his or her prescriptions. Cost is also a major factor contributing to whether or not patients take their medications. Pharmacists can suggest alternative agents that are lower cost, but have similar efficacy. Here is a definite possibility for agreements between physicians and pharmacists. By creating pre-set interchanges, a pharmacist would be able to automatically switch a patient from one drug to another based on cost, insurance, or other issues while maintaining safety and efficacy without ever having to bother the physician about the matter. He or she would obviously be made aware of the change and appropriate documentation made in the patients record, but the patient would not be left in the pharmacy waiting area pending physician approval.

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A major role for pharmacists in community practice cooperative with physicians would be the enforcement of guidelines. JNC 7 states that 66 percent of hypertensive patients have uncontrolled blood pressure readings. This presents an enormous area for pharmacists to get involved. Most community pharmacies have automatic blood pressure monitors and, if not, the majority of pharmacists would be willing to take the readings of anyone who asked. If an established cooperation between pharmacist and physician were present, the pharmacist would be in a prime position to recommend the person The Georgia Pharmacy Journal

Pharmacists also have the ability to decrease polypharmacy and duplicate medications being used for the same indication. A patient with multiple doctors may not have made each one aware of all the medications they are taking. This presents a problem when several physicians write for drugs used for the same conditions, hyperlipidemia for instance. A patient may have prescriptions for both simvastatin and atorvastatin without knowing they are the same type of medication 16

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being used for the same indication. This multiplies the potential for adverse effects.

histories prior to the physician or physician’s-assistant visit. After the physician visit, the pharmacist then educated the patient on their new prescriptions and addressed any concerns of the patient or physician. The patients were then given a brief survey about the visit. Seventy-two percent of the patients stated that this was the first time they had been educated by a pharmacist within a physician’s office and 84.8 percent of the patients would prefer a pharmacist within their physician’s office. When asked about the importance of the information received from the pharmacist, on a scale of 1 (no importance) to 5 (very important), the average score was 4.6. Though this is a small survey of one patient population, it demonstrates the importance of a pharmacist’s education to a patient and a desire from patients for pharmacist interactions.

Pharmacists can play a huge role in increasing medication compliance. By simply asking a patient how they take their medicine, how they remember to take all their medications as directed, and what they do when they forget, patient compliance improves. The pharmacist can offer novel methods of remembering dosing times or recommend the use a pillbox or an alarm. Obviously, in order for this all to work, physicians and pharmacists must be willing to work together. In a recent study, there was a high rate of physician acceptance of pharmacist recommendations especially with regard to discontinuing unnecessary medications (Lim, 224). There was less concern when making recommendations solely on the basis of cost. It also seems that large medical centers and teaching hospitals that routinely have pharmacists rounding with the rest of the staff would be more willing to accept the recommendations of pharmacists when compared to private practices where physicians are accustomed to a high degree of autonomy.

It seems that a pharmacist in a family practice community environment is a welcome addition to the health care team. The addition of a pharmacist would expand the patient base, services offered, and the quality of care given. The patients would benefit the most from the increased personal attention and guidance with regard to medications, therapies, and lifestyle.

Outcomes measured in various studies included patients’ medication knowledge, perception, residual adverse drugs reactions, cost avoidance, compliance, and whether or not the patient was at therapeutic goal. With regard to lipid levels, patients who were seen in pharmacist-managed clinics were more likely to have LDL levels below 100 mg/dL than patients being seen in conventional doctors’ offices, 72 percent versus 39 percent (Mazzolini, 768). There was also a statistically significant increase in medication knowledge in the set of patients visiting a pharmacist consult clinic (Lim, 224). Compliance and adverse drug reactions did not show an appreciable difference between consult clinics and traditional physician visits in Lim’s study; however, one pilot study did show an increase in knowledge and reductions in the number of medications and side effects despite no increase in compliance (225).

A thank you to Barry S. Bryant, R.Ph., David D. Pope, Pharm.D., CDE., and Andrea Byrd-Doak, PA-C for allowing us to use Hope Medical Center. Thanks to the following students for help with this project. Amy Harlen (UGA) Christy Carbonell (UGA) Elizabeth McCormick (UGA) Emily Sprayberry (UGA) Neely Davis (USC) Stephanie Bryant (USC) Works Cited Lim, W.S., et al. “Impact of a Pharmacist Consult Clinic on a Hospital Based Geriatric Outpatient Clinic in Singapore.” Annals Academy of Medicine. Vol. 33. No. 2. March 2004. P 220-227.

With the benefits of a pharmacist in a physicians office having been shown, how would the patient feel about a pharmacist’s presence in his or her doctor’s office? Hope Medical Center in Augusta, Georgia, a small familypractice clinic, utilized pharmacists and pharmacy students to conduct a small anonymous survey of a sample of its patients. The pharmacists retrieved medication The Georgia Pharmacy Journal

Mazzolini, Timothy, et al. “Lipid Levels and Use of LipidLowering Drugs for Patients in Pharmacist-Managed Lipid Clinics Versus Usual Care in Two VA Medical Centers.” Journal of Managed Care Pharmacy. Vol. 11 No. 9 November/December 2005. P 763-771. 17

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A Shot to the Bottom Line Buford Road Pharmacy of Richmond, Virginia, develops a lucrative niche through its immunization program. Chris Linville, Managing Editor, America’s Pharmacist, NCPA s an independent pharmacy owner for almost 35 years, including more than 20 with Buford Road Pharmacy in Richmond, Virginia, Ronald Davis is always looking for ways to grow and diversify his business. And about a decade ago he saw what appeared to be a prime opportunity.

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Davis, an R.Ph., was reading some articles about pharmacists who had implemented flu immunization programs into their practices. He decided it might be worth a try in his own pharmacy. Today, Buford Road’s immunization program has evolved into a lucrative niche, and as a bonus has helped spur additional revenue within the pharmacy.

don’t have to have a prescription— we’ve had a doctor sign off on it (as required by law). As long as you are 18 years old, we can give you an immunization via the protocol.”

Old Dominion University. After about a year, he had second thoughts, and after speaking with a chemistry professor, Davis decided to go into pharmacy.

Building a Program Davis, a native of Fredericksburg, Virginia, lived around the world growing up, as his father was in the military. But he says, the family “always made our way back to Virginia.” Davis would join the military himself, serving in the U.S. Army in Vietnam, where he was wounded. As part of a vocational rehabilitation program offered by the Veterans Administration, Davis enrolled as an engineering student at

In 1973, Davis graduated from the Virginia Commonwealth University Medical College in Richmond, and began his pharmacy career at a chain. In 1975, he purchased his first pharmacy, which he ran for 13 years. Davis joined Buford Road Pharmacy in 1988, and not long after bought a majority interest. Buford Road Pharmacy has been in business for more than 50 years under various incarnations and owners, and

“Like so many parts of my business, a little door opens up, and you walk through it,” Davis says. “You don’t necessarily know where it’s going to lead, but you have a good feeling about it so you go there.” After modestly starting his program by giving about 300 flu shots in the first year, Davis and his staff now immunize about 6,500 patients annually. The pharmacy also provides some 3,000 more shots to combat health ailments such as hepatitis A and B, meningitis, typhoid, yellow fever, and shingles. “We give a whole host of immunizations now,” Davis says. “And it’s all done on protocol, so we The Georgia Pharmacy Journal

Pharmacist Tyler Stevens (right) discusses the immunization program with a patient. 18

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was a 9,000-square-foot facility when Davis acquired it. Wanting to grow his home health care and other clinical services, Davis set out to rebuild the pharmacy in a shopping center near the existing location. The “new” Buford Road Pharmacy, opened in 2000, now has 15,000 square feet. The extra space provided ample room for some of Buford’s staple services, such as blood pressure and blood glucose monitoring, and cholesterol and bone density screenings. Davis also decided to include a dedicated immunization area within the pharmacy. “When we were doing plans for the store it included an actual clinic—as opposed to having a table out front and putting up a screen and doing shots,” Davis says. “We decided to build a clinic room. We also have a conference room that we use quite a bit, especially at the beginning of the flu season when there are a lot of people coming in. We just decided to see where we could go with it.” To help get the program off and running, Davis hired a nurse, and also enlisted students, residents, and other staff pharmacists. Prior to administering any immunizations, individuals must successfully complete an accredited immunization certification program. Davis says that some pharmacy schools offer certification programs, and in his state the Virginia Pharmacists Association also offers annual accreditation certification. To Start, Go Slow For pharmacists who may be considering doing immunizations, Davis suggests consulting with colleagues who have already established a program. “There’s no The Georgia Pharmacy Journal

sense in trying to recreate any wheels,” he says. Also, it’s vital for pharmacists to consult with their state board of pharmacy, public health departments, and other related organizations to be aware of any and all regulations, requirements, restrictions, and laws pertaining to an immunization program. To date, Maine is the only state that prohibits pharmacists from immunizing. Davis also suggests a gradual implementation. “My advice is to go slow,” he says. “Don’t do too many things all at one time. Maybe just start with flu. I would prefer in my first year to give 100 and do it smoothly, and get all the systems down and get everyone trained in what they are doing, as opposed to saying, ‘Hey, there’s a big potential for profit here, let’s try to do 1,000 in the first year.’ If you do that, and make a bunch of mistakes, then you have a negative reaction in the community, as opposed to a positive.” Starting a program doesn’t have to be expensive, Davis says. It can be somewhat labor intensive, at least initially. And the cost of immunizations must be considered. He says that flu vaccines were about $17 per vial when Buford Road Pharmacy started its program. Now a vial costs more than $100. Zostavax (for shingles) is about $150 for a single dose vial. At 10 shots a bottle, Davis points out that 100 bottles would be needed to perform 1,000 vaccinations. He says the pharmacy spends close to $60,000 annually on flu vaccines. “And that’s not spread out because you have to buy it all at one time,” Davis says. However, he adds, “Once you get your customer base in, then 19

you have a good idea of how many shots you’re going to give. You have to bill Medicare, because probably 75–80 percent of the flu vaccines that you’re going to give are going to be from Medicare patients. Then you’re going to have to wait at least 30 days to get reimbursed for that. So there are some financial considerations to keep in mind. “But again, I think if you start slow and you grow with it, and you manage your money well, it shouldn’t be a problem. It’s never been a problem for me—fortunately. You can get a read on things and your cash flow can support that if you manage your money well.” Relationships and Marketing As most pharmacists will say, building a professional, cordial, and collaborative relationship with local physicians can make their jobs much more productive and efficient. And Davis has managed to do so with doctors in his market. He acknowledges that some pharmacists may be hesitant about doing vaccinations, because they don’t want to alienate local physicians by taking business away from them. “I’m not saying that it couldn’t happen in some places, but I’ve found it’s just the opposite of that here,” Davis says. “A lot of our immunizations are done because physicians have referred patients to us.” He says that many doctors don’t want to be burdened with items such as billing, stocking, refrigeration, upkeep, and other issues. “A lot of physicians have just found it too cumbersome to handle. So they just send patients to us, because they know we carry just about everything.”

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“We know exactly how many shots that we’ve given,” he says. “Some people come here on a regular basis for all of their immunizations, so in that regard we’re just like a doctor’s office—we keep their records here, so if they are traveling abroad or they need a copy of their shot records, then we have it.”

To spread the word about the program, Davis says that along with contacting physicians’ offices, the pharmacy does advertising in local newspapers and radio stations. Davis also has a marketing specialist who calls on assisted living facilities and businesses. “We have several assisted living facilities where we go and do all of the immunizations,” Davis says. “All of the paperwork is done prior to us arriving. So when we get there it’s pretty quick and easy.” “We’ll also go to companies and have an immunization day. A lot of those companies will pay for their employees to get those flu shots to decrease their sick days, which helps their productivity.” Davis also says that through a computerized tracking system, Buford Road Pharmacy has a record of all immunizations it has performed, whether for flu or for something else. It’s especially useful for patients who travel, as the pharmacy does a healthy business with travel immunizations.

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One Niche Creates Others Davis has discovered that having a successful immunization program can highlight the pharmacy’s other offerings, thus creating an upward spiral for the business as a whole (“creating synergy” might be the phrase from marketing gurus). Davis points out that during flu season, a lot of people are in the store. After they receive an immunization, they need to stay for about 15 minutes to be sure there are no adverse reactions. So the pharmacy has plenty of potential customers, which can translate to added revenue. “When you’ve got people walking around your store, what we do is to hand them a coupon for a discount off a lot of items we sell,” Davis says. “A lot of flu shots are given in the fourth quarter, which is Christmas time. And our store is pretty heavy into Christmas merchandise. So it encourages those people, while they are here, to do some shopping. So that also adds greatly to the profit structure of your vaccine program. It increases your traffic, and it causes your traffic that’s in the store to stay for awhile. So if your store is well merchandised, and well stocked, you’re bound and determined to sell merchandise. You can’t help but do that.

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“It’s like one niche is creating another niche.” Davis says the pharmacy can also track long-term customer prospects through the immunization program. “We measure that because in the computer, we can see that somebody got a flu shot, and then we have it on record if they come back a few months later to get a prescription filled,” he says. “And if that’s the first time that they had a prescription filled at your store, then you can say, ‘Well the last time they were here they just got a shot. They came here again because they liked us and they liked our store.’ So it does help to build your customer base.” Obviously the financial benefits of a successful immunization program are rewarding. But the opportunity to provide community pharmacy-style patient care is particularly gratifying for Davis. “It’s really an enjoyable thing,” he says. “You get several minutes to sit down with a patient and have a one on one conversation about their health. So you can impact that patient more than just giving them the immunization itself.” This article originally appeared in the April 2009 issue of America’s Pharmacist, published by the National Community Pharmacists Association, Alexandria, VA. Reprinted with permission.

June 2009


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Pharmacy News

10 Facts About Dieting by Trevor Miller, Director of Insurance Services - tmiller@gpha.org

iets Do Work The phrase “diets don't work” has been drummed into us by books, advertising and other such mantras. But the truth is you can lose weight following pretty much any diet on the bookstore shelf. The problem is that unless the diet fits your lifestyle, it's bound to fail, and your weight will creep back on. You want a diet you can live with. If you're trying to lose weight, you’ll have to exercise your options.

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There's No Need to Shun Red Meat on a Low-Fat Diet While it's true that prime and choice grades of meat are high in fat, lean cuts with fewer than 30 percent calories as fat are available. When buying meat, it's best to look for "select" grades of lean cuts like top round and tenderloin as well as extra-lean ground beef. They are among the lowest in fat. Yo-Yo Dieting Won't Wreck Your Metabolism Because of all the diet plans available some people are afraid that dieting might have messed with their metabolism. While extremely low-cal diets temporarily lower your metabolism, recent studies suggest that the effects don't last. Even if you've lost and regained weight countless times, don't give up. Yo-yo diets don't hurt you; they just don't get you anywhere.

Calorie-Free Soft Drinks May Make You Fat Studies have indicated that the artificial sweeteners, perhaps even the caramel coloring, may muddle brain chemistry. The brain in a sense gets a reward, and the desire for more sweets is intensified. The more of these fake sweet products you eat or drink, the more sweets you want. Moderately Overweight Kids Shouldn't Be Put on Restrictive Diets If you have kids who are 10 to 15 pounds overweight, the current thinking is that they should not be put on restrictive diets. Instead, it's better to help them make basic improvements in their diets, ramp up their activity, and give up some T.V. and computer time. Perk up your kids' diet by adding more fruits, vegetables and whole grains while cutting back on the junk foods. That way, you'll automatically slow the rate of their weight gain while they continue to grow in height. Children go through dynamic phases of growth, and a low-calorie diet is not what they need. They need nutrients and activity. Dessert Can Be Dinner Finally someone got it right! Don't call the food police, but you can enjoy a Hot Fudge Sundae for dinner "every now and then," which means as an occasional meal and not a steady routine. Don't deny yourself certain cravings. Make a meal out of a favorite

You Can Lose More in Cold Weather Than You Think Some people swear they gain more weight in the wintertime. Mostly because people believe they are not quite as active in winter. But the reality is, your The Georgia Pharmacy Journal

metabolism revs up to keep your body warm in cold temperatures. This may mean marginally more calorie expenditure each day.

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June 2009


treat and you'll be less tempted to overindulge on your splurge foods. Just swap your dinner for a sundae — and it may help you be more successful in controlling your weight over the long term.

only 1,200 to 1,500 calories a day, save those calories for food and drink more water! There Are No Negative-Calorie Foods You may have heard that some foods, because they are difficult to digest, will make you lose weight. Dubbed "negative-calorie foods," citrus fruits and celery have both basked in this flattering light in fad diets over the years. The problem is that it's not true. Although chewing celery might seem like a strenuous activity, it burns about the same amount of calories as watching the grass grow.

Liquid Calories Count If and when you tally up your calories at the end of a meal or a day, do your calculations take into account what you’ve drank? Did you remember to include that can of soda, smoothie, cup of latte, or cocktail? People tend to guzzle more of their daily calories than they think and it really adds up, often more than they realize. For example, a can of soda has the same amount of calories (150) as of a piece of fruit and a slice of toast. A smoothie can run up to an extra 500 to 1,000 calories despite all the good stuff added in, and a 16-ounce latte with whole milk packs 260 calories. The average margarita has more than 500 calories, per drink! What's more, the brain doesn't seem to register liquid calories as accurately as calories that are chewed, and it doesn't send stop-eating signals to keep you from drinking more. If you're taking in

You Can Eat After 8 p.m. It doesn't matter what time of day you eat. What matters is what and how much you eat and how much physical activity you get during the entire day that determines whether you gain, lose or maintain your weight. No matter when you eat, your body will store extra calories as fat. If you want a snack before bedtime, just think first about how many calories you've eaten that day.

Important Notice Regarding Journal Published Home Study Continuing Education

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The Ohio Pharmacists Association for years has coordinated a program to provide home study continuing education programs, for many states associations including Georgia. The Ohio Association, due to rising costs associated with that program, discontinued providing them for publication this spring. May was the last edition of these studies.

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GPhA is actively determining our best resource to continue this service to our members. We expect to resume publication of the home study courses as early as July or August 2009.

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Thank you for your patience as we explore the most economical method to continue this service to our members. Jim Bracewell Executive Vice President Georgia Pharmacy Association The Georgia Pharmacy Journal

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Cover Story

Eddie Madden, R.Ph.: Preserving the Triad by Kelly McLendon, Director of Public Affairs - kmclendon@gpha.org lways concerned for health care in the state of Georgia, Eddie Madden, R.Ph., has found many ways to both serve the interests of his profession and his community of Elberton, Georgia. For almost 40 years, always protecting their interests, he has served his community and his patients .

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Born in 1948 to parents, Jack and Sue Madden, Eddie attended Elbert County High School. He then attended Middle Georgia College and earned an Associate of Science degree before attending the University of Georgia School of Pharmacy . He graduated in 1971 with a Bachelor of Science in Pharmacy.

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Eddie is married to Linda Driskill Madden. He has three children, M. Bryan Madden, A. Hutton Madden and Ashley Anne Madden. Service to Patients In 1972, Madden opened Madden's Pharmacy, Inc., an independent retail pharmacy which has been serving the Elberton area for over 30 years. He recognizes the importance of a personal relationship between patient and the pharmacist. Madden's Pharmacy provides extensive prescription services, billing most insurance companies, accepting major credit cards, offering free delivery in the Elberton area, in-store charge accounts, and convenient

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drive-in window service. The pharmacy’s location next door to Elberton's largest physician complex, The Medical Center, makes utilizing Madden's Pharmacy even more convenient. Madden's Pharmacy also offers Elberton's only local outlet for your home health care needs. Same day service can be provided for hospital equipment and home oxygen. Setup and delivery is free throughout Elbert and the surrounding counties. They carry a wide selection of hospital equipment, diabetic supplies, ostomy supplies, mastectomy prosthesis, and many other items for the home bound patient.

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Eddie Madden, R.Ph. Born: Place: Parents: Sibling: Children:

August 6, 1948 Elberton, Georgia Jack and Sue Madden Larry G. Madden M. Bryan Madden A. Hutton Madden Ashley Anne Madden Linda Driskill Madden

Wife: Education: Graduate of Elbert County High School-1966 Graduate of Middle Georgia College-1968 A.S. Graduate University of Georgia School of Pharmacy-1971 B.S.Ph.

Founded Madden’s Pharmacy in 1972 in Elberton, Georgia Currently is President of Madden’s Pharmacy, Inc., which operates as a prescription oriented pharmacy, home medical equipment business, Vital Care Home Infusion, and compounding pharmacy. Community Service: President of the Elberton Kiwanis Club, 1976-1977 President of the Elbert County Chamber of Commerce, 1986-1987 President of the Elbert County Chamber of Commerce, 1990-1991 Class Member of Leadership Georgia, 1991 Board of Directors of Leadership Georgia, 1994-1997 Second Vice President, Georgia Pharmacy Association, 2006-2007 First Vice President, Georgia Pharmacy Association, 2008 Public Service: Elected to Georgia Senate 1993, serving 4 terms thru 2000. Chairman, Senate Interstate Cooperation Committee, 1995-1996 Chairman, Senate Ethics Committee, 1997-1998 Chairman, Senate Insurance Committee, 1998-2000 Member, Senate Health and Human Services Committee, 1993-2000 Member, Senate Natural Resources Committee, 1993-2000 Chairman, Environmental Subcommittee, 1996-2000 Member, Senate Appropriations Committee, 1994-2000 Chairman, Subcommittee on State Facilities Member, Governor’s Education Reform Commission, 1998-2000 Member, the Georgia State Board of Pharmacy, 2001-2006 Professional Affliliations: Georgia Pharmacy Association, National Community Pharmacy Association, American College of Apothecaries; American Pharmacy Association; Georgia Society of Health-System Pharmacists Employment:

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Professionally, Madden is a member of GPhA, NCPA, ACA, APhA, and GSHP. Public Service Being involved in local civic organizations has always been important to Madden. He served as President of the Elberton Kiwanis Club 1976 to 1977; President of the Elbert County Chamber of Commerce 1986-1987 and 19901991; Class member of Leadership Georgia in 1991; Board of Directors of Leadership Georgia 1994-1997; Executive Committee of GPhA from 2006-present. Eddie Maddin (center) with David Graves, R.Ph. and Judy Gardner, R.Ph. at the But, his community service did not GPhA Convention in Amelia Island. end there. Madden was elected to Health and Human Resources Board of Pharmacy 2001-2006. the Georgia State Senate in 1993 Committee 1993-2000; Member of where he served four terms. During the Senate Natural Resources Service to Profession his time in the Senate he served as the Committee 1993-2000; Chairman of Madden continues his professional Chairman of the Senate Interstate the environmental Subcommittee of and public service when he begins his Cooperation Committee 1995-1996; the Natural Resources Committee term as president of the Georgia Chairman of the Senate Ethics 1996-2000; Member of the Senate Pharmacy Association. His chosen Committee 1997-1998; Chairman of Appropriations Committee 1994theme for the year, “Preserving the the Senate Insurance Committee 2000; Chairman of the State Facilities Triad,”exemplifies Madden’s vision 1998-2000; Member of the Senate Subcommittee of the Senate for GPhA. To protect the Appropriations Committee 1994-2000; Member of the Governor’s Education Reform Commission 1998-2000 and Member of the Georgia State

relationships the Triad represents: the patient, the physician, and the pharmacy professional who provides an essential link between the patient and the physician.

Eddie Madden exiting the pool into which he was tossed after being elected to the position of 2nd Vice President of GPhA in 2006. The Georgia Pharmacy Journal

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June 2009


Pharmacy News Wholesaler Pharmacy: June 30 of odd numbered years Researcher Pharmacy: June 30 of even numbered years

AIP Announces the Establishment of a Summer Intern Program to Promote Independent Pharmacy for Students

It is illegal to practice as a pharmacist with an expired license.

AIP has established a Summer Intern Program for pharmacy students. This program will allow pharmacy students to receive an extensive 12 week training program with an independent pharmacy. The first student to participate in the program is Nick Cummings. Nick is a student at Mercer University. Nick will split his 12 week internship between Little Five Points Pharmacy and East Marietta Drugs.

How do I renew my license? You may renew your license on the Professional Licensing Board website with a credit card. Click on the “License Renewal” icon and follow the instructions. You will be asked a series of questions including whether you have been arrested, convicted or received a board sanction since your last renewal, whether you have completed your continuing education requirements, and whether or not you are a U.S. citizen. Renewing your license via the website is the fastest way to renew your license.

The AIP Executive Committee is currently establishing goals and criteria for the program. We are very excited to initiate this program with a young pharmacist who has a strong desire to work for an independent and one day own his own pharmacy. If this project is successful, we will expand it in the future to include students from all the pharmacy schools in Georgia. We feel very strongly the intense, specialized training we can provide will greatly encourage young pharmacy students to seek a future in independent pharmacy.

The Professional Licensing Boards do not mail paper renewals unless requested. A paper renewal form may be requested by the licensee by calling the Board office at 478.207.2440, or submitting a written request. Licensees may also call our automated system at 404.463.1100 and request a paper renewal form using their personal identification number included in their renewal notice.

If you have questions about this program contact Jeff Lurey at jlurey@gpha.org.

Disciplinary Issues: The Board addresses these issues on a case-by-case basis and applies sanctions to those who violate the Georgia Board of Pharmacy Practice Act, Board rules, and policies. It is important that licensees review all laws, rules and policies that affect their profession. These may be found on the Board’s website at www.sos.ga.gov/plb/pharmacy.

License Renewals Licenses expire as follows: Pharmacists: December 31 of even numbered years Nuclear Pharmacists: December 31 of even numbered years Clinic Pharmacy: June 30 of odd numbered years Home Healthcare, Retail Pharmacy: June 30 of odd numbered years Hospital Pharmacy: June 30 of odd numbered years Limited Chemical Wholesale Distributors: June 30 of odd numbered years Manufacturing Pharmacy: June 30 of odd numbered years Nuclear Pharmacy: June 30 of odd numbered years Opioid Treatment Clinic Pharmacy: June 30 of odd numbered years PBM-Retail Pharmacy: June 30 of odd numbered years Prison Pharmacy: June 30 of odd numbered years Retail Pharmacy: June 30 of odd numbered years School Pharmacy: June 30 of odd numbered years The Georgia Pharmacy Journal

All public disciplinary actions will be reflected in the Board minutes which may be found on the Georgia Board of Pharmacy website. Grounds for denial, suspension, revocation of a license, or other disciplinary actions may be found at O.C.G.A. § 264-60 or at O.C.G.A. § 43-1-19, which can be found on the Georgia Board of Pharmacy website.

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Pharmacy News

Georgia State Board of Pharmacy Complaints Process Information

authorized to release such records to another enforcement agency or lawful licensing authority.

The Georgia General Assembly created the Georgia Board of Pharmacy to regulate the licensing and regulation of pharmacists and pharmacies in Georgia. The responsibility of administering the laws in O.C.G.A. § 26-4 is given to the Board, whose members are appointed by the Governor. The Board determines if applicants meet licensure requirements, promulgates rules, and considers complaints against licensees and allegations of unlicensed practice. The process for disposing of complaints is as follows:

Notification Process: While the investigation is ongoing, the Board is unable to discuss the status of a complaint with anyone, including the complainant. All public disciplinary actions will be reflected in the Board minutes which may be found on the Board’s website.

Actions Taken by the Georgia State Board of Pharmacy January: The Board adopted two new rules governing the practice of pharmacy as follows: * 480-31-.01 Patient Counseling: The change allows for professional judgment concerning patient counseling pertaining to prescription drug refills. * 480-27-.01 Definitions, 480-27-.02 Prescription Drug Order Requirements, and 480-27-.04 Use of Facsimile Machine or Other Electronic Means to Transmit or Receive Prescription Drug Orders: The changes provide guidelines for acceptable types of electronic signatures on prescription drug orders.

Complaint Form: Complaints must be reported to and received by the Board in writing. Written complaints may be submitted to the Board office or online at http://sos.georgia.gov/myverification/ submitcomplaint.aspx. Documents received in connection with a complaint will not be returned. The complaint must contain sufficient factual evidence indicating a clear violation of Georgia law or Board rules. Investigations: The Board gives serious consideration to all complaints. Further investigative action may be taken. Generally, complaints are referred to Georgia Drugs and Narcotics Agency for an investigation. Should you file a complaint, you may be contacted by a Georgia Drugs and Narcotics agent for additional information. Investigative files are considered confidential for any purpose other than a hearing before the Board. However, the Board is

The Board voted to reinstate the license of Joe T. Ricketson, Fort Valley. February: The Board voted to accept the consent orders from the following individuals: * Crystal L. Johnson, Nacoochee: Probationary licensure. * Gregory P. Sullivan, Martinez: Suspended license.

Pharmacy Law CE given for Pharmacy Technicians on May 17, 2009, at Pharmacy Partners of Georgia LLC. The Georgia Pharmacy Journal

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June 2009


The Board voted to accept the voluntary surrender of a pharmacist license from Murriel Michael Williamson, Dublin. March: The Board voted to accept public consent orders from the following individuals for probationary licensure: * William Jason Warren, Centre, AL * Danna Brown, Birmingham, AL

Academy of Pharmacy Technicians (APT) Election Results As provided by the newly revised bylaws of APT, an election of the officers was held during the business meeting of the Academy held on Sunday, May 17. The following are the officers of APT for 2009-2010 and they will serve for one year: Chair: K. DeAnna Flores of Douglasville - employed by Pharmacy Partners of Georgia LLC Vice Chair: L. Gail Lowney of Dallas employed by Pharmacy Partners of Georgia LLC Board Members: Donna P. Kelley of Anniston, AL - employed by Robinson Drug Company Shanna Martin of Canton - employed by Pharmacy Partners of Georgia LLC Carolyn D. Winney of Roswell - employed by the Kroger Company

GPhA-ASA Members Participate in Multicultural Health Fair Submitted by Meagan Spencer On April 18, 2009, GPhA-ASA held its second annual state-wide Multicultural Community Health Fair. This event was started in 2008 with a $2000 seed grant from GPhA. The three pharmacy schools in the state, UGA, Mercer, and South, each organized a health fair in their respective region. Mercer’s health fair was located at the parking lot of the International Farmer’s Market on Buford Highway in Atlanta, GA. This area targeted a large international population that is often underserved by the health care system. To advertise, brochures and posters were printed and posted around the market and on Buford Highway prior to the event. Additionally, the day of the event, lots of balloons and a large jump castle were utilized to attract additional bystanders. Mercer screened over 150 individuals for diabetes, deep vein thrombosis, hypertension, obesity and gastroesophageal reflux disease (GERD) in nine different languages (Vietnamese, Korean, Arabic, Spanish, French, Portuguese, Indonesian, Hindi, and Gujragi). Additionally, tables were set up for information on AIDS/HIV, poison control for pediatric populations, smoking cessation, cancer where complimentary sunscreen was provided, geriatric populations, and women’s health. With face painting, stick-on tattoos, and a large jump castle, the children were not left out of the event and supervision was provided while their parents received screenings. This event provided essential health care services to an underserved population. Many of the participants had never seen a physician, had recently lost their job and thus their medical coverage insurance, or were having issues finding health care services with a provider that spoke their language. Mercer, UGA, and South would like to thank GPhA, the Foundation, and its contributors for helping make this event a possibility. We look forward to our next annual Multicultural Community Health Fair.

Before the election we held a CE program for Technicians on Pharmacy Law taught by Flynn Warren. This event was held at Pharmacy Partners of Georgia, LLC, and was attended by 22 technicians and pharmacists. Dinner for this event was provided by GlaxoSmithKline.

The Georgia Pharmacy Journal

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June 2009


2008 - 2009 GPhA BOARD OF DIRECTORS

The Georgia Pharmacy Journal Editor:

Jim Bracewell jbracewell@gpha.org

Managing Editor & Designer:

Kelly McLendon kmclendon@gpha.org

The Georgia Pharmacy Journal® (GPJ) is the official publication of the Georgia Pharmacy Association, Inc. (GPhA). Copyright © 2009, Georgia Pharmacy Association, Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical including by photocopy, recording or information storage retrieval systems, without prior written permission from the publisher and managing editor. All views expressed in bylined articles are the opinions of the author and do not necessarily express the views or policies of the editors, officers or members of the Georgia Pharmacy Association.

ARTICLES AND ARTWORK Those who are interested in writing for this publication are encouraged to request the official GPJ Guidelines for Writers. Artists or photographers wishing to submit artwork for use on the cover should call, write or e-mail the editorial offices as listed above.

SUBSCRIPTIONS AND CHANGE OF ADDRESS The Georgia Pharmacy Journal® (GPJ) (ISSN 1075-6965) is distributed as a regular membership service, paid for through allocation of membership dues. Subscription rate for non-members is $50.00 per year domestic and $10.00 per single copy; international rates $65.00 per year and $20.00 single copy. Subscriptions are not available for non-GPhA member pharmacists licensed and practicing in Georgia. The Georgia Pharmacy Journal® (GPJ) (ISSN 1075-6965) is published monthly by the GPhA, 50 Lenox Pointe NE, Atlanta, GA 30324. Periodicals postage paid at Atlanta, GA and additional offices. POSTMASTER: Send address changes to The Georgia Pharmacy Journal®, 50 Lenox Pointe, NE, Atlanta, GA 30324.

ADVERTISING Advertising copy deadline and rates are available at www.gpha.org upon request. All advertising and production orders should be sent to the GPhA headquarters as listed above.

GPhA HEADQUARTERS 50 Lenox Pointe, NE Atlanta, Georgia 30324 Office: 404.231.5074 Fax: 404.237.8435

Position

Sharon Sherrer Robert C. Bowles Eddie Madden Dale Coker Jack Dunn Jim Bracewell Burnis Breland Hugh Chancy Judy Gardner Keith Herist John McKinnon Andy Rogers Tommy Whitworth Alex Tucker Tony Singletary Renee Adamson Bill McLeer Shobhna Butler Bobby Moody Pam Marquess Larry Batten Alissa Rich Chris Thurmond Marshall Frost Ken Eiland Rusty Lee Liza Chapman Debbie Nowlin Tim Short Michelle Bishop Hillary Volsteadt John T. Sherrer Michael Farmer Fred Barber

Chairman of the Board President President Elect First Vice President Second Vice President Executive Vice President/CEO State at Large State at Large State at Large State at Large State at Large State at Large State at Large Region One President Region Two President Region Three President Region Four President Region Five President Region Six President Region Seven President Region Eight President Region Nine President Region Ten President Region Eleven President Region Twelve President ACP Chairman AEP Chairman AHP Chairman AIP Chairman APT Chairman ASA Chairman Foundation Chairman Insurance Trust Chairman Ex Officio - President, GA Board of Pharmacy Ex Officio - Chairman, GSHP EX Officio Mercer Ex Officio Mercer ASP Ex Officio South Ex Officio South ASP Ex Officio UGA Ex Officio UGA ASP

Cynthia Pangburn Gina Ryan Meagan Spencer Rusty Fetterman Rebecca Cubbedge Brian Buck Kyle Burcher

www.gpha.org

Print: Star Printing - 770.974.6195

The Georgia Pharmacy Journal

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June 2009


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