North Carolina Pharmacist Summer Journal 2012

North Carolina

Pharmacist Vol. 92, Number 3

Advancing Pharmacy. Improving Health.

Summer 2012

Join us for the 2012 NCAP Annual Convention “Making Your Voice Heard”

Oct. 28-30, Raleigh Convention Center, Raleigh, NC Keynote: Commander Michael E. Lee, US Public Health Service, is Director of Pharmacoeconomic and Theraeutics Research, and Vice-Chair of the Indian Health Service National Pharmacy & Therapeutics Committee. CDR Lee co-authored the paper “Improving Patient and Health System Outcomes through Advanced Pharmacy Practice” which advocates to the Surgeon General that pharmacists be recognized and compensated as healthcare providers.

Keynote: “Success in Action and Off Balance on Purpose” presented by award winning, high impact performer, author and motivational speaker Dan Thurmon, President of Motivation Works, Inc. Dan has delivered thousands of presentations worldwide. A recent inductee to the prestigious “Speakers Hall of Fame,” his programs have educated and uplifted Fortune 500 companies, young audiences, and even troops on the front lines of Afghanistan and Iraq. An educational, entertaining and action-packed session not to be missed See Full Convention Preview on page 6

Join the North Carolina Association of Pharmacists

for a golf outing on September 12 at the beautiful River Ridge Country Club in Raleigh.

Proceeds from this tournament will benefit the NCAP Endowment Fund.

It’s

! e m i tee t

• Shotgun start at 9:00 am

• 18 holes and prizes followed by a barbecue lunch!

• Cost: $65

The Endowment Fund provides income to aid in achieving charitable, scientific, literary and educational goals.

Register Now at www.ncpharmacists.org North Carolina Pharmacist, Summer 2012 7

Official Journal of the North Carolina Association of Pharmacists 109 Church Street • Chapel Hill, NC 27516 800.852.7343 or 919.967.2237 fax 919.968.9430 www.ncpharmacists.org

JOURNAL STAFF EDITOR Sally J. Slusher ASSOCIATE EDITOR Christopher R. Gauthier EDITORIAL ASSISTANTS Linda Goswick Teressa Horner Reavis

BOARD OF DIRECTORS PRESIDENT Jennifer Askew Buxton PRESIDENT-ELECT Mary Parker PAST PRESIDENT Cecil Davis TREASURER Dennis Williams BOARD MEMBERS Michelle Ames Ashley Branham Jennifer Burch Valerie Clinard Stephen Dedrick Jennifer Gommer Kira Brice Harris LeAnne Kennedy Beth Mills North Carolina Pharmacist (ISSN 0528-1725) is the official journal of the North Carolina Association of Pharmacists. An electronic version is published quarterly at 109 Church St., Chapel Hill, NC 27516.

The journal is provided to NCAP members through allocation of annual dues. Subscription rate to nonmembers is $40.00. annually. Opinions expressed in North Carolina Pharmacist are not necessarily official positions or policies of the Association. Publication of an advertisement does not represent an endorsement.

Nothing in this publication may be reproduced in any manner, either whole or in part, without specific written permission of the publisher.

Volume 92, Number 3

Summer 2012

Inside • From the Executive Director .......................................... 4 • From the President ........................................................ 5 • 2012 NCAP Annual Convention:

Preview of Programming and Events ....................... 6

• 2012 Legislative Summary ............................................. 8 • Carolina Pharmacy Leaders Join Forces ..................... 11 • Bowl of Hygeia Award

Winners Give Back to the Program .......................... 12

• New Practitioner Network:

Transitioning to a New Practitioner .......................... 14

• NPN Spotlight: David Line ........................................... 14 • Food or Medicine?

NC MedAssist Solves Dilemma ................................16

• New Anticoagulants for the Prevention

of Stroke in Nonvalvular Atrial Fibrillation ................ 18

• Community Care Practice Forum Meeting Highlights... 21 • Member Spotlight: Gene Rhea .................................... 24 • Pharmacy Time Capsules ............................................ 24 North Carolina Pharmacist, Summer 2012 3

From the Executive Director

NCAP’s Annual Convention “Making Your Voice Heard.” I’ve been thinking about that a lot lately with the close of my first legislative session as your Executive Director. The profession has come a long way over the last twenty years, but as the process unfolded this year, we still have a long way to go.

As you know, despite our best efforts, S246 was not heard in the short session. This means that we need to start over to increase expansion of access to immunizations for North Carolinians. What did we learn from the process? I learned that we need to be much more vocal about our profession and about our worth. It’s a matter of education, both of the public and of the medical community.

Now we’re not alone in North Carolina with this issue.

Every state in the country and every national organization is facing the same issues: How do we step into the limelight and tout our value as integral members of the health care team?

So, I’m very glad that our NCAP Annual Convention is focusing on “making your voice heard!” We have a tremendous show planned for all y’all (yes, that’s plural. See! You can teach a Yankee!) This show is meant to not only educate but to inspire us to stand proud in our profession.

We open the program with a special extra offering on Sunday, October 28th. We have been lucky enough to partner with both APhA and Merck to offer the complete 20-hour continuing education certificate program on community-based immunization for only $99! Once again we are renewing our commitment to you, our members, to provide quality education at a reasonable cost.

Speaking of education, did you know that we are offering five educational tracks on the 29th and another three educational tracks on the 30th? I’m certain that there is truly something for

everybody at this year’s convention. Whether you are an Acute Care, Community Care, or Chronic Care pharmacist, pharmacy technician, student pharmacist, or pharmacy manager, we have something for you.

The theme of this show, however, is “Making Your Voice Heard.” We have constructed our plenary sessions to inspire you to do just that. Kicking off our first plenary session is Commander Michael Lee of the US Public Health Service.

Commander Lee was one of the main authors of the landmark paper to Surgeon General Benjamin that touted pharmacists as health care providers. We are finally on our way to the next level and Commander Lee is helping us get there! You do NOT want to miss this!

OK, so now you’re fired up! You need to figure out how to channel this newfound professional energy into a positive change in your life. Well, let me introduce Dan Thurmon. He will show us all how to be successful in an off balance world.

His entertaining and motivational talk is complete with acrobatics, juggling, and more! Talk about a memorable experience!

That is just Monday morning plenary. This convention has much more to offer! I’m glad to be a part of it, and glad to see so many of my new colleagues and friends be honored by their peers. I hope that you feel as I do and come on out to the Raleigh Convention Center for this amazing show. I know that it is going to be the best ever!

Can’t wait to see you all there!

Christopher R. Gauthier, RPh

“Making Your Voice Heard” 4 North Carolina Pharmacist, Summer 2012

North Carolina Association of Pharmacists 109 Church Street Chapel Hill, NC 27516 phone: 919.967.2237 • fax: 919.968.9430

Dear NCAP Members: In my first two messages, I encouraged you to give back to your profession and to become a mentor.

Now comes the part where I get to tell you to be selfish! Not only should you give of your time and talents to your profession, but you should also allow your profession (and your professional association) to give back to you!

With the NCAP Annual Convention coming up, now is the perfect time to allow your professional association, NCAP, to give back to you. The theme of the meeting is “Making Your Voice Heard” and this convention will give you the chance to do just that.

The Annual Convention is the perfect opportunity to network, connect, (and reconnect) with pharmacists from all over the state. You can make your voice heard by sharing practice-enhancing ideas with one another and brainstorming great ideas for the future.

It’s also a great way to get caught up on the latest clinical, legislative, and administrative hot topics – both locally and nationally. Plus, there will be programming specifically designed for students, new practitioners, administrators, preceptors, technicians, and members of each of the Practice Forums. There will even be an Immunization Certificate Program offered on the Sunday of the convention for only $99! Surely, the knowledge you gain in these sessions will allow you to return home with an increased ability to make your voice heard as a member of a healthcare team or during other professional activities at a local level.

If you are recruiting for a residency program, make sure your residency is featured in the showcase. Or if you have a product or service to market, sign up to be an exhibitor. If you trained in North Carolina or work or precept for one of the schools of pharmacy, come cheer on your school’s team in OTC Jeopardy or attend a school reception to catch up with other alumni and affiliates.

In addition to the practice-relevant education available at the meeting – both clinical and non-clinical, NCAP will be hosting Commander Michael Lee of the US Public Health Service and Dan Thurmon as plenary session speakers. Commander Lee will inspire us to keep fighting for pharmacists’ recognition as health care providers, and Mr. Thurmon will teach us to “embrace uncertainty and initiate positive changes.” With the knowledge and wisdom these two gentlemen provide, I know you’ll be motivated and poised to make your own voice heard when working to advance our profession in your own communities!

All of these activities and opportunities are just some of the ways that NCAP continues to give back to us, the NCAP membership. Being able to attend cutting-edge continuing education and stay up-to-date on the latest issues in pharmacy without leaving the state and emptying my wallet is a luxury that I truly enjoy. So, I encourage you to be selfish! Take advantage of the quality (and wallet-friendly) education and networking opportunities that NCAP provides during the Annual Convention. You’ll come away more knowledgeable and more inspired when returning to your own pharmacy practice.

I’m sure I’ll be seeing all of you at the Annual Convention, but, as always, if there is anything I can do to help NCAP meet your professional needs, you are welcome to contact me personally anytime.

Sincerely,

Jennifer Buxton, BS, PharmD, CPP President

jbuxtonunc@gmail.com

Advancing Pharmacy. Improving Health.

North Carolina Pharmacist, SSummer 2012 5

Join us for the 2012 NCAP Annual Convention “Making Your Voice Heard”

Oct. 28-30, Raleigh Convention Center, Raleigh, NC There’s programming for everyone! Meeting topics include: • APhA Immunization Certificate Program • CMS Core Measures • The Future of Community Pharmacy Interview Skills for Students • Evolving Pharmacy Practices • Patient Adherence • Antimicrobial Stewardship • Midyear Prep for Students • Pharmacy Technician Law Review • Exploring the Role of the Pharmacist as a Provider • Sedation Education • Demonstrating Advances in the Intensive Care and Perioperative Settings • Medical Marijuana • Meeting Medication Reconciliation Standards • Platelet Testing • Development of Clinical Services • OTC Jeopardy • Update from NC State Treasurer Janet Cowell • Collaborative Sessions with Three Schools of Pharmacy • Pharmacy Technician Calculations Review • How to Give Effective Formative Feedback • Legislative Update • PPMI And a Law Review and Town Hall, Award Presentations, Residency Showcase, Installation of NCAP Officers, Exhibits and Pharmacy School Receptions

Plus, not one, but two incredible keynote speakers: Michael Lee and Dan Thurmon

Keynote: Commander Michael E. Lee Commander Lee of the US Public Health Service is Director of Pharmacoeconomic and Theraeutics Research, and Vice-Chair of the Indian Health Service National Pharmacy & Therapeutics Committee. CDR Lee co-authored the paper “Improving Patient and Health System Outcomes through Advanced Pharmacy Practice” which advocates to the Surgeon General that pharmacists be recognized and compensated as healthcare providers. CDR Lee joined the Indian Health Services Headquarters in 2009 and oversees activities involved with developing and maintaining a national formulary, as well as providing educational guidance to IHS providers.

6 North Carolina Pharmacist, Summer 2012

Keynote: Dan Thurmon “Success in Action and Off Balance on Purpose”

Dan Thurmon is the author of two books, a renowned speaker, and a recognized expert in delivering peak performances – on stage and in the workplace. As president of Motivation Works, Inc., he has worked with hundreds of clients and delivered thousands of presentations worldwide.

Dan helps organizations and individuals implement actions plans and move confidently through transitions.

He began his performance career at eleven years old, crafting a one-man-show incorporating comedy, juggling and acrobatics. This enabled him to, at a very early age, develop a strong work ethic and learn fundamental lessons about performance excellence. Dan graduated from the University of Georgia with a degree in Marketing and Management. He has also extensively studied Personal Development and developed a unique methodology he teaches to audiences and clients.

A recent inductee to the prestigious “Speakers Hall of Fame,” Dan Thurmon delivers experiences that go beyond motivation, teaching concepts and skills in a highly engaging and entertaining manner. He incorporates his lifelong performance skills to create high impact events. His programs have educated and uplifted Fortune 500 companies, young audiences, and even the troops on the front lines of Afghanistan and Iraq.

Dan’s philosophy can be summarized by the title of his book, Off Balance On Purpose. He believes that we will never achieve “perfect balance” and should, instead, learn to embrace uncertainty and initiate positive changes that lead to growth. Also, we should go beyond the pursuit of “success” and enhance our life experiences and professional endeavors with purposeful, positive contributions.

Register now! Early Bird Rates end October 14 www.ncpharmacists.org

Hotel Information: Sheraton Raleigh Hotel 421 S. Salisbury Street, Raleigh, NC 27601 • 919-834-9900 Group Code: NC Association of Pharmacists Rate: $135 • Cut-off: October 5, 2012 North Carolina Pharmacist, SSummer 2012 7

2012 Legislative Summary from NCAP’s Lobbyist The 2012 Session of the North Carolina General Assembly adjourned July 3. In less than two months, lawmakers introduced and considered 459 bills, not including those bills carried over from the 2011 session.

Budget Negotiations Teetered On Volatile Issues, Including Health Care During the “Long Session” that occurred in 2011, lawmakers passed a biennial (two year) budget. Technically, state government can continue to operate even if no budget action is taken during the 2012 “Short Session.” That fact is a point that members of the Republican leadership knew and used in negotiations with Democrat Governor Bev Perdue, whose term in office expires upon the inauguration of the candidate elected in November of 2012. Frequently during the session, House and Senate leaders threatened to adjourn the session without approving any adjustments to the 2011 budget. As expected, Gov. Perdue vetoed the budget she received. While her arguments against approving the budget focused upon insufficient funding for education, advocates for pharmacy and other health care providers were concerned about the Health and Human Services budget Medicaid lines, which were running short of expectations. Medicaid was running so short that two stop-gap bills were passed, H 14 and S 797, within the short session timeline to ensure payment of Medicaid bills.

In the end, lawmakers overrode Governor Perdue’s veto.

Medicaid continues, but many questions about its future will hold until the 2013 Session. Among those questions is how North Carolina will respond to changes mandated by the Affordable Care Act, including mandates for preventative care, which was deemed consistent with the US Constitution by the US Supreme Court this summer.

The Mysterious Near Future Eleven Senators and 38 House members announced their retirement prior to the 2012 General Election. Following the 2012 elections, at least 28 of 50 Senators and 67 of 120 House members will have served for one term or less. That means that more than half (56 percent) of both chambers will be comprised of members who have served for two years or fewer in the General Assembly. A report by the NC Free Enterprise Foundation states that the General Assembly will lose almost 500 years of legislative experience due to retirements.

Similarly, the next occupant of the Governor’s Mansion will either be someone with no legislative experience or someone with a lot of legislative experience. Of the two major party candidates, one is a relative newcomer – Republican Pat McCrory, the former Mayor of Charlotte. The other is Democrat Walter Dalton, the current Lieutenant Governor and a 12-year veteran of the North Carolina General Assembly.

All of these changes in the Legislative and Executive Branches of North Carolina government have bearing upon the political environment within and, most importantly, upon the health care policies generated by the House and Senate Chambers in the North Carolina General Assembly of 2013.

8 North Carolina Pharmacist, Summer 2012

Positioning NCAP Well for Inevitable Change The best advocacy happens one-on-one with elected officials.

Campaign season is a key time – lawmakers seek out opportunities to meet with health care providers in communities across North Carolina – and lots of registered voters. NCAP members can take part in the most effective advocacy efforts during the interim between legislative sessions, right now! Support NCAP’s efforts on your behalf by hosting visits for your elected officials at your pharmacies. Reach out to your elected officials/candidates for office by offering fall flu shots. NCAP can help to arrange such visits. Not only will the elected officials appreciate the visits, your customers will too!

For more information about participating in advocacy efforts, please contact Evelyn Hawthorne, NCAP’s Government Relations Consultant (evelynhawthorn@nc.rr.com).

Thank you for all that you do to support NCAP. Evelyn Hawthorne, Government Relations Consultant

Budget Bills of Interest HB950, MODIFY 2011 APPROPRIATIONS ACT An Act to Modify the Current Operations and Capital Improvements Appropriations Act of 2011 and for Other Purposes.

07/02/2012 – H Veto Overridden.

07/02/2012 – R Chaptered Session Law 2012-142. http://ncleg.net/gascripts/BillLookUp/BillLookUp.pl?Session=20 11&BillID=h950&submitButton=Go ____________________________________________________ SB187, MODIFICATIONS/2012 APPROPRIATIONS ACT An Act to Make Technical, Clarifying, and Other Modifications to the Current Operations and Capital Improvements Appropriations Acts.

07/10/2012 – R Chaptered Session Law 2012-145. http://ncleg.net/gascripts/BillLookUp/BillLookUp.pl?Session=20 11&BillID=s187&submitButton=Go Discussion House and Senate Conferees on H 950, Modify 2011 Appropriations Act, issued a conference report June 20. Lawmakers accepted the work of the conferees almost immediately-- June 21-and by margins that would override a gubernatorial veto. Gov. Perdue vetoed the budget bill June 30 and the General Assembly overrode her action July 2.

In Medicaid pharmacy appropriations, budget conferees agreed to the House’s position recommending greater savings through the implementation of 340B Pricing and recommended a $6.7million reduction. Conferees also accepted House recommendations to continue funding for ChecKMeds and for the Medication Assistance Program. The House recommended continuing those Health and Wellness Trust legacy programs with non-recurring funding

that added up to about $3.4 million. Funding for ChecKMeds and the Medication Assistance program were promoted by Rep. Tom Murry (R-Wake,) the only pharmacist serving in the North Carolina General Assembly. NCAP appreciates Rep. Murry’s recognition of the benefits of the program and his efforts to continue their support.

The budget also provides funds to the State Health Plan to cover the cost of the pharmacy benefit management contract to administer a Medicare Part D Employer Group Waiver Plan to reduce the Plan’s cost of drug coverage.

Both bills referenced above address a directive to the State Auditor to conduct a full audit of North Carolina’s Medicaid program, including the administration of the program, staffing, data collection, analysis and distribution, and the processes by which the Division of Medicaid Services applies for State Plan Amendments to the Centers for Medicare and Medicaid Services (CMS). ____________________________________________________

Bills of Interest that Became Law in 2012 HB614, ENACT VOLUNTEER HEALTH CARE SERVICES ACT An Act Allowing Registered Sponsoring Organizations to Arrange for the Voluntary Provision of Health Care Services in this State, Relieving Providers of Voluntary Health Care Services from Additional Licensure Requirements, and Providing Limited Protection from Civil Liability to Persons Providing Voluntary Health Care Services in Association with Sponsoring Organizations.

07/12/2012 – R Chaptered Session Law 2012-155. http://ncleg.net/gascripts/BillLookUp/BillLookUp.pl?Session=20 11&BillID=h614&submitButton=Go ____________________________________________________ HB799, LICENSURE BY ENDORSEMENT/MILITARY/ SPOUSES An Act to Allow Licensure by Endorsement for Military Personnel and Military Spouses.

07/24/2012 – R Chaptered Session Law 2012-196. http://ncleg.net/gascripts/BillLookUp/BillLookUp. pl?Session=2011&BillID=H799 ____________________________________________________ HB941, PSEUDOEPHEDRINE AMOUNT CLARIFICATIONS Summary: An Act to Clarify the Appropriate Measurement of Pseudoephedrine Products for Purposes of the Pseudoephedrine Transaction Limits, and to Clarify the Identification and Electronic Record-Keeping Requirements for Pseudoephedrine Products, as Recommended by the House Select Committee on Methamphetamine Abuse.

06/20/2012 – R Chaptered Session Law 2012-35. http://ncleg.net/gascripts/BillLookUp/BillLookUp.pl?Session=20 11&BillID=h941&submitButton=Go Discussion H 941 continued the efforts to curtail the production and distribution of methamphetamine by impeding access to a key ingredient. The bill limits persons to purchasing no more than 9 grams of pseudoephedrine in 30 days, requires the purchaser to present a valid government-issued identification bearing a photo and

provide a current address. It also addresses the record-keeping requirements for pseudoephedrine purchases by making them less burdensome. ____________________________________________________ HB1085, STATE HEALTH PLAN/STATUTORY CHANGES. -AB An Act To, for the State Health Plan for Teachers and State Employees, Which Covers Retirees Within the Retirement System, (1) Amend the Definition of “Dependent Child” in Order to Comply with the Affordable Care Act, (2) Limit Enrollment Without a Qualifying Event to the Annual Enrollment Period, (3) Repeal the Optional Program of Long-Term Care Benefits, and (4) Make a Clarifying Change Related to Coinsurance.

07/12/2012 – R Chaptered Session Law 2012-173. http://ncleg.net/gascripts/BillLookUp/BillLookUp.pl?Session=20 11&BillID=h1085&submitButton=Go ____________________________________________________ SB810, REGULATORY REFORM ACT OF 2012 An Act to (1) Reestablish the Joint Legislative Administrative Procedure Oversight Committee; (1A) Modify Appointments to the Mining and Energy Commission; (2A) Make Various Technical and Clarifying Changes to the Administrative Procedures Act; (2B) Make Conforming Changes to the State Personnel Act; (3) Extend the Effective Date for Changes to Final Decision-Making Authority in Certain Contested Cases; (4) Limit the Period During Which Records of Unclaimed Property Must be Maintained; (5A) Direct Agencies to Submit a Report on Notice Given Before Auditing or Examining a Business to the Joint Legislative Administrative Procedure Oversight Committee; (5B) Limit State Agency Identity Theft Reporting Requirements; (5C) Require the Department of Labor to Provide Notice Prior to Inspections; (6) Clarify that the Discharge of Waste into Waters of the State Does not Include the Release of Air Contaminants into the Outdoor Atmosphere; (7) Authorize Rather Than Require the Commission for Public Health to Adopt Rules for the Testing of Water from New Drinking Water Wells for Certain Volatile Organic Compounds; (7A) Clarify Application of Certain Nutrient Rules to Small Wastewater Discharges; (8) Direct the Department of Environment and Natural Resources to Track and Report on Permit Processing Times; (9) Delay the Effective Date for Compliance with Wading Pool Fencing Requirements from July 1, 2012, to January 1, 2013; (10) Direct the Commission for Public Health to Amend the Rules Governing the Duration of Permits for Sanitary Landfills and the Period in Which Those Permits are Reviewed; (11) Amend the Criteria for Designation as a Port Enhancement Zone; (12) Exempt Certified Roadside Farm Markets from Certain Building Code Requirements; and (13) Allow the Permitting of Mobile Food Units that Meet the Sanitation Requirements of a Commissary.

07/16/2012 – R Chaptered Session Law 2012-187. http://ncleg.net/gascripts/BillLookUp/BillLookUp.pl?Session=20 11&BillID=s810&submitButton=Go ____________________________________________________ SB847, GSC TECHNICAL CORRECTIONS/OTHER CHANGES An Act to Make Technical Corrections to the General Statutes, Including Specifically Authorizing the Revisor of Statutes to Print North Carolina Pharmacist, Summer 2012 9

Drafters’ Comments to Three Acts Enacted in 2011 in Which this Authorization Was Inadvertently Omitted, as Recommended by the General Statutes Commission, and to Make Other Amendments.

07/17/2012 – R Chaptered Session Law 2012-194. http://ncleg.net/gascripts/BillLookUp/BillLookUp.pl?Session=20 11&BillID=s847&submitButton=Go ____________________________________________________

Bills Not Enacted, but that Could Be Reintroduced in 2013 SB246, EXPAND PHARMACISTS’ IMMUNIZING AUTHORITY An Act to Protect the Public’s Health by Increasing Access to Immunizations and Vaccines Through the Expanded Role of Immunizing Pharmacists.

06/09/2011 – H Referred To House Committee On Health and Human Services and Human Services. http://ncleg.net/gascripts/BillLookUp/BillLookUp.pl?Session=20 11&BillID=s246&submitButton=Go Discussion NCAP worked diligently throughout the short session and the interim with Sen. Fletcher Hartsell (R-Cabarrus) and Rep. Tom Murry (R-Wake) to enable passage of S 246, Expand Pharmacists’ Immunizing Authority. Despite a myriad of compromises to the bill, which included limiting the expanded access to adults only, the Medical Community, particularly the Academy of Family Physicians, refused to work with Pharmacy to improve access to vaccines that protect the public’s health. The bill was never allowed to be heard by the House Health Committee, where it resided for the duration of the short session.

NCAP has learned that legislators are interested in revisiting the issue of expansion of immunizing authority and to do so in a way that carries recommendations from the affected licensure boards – Pharmacy, Nursing and Medicine. NCAP welcomes that opportunity when it comes to fruition and invites NCAP members to join in the effort.

At the same time, NCAP recognizes that an immunization expansion bill supported by licensure boards does not ensure support from the corresponding constituencies. At present, NCAP has no reason to think that the medical community would support an expansion of immunizing authority even if the Medical Board endorsed a proposal. But such a scenario would make Medicine’s opposition appear even more extreme, especially when one considers that North Carolina’s law is appearing more and more restrictive, as other states continue to approve expanded immunizing authority. Some of the states that approved expansion did so with the support of physicians.

NCAP hopes that others in pharmacy – especially in the community and retail settings – will embrace the effort to approve expansion of immunizing authority for pharmacists to improve public. Such support will be critical to success of such legislation in 2013. ____________________________________________________ SB517, FREEDOM TO NEGOTIATE HEALTH CARE RATES An Act to Allow Health Providers and Health Insurers to Freely 10 North Carolina Pharmacist, Summer 2012

Negotiate Reimbursement Rates by Prohibiting Contract Provisions that Restrict Rate Negotiations.

06/26/2012 – H Re-assigned To Judiciary Subcommittee B. http://ncleg.net/gascripts/BillLookUp/BillLookUp.pl?Session=20 11&BillID=s517&submitButton=Go Discussion S517 would have prohibited the use of a “most favored nation” clause by insurers, meaning that an insurance company could not demand that it receives the best rate from a health care provider.

Rates would be the result of a contract negotiation. Legislative discussion of this issue circulated around Blue Cross/Blue Shield of North Carolina’s use of such provisions in its contracts, which company spokespersons say that they do not use. This issue could reappear in 2013. ____________________________________________________ SB696, ADDRESS PRIMARY CARE SHORTAGE An Act to Direct the General Administration of the University of North Carolina to Study Ways to Increase Primary Care Residencies in Underserved Areas of North Carolina.

05/24/2012 – H Re-referred To House Committee On Health and Human Services and Human Services. http://ncleg.net/gascripts/BillLookUp/BillLookUp.pl?Session=20 11&BillID=s696&submitButton=Go ____________________________________________________ SB851, BOARDS & COMMISSIONS EFFICIENCY ACT OF 2012 An Act to Improve the Efficiency of State Government by Abolishing Certain State Boards, Commissions, and Committees, Reorganizing the Membership of Some State Boards, Commissions, and Committees, and Making Conforming Changes, as Recommended by the Joint Regulatory Reform Committee.

06/06/2012 – S Re-referred To Senate Committee On Finance. http://ncleg.net/gascripts/BillLookUp/BillLookUp.pl?Session=20 11&BillID=s851&submitButton=Go v

Carolina Pharmacy Leaders Join Forces Eugene O’Donnell, Chief Executive Officer of the South Carolina Pharmacy Association, recently visited the NCAP offices at the Institute of Pharmacy in Chapel Hill to meet with Executive Director Chris Gauthier. The two pharmacy leaders spent the day brainstorming and exploring ways to provide the best possible services to member pharmacists in the Carolinas.

They discussed how to collaborate on meetings, special projects, and social gathering that would provide new educational and networking opportunties for members in both states. NCAP will announce the details of these events as soon as plans are finalized. Next year they will meet at the SCPhA office in Columbia, SC.

SCPhA Chief Executive Officer Eugene O’Donnell (left) and NCAP Executive Director Chris Gauthier.

North Carolina Pharmacist, Summer 2012 11

Bowl of Hygeia award winners give back to the program his numerous pharmacy-related contributions to his community, including his work in establishing permanent pharmacist positions in county mental health and alcohol treatment centers and assisting with creating a live phone-in television segment called The Bowl of Hygeia Award has been the symbol of out“Ask the Pharmacist” in Raleigh. He also works as a volunteer standing achievements in community service by pharmacy spokesperson and pharmacy advocate for community and civic professionals for more than 60 years. Among the recipients of groups and has provided service to a number of pharmacy comthis prestigious honor, Al and Ginger Lockamy of Raleigh, NC, mittees, commissions, and organizations. stand out for one unique reason: they are married and have each In light of the significance of the Bowl of Hygeia Award in won the award individually for their service. Both graduates of their own lives, Al and Ginger the University of North Carolina have chosen to give back to Eshelman School of Pharmacy, Al the program by investing in the and Ginger began their careers as Bowl of Hygeia Endowment. community pharmacists and have In late 2010, the APhA Foundapracticed pharmacy for 49 and 39 tion, together with APhA and years, respectively. the National Alliance of State Ginger, who received the Pharmacy Associations, took award in 1990, was recognized ownership of the award and set for her service in several comout to raise $600,000 to fully munity-oriented organizations endow the award program. Gifts including the Junior Woman’s from donors such as Al and Club of Raleigh, Friends of the Ginger are critical to the effort Children at Wake Medical Center, to fund the award in perpetuity, Women’s Auxiliary of the North which allows pharmacists like Carolina Pharmaceutical Asthe Lockamys to be recognized sociation, and her local church. for their extraordinary contribuThe Bowl of Hygeia program is tions both to pharmacy and to important to her, she explained, their community. because it really is the icing on Regarding their decision to the cake of her career. “Just being Photo by Robb D. Cohen give to the endowment, Ginger able to serve others and knowing explained, “The Bowl of Hygeia that what you do makes a differ- Bowl of Hygeia Award recipients Al and Ginger Lockamy serves to inspire pharmacists to ence in their lives is [a] reward extend themselves into the community to assist others. I want to in [and of] itself. To be recognized by your peers with this award see it continue to give inspiration to pharmacists to get involved.” is a very special and humbling honor because there are so many Al agreed: “We have chosen to contribute to the Bowl of Hygeia pharmacists who do so much to make life better for those in Endowment because of the significant value of this award to our need,” said Ginger. profession. We want to encourage all previous and future recipiHer husband Al, a 2010 award recipient, points to the longstanding esteem of the award as one of the reasons why he values ents to participate in APhA’s efforts to continue this time honored recognition.” it so highly. “The Bowl of Hygeia is the most widely recognized The APhA Foundation applauds Al and Ginger for their international symbol of pharmacy and the most prestigious award shared accomplishment and is grateful for their ongoing support given to a pharmacist. The recipient is forever recognized, both of the Bowl of Hygeia program. To help sustain this unique recstate and nationally, for outstanding community service and as ognition for pharmacists, visit http://bit.ly/BowlofHygeia. v a visionary in our profession,” Al said. He was recognized for Copyright American Pharmacists Association (APhA).

Reprinted by permission of APhA.

e-Prescribing PEER Portal is Open for Business!

The Pharmacy and Provider e-Prescribing Experience Reporting Portal and instructions on how to report can be found at: https://www.pqc.net/eprescribe

Help us save lives… Report eRx problems TODAY! 12 North Carolina Pharmacist, Summer 2012

North Carolina Pharmacist, Summer 2012 13

New Practitioner Network

Transitioning to a New Practitioner

By John Brock Harris, PharmD, BCPS, and Randi B. Raynor, PharmD

The transition from pharmacy student to practitioner after graduating from pharmacy school brings a flood of emotions and feelings: excitement, relief, trepidation, and fear. Excitement is felt because of all the new upcoming experiences in the profession. After completing all the hard work, a feeling of relief is experienced.

Trepidation and fear comes with the unknown in the future. The decisions in the pharmacy that rested on the shoulders of preceptors now fall on new practitioners.

“Will I make the right choice, is this the acceptable thing to do” and “did I make the correct decision” are common questions new pharmacists ask themselves.

The key to transitioning from pharmacy student to new practitioner is overcoming the hesitation and anxiety associated with becoming the primary decision maker in the pharmacy.

As primary decision maker, developing a routine when performing tasks lessens trepidation and anxiety. A comfort comes with repetition and routine. When transitioning, stay true to the routine established during pharmacy school rotations and simply expand that routine to

the new responsibilities of a practitioner.

Patient, medication, and pharmacotherapy evaluation processes developed and honed during learning experiences as a student transition into practice as a new pharmacy professional. Continue to utilize the evaluation skills learned throughout pharmacy education in everyday practice to maintain routine.

Often a new practitioner has doubts about his or her pharmacotherapeutic knowledge base when beginning a career. Pharmacy education is structured to teach students the skills and knowledge needed to practice as a pharmacist. Students are also educated on the thought processes needed to determine appropriate pharmacotherapeutic regimens and treatments if unknown. An exact answer or decision may not be drawn from the pharmacist’s knowledge base, but the exposure to drug information skills provided during pharmacy school allow practitioners to find and gather information that can be evaluated.

Pharmacy education prepares students to collect information, evaluate data, and develop a reasoned conclusion.

Learning experiences do not stop at graduation. Pharmacy is a profession that demands its practitioners to continue to

learn, because the profession itself is constantly changing. Daily experiences shape practice for all pharmacy professionals, especially new practitioners. Continue to grow professionally from daily experiences and participation in continuing education. Continuing education is not only required for state licensure, but is an excellent opportunity to learn and grow professionally. Participation in selected educational opportunities in areas of knowledge base deficits decreases practitioner apprehension with future experiences in the pharmacy.

When transitioning from pharmacy student to practitioner, stabilizing emotions is vital. Trepidation and anxiety are common with new practitioners and may slow professional growth. By developing a routine, relying on all aspects of pharmacy education, and continuing to learn by experience and with educational opportunities, apprehension declines and pharmacy students transition to confident practitioners. Graduation from pharmacy school does not make a practitioner; graduating simply means the tools to become a great practitioner have been provided. The tools along with emotional and professional experiences shape new practitioners. v

New Practitioner Spotlight: David S. Line, PharmD David Line was born and raised in the great state of Kentucky. After two years of attempting to “find himself” after graduating from Centre College in Danville, KY, he decided to join the inaugural pharmacy class at Wingate University School of Pharmacy. Upon graduation in 2007, he was accepted in an Advanced Community Pharmacy residency program at Kerr Drug in Lenoir, NC. This wonderful experience reinforced his commitment to advancing the profession of pharmacy, especially in the community setting. He then began working full time for Kerr Drug as a Clinical Coordinator in Concord, NC. Kerr Drug has been a leader in community pharmacy, so he could not have chosen a better company to work with to accomplish this mission.

David has since been promoted to the newly created position of Patient Care Services Coordinator with Kerr Drug for their Western NC stores. This position has allowed Kerr Drug to train and develop their entire staff of community pharmacists to embrace and implement Kerr Drug’s spirit of innovation in community pharmacy.

“The process has been challenging, but rewarding. Community pharmacy is at a crossroads where dispensing medications accurately is no longer enough, and services such as MTM enables community pharmacists to make a positive and profound difference in patients’ lives and on the health care system,” he said.

He has been a member of NCAP since his days as a pharmacy student and has seen, first hand, the impact that the organization can have. Several years ago at Pharmacy Day in the Legislature in Raleigh, he along with the help of Mark Gregory and Ralph Petri of Kerr Drug, sponsored student participation in the event. This coincided with a committee meeting focused on requiring state workers to use mail order exclusively for their chronic medications. Through that lobbying effort and several others, the bill was withdrawn from consideration, thus, a temporary victory for community pharmacy. As David recalls, “That moment for me helped to define the impact that NCAP can have to help shape and advance the profession of pharmacy in North Carolina.”

14 North Carolina Pharmacist, Summer 2012

Food or Medicine? NC MedAssist Solves the Dilemma Buy food or my medicine? That’s the choice that far too many uninsured North Carolinians face every day.

There are more than 1.1 million lowincome, uninsured people in our state and more than three-quarters of them are in working families, according to the North Carolina Institute of Medicine. National numbers show that almost half of the uninsured have at least one chronic illness, and that’s where NC MedAssist comes in.

NC MedAssist is a statewide non-profit pharmacy that provides free prescription medicines to low-income, uninsured North Carolinians. We are able to reach those in need by partnering with free clinics, health departments and hospitals across the state.

And we can serve clients directly by providing mail order service to their homes.

Our goal is to supply essential medicines to every one of our neighbors in need and to improve the health of North Carolinians one prescription at a time.

That’s where you come in. When you are presented with a patient who has no form of prescription coverage and meets our eligibility requirements, you can refer them to NC MedAssist.

In order to qualify for our program, clients must be uninsured and earn less than 200% of the Federal Poverty Level – that’s $22,340 a year for an individual and $46,100 for a family of four.

Since expanding statewide in 2009, NC MedAssist has filled more than 211,188 prescriptions valued at nearly $20.1 million for more than 11,000 North Carolinians.

Mike T. of Rowan County said “I sat

16 North Carolina Pharmacist, Summer 2012

Pharmacy Manager Karen Garner, RPh counsels a patient at NC MedAssist.

down and cried when I found out I could get medicines from NC MedAssist. It was such a weight off my shoulders that I wasn’t going to have to choose any more between heat or food or medicine. Now I can sleep at night. I feel so much better physically and mentally.”

By operating a free pharmacy, MedAssist is not only improving the health of low-income, uninsured clients, but is also increasing their ability to be economically self-sufficient. On average, clients are picking up $500 worth of medication from MedAssist every month, which represents a third of their monthly income. MedAssist allows clients to live a more productive and self-sufficient life. To learn more

about the eligibility process or if you have a client who needs our help, please call Jennifer Teague at 866-331-1348 or visit the website at www.medassist.org.

As a charitable pharmacy, MedAssist operates through the generosity of caring individuals. How much does it cost to save a life? It costs MedAssist only $144 dollars a year on average to serve one client.

If you would like to partner with us in saving lives, please join us in our new 12 for 12 campaign. By donating $12 for 12 months in 2012 to NC MedAssist, or $144 a year, you can save the life of one friend or neighbor. Please visit the website for more information on the 12 for 12 campaign. v

North Carolina Pharmacist, Summer 2012 17

New Anticoagulants for the Prevention of Stroke in Nonvalvular Atrial Fibrillation

By Maria Tzefos, PharmD, CDE, BCPS, Alex Jenkins, PharmD, MS, and Jason Moss, PharmD, CGP

In the last year, the FDA approved dabigatran (Pradaxa速) and rivaroxaban (Xarelto速) for the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (AF). In the RE-LY and ROCKET-AF trials, both dabigatran and rivaroxaban were found to be non-inferior to warfarin for the prevention of stroke and systemic emboli.1,2 Additionally, dabigatran 150 mg twice daily was found to be superior to warfarin in the RE-LY trial.1 Advantages of the newer agents over warfarin include no routine coagulation monitoring, fewer drug interactions, no food interactions, and less patient coagulation variability. Conversely, several disadvantages exist with the new agents such as not knowing the anticoagulation status for a patient without routine coagulation monitoring; there is no antidote to stop excessive bleeding, and major gastrointestinal bleeding events. The FDA and the Institute for Safe Medication Practices are currently investigating adverse event reports of patient deaths and serious bleeding events associated with dabigatran.3,4 Elderly patients and patients with poor renal function are the highest risk patients for adverse events. The 2012 BEERS Criteria designates dabigatran as a potentially inappropriate medication to use in older adults.7 The 2012 CHEST guidelines recommend the use of an oral anticoagulant for a CHADS2 score > 1 for stroke prevention in patients with nonvalvular AF.8 The guidelines, however, do not specify which oral anticoagulant to use. When selecting anticoagulation strategies, consideration for individual patient factors and unique pharmacokinetic and pharmacodynamics drug properties will be important when weighing risks versus benefits. The followoing are some key points to consider:

Dabigatran (Pradaxa速) Class: Direct thrombin inhibitor

Rivaroxaban (Xarelto速) Class: Factor Xa inhibitor

Approved Indications

Stroke prevention in nonvalvular atrial fibrillation

Stroke prevention in nonvalvular atrial fibrillation

Venous thromboembolism (VTE) prevention post-hip or knee replacement surgery

Dosing

Nonvalvular atrial fibrillation: 20 mg once daily

150 mg twice daily

VTE prevention: 10 mg once daily

Renal adjustment

CrCl 15-30 mL/min Decrease dose to 75 mg twice daily Avoid use CrCl < 15 mL/min

Nonvalvular atrial fibrillation: CrCl 15-50 mL/min Decrease dose to 15 mg once daily with evening meal Avoid use CrCl < 15 mL/min

Administration

Stored/dispensed in original container Once medication is opened must be discarded after 4 months Instruct patients not to crush, chew, or open capsules

Administer doses > 15 mg with food for improved absorption Doses of 10 mg/day may be taken without regard to meals

Antidote

No

No

Switching from warfarin

Stop warfarin

Stop warfarin

Have you voted?

Log on to www.ncpharmacists.org and mark your ballot in the NCAP election.

Voting ends September 4.

18 North Carolina Pharmacist, Summer 2012

Start dabigatran when INR < 2.0

Start rivaroxaban when INR < 3.0

Monitoring Check renal function at baseline and yearly in patients Check renal function periodically

with CrCl < 50 mL/min or > 75 years of age

Evaluate for signs and symptoms of bleeding/blood loss

Evaluate for signs and symptoms of bleeding/blood loss

Consider PT and CBC in some patients with renal or

Consider aPPT, thrombin time, and CBC prior to initiation hepatic impairment, low body weight, or obese

and periodically as needed in some patients, such as those

with worsening renal impairment Missed dose

Take dose as soon as possible on the same day Missed doses should be skipped if it cannot be taken at least 6 hours before next scheduled dose

Other warnings Post-marketing reports of serious bleeding events

If dose is missed, take dose as soon as possible on the same day Black box warning: increased risk of thrombotic events when rivaroxaban is discontinued. If anticoagulation with rivaroxaban is to be discontinued for some reason other than bleeding, consider alternative anticoagulation method

References: 1. Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009;361:1139-51.

2. Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med2011;365:883-91.

3. FDA Drug Safety Communication: Safety review of post-market reports of serious bleeding events with the anticoagulant Pradaxa (dabigatran etexilate mesylate).

December 7, 2011. Available at http://www.fda.gov/Drugs/DrugSafety/ucm282724.htm.

4. ISMP Medication Safety Alert 2012;17(7):3 5. Pradaxa prescribing information. Ridgefield, CT: Boehringer Ingleheim Pharmaceuticals, Inc.;2011 Nov. 6. Xarelto prescribing information. Gurabo, PR: Janssen Pharmaceuticals, Inc.;2011 Nov. 7. The American Geriatrics Society 2012 Beers Criteria Update Expert Panel. J Am Geriatr Soc 2012;60(4):616-631.

8. You JJ, Singer DE, Howard PA, et al. Antithrombotic therapy for atrial fibrillation: Antithrombotic therapy and prevention of thrombosis, 9th ed. The American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. CHEST 2012;141:e531S-e575S.

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1-800-321-4344 www.displayoptions.com

North Carolina Pharmacist, Summer 2012 19

20 North Carolina Pharmacist, Summer 2012

NCAP Community Care Practice Forum Meeting NCAP’s Community Care Practice Forum meeting was held August 3-4, 2012 at the Sheraton Myrtle Beach Convention Center in conjunction with the NC Mutual Wholesale Drug Company meeting. Attendees enjoyed networking opportunities, quality CE programming and some fun in the sun!

The Community Care Pharmacist of the Year was awarded to Jessica Lee, PharmD, Manager of Patient Care Services at Kerr Drug, was named NCAP’s Community Care Pharmacist of the Year.

Jessica heads up a team of three other clinical pharmacists who are responsible for the development, training, and integration of clinical programs into all Kerr Drug retail pharmacy locations. The Patient Care Services team focuses on Medication Therapy Management, Immunization programs, Diabetes Education programs, as well as workflow integration and improvement strategies that have enabled the advancement of the retail clinical model at Kerr Drug.

“I am very honored to receive this award from such an important organization and group of people in our profession.

I feel that this honor further compels me to continue to explore avenues that will continue to advance the profession and opportunities within community pharmacy. My co-workers and students inspire

me everyday to continue to push for our growth as a dedicated and important part of quality patient care, education, and research within the profession of pharmacy,” she said.

Jessica Lee (left) receives the NCAP Community Care Pharmacist of the Year Award from Community Care Chair-Elect Tasha Michaels and Executive Director Chris Gauthier.

NCAP has partnered with the Connecticut Pharmacy Association to offer The Pharmacist Refresher Course, an online course designed for pharmacists who wish to return to community pharmacy practice Online after an absence from practice for three or more years. The course Offerings: consists of three modules, all of which have been approved for ACPE credits. The first two modules are online and composed of weekly Pharmacist study segments that allow course participants to work at their own Refresher pace, on their own time.

The third module consists of a three-week, 90-hour live experience Course in a community pharmacy. Only those who participate in all three & QA/Law modules will earn a Pharmacist Refresher Course Certificate from Charter Oak State College. Those taking modules One and/or Two for personal enrichment will earn ACPE credits through CPA. This course will give home study law credit to any pharmacist wanting to learn about quality assurance strategies and North Carolina’s pharmacy laws.The QA/Law Course can be used to prepare for reciprocity into North Carolina, or for those who want an update on Pharmacy Law and Quality Assurance.

Students must follow a two-week course schedule. Online discussion boards and instructor monitoring and interaction keep you on track throughout the course. The course is offered the first two full weeks of every month. This course is accredited by ACPE for 15 hours of home study law education.

For more information visit www.ncpharmacists.org North Carolina Pharmacist, Summer 2012 21

22 North Carolina Pharmacist, Summer 2012

Don’t miss out on two great travel deals!

Be sure to contact Holiday Cruises & Tours at (800) 805-7245 ext. 212 to book your stateroom in our group block. By booking into our block, you will get the best rate available and support the Association. We offset some of the costs of our materials and instructors by having staterooms booked into the group block. For a limited time, “Early Saver Rates” are available, so be sure to call today. If you choose to book elsewhere, there will be an additional $50 per person charge to offset expenses.

CE Details are TBA. For more information on this cruise, visit www.funseas.com/SCPHA/index.html

North Carolina Pharmacist, Summer 2012 23

Member Spotlight Q&A: Gene Rhea, PharmD, Duke University Hospital ,

Gene Rhea received his BA in Chemistry from DePauw University in 2002, and a PharmD from Purdue University in 2006. He currently works at Duke University Hospital as the Manager of Procurement, Distribution and Repackaging. Duke University Hospital is an academic medical center that is part of the Duke Health System, which includes two other hospitals in the Triangle and a multitude of clinics throughout the area.

Gene spends a significant amount of his time on inventory management, specifically in managing drug shortages. Like other hospitals across the country, Duke University Hospital has been acutely affected by the drug shortage crisis, and Gene spends more than 50% of his time just on shortage related issues. He coordinates their internal pharmacy drug shortage task force, which monitors inventory levels and identifies ways to maximize the scarce resources that are available. He also serves on the Critical Drug Shortage Force, which is convened when shortages reach a critical level and have direct patient impact. He is also tasked with managing their 340B program compliance and ensuring that they maximize the benefits of that program.

According to Gene, “Inventory management requires organizational and interpersonal relationship skills that are not taught in most pharmacy programs. I would encourage someone new in this area to work to understand the complex supply chain for pharmaceutical delivery, and to make strong relationships with

Pharmacy Time Capsules

By Dennis B. Worthen, Lloyd Scholar, Lloyd Library and Museum, Cincinnati, OH

1987 - Twenty-five years ago: • Major pharmacy issue of the year was the increase in physician office based dispensing.

• Acuvue launched by J&J was the first disposable soft contact lens.

1962 - Fifty Years Ago: • Trivalent oral polio vaccine (Sabin) was licensed in the US. • Rite-Aid (Pennsylvania), Meijer’s (Michigan), and Wal-Mart (Arkansas) were formed.

1937 - Seventy-five Years Ago: • Cook County Hospital in Chicago, Illinois was the site of the first blood bank, set up by Bernard Fantus.

1912 - One hundred Years Ago: • Phenobarbital (Luminal) first marketed by Bayer.

1887 - One hundred twenty-five years ago: • The National Institutes of Health established when a one-room laboratory was created within the Marine Hospital Service (predecessor agency to the U.S. Public Health Service (PHS).

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 24 North Carolina Pharmacist, Summer 2012

both manufacturers and wholesalers. Understanding the dynamics of the supply chain industry is key to making sound purchasing and inventory management decisions, as well as being able to react to disruptions in the marketplace.”

Gene has been an NCAP member since 2008, shortly after he moved to North Carolina. He was initially employed in the community pharmacy setting and is currently a member of the Community Care Practice Forum Executive Committee.

“I wanted to be a part of such a strong pharmacy organization. I grew up in Indiana and am a third generation pharmacist.

Both my father and grandfather served in many capacities, including President of the Indiana Pharmacists Alliance so I was exposed to professional organizational involvement at a young age,” he said.

“NCAP is an extremely influential body in this state and plays a key role in advocacy and leadership in our profession.

I have been able to meet and network with people that I would never have interacted with if I had not been involved with NCAP. I think NCAP is the voice of North Carolina Pharmacists. NCAP is one of the strongest state organizations in the country, and when our profession acts in a unified fashion we accomplish many things that would be impossible if we tried to accomplish them on our own,” he added.

Congratulations to Gene for taking on such a rampant problem as drug shortages and managing it effectively for the safety of North Carolina citizens!

calendar September 12, 2012: NCPhA Endowment Golf Classic, River Ridge Country Club, Raleigh, NC October 2, 2012: NCAP Board of Directors Meeting, NCAP/Institute of Pharmacy, Chapel Hill, NC. Join us in person or via live webinar. Contact NCAP for details.

October 28-30, 2012: NCAP Annual Convention, Raleigh Convention Center, Raleigh, NC November, 2012: NCAP Technician Review Seminars 11/3, Raleigh 11/4, Greensboro 11/10, Hickory 11/11, Charlotte December 4, 2012: NCAP Board of Directors Meeting, NCAP/Institute of Pharmacy, Chapel Hill, NC. Join us in person or via live webinar. Contact NCAP for details.

For more information visit www.ncpharmacists.org

NCAPâ&#x20AC;&#x2122;s Technician Review Seminar will help you prepare for the PTCB Exam. Check www.ncpharmacists.org for Seminar dates and locations.

North Carolina Pharmacist, Summer 2012 25

26 North Carolina Pharmacist, Summer 2012