PA Pharmacist May-June 2020

pennsylvania

PHARMACIST May/June 2020 • Volume 101 • Issue 3

COVID-19: Changing Our Lives and Pharmacy Practice

Also Inside:

Mid-Year 2020 Recap THE OFFICIAL PUBLICATION OF THE

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CONTENTS PPA BOARD OF DIRECTORS PPA OFFICERS President: Richard Demers, MS, RPh, FASHP President Elect: Chuck Kray, RPh Vice President: Thomas Franko, PharmD, BCACP Immediate Past President: Lauren Simko, PharmD REGIONAL DIRECTORS Central Region: Deron Shultz, RPh Northeast Region: Vick Shah, PharmD, BCPS Northwest Region: Brandon Antinopoulos, PharmD Southeast Region: Karleen Melody, PharmD Southwest Region: Brian Sidone, PharmD PRACTICE DIRECTORS Academia: Nicole Pezzino, PharmD, BCACP, CDE Chain Pharmacists: Renee Richardson, PharmD Community Independent: Shawn Nairn, RPh Community Independent: Christopher Antypas, PharmD Health System Pharmacists: Darryle Tillman Jr., RPh MCO/Industry/Government/Other: John Barrett, MBA, RPh Associates: Pat Lavella, RPh STUDENT DIRECTORS Student Director East: Dylan Fox Student Director West: Elizabeth Leonard

ON THE COVER: In what seemed like the blink of an eye – our world suddenly changed. Now mostly home bound, we are relying on technology to keep us connected. Zoom and other apps are serving as the new gathering for family and friends. Community pharmacies had to quickly adapt to a new world of patient access and demand. Those in our hospitals saw a huge influx of patients among shortages and long hours. Academia and students finished out a school year online. Ambulatory care increased remote access. Pharmacists across Pennsylvania and the country have gone to extraordinary efforts to help their patients and our country. We also must thank the pharmacy technicians, delivery drivers , and other staff for continued support and flexibility. We say a proud thanks to all you have done and continue to do!

DEPARTMENTS

JOURNAL 37 The Impact of Select Pharmacy Services on HIV Medication Adherence: An Exploratory Analysis

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President’s Message

PPA OFFICE STAFF CEO: Patricia A. Epple, CAE pepple@papharmacists.com | Ext. 3 Government Relations Manager: Angela Zaydon, JD azaydon@papharmacists.com | Ext. 6 Communications Manager: Victoria Madonna, CPhT vmadonna@papharmacists.com | Ext. 5 Conference and Membership Manager: Katie Hoster khoster@papharmacist.com | Ext. 1 Bookkeeper: Michele Dibble mdibble@papharmacists.com | Ext. 4 PPCN Executive Director of Network Operations: Stephanie McGrath, PharmD smcgrath@papharmacists.com

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Calendar of Events

8

Welcome! New Members

Pennsylvania Pharmacists Association (PPA) 508 North Third Street, Harrisburg, PA 17101 (717) 234-6151 Fax: (717) 236-1618 www.papharmacists.com | ppa@papharmacists.com

28 PPA Pharmacies and Coping with COVID-19

Pennsylvania Pharmacist (ISSN 0031-4633) is the official publication of the Pennsylvania Pharmaceutical Association d/b/a Pennsylvania Pharmacists Association and is published every other month, six times per year. Annual subscription is $100 for non-members; for members it is included in the annual dues. Editorial information should be addressed to the PPA address listed above. Peer reviewed articles accepted according to the stated guidelines available from PPA.

EDITORIAL BOARD Kim Coley, FCCP, PharmD, RPh, Chair Michael Gionfriddo, PharmD, PhD Elizabeth Harris, PharmD, BCACP Yardlee Kauffman, PharmD, MPH, BCACP Jinsun Paek, PharmD, BCPS Associate Editor: Victoria Madonna Editor/Manager: Pat Epple PUBLISHED BY GRAPHTECH Alexis Kierce, Publications Manager (717) 238-5751 x119 alexis@thinkgraphtech.com For Advertising Information: Jen Smith, Account Manager (717) 238-5751 x124 jen@thinkgraphtech.com DESIGNED BY GRAPHTECH PHARMACIST STATE BOARD OF PHARMACY MEMBERS Institutional: Vacant Independent Community: Rob Frankil, RPh Chain Community: Janet Hart, RPh Chain Community: Theresa M. Talbott, RPh Board of Pharmacy Meeting Dates: June 16, 2020 July 21, 2020 September 1, 2020 October 13, 2020

10 Member News 12 Affiliated Member News

RESEARCH

18 Campus Checkup

38 Professional Development for the Practicing Pharmacist: Five Tips for Analyzing Data

FEATURES

31 Pharmacy Spotlight 32 Student Member Profiles

OUR VISION

34 Legislative Profiles

Pennsylvania pharmacists will be recognized, engaged, and fairly compen­sated as healthcare providers.

ASSOCIATION NEWS

OUR MISSION

33 Member Profile

14 2020 Mid-Year Conference Highlights 20 PPCN Update 23 PPCN 2019 Annual Report 27 Congratulations to the 2020 PPA Graduating Students 30 PPA Foundation Grant — Final Report

INDUSTRY NEWS 36 Prohibition of the Sale of Dextromethorphan 36 How to Survive a DEA Inspection Series: Understanding the DEA CSOS System©

The Pennsylvania Pharmacists Association, as the leading voice of pharmacy, promotes the profession through advocacy, education, and communication to enhance patient care and public health.

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President’s Message Well here we are! Who would have ever thought that a single cell organism would bring this country/world to an abrupt halt? We now live in the “New Normal.” Tragically, many lives have been lost and many more have felt the devastating impact that this disease put upon their health and livelihood. Things will never be the same.

As healthcare providers, we are strong and stand firm and ready to act and support our patients in this time of need. We have now fit the definition of “essential.” We all know that we have this duty to serve patients. But we continue to show that this unprecedented opportunity has evolved our profession to another level of value and demonstrated the unique contributions of the pharmacy profession. Often, our patients and professional colleagues may take what we do without much notice, but in these times we are able to now create a new lens through which to be seen.

Wherever we were able to be there in this time of need, I would ask that you share your stories with PPA. For too long we have gone unnoticed as the hidden profession in healthcare. I think it is time to change this. Not to call undue attention to ourselves, but to highlight those who have impacted our future delivering patient care during these challenging times and who must be supported and appreciated for doing so.

I hope this writing will find us through this pandemic. Additionally, I hope we as an organization (PPA) can come together and take the learnings from it to build a stronger profession for those who need us, our patients. In closing, I’d ask all to become active with PPA. I hope all is well with you and your loved ones.

Richard Demers, RPh, MS, FASHP PPA President 2019–2020

“Often, our patients and professional colleagues may take what we do without much notice, but in these times we are able to now create a new lens through which to be seen. ” — Richard Demers

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Calendar of Events May 4–6

Advertisers Index QS/1

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17–18

IPBG

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NASPA – PMI Leadership Conference — San Antonio, TX

AAP

6

PRS

9

July 13–14

The Partnership for Safe Medicines

NCPDP Annual Conference — Scottsdale, AZ

PPA Boards of Directors Retreat — State College, PA

October 1–4 PPA Annual Conference — Mount Pocono, PA Due to the COVID-19 some dates on our calendar have been canceled or postponed. For more information on events including webinars, CE opportunities and PPA committee meetings, be sure to see our Calendar of Events page on the PPA website!

R.J. Hedges EPIC

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17

21

Value Drug Company

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AmerisourceBergen

28

Pharmacists Mutual

40

www.papharmacists.com 7

Welcome! New Members PPA Welcomes the following New Members who joined the association from February 1, 2020–April 3, 2020.

Please make these new members feel welcome and part of Pennsylvania pharmacy!

ASSOCIATES

LECOM School of Pharmacy

Margot Mercer, West Chester

Andrea Cameron, Cleveland Heights, OH, Value Drug Company

Maria Pirritano, Erie

Victoria Miklus, Pittsburgh

Cassidy Taylor, Randallstown MD

Jessica Nguyen, Peckville

Michael Gross, Pittsburgh, Value Drug Company

St. Johns University

Jeffrey Onyeador, Pittsburgh Abigail Reigh, Duncansville

Lisa Steptoe, Ellicott City, Value Drug Company

Christina Swiger, Coatesville

PHARMACISTS

Alex Taormina, Philadelphia

John Bosha, Camp Hill

University of Pittsburgh School of Pharmacy

Roisin Sabol, Pittsburgh

Joseph Cirrincione, Pittsburgh, Otsuka

Janine Abate, Pittsburgh

Shane Seager, Monroeville

Jamie Holowka, Pittsburgh, HM Insurance Group

Steven Astrachan, Pittsburgh

Jack Seton, Pittsburgh

Brianna Bartley, Wampum

Ryan Sitko, Pennsburg

Heather Kerstner, Bethlehem

Nicole Bendis, Clarksburg

Christine Sun, Pittsburgh

Young Eun Kim, Blue Bell

Randall Bendis, McKees Rocks

Kimberly Tkach-Pelgrim, Trinity, FL

Jeffrey Kreitman, Mechanicsburg, PerformRx

Rachel Brickman, Pittsburgh

Isabelle To, Pittsburgh

Justine Maley, Trucksville, Geisinger Wyoming Valley

Samantha Broders, Pittsburgh

Angela Tsang, East Petersburg

Lia Cahill, Lansdale

Jiali Wen, Pittsburgh

Jack Moschgat, Pittsburgh

Markella Cervenak, Venetia

Catherine Wymer, Pittsburgh

Jeffrey Moschgat, Ebensburg

Hui Chen, Pittsburgh

Alan Yee, Pittsburgh

Jennifer Obenrader, Allison Park, Premier Medical Associates

James Cownie, Katonah

Yeeun Yoon, Pittsburgh

Tony Daesio, Coraopolis

Isabelle Zerfas, Pittsburgh

Adam Root, Chapel Hill, PerformRx

Noah Delapaz, King of Prussia

Garrett Sipes, Chambersburg, Chambers’ Apothecary

Leah Deroche, York

Theodore Spontak, Cressona, Thomas Pharmacy

Gianna Emmett, Swedesboro, NJ

Tanya Stash, Shrewsbury, CVS Caremark

Temple University School of Pharmacy

Noah Donnenberg, Pittsburgh Tyler Gates, Pittsburgh Kobi Griffith, Pittsburgh

TECHNICIANS

Casey Gudenburr, McMurray

Tracee Denlinger, Homer City, Gatti Pharmacy

Lindsay Heck, Tunkhannock

Nancy Rihtarchik, Pittsburgh, University of Pittsburgh

Ann Herbster, Sunbury

STUDENTS Duquesne University School of Pharmacy

Ben Herrmann, Pittsburgh Casey Holliday, Hollidaysburg Megan Husted, Fairport Josephine Kim, East Stroudsburg

Carly Bruscemi, McKees Rocks

Vincent Knecht, Pittsburgh

Jennifer Carraway, Pittsburgh

Luke Kulak, Cranberry Twp

Madison Henry, Pittsburgh

Taylor Laffey, Glenshaw

Patrick Huber, Hastings

Yihan Li, Pittsburgh

Stephanie Johnson, New Castle

Alina Liang, Chadds Ford

Hannah Kohley, Pittsburgh

Yunjing Liao, North Billerica, MA

Matthew Roberts, Jamison

Yuhan Lu, Irwin

Jefferson College of Pharmacy Diana Koval, Philadelphia Anthony Vu, Philadelphia Alexander Wolanin, Newtown Square Douglas Zeman, Nazareth

8 Pennsylvania Pharmacist — May/Jun 2020

Lilianna Ly, North Wales Hannah Madara, Pittsburgh Mujtaba Mahmud, Pittsburgh Joseph Mancini, Pittsburgh Ethan Markowski, Mountain Top James Matis, Uniontown

Grace Rong, Pittsburgh Anika Roy, Monroeville Thomas Rust, Succasunna, NJ

Philadelphia College of Pharmacy Kevin Abraham, Yonkers, NY Janan Amin, Philadelphia Logan Bersani, Philadelphia Victoria Chen, Paoli Gabrielle Cromley, Philadelphia Michelle Farrell, Bensalem Caroline Germain, Upper Darby William Hallinan, Paoli Shane Henson, Lewsberry Kelly Houghton, Newton Square Siham Hubi, Philadelphia Paige Jacobs, Philadelphia Jasmeen Kaur, Ephrata Brianna Mathis, Norwood Kishan Patel, Lansdale Trisha Patel, Philadelphia Joseph Shaji, Sinking Spring

Member News Another Future Pharmacist Has Been Born

APhA-ASP National Patient Counseling Competition Announces Top Ten Finalists

Congratulations to Nicole Pezzino, PharmD, BCACP, CDE, PPA’s Academia Practice Setting Director, on the recent birth of her second child. Nicole and her husband, Jeremy, welcomed Lucas Edward, born March 1st 2020, at 8lbs 6 oz and 20.5 in.

Congratulations to Nicole and her family!

PPA Student member, Arianna Sprando, PharmD Candidate 2021, University of Pittsburgh School of Pharmacy was named a top ten finalist in the APhA-ASP National Patient Counseling Competition. The top ten finalists in the national competition will be recognized during the APhA-ASP Awards Celebration and will receive a cash prize compliments of APhA-ASP and CVS Health.

Congratulations Arianna!

Made the News Asti’s South Hills Pharmacy

Future Pharmacist Times Two

Dan Asti, founder and CEO of Asti’s South Hills Pharmacy wrote a piece for the Pittsburgh Gazette in early March on how legislators should embrace PBM reform to lower prescription drug costs.

Congratulations to Nick Leon, PharmD, BCPS, BCACP, PPCN Chair and Director of Network Development, on the recent birth of his second child. Nick and his wife, Iris, welcomed Penelope Mireya, born March 25, 2020.

Congratulations to Nick and his family!

Klingensmith Drug Stores Inc.

COVID-19 Prep LIVE On The Air

John Luckovich, owner of Plumb’s Drug Store was featured in State College’s Town and Gown online in late January for the rich history of providing quality service to their patients.

Vince Hartzell, PharmD, Owner of Hartzell’s Pharmacy recorded a video podcast with colleagues on how to prepare for COVID-19. You can listen to the podcast by visiting: https://bit.ly/2XktKNx.

Dave Cippel, owner of Klingensmith Drug Store Inc. wrote a piece for the Indiana Gazette in late February on PBM reform and how its effecting his patients and stores.

Plumb’s Drug Store

Kyle McCormick Opens Blueberry Pharmacy Kyle McCormick, PharmD, PPAEF Board Member, opened Blueberry Pharmacy located in West View Borough serving the Pittsburgh community.

Blueberry Pharmacy sets itself apart from the rest by providing access to low-cost medications without the need for insurance. Congratulations to Kyle and his team!

SHARE YOUR NEWS WITH US Send all snippets of achievements and honor to PPA’s Communications Manager — Victoria Madonna vmadonna@papharmacists.com 10 Pennsylvania Pharmacist — May/Jun 2020

Affiliated Member News Allegheny County Pharmacists Association (ACPA) Update As so many of us are doing, ACPA has worked to implement social distancing while still providing extraordinary care for our patients.

In place of our typical summary of events, we wanted to highlight the work of our members. We wish everybody safety in the coming weeks and hope we can resume our face to face meetings very soon! Past president, AJ Grecco, is a cardiometabolic Medical Science Liaison pharmacist working remotely from home to respond to providers and pharmacists to positively impact patient care.

12 Pennsylvania Pharmacist — May/Jun 2020

President-elect Ashley Firm practices social distancing by working from an “office” in her pharmacy’s over the counter section to complete patient outreach and MTM calls. Amanda Creameans, a student pharmacist at the University of Pittsburgh, shared one of her online meetings to continue planning for RxPLORE, a weeklong camp for high school Juniors and Seniors interested in health care professions. Erin Burke, a community pharmacist in Virginia but still an active ACPA member, lends her sewing talents

to sew masks for her friends and fellow health care workers. In one weekend, Erin was able to sew more than 45 masks and create step by step instructions for those wishing to recreate at home. Finally, Past president, Kyle McCormick, opened his new pharmacy in the midst of the pandemic. Blueberry pharmacy, located north of Pittsburgh, is an insurance-free pharmacy striving to provide affordable medications to the community.

BucksMont Pharmacists Association (BMPA) Update Despite the looming threat posed by the COVID-19 restrictions, our two organizations managed to host this joint event and had a relatively good attendance, considering the unfavorable conditions. This event also hosted a food collection to support The Sunday Breakfast Mission in Philadelphia. All attendees who provided unperishable food donations were entered into a raffle to win an Alexa device.

Approximately 20 members of each organization gathered for our joint meeting, which was a long time in planning, and were able to enjoy networking, socializing (at a safe distance from one another “socialBoard directors of PSHP and BMPA (and members) gathered distancing”), a delicious buffet dinner with for a group photograph. Pictured left to right: Sammar Dorvil complimentary beverages and a featured (PSHP)– Ashley Rauchet (PPA) – Frank Konzelman, Jr. (PPA) – presentation sponsored by OptumRx RoseEllen Gatto (PPA) – John Gatto (PPA) – Melinda Williams Specialty Pharmacy. The topic for the (PPA)– Shawn Parekh (PSHP)– Chantel Farrello (PSHP/PPA) – presentation was “Multiple Myeloma (MM): Jan Kitzen (PPA)– Rebecca Davey (PSHP) – Larry Jones (PSHP).

Discussion of the disease state, REMS program, and treatment.” Clinical pharmacist dispense most of these medications, it is useful for us to Holly Ouellette delivered the presentation via WebEx. be aware of these as some of our patients may be using We learned that MM is the second most common form some of these products. Overall, it was a pleasant of blood cancer in the world and treatment of MM is evening and many of our BMPA/PSHP colleagues very complex and many of the medications used are enjoyed each other’s company. specialty pharmacy products. Despite the fact that many of our pharmacist attendees will most likely not

Lehigh Valley Pharmacists Association (LVPA) Update This year has been a challenging one for the members and officers of the Lehigh Valley Pharmacists Association. However, it is those same challenges that are driving the membership to evolve and grow, from both a professional as well as an organizational perspective.

Members of our local association have served the pharmacists of Pennsylvania as PPA Presidents, State Committee members, Board of Pharmacy leaders, as well as presenters at our two major state educational meetings. With a legacy such as this, a major objective undertaken by the LVPA Board of Directors is to encourage and enhance membership. There are two methods in place to achieve just that.

Since November, we have been running the “Fall In Love with LVPA and PPA” membership recruitment contest. All new members during the period running from October through Valentine’s Day, February

14th, were entered into a drawing for one year’s FREE membership in PPA/LVPA (to be awarded at the end of their current year’s membership). The winner of the contest was Bahar Khalighi, of Whitehall Pharmacy!

Second, we have undertaken an evaluation of not just when we meet as an Association, but how we meet and the nature of those meetings. In the coming months, a new combination of live continuing education and business meetings, as well as networking and social gatherings, will be unveiled to the membership. Our use of contemporary technology and social media will play heavily into the new schedule.

At this time, we wish to thank the LVPA Board of Directors for their leadership and energy throughout the past two years. We look forward to seeing their efforts come to fruition as we all escape our current situation of confinement and return to our active (if not interactive) lifestyles.

www.papharmacists.com 13

2020 Mid-Year Conference Highlights Thank you to everyone who attended the 2020 Mid-Year Conference “Connect, Collaborate and Create” at the Harrisburg Hilton from January 24th to 26th!

Special Thank Yous!

PPA sends a special thank you to the 2020 Conference Committee for all of their hard work and dedication.

Committee members include: Brandon Antinopoulos, Tanya Dougherty, D Scott Himler, Robert Kayden, Danielle Kieck, Jamie McConaha, Erica McGovern, Nicole Pezzino, and Vick Shah.

Thank You Sponsors!

PPA thanks our Annual Corporate Partners and Conference Sponsors! The funding and support they provide allows PPA to provide conference attendees with a remarkable experience. We thank them for their generosity to PPA! Continued on next page

14 Pennsylvania Pharmacist — May/Jun 2020

Special Thank Yous! continued Annual Corporate Sponsors

Conference Sponsors

Diamond Level: Independent Pharmacy Buying Group, Pharmacists Mutual Companies

Contributor Conference Sponsor: Rite Aid

Platinum Level: Value Drug Company

Soda Breaks: BucksMont Pharmacists Association, National Association of Chain Drug Stores

Gold Level: Keystone Pharmacy Purchasing Alliance Silver Level: AmerisourceBergen, McKesson Bronze Level: R.J. Hedges & Associates

Supporter Conference Sponsor: Performrx

Documentation Boot Camp Sponsors: Omnisys, PioneerRx, Prescribe Wellness, QS/1.

OTC Competition The OTC Competition was once again a signature event of Mid-Year Conference! Teams from LECOM, the Philadelphia College of Pharmacy, Duquesne University, Jefferson School of Pharmacy, the University of Pittsburgh, Temple University and Wilkes

University competed and Duquesne University School of Pharmacy took home the 2020 traveling plaque!

Congratulations to the Duquesne Team members: Katie Debliasio, Julia Fadul and Kelsee Lazor!

Know Pain, Know Gain Competition Contestants competed in a rapid-fire Q&A session on pain management, followed by the top three finalists competing in a patient counseling session.

Congratulations to this year’s Know Pain, Know Gain Competition winner: Harrison Ferro, Wilkes University Nesbitt School of PharmacyThe other two finalists were: Dylan Fox, Wilkes and Kaitlyn Gaynor, PCPOther competitors included: Erica Jackson, Julia James, Jenna

Januszka, Sejla Jukic, Kevin Kachurak, David Katz and Cody Morcom.

A big thank you to our competition judges and committee: Coleen Kayden, Michele Musheno Jennifer Smith and Tanya Uritsky. Maria Foy, who posed as our pain patient for the counseling portion and Tom Franko, who served as our moderator for the competition.

Continued on next page

www.papharmacists.com 15

2020 Mid-Year Conference Highlights continued Poster Presentations A total of 25 posters were presented on Saturday evening during our always popular poster and CE Session at MidYear. Those who attended earned CE credit by learning from each student, resident and new practitioner about their work. The session was also a great time to mix and mingle. Thank you to the multitude of pharmacists who evaluated these posters – we appreciate your interest and support!

Educational Foundation Fundraisers The Foundation hosted its annual Sunnyside Up Breakfast on Sunday, January 26th, which included presentations on the Foundation and five reports from the grants that were awarded in 2019. Additionally, the four grants awarded for 2020 were announced, new Board members installed, and outgoing board members were recognized and thanked for their dedication through the last few years. The Foundation also held a Chinese Raffle and 50/50 Raffle during the weekend.

Newly installed PPAEF members: (left to right) Frank Konzelman, Lauren Megargell, Elizabeth Harris, and Missy Krause.

16 Pennsylvania Pharmacist — May/Jun 2020

Campus Checkup

LECOM School of Pharmacy Contributed by: Lauren Howell, Communications Ambassador During February, LECOM Erie PPA student chapter held a fundraiser which promoted Voices for Vaccines and the PPA Pharmacy Political Action Committee (PharmPAC). A total of 31pins were sold, with much student engagement in activism and immunization promotion garnered. Proceeds were donated to the non-profit organizations. The chapter also held its annual fundraiser, aiming to prepare students for upcoming rotations in the field. White coats, portfolios, and PPA pins were sold, in order to keep the young aspiring professionals ready to tackle new experiences. In early March, LECOM students, partnered with Rx Runners, and the LECOM Erie Student Osteopathic Medical Association (SOMA), hosted a Health Fair at the Erie Insurance Arena, home of the Erie BayHawks.

Students educated the community on diabetes awareness, heart health, immunization awareness, drug abuse, and OTC medication safety, while supporting their local basketball team. LECOM has also teamed up with Script Your Future throughout the years, in order to promote medication adherence in the community, and to spread awareness about the health consequences and hospital costs of not taking medications as directed. Most recently, LECOM was recognized by the mayor of Erie, Joseph Schember, and was awarded a proclamation. The proclamation was inspired by the Script Your Future’s annual Medication Adherence Campaign. The week of March 8th - March 14th was proclaimed “LECOM School of Pharmacy Week” in the City of Erie. This was certainly a proud achievement for LECOM Erie School of Pharmacy.

Philadelphia College of Pharmacy Contributed by: Julia James, Communications Ambassador PPA members from PCP held a white coat pin sale!

Our students collaborated with students from ONU and LECOM to sell pro-vaccination pins to promote Senate Bill 274. 50% of the website’s profits went to Voices for Vaccines, which is an organization that provides parents with information regarding vaccine-preventable diseases. We sold a total of 125 pins, and all of our profits are being donated to PPA’s PharmPAC! We would like to thank ONU and LECOM, as well as all PCP students who purchased pins!

18 Pennsylvania Pharmacist — May/Jun 2020

University of Pittsburgh School of Pharmacy Contributed by: Emily Dell, Communications Ambassador Students at the University of Pittsburgh are approaching the end of the Spring semester. As you read this, things are changing every day around us due to COVID-19. We had several events planned for the end of the semester, such as a social event with Pitt and Duquesne and an event for students to come together and complete their Government Relations Advocacy for Student Pharmacists (GRASP) modules. Unfortunately, many of these had to be canceled due to the need for social distancing. We look forward to when students can come back together for events like these. When we can, we plan to have students volunteer with the Allegheny County Pharmacists Association (ACPA) at food banks and other organized community service events. We are still working together to have students advocate for the pharmacy profession. Students are continuing to complete GRASP modules from home, and we keep an eye out for updates provided to us from the Pennsylvania Pharmacists Association (PPA) about new legislation and opportunities for pharmacists during this pandemic. We hope that everyone is staying safe and we wish the best of luck to P4 students heading out on rotations starting this summer!

Wilkes University Nesbitt School of Pharmacy Contributed by: Stephanie Ostir, Communications Ambassador The spring semester flew by for Wilkes PPA! Our favorite part of the semester was attending the Mid-Year Conference.

We enjoyed networking, competing, and learning more about our profession.

At the conference, some of our members competed in the Know Pain, Know Gain Patient Counseling Competition. Dylan Fox and Harrison Ferro made it to the top three finalists, where Harrison received first place! We are very proud of their hard work. We finished off our school year with a few events centered around giving back to the community. The highlight to the end of our semester was being involved in the Big Event, hosted by Wilkes Student Government. During the Big Event, we had the opportunity to participate as a chapter in school-wide community service projects.

It was nice to be able to interact with the members of the community and give back to the place we call home during the school year. Another way we gave back to our community this semester was by participating in Random Act of Kindness Day. During this event, we distributed bags of popcorn to students walking to class.

These were rewarding experiences for our chapter. During the spring months, we also brought back our Wilkes umbrella fundraiser from last year. It was another big hit on campus!

Although some of our events for the remainder of the semester were cancelled due to potential health concerns, we look forward to incorporating these ideas and events into the next school year. We are excited to see what the new year will bring!

SAVE THE DATE www.papharmacists.com 19

PPCN Update COVID-19 Response

Flipping the ‘Burgh!

As the number of COVID-19 cases grew in Pennsylvania, our pharmacies responded quickly to the public health crisis to keep their pharmacy staff safe while continuing to care for their patients and communities. Our pharmacies rapidly deployed safety measures which include home delivery, curb-side medication pickup, extra pharmacy cleaning procedures and distancing of pharmacy employees. Their enhanced services such as adherence packaging and medication synchronization have proven to be more valuable than ever as patients hurried to make sure they had enough medication on hand. Pharmacies mobilized quickly to compound hand sanitizer for their patients and local emergency personnel and to serve as a resource of valid, factual health information amid this pandemic. Thank you to our pharmacy teams on the front lines who are courageously caring for their communities!

In early March, Flip the Pharmacy national leaders Randy McDonough, Co-Owner of Towncrest Pharmacy and Suzanne Feeney, PharmD, Vice President of Business Development for CE Impact presented to student pharmacists and Flip the Pharmacy teams and coaches at the University of Pittsburgh School of Pharmacy. Our Flip the Pharmacy teams got some face-to-face time with Randy and Suzanne to share their own pharmacy innovations and talk best practices.

Over 80,000 eCare plans have been submitted in the first 5 months of the Flip the Pharmacy program, which highlight that pharmacists are identifying drug-related problems, making interventions, and working with their patients to set goals. With the developments of COVID-19, Flip the Pharmacy quickly pivoted to focus on supporting community pharmacies in the pandemic. To learn more about best practices in the national COVID-19 response, visit https://www.covidbestpractices.com/.

Vince Hartzell, PharmD, Owner of Hartzell’s Pharmacy recording a video podcast on how to prepare for COVID-19.

DePietro’s Pharmacy compounds hand sanitizer for the local police department to help prevent the spread of COVID-19.

Flip the Pharmacy coaches John Dejames, Gale Garmong, Katie Doong, PPCN Executive Director Stephanie McGrath, Duquesne University PGY-1 Resident Alexandria Lacombe, Pharmacy Podcast Network founder Todd Eury, Flip the Pharmacy national leaders Suzanne Feeney and Randy McDonough, and PPCN/Flip the Pharmacy pharmacists Anthony Bertola, Adrienne Cervone, Alex Lavella, and Sarah Hoover.

20 Pennsylvania Pharmacist — May/Jun 2020

ACT Update

Welcome to new PPCN Pharmacies!

The ACT Pharmacy Collaborative is an operational learning and ACTing collaborative between colleges/ schools of pharmacy and clinically integrated networks of community-based pharmacies. ACT has expanded to 85 Colleges/Schools of Pharmacy and in February kicked off the 2020 ACT Patient Case Challenge!

PPCN would like to welcome Clarion Pharmacy, Jamestown Pharmacy, Linesville Pharmacy, and Vine Pharmacy to the network! We appreciate your partnership!

The goal of this Challenge is to collect and share impactful cases that demonstrate enhanced patient care provided by pharmacists and student pharmacists in community pharmacies.

If you would like to learn more about PPCN, visit http:// papharmacistsnetwork.com/ or email PPCN Executive Director of Network Operations Stephanie McGrath, PharmD at smcgrath@papharmacists.com.

All participating colleges/schools will be recognized at the AACP Annual Meeting in July 2020.

Follow us on

Twitter @PPCN_CPESN and Instagram papharmacistsnetwork

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Congratulations to the 2020 PPA Graduating Students!

PPA wishes the 2020 PPA graduating students all of the best as they embark on their pharmacy careers! Remember to remain a committed member of our state pharmacy association, no matter where you reside! For those staying in Pennsylvania, we invite and encourage you to update your membership as a New Practitioner! This can be done online or by contacting Katie Hoster, khoster@papharmacists.com.

Appalachian College of Pharmacy Lindsey Ratliff Creighton University Andrea Getz Duquesne University School of Pharmacy Sa’ed Al-Olimat Deena Awadalla Conor Boston Scott Carson Matthew Cippel Katharine Damico Madeline Davidson Zachary DeJames Callie Drennen Destiny Fisher Stephanie Franciscus John Harris Tyler Herman Abigail Hopple Allison Kachel Elizabeth Leonard Jacquelyn Madler Christina Marinari Brenna Moriarity Jessica Murray Lisa Mutooni Connor Och Kimberly Pacy Bhuneshwari Patel Alaina Pericoloso Corey Perrotte Lauren Pheasant Choniece Phillips Briana Schreckengost Adam Thompson Chad Vomer Rachel West Jared Williams Anna Zuschnitt Jefferson School of Pharmacy Saadiya Ali Mercedes Bellam Taylor Cercella Michelle Culbert Julian De La Calzada Ryan Derstine Rana Elmekadem Roy Kim Charles Korn Nicole Leshko Maggie Lycouras Elvis Nkemta Nicholas Paulson Jordyn Richman Brandi Steady Shannan Street George Tadroes Danielle West Douglas Zeman

LECOM School of Pharmacy Rym Abdouny-Smidi Aisha Acha Albert Addai Oluwafunmilayo Adeyinka Daniel Afari Ahmad Al Rubaie Marwah Alfatlawi Nasser Algabri Mohamed Alhashidi Hayley Allen Oyi Amasiani Lois Anti Rania Bashi Emily Bauman Sabrina Blake Selena Bouapha Ali Chammout Carley Church Reide Cooper Tuan Doan Ruaa Edani Nathalie El Hadi Sanaa Elghlami Francis Essel Christopher Evans Taylor Ewing Getty Eyong Taghrid Hassoun Emily Humes Adedoyin Idowu Erica Jackson Elyssa Johannesen Gloria Jones Stephen Kazmer Prem Khatiwoda Kiana King Elise King Sun Kyung Kwon Nathan Lieb Becky McCracken Nick Miles Shannon Morris Vivian Munakwa-Njah Minh Nguyen Thanh Nguyen Jasmine Oro Lama Ozeir Kimberly Parada Maria Peluso Hang Pham Paul Popitan Roger Raby Theron Richardson Ashley Roland Luiza Sakhibnazarova Evan Sebastian Yousif Shamoon Angela Song Whitnie Sullivan Augustine Tafor Noah Vasil Gaoseng Yang

Northeast Ohio Medical University Brianna Bailey Ohio Northern University Haley Empfield Aliya Hutman-Zahler Mary Komandt Michaela Mrozek Temple University School of Pharmacy School of Pharmacy Tesfahun Angasso Andrew Chen Unnati Hajari William Huang Steven Lee Allen Ly Barbara Ohiaeri Tina Paris Daniel Thai Tai Tram University of Findlay Madison Donnelly University of Maryland Taylor Kaminsky University of Pittsburgh School of Pharmacy Victoria Blake Emily Craine Garrett Day Kiana Green Jenna Ingram Kelly Jenniches Hannah Kelly Emily Kistler Kevin Mahar Diana Mansour Madison McConnell Erin McIntyre Jeffrey Onyeador Megha Patel Domenica Ricciuti Alexandria Taylor Lauren Xu Philadelphia College of Pharmacy Haithm Abdou Dianna Arndt Kayla Askey Alexandra Cerino Meghan Chan Karissa Chow Lauren Chun Enid Curevac Samantha Frear Adetutu Gbadebo Christina Haddad Caityln Heaps

Graduation Gift Voucher

$5 off membership + 6 months FREE + FREE county dues *Must be a current PPA Student member to get this deal.

Offer ends July 1st, 2020.

Shane Henson Sophonny Huynh Insung Hwang Sarah Kerdesky Daniel Leehan Daphne Liang Hajar Mokhlis Bianca Nguyen Sarah Park Zachary Prall Mei Ling Rong Katherin Sesuca Sara Skoritowski Marques Williams Kaleb Zhang Yiming Zhang Wilkes University — Nesbitt School of Pharmacy Sarah Ahearn Kara Cooper Elena Denger Kirsten Fisher Dylan Fox Antonia Gobo Lauren Hertzog Ashley Hoffman Sarah Hughes Nicole Jankowski Katelyn Jimison Vienna Jones Kimberly Jones Kevin Kachurak Courtney Keyasko Sohaib Khaliq Chelsey Klein Lisa Koppenhaver Rachel Lazevnick Theodore Marines Lauren Merli Sarah Metzinger David Moll Cody Morcom Meghan Muretta Alexis Nicholson Austin Paisley Himani Patel Nick Preston Christine Scavone Justine Seymour Shaiva Shah Brittney Smith Maria Torsiello Lucas Whittaker Sidney Wilson Rachel Wood Kaitlin Yurko

www.papharmacists.com 27

PPA Pharmacies and Coping with COVID-19 Displaying their unique creativity and nimble response, despite overwhelming challenges (think ridiculous PBM reimbursements and incredible patient demands), our Pennsylvania community pharmacies, especially our independents stepped up to the challenge of “Coping with COVID.” PPA and PPCN joined them in the effort, hosting both a COVID-19 webpage, information in the regular e-bulletins, and starting our weekly COVID-19 forums. During the forums, current updates are featured along with ideas and resources to help you keep your pharmacy practice going. And while considerable focus has been on community independent pharmacies, we welcome ideas from other practice settings.

Continued on next page

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28 Pennsylvania Pharmacist — May/Jun 2020

PPA Pharmacies and Coping with COVID-19 continued PPCN has also focused its attention to COVID-19, highlighting the CPESN COVID Best Practices webpage and the Flip The Pharmacy change package was all about adapting to and making changes in your pharmacy in the face of this pandemic.

taking on the reprehensible reimbursements and further decreases implemented by many PBMs. Follow Your PA Community Pharmacies on Twitter @YPACP

Your PA Community Pharmacies continued to help us advocate for much needed changes,

Kudos to our many independents who have stepped up to the challenges.

While we only heard from a handful of you, we know many are doing extraordinary things and we thank you for it.

Recognition and shout outs go to: (Only a small list of all that you are doing!)

• Thompson Pharmacy creating your own informative webpage

• Lifestream and Skippack

Pharmacy to be among the first to embrace curbside delivery at the beginning

• DePietros Pharmacy for

its unique “car hop” idea — local football players and all your connection with the community including your newsletter

• Gatti Pharmacy for your remote entry tips and

sharing your OTC and supply shopping list — a simple but effective idea!

• AcorRx for your staff splitting idea • Astis South Hills for suggesting the buddy system and being prepared

• St. Mary’s for showcasing the protective barriers they put up

• And all the countless others for your creativity, your

imagination and always your can do and putting the patient first attitude!

We also need to thank our health system pharmacists who are in the thick of the crisis of shortages of space to treat the seriously ill. We thank our clinics where pharmacists are helping patients remotely. Thank you to all our academia members who scrambled to accommodate the end of school sessions with remote classes and figure out final rotations. We would be terribly remiss if we did not recognize all our pharmacy technicians and the student interns who have been helping where they can.

March and April have been a life-altering experience. Six months ago, none of us expected to ever see our great country and the world so brought to its knees. At the end of the day, we will come out of this stronger, and pharmacists will be recognized for all they did and continue to do!

www.papharmacists.com 29

PPA Foundation Grant ­— Final Report Each year, the PPA Educational Foundation awards several grants to explore innovation in pharmacy practice.

All awardees are required to submit a report of their work. Below is the report from one of the 2019 awardees.

Reports are also retained on the website under the Educational Foundation section.

Evaluating the Impact of a Targeted Naloxone Protocol on Naloxone Dispensing for High Risk Patients in a Community Pharmacy Setting Authors: Vidhi Gandhi, PharmD Candidate 2020 — vgandhi@mail.usciences.edu

Karleen Melody, PharmD, BCACP — k.melody@usciences.edu

Daniel Ventricelli, PharmD, MPH — d.ventricelli@usciences.edu

Philadelphia College of Pharmacy, University of the Sciences

Acknowledgements The authors extend much appreciation to SunRay Drug Pharmacies and the participating pharmacists, as well as Pennsylvania Pharmacists Association (PPA). The GetNaloxoneNow.org certificate training was supported through the 2019 PPA Educational Foundation award.

Abstract Naloxone is an FDA approved medication that is used to reverse an opioid overdose. Stigma associated with opioid misuse, uncertainty about naloxone administration, and complications with reimbursement are some of the barriers pharmacists encounter that may impact their ability to dispense naloxone. The objective of this study was to increase the number of naloxone prescriptions dispensed by community pharmacists through improving their knowledge and confidence in three key areas: 1) identifying patients at high risk of a possible opioid overdose, 2) utilizing the Pennsylvania standing order protocol, and 3) in providing appropriate training for each patient receiving the medication.

Methods and Analysis Pharmacists from 24 SunRay Drugs pharmacy locations in the Greater Philadelphia area were recruited for this project. They received a student developed web-based training module on naloxone including a protocol to help identify high-risk patients. The training module provided education about the opioid epidemic and strategies for addressing barriers to dispensing naloxone. Additionally, the pharmacists completed the GetNaloxoneNow.org certificate training program. An anonymous Qualtrics survey using a 7-point Likert scale was administered one month pre- and post-intervention to determine the knowledge and comfort of pharmacists to dispense naloxone.

The total number of naloxone prescriptions dispensed at each pharmacy was collected 6-months pre- and postintervention. Descriptive statistics were used to help summarize and identify emerging patterns in the data for the study objectives. The paired samples t-test was used to compare survey results and the amount of naloxone dispensed at each pharmacy pre- and post-intervention. This study was IRB approved by the University of the Sciences.

The full grant report can be found on the PPA website at https://www.papharmacists.com/page/FGrantHistory.

30 Pennsylvania Pharmacist — May/Jun 2020

Pharmacy Spotlight: SunRay Drugs This article was written by Shane Henson, PharmD Candidate 2020, Philadelphia College of Pharmacy while on rotation at PPA. The story of SunRay Drugs began in Philadelphia in the late 1920’s, when brothers Harry, Albert and William Sylk opened an affordable retail store on Ridge Avenue. They would eventually build an empire, with more than 150 stores in Pennsylvania, Delaware, New Jersey and Maryland by the mid-1900’s.

Their fantastic ability to promote their stores may have contributed to their success. In mid1947, a US Army Air Forces balloon crashed at a ranch near Roswell, New Mexico.

This sparked interest in flying saucers nationwide. The Sylks used this event to promote the opening of their new store in Patterson, N.J. by dropping discs from an airplane and offering free ice cream to anyone who could find one and bring it into the store. They also gave away free chicks on Easter Day to their customers.

Radio was the main form of media during their time and they didn’t just use it to advertise, they owned two stations: WPEN AM & FM. On top of all their promotional methods, they believed that store location was the first priority. Harry Sylk told the Philadelphia Inquirer, “Wherever there was a Woolworth’s store, we’d tried to open a store right next to them.” They were true believers in the power of promotion and would use bright neon SunRay signs like the one that can still be seen today along Germantown Avenue.

Despite the amazing successes of SunRay in its early days, by 2003 there remained only 1 store in West Philadelphia and it was in danger of being bought out by a large corporate chain. This was when a group of pharmacists joined together to keep the once thriving chain under independent management. Since that time, SunRay Drugs

has expanded to eight pharmacies and sixteen affiliate pharmacies in Pennsylvania and New Jersey.

They are also expanding the role of retail pharmacy in order to serve those in need. SunRay Drugs partnered up with Mercy Philadelphia Hospital and initiated a “meds-to-beds” program that makes sure patients had their prescriptions filled and in their hands prior to leaving the hospital.

All of the SunRay Drug locations offer delivery services and specialty packaging services free of charge to their customers.

SunRay has also partnered up with the Philadelphia College

of Pharmacy to provide many services to their communities and to help advance students into promising careers.

A SunRay Drug Company pharmacist said, “SunRay Drugs is not just a great place to be a community pharmacist, it is an excellent organization that serves those in need.”

The SunRay Drug Company is a shining example of the positive impact independently owned pharmacies can have on their communities. It is crucial that we continue to support the independents in the communities of Pennsylvania.

www.papharmacists.com 31

Student Member Profiles Why did you choose to become involved in PPA? I chose to become involved in the Pennsylvania Pharmacy Association to learn more about the role of advocating in healthcare and to do my part in resolving the arising challenges in the profession of pharmacy.

Shane Henson Lewisberry, PA 2020 PharmD Candidate Philadelphia College of Pharmacy How did you hear about PPA? I first heard about the Pennsylvania Pharmacy Association from Dr. Karleen Melody at the Philadelphia College of Pharmacy. She also helped my friends and I attend our first legislative day.

Favorite drug name to pronounce Tacrolimus Flashback to your first year of pharmacy school; what advice would you give yourself knowing what you know now?

The college experience is what you make it, so get involved both on and off campus.

Have any professors influenced you since you have started down this career path?

Yes, there are many professors who have positively influenced my professional development.

I’d like to specifically thank Professor Greene, Professor Thomson, and Professor McGiness for their dedication to helping students reach their professional goals.

Where do you think you’ll be in five years?

In five years I will be working in a job I both enjoy and am passionate about.

Favorite food you have eaten on campus?

Linda’s Cart! Everything is amazing there, but I normally go with the JT Special (Buffalo Chicken Cheesesteak with Bacon).

HAVE YOU

UPDATED YOUR PROFILE

LATELY? 32 Pennsylvania Pharmacist — May/Jun 2020

Insung Hwang Horsham, PA 2020 PharmD Candidate Philadelphia College of Pharmacy How did you hear about PPA? I heard about PPA through the many scholarships/ grants they offer within their Affiliated Counties and Educational Foundation.

Favorite drug name to pronounce Levetiracetem … vortioxetene is also fun Flashback to your first year of pharmacy school; what advice would you give yourself knowing what you know now?

I would want to tell myself that while there’s a lot going on at once with pharmacy school and that stress can pile high for weeks and months on end, to never lose focus of what is important and to always have confidence that through hard work things will see themselves through.

Why did you choose to become involved in PPA? Even though I have been a member since before P1, I wasn’t really involved with PPA until my P3 year. My roommate and I got involved with the Achieving Independence Competition PPA hosts each year and we spent two years prepping for that. And then this past September, we went to the annual meeting (hosted in Champion, PA), presented our poster, and had a good time.

Have any professors influenced you since you have started down this career path?

Being just a student still, I think most, if not all my career path is owed to the many great professors I’ve come to know during my time at PCP. One professor who helped get me started was Dr. Steven Schaeffer. He encouraged me to apply for summer internships early on and wrote recommendation letters for me, even got me interviews at a local hospital where he knew the head pharmacist.

Where do you think you’ll be in five years?

I’m not quite sure, I’m focused more on finishing school and what is immediately ahead of me right now.

Favorite food you have eaten on campus?

Linda’s cart, specifically her sausage and eggs over rice.

PPA wants to make sure you are receiving the latest news concerning CE’s, Advocacy, and latest industry trends. Please take the time to update your mailing address, email, place of employment and any other information that has changed.

Don’t remember how to login? Email Katie, Conference and Membership Manager at khoster@papharmacists.com.

Member Profile answers. Remember that you are not expected to have all the answers at your fingertips. Pharmacy school prepared you to be a competent pharmacist that knows where to find correct answers. Do not be afraid to tell your customer or a physician that you will get back to them with an answer after you look into it.

Tom DePietro, PharmD Pharmacist/Owner DePietro’s Pharmacy Temple University Class of 2009

What is the most important piece of advice you would give a newly licensed pharmacist on their first day of work?

The most dangerous pharmacist is one who believes they have all the

ways to advance my knowledge and become a better pharmacist for my patients.

Name the number 1 reason why you became a pharmacist?

How has becoming a member of PPA made you grow professionally?

APPA has inspired me to become more of an advocate for our profession. It has also connected with me with very talented pharmacists across the state that I would otherwise have not met. Lastly, as a pharmacist I got bogged down into the day to day. PPA gives me a nudge to explore different

I have always had a passion for building relationships and helping people. As a pharmacist, I feel the most important part of our job is developing a relationship with our patient first. Once we establish a relationship, the pharmacist part of our job falls into place easily.

Is there anyone in your professional career that helped shape you into the Pharmacist you are today?

As a child I was surrounded by healthcare. My mother was a nurse and my father was a pharmacist. The stories at the dinner table

always revolved around how my mom or dad were able to help someone else that day. Early on new healthcare would be a rewarding area to work in because of the ability of help others.

Out of anywhere in the world, if you had to choose a different place to live and practice pharmacy where would it be and why?

I am a licensed pharmacist in Florida! After college I practiced in Fort Myers, Florida. I plan on retiring here.

Best thing you ever ate?

Sweet potato casserole from Ruth’s Chris.

If you, someone you know or a pharmacy would like to be featured in a future issue of the magazine, please contact Victoria Madonna, Communications Manager at vmadonna@papharmacists.com

Pharmacy Technician Corner Complete the following conversions:

Super-tech bonus questions:

A) 2 tbsp = _______ tsp

H) ½ gr = _______ mg

B) 2.5 tsp = _______ mL

I) 4 fl dr = _______ fl oz

C) 4 oz = _______ mL

J) 0.9% NaCl @ 100 mg/hr for 24 hr = _______ mL

D) 1 pint = _______ mL E) 1 lb = _______ g F) 150 mcg = _______ mg G) 5 mL = _______ gtt See answers on page 35.

www.papharmacists.com 33

Legislative Profiles Sen. Scott Martin R-13 What are the key issues you would like to see addressed this session (2020)?

A top priority is to pass my Pediatric Cancer Tax Credit Bill. Senate Bill 74 would provide for a $100 million tax credit of private donations over 10 years for childhood cancer research for our state’s four main pediatric cancer research centers. Another priority is my Senate Bill 530 which would mandate the expulsion of a student who is adjudicated for sexual assault against another student in the same school. It is my belief that victims should not have to go to school with those who have sexually assaulted them. In addition, Medicaid reform is desperately needed in Pennsylvania. I have introduced legislation that would create a pilot program for a Total Population Medicaid Decision Health Initiative that has been used in other states to improve health outcomes while saving tax dollars.

Tell our members a little about your background and why you became a legislator?

I came from working in the Juvenile Justice System as the Director of the Lancaster County Youth Intervention Center. After being encouraged by others and because of my belief that our County Government could be run more efficiently, I decided to run for County Commissioner. As a County Commissioner for eight years I never raised taxes, I lowered the county debt, and cut spending. I believed that I could bring that experience to Harrisburg. I am constantly working on issues that I believe will bring efficiencies to state government and to implement common sense reforms.

How do you see pharmacy and its role in health care evolving in the in the future?

Given the rising costs of healthcare, the role of pharmacists is crucial in helping the legislature understand their industry, the roles of PBM’s and how the system can be improved to keep prices affordable for Pennsylvanians.

Advice for pharmacists about the political process?

Communication with elected officials is essential.

Pharmacists need to let members of the legislature know the impact bills would have on the industry so they can make informed decisions. Providing a background to members of the general assembly on the different types 34 Pennsylvania Pharmacist — May/Jun 2020

of pharmacies, how they work with insurance companies, and the impact that you have on patients is key. Clear and consistent communicating with members of relevant committees and chairs helps to spread your message out to the entire Senate and to promote issues that are important to you.

What do you do for relaxation or enjoyment?

My wife and I spend most of our free time doing family activities and we enjoy going to the shore throughout the year. I often find myself on the weekends on the sidelines of either a football game, basketball game, or wrestling match as our children are very active in various sports and activities, some of which I coach.

Rep. Kyle Mullins D-112 What are the key issues you would like to see addressed this session (2020)?

I ran for this office on a platform of strengthening our communities; fairly and adequately funding our children’s education; protecting vulnerable individuals; and fighting for the responsible stewardship of tax dollars and effective governance. During my first year in office I was proud of our work in many of these areas: I voted for a state budget that increased education funding; introduced a bill to define and penalize chronic “bullying;” supported new laws to protect victims of childhood sex abuse; and fought for a package of bills to regulate and enforce greater transparency over Pharmacy Benefit Managers (PBMs) and level the playing field for our community pharmacies.

These bills are now in the State Senate where I hope they receive a vote soon.

Tell our members a little about your background and why you became a legislator?

Simply put, my upbringing, background, and belief in my community are exactly why I became a legislator. I grew up in a loving and supportive home in a great community, with blessings and opportunities that I believed future generations should also have, so I wanted to give back. My sister Kelly and I were raised in Peckville, PA by our loving parents, Mike and Christina, who instilled in us the value of hard work and caring for others. My wife, Lauren, was also raised here, and that’s where we decided to start a family of

our own. Both in high school and while studying political science at West Chester University, I felt the pull toward public service and governance. After graduating in 2007, I moved to Harrisburg where I spent two years as an analyst in the Senate Democratic Research Office; two years as an assistant to then-state Sen. Mike Stack; and eight years as legislative director to state Sen. John Blake before resigning to run for the state House seat I now hold. Every one of these experiences affirmed for me that the work we do in the legislature and back in our districts can have a lasting impact on the quality of life in our communities.

How do you see pharmacy and its role in health care evolving in the in the future?

For decades, my grandmother, Anne Flannery, worked at Biancarelli’s Pharmacy in Jessup, PA — a place where everyone knew your name and “just what the doctor ordered.” So, from a very young age, I understood that community pharmacies were a special place. The competitive and health care landscape since her time there has certainly changed, but I still believe that community pharmacies serve an irreplaceable and critical role on the frontlines of our health care system. Our pharmacy, Medicap, in Olyphant, PA has been there for my wife and me every step of the way through our high-risk pregnancy, and it comes as no surprise that so many of our local pharmacies have stepped up and gone above and beyond to serve their customers and communities amid the COVID-19 health crisis. Knowing that we’re holding our breath through the remainder of this pregnancy, my friend Tom DePietro, owner of DePietro’s Pharmacy in Dunmore, PA reached out to see if we needed any masks on the day the Governor recommended Pennsylvanians wear one – now that’s something special.

Advice for pharmacists about the political process?

When it comes to legislative advocacy and the political process, I would offer the following, which comes from years of experience as a legislative staffer and now a legislator. First, the most seemingly-agreeable legislation in all the world still requires the same things as the most controversial: 102 votes in the House, 26 votes in the Senate, and a signature by the governor. Secondly, don’t settle for a legislator simply “co-sponsoring” a bill.

Regardless of the party in power, the majority controls what bills get to the governor’s desk. So, in addition to asking for a co-sponsorship, ask for members to push their leadership to consider your position, and then be sure to track how the votes fall. Third and finally, be prepared to work toward and accept a compromise product; it’s how our founders intended and structured the process.

What do you do for relaxation or enjoyment?

My wife, Lauren, and I have a three-year-old son, Conor; a chocolate lab, Jagger; and a baby girl on the way in late May, so while there’s not a whole lot of “relaxation,” there’s plenty of enjoyment. When I’m not traveling to Harrisburg for session or attending local commitments, I do my best to “unplug” at night, build trains or play in the back yard with Conor, Jagger, and Lauren. Many of our immediate family members and friends live nearby, so cooking, eating, toasting, and laughing together with those loved ones is what we do for fun. Simply put, there is nothing more important or enjoyable than knowing when you’re living “the good old days.”

Pharmacy Technician Corner continued Answers to questions on page 33: All answers are rounded as typically found in practice. Your answers may vary slightly based on individual practice site standards. Answers: A) 6 tsp

Bonus Question Answers:

B) 12 mL

H) 30 – 32.5 mg (1 gr = 60 - 65 gr)(

C) 120 mL

I) 0.5 fl oz

D) 473 mL

J) 266.7 mL

E) 454 g

24 hr 100 mg 1 hr

F) 0.15 mg

1g 100 mL = 266.7 mL 1000 mg 0.9 g

G) 75 – 110 gtt (1mL = 15 - 22 gtt/mL)

www.papharmacists.com 35

Industry News Prohibition of the Sale of Dextromethorphan to Minors Hearing that not all pharmacies may be aware of this and following the proof of age requirement, PPA is taking this opportunity to remind you: On October 24, 2018, Governor Wolf signed into law Act 116 of 2018, which provided for the offense of minors to dextromethorphan and imposed a penalty:

(a) (1) A person commits a summary offense if he

knowingly sells or purchases with the intent to sell a finished drug product containing any quantity of dextromethorphan to a person who is less than 18 years of age.

(2) A person commits a summary offense if he falsely represents himself to be 18 years of age or older to another for the purpose of procuring a finished drug product containing any quantity of dextromethorphan.

(b) Proof of age requirements. — A person making a

retail sale of a finished drug product containing any quantity of dextromethorphan shall obtain proof of age from the purchaser before completing the sale, unless the purchaser’s outward appearance is such that a person would reasonably presume the purchaser to be at least 25 years of age.

(c) Penalty. — A person who is convicted of violating

subsection (a) shall be sentenced to pay a fine of not less than $250 nor more than $500 for the first violation and a fine of $500 for each subsequent violation.

(d) Exception. — This section does not apply to a

medication containing dextromethorphan that is sold pursuant to a valid prescription.

(e) Preemption. — This section shall be construed

to preempt any ordinance regulating the sale, distribution, receipt or possession of dextromethorphan enacted by any political subdivision, and dextromethorphan is not subject to further regulation by political subdivisions.

(f) Definitions. — As used in this section, the following

words and phrases shall have the meanings given to them in this subsection unless the context clearly indicates otherwise: “Finished drug product.” A drug legally marketed under the Federal Food, Drug, and Cosmetic Act (52 Stat. 1040, 21 U.S.C. §321 et seq.) that is in finished dosage form.

“Proof of age.” A document issued by a governmental agency that contains a description or photograph of a person and gives the person’s date of birth, including a passport, military identification card or driver’s license.

How to Survive a DEA Inspection Series: Understanding the DEA CSOS System© Carlos M. Aquino, PharmaDiversion LLC™

Every month an independent pharmacy supervising pharmacist or a pharmacy owner will contact us on applying for access to the DEA Controlled Substance Ordering System also know as CSOS. Generally, the application they submitted was incorrectly done. So, let me help you understand the system and application.

For a pharmacy to purchase Schedule II controlled substances, they are required by DEA regulations to use a paper DEA Form 222 or use the option of the CSOS system. Yes, I say option. If your CSOS account is suspended by DEA or the supplier, you will need to use the paper DEA Forms 222. We have seen many cases where a supplier has cancelled an account or that DEA suspended

a CSOS account because of the late renewal of the pharmacy registration renewal.

For CSOS, there are three types of applications. They are the Form 251 for registrants, Form 252 for coordinators, and Form 253 to grant Power of Attorney (POA). Here is what you need to know.

Continued on next page

36 Pennsylvania Pharmacist — May/Jun 2020

The Impact of Select Pharmacy Services on HIV Medication Adherence: An Exploratory Analysis Corresponding Author: Nicholas Field, PharmD Candidate 2020, Philadelphia College of Pharmacy University of the Sciences Author: Elizabeth Harris, PharmD, BCACP, Assistant Professor of Clinical Pharmacy, Philadelphia College of Pharmacy University of the Sciences The author of this paper have no financial or personal conflicts of interest to disclose.

Keywords: Medication adherence, pharmacy services, delivery, text-messaging, medication synchronization, antiretroviral therapy, HIV Background Pharmacy services can have a positive impact on patients infected with human immunodeficiency virus (HIV) reaching optimal antiretroviral therapy (ART) adherence, defined as ≥ 95%. The purpose of the study is to describe ART adherence rates for patients based on the use of select community pharmacy services including: home delivery, text-message reminders, and medication synchronization, as well as to describe any possible correlation between the use of these services and patients achieving an ART adherence rate ≥ 95%.

Methods Retrospective analysis of a community pharmacy’s dispensing system from September 1, 2017-August 31,

2018. Patient profiles and refill reports provided by the dispensing system were reviewed to determine patient utilization of the pharmacy services, in addition to their overall ART adherence rate. Patient ART adherence was calculated by the pharmacy dispensing system using medication possession ratio and was capped at 100%.

Results There were a total of 234 patients included in the study and the sample had a mean ART adherence rate of 87.2 ± 17.2. The average ART adherence rate of patients utilizing each service are as follows: home delivery 90.5 ± 14.5, textmessaging 88.8 ± 15.3, and medication synchronization 92.9 ± 10.3. Utilization of home delivery and medication synchronization were associated with a statistically higher proportion of patients with an ART adherence rate of ≥ 95%.

Conclusions Home delivery and medication synchronization were both correlated with a statistically higher ART adherence rate and more patients with an optimal ≥ 95% adherence rate.

These services have the potential to positively impact patient ART adherence rates in a community pharmacy setting.

To read the full article, please visit: www.papharmacists.com/Articles.

Industry News continued CSOS DEA FORM 251 ­— This form is submitted by the pharmacy owner who wants to order Schedule II controlled substances for the pharmacy. We recommend that all owners apply for this category. Why, because if you give that responsibility to someone else as a Coordinator and that person leaves, the account will be closed by the DEA CSOS Unit. Therefore, you need to be the registrant and you can grant POA to other persons. With regards to the application and any renewals, we recommend you place your name as the person doing the initial or the renewal application. By doing this, the CSOS account will only be closed by you.

we want you to know that if the Coordinator leaves the pharmacy, you are responsible to contact the DEA CSOS Unit within 6 hours of the person leaving the pharmacy.

This will automatically close your account and you will need to use the paper DEA Form 222. We don’t recommend you have a Coordinator. Period!

CSOS DEA Form 252 ­— This form is submitted by someone that the pharmacy owner delegates the authority of a Coordinator to purchase Schedule II controlled substances and to give POA to other persons. This form is signed by the owner who has claimed that they don’t want to have CSOS privileges. As the owner of the pharmacy,

So, as the owner of a DEA registered independent retail pharmacy, we recommend you apply with DEA Form 251 and grant POA to others using DEA Form 253. We don’t recommend you use a Coordinator.

CSOS DEA FORM 253 ­— This form is used by the DEA CSOS registered owner to grant any individual POA to purchase Schedule II controlled substances. If you, the owner, submitted your DEA Form 251, you can grant and revoke POA to anyone. We recommend you go this route.

www.papharmacists.com 37

Professional Development for the Practicing Pharmacist: Five Tips for Analyzing Data Catelin Fulghum, PharmD; Pharmacy Department, Penn State Health St. Joseph, Reading PA Megan Sheriff, PharmD; Pharmacy Department, Penn State Health St. Joseph, Reading PA Previous articles in this series have reviewed the basics of designing and conducting a study. This article reviews basic tips to consider when analyzing the data collected as part of your study.

Tip #1: Review Your Data The first step you should take when analyzing your data is review it. Reviewing your data can provide a general overview of your results and help determine what statistical analyses will be used going forward. For example, are data clustered or are they more spread out? Are outliers (data points far away or different from most of the data) present? Are there a large amount of missing data? What type of distribution does the data follow? There are many types of distributions, but we will highlight two common distributions of continuous data (see Tip #2). Continuous data distributions can be broadly broken down into normal (Gaussian) and non-normal distributions. In a normal distribution, the data is arranged in a bell-shaped curve where approximately 68% of the data is located within 1 standard deviation of the mean (See Tip #4), 95% within 2 standard deviations, and 99.7% within 3 standard deviations.

Data that are normally distributed can utilize a family of statistical tests called parametric tests which have useful statistical properties. In contrast, non-normally distributed data can sometimes be analyzed using parametric statistics, but a distribution free alternative (i.e. non-parametric tests) may be more appropriate.

Tip #2 Classify Your Data After examining your data, the next step is to understand what type of data you are planning to analyze. To start, determine whether your data is continuous or discrete.

Discrete data, sometimes referred to as categorical data, are those variables that take on a finite number of values, such as sex or mortality.

Interval data represents quantitative data with a consistent magnitude of difference between data units on a scale with an arbitrary zero point. The Fahrenheit temperature scale is an example of interval data as the zero point is arbitrarily appointed and the degree of change between values is equal. Similarly, ratio variables have a consistent magnitude of difference between data units, but the scale contains an absolute zero. This is best reflected in measures of blood pressure, where the zero indicates an absolute absence of any measurable blood pressure.

Tip #3 Check for independence The independence of your individual data points is an important assumption for many statistical tests. Dependent data are most often derived from the same subjects (e.g. paired data, pre-post data, cross-over data) while independent data come from different subjects (e.g. most randomized trial data). Data can also be considered dependent if data are matched with participants based on characteristics such as age or sex

Tip #4 Describe Your Data Two main aspects of data you should consistently be described. These include where the majority of the data are located (e.g. central tendency) and how widely spread or distributed it is (e.g. variability). These characteristics are also referred to as descriptive statistics.

Discrete data are further classified into either nominal or ordinal variables. Nominal data have two or more conditions or states that have no intrinsic ranking. For example, marital status (single, married, divorced) or smoking status (current, former, non-smoker). Ordinal data are similar, but are differentiated by the presence of a meaningful ranking. Many classification systems in medicine are ordinal such as the New York Heart Association (NYHA) Heart Failure classification system, the APACHE II score for assessing mortality risk, and simple scales (e.g. never, rarely, sometimes, usually, always).

Measures of central tendency include: mean, median, and mode. The mode of a data set is the value that occurs most frequently. The mean of a set of data points is the overall sum divided by the number of data points; the mean can also be referred to as the average of the dataset. Means are most useful for describing data that is normally distributed and without outliers. The median represents the value of the data set that is directly in the middle of all of the other values when they are arranged in order. The median is useful in describing data which is non-normally distributed or contains outliers. Consider the classic example of individuals in a room with a mean salary of $50,000.

Suddenly, Bill Gates walks in; the median salary remains the same, but the mean greatly increases due to the presence of an extreme outlier, and as a result, no longer represents the bulk of the data.

Continuous data are quantitative measures that may be any value between the minimum and maximum measurable range, such as body weight. Continuous data are further classified into interval or ratio variables.

The two most common measures of variability are the standard deviation and the range. The range of a set of data points describes the difference between the highest value and the lowest value in the set. The standard

38 Pennsylvania Pharmacist — May/Jun 2020

Table 1: Common Statistical Tests Variable Classification

Independent vs.

Dependent Data

Number of Data Sets Two

Independent Three or more

Statistical Test Indicated Chi Square, Fisher Exact Test Contingency Table

Nominal Two Dependent Three or more Two Independent Three or more

McNemar Test Chi Square with Multiple Comparison Correction Mann-Whitney U Test, Wilcoxon Rank Sum Kruskal-Wallace Test

Ordinal Two

Wilcoxon Signed Rank

Dependent Three or more

Friedman Test

Two

Student t Test

Independent Three or more

ANOVA (analysis of variance)

Continuous* Two

Paired Student t Test

Dependent Three or more deviation compares each value to the mean of the data set. In normally distributed data, one standard deviation from the mean includes 68% of values and two standard deviations from the mean includes 95% of values for the data set.

Tip #5: Choosing a Statistical Test The type of statistical test you choose depends on many of the factors discussed above. Table 1 provides a list of common statistical tests and the circumstances in which they should be used. Keep in mind, some of these tests have additional caveats or assumptions to consider, and whenever possible, you should consult a statistician.

Conclusion Analyzing data can be intimidating. These simple tips can help you begin to understand your data. More sophisticated analysis is often possible and necessary to gain the most out of your data and partnering with a statistician is highly recommended. Beyond your own projects, these tips can be used to help you understand

ANOVA for Repeated Measures

and appraise data presented in the literature facilitating application to practice.

References 1. Heim M, Look K, Margolis A et al. Statistics Review Series. Pharmacy Society of Wisconsin. October 2013.http://www.pswi.org/ Communications/The-Journal/Statistics-Review-Series. Accessed: February 28, 2020.

2. DeYoung GR, Olin JL, Vasquez EM, Waller JL. Understanding Statistics: An Approach for the Clinician.

Pharmacotherapy Self Assessment Program. https://www.accp.com/docs/bookstore/psap/p5b05samplemod1.pdf.

Accessed: February 28, 2020.

3. Nigam V. Statistical Tests - When to use Which ? Medium - Towards Data Science. https://towardsdatascience.com/statistical-tests-whento-use-which-704557554740. Published December 4, 2018. Accessed February 28, 2020.

4. Normal vs. Non-Normal Distributed Data Comparing Results. Statit Support. http://www.statit.com/support/quality_practice_tips/ normalvsnon-normal.shtml. Accessed March 10, 2020.

5. What do we mean by “Normal� data? Engineering Statistics Handbook. https://www.itl.nist.gov/div898/handbook/pmc/section5/pmc51.htm.

Accessed March 10, 2020.

7. Non Normal Distribution. Statistics How To. https://www. statisticshowto.datasciencecentral.com/probability-and-statistics/ non-normal-distributions/. Accessed March 10, 2020.

www.papharmacists.com 39

CONGRATULATIONS

2020 SCHOLARSHIP WINNERS

Pharmacists Mutual is proud to support students who are interested in serving in an independent or small chain community pharmacy or an underserved geographic or cultural community. Each student listed received a $2,500 scholarship.

AMNA PARACHA University of Maryland Eastern Shore

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