Pennsylvania The official publication of the Pennsylvania Pharmacists Association
PERMIT NO. 533
PAID
HARRISBURG PA
PRSRT STD
U.S. POSTAGE
May/June 2016 z Volume 97 z Issue 3
NOW IS THE TIME
Advancing pharmacists’ role in health care and for protecting patient care
Since 1982
PPA Board of Directors PPA Officers: President: Donna Hazel, R.Ph President-Elect: Eric Pusey, R.Ph, CDE First Vice President: Nick Leon, PharmD, BCPS, BCACP Immediate Past President: Eric R. Esterbrook, RPh
Our Vision
Pennsylvania pharmacists will be recognized, engaged, and fairly compensated as health-care providers.
Regional Directors: Central: Ellen Nastase, RPh Northeast: Tom Franko, PharmD, BCACP Northwest: Nickolas Kernich, PharmD Southeast: Mark Lawson, PharmD, MBA Southwest: Lauren Simko, PharmD
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.
Pennsylvania
Practice Directors: Academia: Roshni Patel, PharmD Chain Pharmacists: Cory Krebs, R.Ph. Community Independent Pharmacists/LTC: Martin J. Kendra, R.Ph and Chuck Kray, R.Ph Health System Pharmacists: Rick Demers, R.Ph, MS FASHP Manage Care/Industry/Government/Other: Julene Vidic, RPh Associates: Todd Eury Student Pharmacists: East: Hamad Juboori West: Madison Adams PPA Office Staff: CEO: Patricia A. Epple, CAE pepple@papharmacists.com Program Manager: Sara Powers spowers@papharmacists.com Government Relations Manager: Donald L. Smith, III dsmith@papharmacists.com Communications Coordinator: Danielle Adams dadams@papharmacists.com Membership Coordinator: Ashley Robbins arobbins@papharmacists.com Bookkeeper: Mia Bostic mbostic@papharmacists.com PPCN Executive Manager: Mindy Kozminski, PharmD, BCACP mkozminski@papharmacists.com PPCN Trainer: Brandon Antinopoulos, PharmD ppcntrainer@papharmacists.com
Our Mission
Ext. 3 Ext. 2 Ext. 6 Ext. 1 Ext. 5 Ext. 4
Pennsylvania Pharmacists Association (PPA) 508 North Third Street, Harrisburg, PA 17101 (717) 234-6151 Fax: (717) 236-1618 www.papharmacists.com ppa@papharmacists.com 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 nonmembers; 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: Hershey S. Bell, M.D.,M.S.,FAAFP, Chair Kim Coley Stephanie Smith Cooney, PharmD. Bernard Graham, PhD. Associate Editor: Danielle Adams Editor/Manager: Pat Epple Designed and Published by: Graphtech Sarah DiCello, Publications Manager (717) 238-5751 x118, sarah@thinkgraphtech.com
MAGAZINE
Departments
President’s Message................................................................................................................3 Calendar of Events..................................................................................................................5 Campus Checkup...................................................................................................................6 New Members.......................................................................................................................44
Features Member Profile: Tamre Joyce, RPh..........................................................................................9 Student Profile: Fidelia Bernice..............................................................................................10 Student Profile: Sydney Kehr.................................................................................................10 Pharmacy Spotlight: Gateway Pharmacy...............................................................................12 PPA Educational Foundation Final Report..............................................................................16 APhA’s Annual Meeting & Exposition......................................................................................19
Journal
Abstract: Assessing Knowledge, Barriers, and Attitudes Regarding Pertussis Disease and Immunization................................................................35
Association News Pennsylvania Pharmacy Legislative Day “NOW Is The Time ...”..............................................21 Pennsylvania Pharmacists Care Network Update...................................................................24 Immunization Grant...............................................................................................................25 Important Message — PPA Elections for 2016–2017.............................................................26 Member News.......................................................................................................................28 ACPA Update........................................................................................................................29 BMPA Meeting February 25, 2016.........................................................................................30 PPA Educational Foundation 2015 Annual Report.................................................................31
Industry News Rx and the Law.....................................................................................................................36 Pharmacists Mutual Releases Fourth Quarter Financial Results.............................................37 Who Are They? What Are They Thinking? Offenders and Pharmacy Robbery & Burglary..........................................................................................38 Financial Report: Comprehensive Financial Planning: What It Is, Why It Matters.....................40 Value Crug Company announces partnership With Avella......................................................41 Script Your Future: Student Driven and Patient Focused with Results....................................43
For Advertising Information: Alexis Kierce, Account Manager (717) 238-5751 x119, alexis@thinkgraphtech.com Pharmacist State Board of Pharmacy Members: Gayle A. Cotchen, PharmD., MBA – Institutional Rob Frankil – Independent Community Janet Hart – Chain Community Theresa M. Talbott, R.Ph. – Chain Community Mark J. Zilner, R.Ph. – Independent Community Board of Pharmacy Meeting Dates: May 10, 2016 June 21, 2016 July 19, 2016 August 16, 2016 On the Cover: Photos from Legislative Day 2016
Disclaimer — The opinions of the authors reflected in this publication do not necessarily reflect PPA’s official position on an issue.
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Departments
Message from the President W ow, it is amazing how quickly time flies. This is my last message as President for the Pennsylvania Pharmacists Association. It seems like just yesterday I was writing my first article, explaining my goals to push patient care to the highest level in the Commonwealth of Pennsylvania and to have “excel lence” in the Board of Directors. I do believe in talking with many of you, pharmacists in the state of Pennsylvania, we have pushed patient care to a higher level. I witnessed first-hand what PPA has done to advance patient care at Legislative Day. The theme for the day was NOW is the time. For PBM Oversight – For Advancing the Role of Pharmacists in Health care – For Protecting Patient Care. I saw so many pharmacists and students tell their State Senators and Representatives what we, as pharmacists, can do to help with patient care across the Commonwealth. As the pharmacists explained what they do for their patients to their legislators, the empathy and care demonstrated by these pharmacists was very heartfelt. Regarding the PPA Board of Directors, I do believe the entire Board acted with the best interest of the entire membership when decisions were made for PPA over the past year. I want to thank the entire Board of Directors for
always upholding our mission statement: “as the leading voice of pharmacy, promotes the profession through advocacy, education, and communication to enhance patient care and public health.” Additionally, the PPCN Network has gained momentum and we have watched it move forward. Looking to the future, PPCN will solidify a payer and be a strong part of PPA. I am looking forward to watching it grow and develop. I would like to thank CEO, Pat Epple, and her staff for all their hard work this last year. We are very fortune to have Pat and her team working for PPA and moving our state association to the next level. I would also at this time like to congratulate Pat Epple, for being named president of NASPA (National Alliance of State Pharm acy Organizations). I know Pat will represent Pennsylvania well!
Many of you have reached out to me and mentioned how each of my President’s Messages has had an element of the Oath of a Pharmacist somewhere in the article. At the end of this, my very last President’s Message, I have the entire Oath. It is a special oath to me, which I have tried to follow throughout my professional career. In closing, I want to thank you, the membership, for giving me the opportunity to serve as your president. I have met many new members across the state this year and many of you have great and innovative ideas, so I challenge you to become more involved with PPA and bring those ideas to the organization as we continue to grow and become stronger. Thank you.
Donna Hazel, R.Ph PPA President 2015–2016 z
The Oath of a Pharmacist “I promise to devote myself to a lifetime of service to others through the profession of pharmacy. In fulfilling this vow: I will consider the welfare of humanity and relief of suffering my primary concerns. I will apply my knowledge, experience, and skills to the best of my ability to assure optimal outcomes for my patients. I will respect and protect all personal and health information entrusted to me. I will accept the lifelong obligation to improve my professional knowledge and competence. I will hold myself and my colleagues to the highest principles of our profession’s moral, ethical and legal conduct. I will embrace and advocate changes that improve patient care. I will utilize my knowledge, skills, experiences, and values to prepare the next generation of pharmacists. I take these vows voluntarily with the full realization of the responsibility with which I am entrusted by the public.”
Pennsylvania Pharmacist I May/June 2016 I 3
Departments
Calendar of Events
Thank You to Our Corporate Partners These companies support PPA activities throughout the year.
DIAMOND LEVEL
May 1–3
NASPA Leadership Conference Denver, CO
2–4
NCPDP Annual Conference Scottsdale, AZ
12
Foundation Board of Directors Meeting
12–13
PCP Law Review
14–17
NABP Annual Meeting San Diego, CA
19
PPA Board of Directors Meeting
PLATINUM LEVEL
GOLD LEVEL
SILVER LEVEL
June 11–15
APhA Summer Meeting Baltimore, MD
July 12–13
PPA Board of Directors Orientation/ Leadership Retreat/ Meeting
23–27
AACP Annual Meeting Anaheim, CA
BRONZE LEVEL
September 22–25 25 25–27
Annual Conference King of Prussia, PA PPA Board of Directors Meeting AACP Annual Meeting
October 3–6 15–19
AMCP Educational Conference National Harbor, MD NCPA Annual Conference New Orleans, LA
For additional events including webinars, CE opportunities, and PPA committee meetings, be sure to see our Calendar of Events on the PPA website!
Tony Hayslip, ABR/AREP 713-829-7570 Tony@RxBrokerage.com
Ernie Zost, RPH 727-415-3659 Ernie@RxBrokerage.com
Pennsylvania Pharmacist I May/June 2016 I 5
Departments
Campus Checkup Duquesne University Contributed by: Michaela Palermo, Communications Ambassador Duquesne University PPA Chapter has had quite year. We also took nominations at the March General an active semester thus far! Two financial advisors Meeting. The last meeting of the semester and PPA spoke at our February General Meeting. We had a elections will be held later this month. Currently, four very special guest, the President of PPA, Donna Hazel; Duquesne members are running for positions on the speak at the March General Meeting. She spoke about PPA Student Advisory Board. We will be voting and Legislative Day preparation and current pharmacy hoping that the elections turn out in their favor! z legislation. We had 32 attendees at Legislative Day this
Jefferson College of Pharmacy Contributed by: Matthew McGuire, Communications Ambassador Students at JCP have been very busy. Our Legislative Day, JCP hosted Don Smith for a lunchtime Generation Rx - Be a Part of the Conversation Event information session. During the event at the State —“From Rx to Heroin”— had a very large turnout Capitol we had an interactive display to help from students, healthcare professionals, and the generate awareness about peripheral neuropathy in general public; 268 people in total. All of our patient older adults and our student pharmacists conducted care organizations have been actively blood pressure readings. Our PPA SPPA Leadership educating patients while conducting events at wanted to bring information from the PPA MidWalgreens, Mother Bethel Church, and the Rittenhouse Year Conference back to our members who were Square farmers market. Our Generation Rx members unable to attend, so we have planned an Emergency even spoke with young students at the Southward Preparedness Event to provide our students with an Elementary School on topics such as medication idea of how they can make a difference during a safety. Given the level of student interest in attending disaster. z
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Departments
Philadelphia College of Pharmacy Contributed by: Ada Wu, Communications Ambassador Students at the Philadelphia College of Pharmacy held a briefing before Legislative Day, so that students who attended could be prepared to meet with Legislators. We promoted awareness of students advocating for propositions that matter to them, such
as obtaining Provider Status. We hosted a letter writing campaign to allow students to learn more about what Provider Status would mean for pharmacists, and how they could communicate their opinions on why it would be beneficial to have in Pennsylvania. z
Temple University Contributed by: Jennifer Nguyen, Communications Ambassador A successful Letter-Writing Campaign was held in on drug safety. Lastly, an interprofessional health fair conjunction with Wilkes and PCP where together we was organized in collaboration with PHSP and IHI to sent Senator Toomey about 400 letters in support provide about 150 kids grades K-2 education about of Provider Status. Additionally, two Legislative Day a variety of topics including medication safety, how training sessions took place in order to further prepare some medications can sometimes look like candy, a very large Temple turn-out of about 70 student and proper teeth brushing technique. The health fair attendees. In honor of Patient Safety Week, a poster featured students from Temple pharmacy, medicine, on OTC medications was prepared and presented at dental, and physical therapy. z the Temple University Hospital to educate the public
University of Pittsburgh Contributed by: Laura Yost, Communications Ambassador The University of Pittsburgh had an incredibly eventful Legislative Day. In preparation for our trip to Harrisburg, Pat Epple was able to visit Salk Hall to discuss important Legislative Day topics with the entire P2 class. On April 6th, nearly 150 Pitt student pharmacists met with state Senators and Representatives to promote important issues such as fair pharmacy audits and interchangeable biological products. Also during Legislative Day, Pitt students presented data from various patient care initiatives implemented in 100 pharmacies throughout the Pittsburgh area. Script Your Future, a medication adherence challenge, impacted 1,140 individuals in
the community who pledged to take their medications as prescribed. We also implemented the CDC program, “Get Smart About Antibiotics�, in order to raise awareness of antibiotic resistance and the importance of appropriate use. Finally, we held an immunization screening booth at which legislators could determine if they were up to date with their vaccination schedule. The Pitt PPA chapter has also been participating in patient care initiatives within the Pittsburgh community. As part of Operation Immunization, students tabled in local pharmacies to promote influenza, pneumococcal, and shingles immunizations — all of which can be administered directly in most community pharmacies.
Pennsylvania Pharmacist I May/June 2016 I 7
Departments CAMPUS CHECKUP continued We debunked common myths about vaccinations and explained the benefits of getting immunized by your pharmacist! We have also been preparing to implement Katy’s Kids programming. Student pharmacists have been formally trained on educating kindergarten – 2nd grade kids about medication safety and poison prevention. All participants will shadow a poison prevention call center for an hour in order to observe how emergency situations are handled. Katy’s Kids events are planned in local elementary schools and libraries in the upcoming months. z
Wilkes University Contributed by: Kristen Lopatofsky, Communications Ambassador The Wilkes University PPA chapter was very busy the Wilkes APhA Generation Rx at the annual Wilkes preparing for Legislative Day. Wilkes had around 30 Health Fair to educate on proper medication safety students attend Legislative Day! Thank you to our and disposal. In addition, we held a Wilkes portfolio Government Relations Ambassador, Keri Diehl for fundraiser and are planning a chapter social. coordinating with the PPA office for this event. In As the year comes to a close, the Wilkes chapter addition, we have a number of students participating will be sending off many of its officers and will be in the GRASP program and held mock legislative meet introducing a new crew for this coming fall. Thank ings with our professors to prepare for Legislative Day. you to our past officers and good luck in your future The Wilkes PPA chapter also collaborated with endeavors! z
8 I Pennsylvania Pharmacist I May/June 2016
Features
Member Profile Tamre Joyce, RPh Contributed By: Shaina Kulp, Philadelphia College of Pharmacy, PharmD Candidate 2016 Pharmacy/Practice Site: CVS (34 years) Education: RPh — Duquesne What made you choose the profession of pharmacy? I really liked the sciences, especially biology and medicine and wanted to do something in medicine. Also, my godmother was a pharmacy technician for an independent pharmacy and I always thought what she did was pretty interesting. What are some of the most memorable experiences you have had in your career? I have received some grants and went out into the community and helped with ribbon week, drug awareness week, and career programs with the schools in the local Stroudsburg area. I really enjoyed working with the kids and teaching them about medications and pharmacy and I still volunteer with schools for these events. If I was not a pharmacist, I would not be able to participate in those kinds of events. When I first started working as a pharmacist, I did not realize I would have these opportunities to teach children and the community Why did you decide to join PPA? I have been a member since I was student, but I really got involved after I started practicing. Even as a student I wanted to get more involved, meet more people and
be a part of a group that would move my career forward and being involved in PPA allowed me to do all of that. I also believe in grass roots politics and did not know how to pursue that on my own, but being involved in PPA gives me the opportunity to explore that and be a united front. Where do you see the profession of pharmacy in five years? I see us being a lot more involved in people’s overall health and working more closely with doctors and other healthcare providers. I also see pharmacy becoming more specialized and pharmacists getting into more specialized fields. I think we will be more utilized for the unique knowledge that we possess.
What advice do you have for new pharmacists? Find your talent and utilize everything you learned in school. It is also important to work with a mentor so they can help translate things into the real world because it can be overwhelming, but do not get discouraged. There are a lot of ways you can get involved and make a difference. If you were on a stranded island what 3 medications would you take with you and why? I love this question! Only pharmacists would ask something like this! I would bring Claritin in case something would bite me and I would swell up. I would bring also Imodium because I do not know what I would be are eating and Tylenol for any aches and pains I might have. z
Pennsylvania Pharmacist I March/April 2016 I 9
Features
Student Profile Fidelia Bernice School: Philadelphia College of Pharmacy, PharmD Candidate 2016 Internships: Pharmacy Intern at the Hospital of the University of Pennsylvania What made you choose to study pharmacy? I have been interested in the sciences since I was younger and always envisioned myself in healthcare. I learned about pharmacy during my junior year of high school through a mentor. This career path seemed to be the perfect blend of science and practical, meaningful work that helped people. Why did you become involved with PPA? I initially became involved in PPA through the encouragement of one of my school’s previous student directors, Antonella Frattarelli. She introduced my classmates to the organization and persuaded us to attend a Mid-Year Conference. Since attending this conference two years ago I have continued to be involved with the organization and even took on a leadership role as a Communications Ambassador during my P3 year. What is your favorite experience you have had since studying pharmacy? While in school, I was part of a specialized, longitudinal interprofessional IPPE where pharmacy and medical students worked together to deliver healthcare
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services to the uninsured population of Camden, NJ. We were able to provide healthcare services and free medications to patients who may have otherwise not been helped. Access to healthcare is something that I am very passionate about and I was glad to be a part of this program that helped so many people. What would you like to do in your pharmacy career? After graduation, I would like to compete at PGY1 residency program and pursue specialized training in infectious disease afterwards. Ultimately, I would like to be an infectious disease specialist with a focus in HIV within a large academic medical center. What advice would you give to first year pharmacy students? You are going to learn and grow so much during your time in pharmacy school. I think the most important thing you can do is to explore any and every opportunity that is presented to you. You may surprise yourself and find a new interest or a new path in pharmacy that you were never exposed to before. What do you like to do when you are not studying or working? When I’m not studying or working I like to spend time with my family. I also love to travel and going to concerts and Paint Nites with friends. z
Sydney Kehr School: Duquesne University, PharmD Candidate 2016 Internships: NCPA, Select Specialty, Asti’s South Hills Pharmacy, UPMC Passavant Member since: 2015
Would you recommend joining PPA to other students and why? Yes, even if you are from out of state, PPA and NCPA believe in advocating for our profession. If we don’t, no one else will, so it is important to join organizations that support our cause. What is your favorite experience you have had since studying pharmacy? I chose the Entrepreneurship concentration at Duquesne University with Dr. Robert Maher, Jr., to learn how to properly develop a business plan in order to open my own pharmacy. PPA also awarded me a grant to attend the NCPA annual convention in Washington, DC this year. These opportunities together made my pharmacy experience so memorable and I am so grateful for PPA and NCPA’s support. What has been your favorite rotation/internship/pharmacy related job you’ve been on and why? I absolutely loved my rotation with NCPA in Alexandria, Virginia. While there I was able to write articles for their national publication, America’s Pharmacist, visit Capitol Hill to attend hearings related to pharmacy, including a nationally televised hearing on Medicare Part D, and visit the other pharmacy associations in the Virginia, Maryland and DC area. What advice would you give first year pharmacy students? If this is what you really want, do not give up. It is going to get harder, and it is going to be stressful, but you can do this. Find friends who will support you. Remember God is there for you and He will get you through this. z
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Features
Gateway Pharmacy: It’s All In the Family By: Lindsey Wenger, Philadelphia College of Pharmacy PharmD Candidate 2016 The Pharmacy’s History Gateway Pharmacy has been a staple of the Phoenixville, Pennsylvania community since the 1950’s. Located in the heart of Phoenixville, convenience is a huge reason for its success. Gateway is located across the street from the Phoenixville Hospital and near many local businesses, schools, and homes. In 1982, the Katra’s and the Szilagyi’s came together and bought the historic Gateway. In the late 1980’s, they began renovating the pharmacy and added additions onto the original pharmacy in order to expand their services to the community. In 2001, Custom Prescriptions was created, which provides compounding services to patients. Since Gateway has the ability to “fill the niche of the community”, patients have and will remain loyal to Gateway Pharmacy for years to come. The Families Behind the Pharmacy The Katra’s and the Szilagyi’s have owned Gateway Pharmacy for over 30 years. Together, the families have four children who are all pharmacists: Nick, Kristin, Jenn, and Mark. Jenn and Mark are the children of co-owner Mark Szilagyi. Practically growing up in Gateway
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pharmacy, they both followed in their parent’s footsteps and went into the business. Jenn, the pharmacist for Custom Prescriptions, graduated from the University of the Sciences in Philadelphia in 2008. Jenn has been interning at Gateway since she was old enough to work. Long before that, she “barely has a memory that doesn’t include Gateway.” Jenn
had worked with compounding throughout her educational years and when Gateway acquired Custom Prescriptions, she knew that she wanted to work there again. Now that Mark and Jenn are licensed pharmacists, they have been learning the ropes of owning a business and will likely take over Gateway Pharmacy in the future. Continued on page 14
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Features Although Jenn is not an owner yet, she has seen how much work it takes to run a successful business. When asked what her biggest challenge has been in the learning process, she noted how difficult it is to nail down the little details in each department of the store. She knows the pharmacy like the back of her hand, but she’s working on learning everything there is to know about running the store as a whole. Even though there will be some challenges along the way, Jenn knows that she has the support of Gateway Pharmacy behind her. She has been a part of Gateway her entire life and many of the technicians and sales associates have been there since before she was born. “I grew up here. We’re all a big family.” Gateway Has It All! When entering Gateway Pharmacy, you are immediately struck by the size of the facility. In the front of the store, there is an abundance of gifts, cards, food, school supplies, cosmetic products, and a candy counter. Custom Prescriptions is located in the area where the old pharmacy once stood. Custom Prescriptions started out providing mainly hormone replacement therapy. They have since expanded their services to include veterinary products, other medications that need to be put into a liquid form for easier administration, and much more. In the new addition, located in the back of the store, are a home medical equipment area, over-the-counter products, and the main pharmacy. The home medical equipment area is abundant; containing canes, walkers, wheelchairs, lift chairs, nebulizers, and plenty more. More importantly, there are educated sales associates who work in this area to suggest and locate products for patients in need. Being directly across the street from the Phoenixville Hospital provides Gateway with an opportunity to deliver medical equipment to inpatient and outpatient facilities as needed, especially nebulizers. Pharmacy Involvement in the Community Gateway Pharmacy did not become a renowned business by filling prescriptions alone; they did so by giving back to the community. For years, Gateway has held health fairs at the YMCA and the senior circle hospital about hygiene, disease states, and many other topics. Jenn also speaks with senior citizens about
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compounding and medical equipment that may assist them. “You never realize you are struggling until you find something that makes your life easier.” Gateway also runs a free clinic at different points throughout the year and participates with Phoenixville Area Community Services (PACS) during food and hygiene drives. Value of Professional Organizations Many pharmacists understand the importance of professional organizations and individuals at Gateway Pharmacy are no different. They value organizations like the Pennsylvania Pharmacists Association (PPA) and the National Community Pharmacists Association (NCPA) because they give independent pharmacies a voice. At times, chain pharmacies have an upper hand. Independent pharmacies gain support from organizations like PPA and NCPA as well as from other independent pharmacy owners. Independent pharmacy is like one huge chain pharmacy and organizations bring them together. z
IT’S TIME TO HAVE THE TALK WITH YOUR FUTURE PHARMACISTS. As a pharmacist, you may know someone in your family or at work who’s thinking about becoming a pharmacist. Let them know pharmacy is a well-paying, patient-centered profession with a major role in health care. Then tell them about the LECOM School of Pharmacy and our innovative, affordable student-centered pathways. Tell them how the Erie three-year accelerated program can save as much as $70,000 or more* in tuition compared with more expensive, private four-year programs. Tell them how the LECOM Distance Education program allows students to learn from home without the expense or burden of moving to another city. Tell them how they can also choose the equally affordable traditional four-year program at our beautiful state-ofthe art campus in Bradenton. Tell them to choose the Lake Erie College of Osteopathic Medicine School of Pharmacy. Welcome to LECOM. Visit LECOM.edu *LECOM, PA 3-year tuition = $76,470; LECOM, FL 4-year tuition (out of state) = $101,960; LECOM Distance Education Pathway = $100,120; National Average tuitions range from $149,064 for a 3-year program to $145,500 for a 4-year program. (Source: American Association of Colleges of Pharmacy).
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Features
PPA Educational Foundation
Final Report
Medication Discrepancies in the Dental Record: Implications on Oral Health By: Hailey Choi, PharmD; Autumn Stewart, PharmD, BCACP This study and report was made possible in part through a grant provided by the PPA Educational Foundation grant in 2015. This report was not submitted through the peer review process and is presented as a report only. The full report may be found under the Foundation section Grants — 2015 Grants http://www.papharmacists.com/page/FBOD_Grants15 Introduction Patients presenting for dental care frequently use medications with the potential for negative implications on oral health or the dental provider’s plan of care.1-5 Medications may affect oral health by causing orofacial effects (e.g., xerostomia, mouth ulceration, oral candidiasis, etc.).2,5 Medications can affect dental management as a result of direct effects of medications on parameters such as bleeding risk or drug-drug interactions with local anesthetics and vasoconstrictors.7,8 In addition, there are potential drug-drug interactions between medications taken by patients and those prescribed by a dental provider.2,9-13 In 1992, Miller and colleagues reported on findings from a retrospective chart review of over 5,000 patients from two dental school clinics in the United States. Over 40% of patients in this study were taking medications with the greatest use among the elderly, women, and blacks. The most common types of potential adverse effects of dental importance by medication use were xerostomia (15.8%), gastroesophageal irritation (12.9%), and abnormal bleeding (11.2%). The authors emphasize the need for dentists to be aware of not only the medications
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taken by their patients but also the potential effects and drug interactions that can result from their therapies.1 Similar findings were reported in a 2003 study from five general dental practices in England, where Brindley and colleagues found that over the course of a 5 month period, 26% of patients seen were taking systemic medications with a majority having the potential for significance to the dental provider’s plan either due to orofacial side effects caused by the medication or a potential interference with the dental management of the patient due to the medication itself.2 The research findings from Brindley and Miller emphasize the need for dentists to identify each medication and its potential effects or interference with the plan of care. However, each of these studies’ findings is limited by the presumed accuracy of the medication list in the dental chart or assessing prescription medications only. Little is known about discrepancies in medication lists in general dental practices or the clinical significance of those discrepancies on oral health and dental treatment procedures. Although patient medication histories are routinely gathered prior to the dental visit in
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Features most practices, observations from other outpatient care settings suggest the list generated in the dental provider’s office may contain incomplete and inaccurate medication lists.14-15 A 2007 study by Nassaralla et al reported only 7.7% of medication lists in an internal medicine outpatient clinic were accurate.14 Even with the use of electronic medical records, discrepancies persist at an alarming rate.15 Discrepancies between the list gathered in the dental provider’s office and the patient’s actual behaviors may lead to drug interactions, duplicate therapy, unnecessary therapy, or a failure to evaluate adverse oral effects caused by medications. Given the amount of time since the previous studies were conducted and their limitations, a more accurate estimate of the current frequency of use of medications with potential negative implications on
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oral health is needed. Using models for medication reconciliation from other ambulatory care settings and adapting them for use in dental practices may provide a more complete medication list and thus, a more accurate estimate of the problem. To respond to this need, phase 1 of the study was conducted to describe the frequency and clinical significance of medication discrepancies between the lists collected through usual care and medication reconciliation conducted by a clinical pharmacists, and phase 2 of the study was conducted to evaluate the impact of a pharmacist led training on dental professionals ability to obtain an accurate medication list. Please see the rest of this report online at http://www. papharmacists.com/page/FBOD_Grants15 z
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18 I Pennsylvania Pharmacist I March/April 2016
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Features
APhA’s Annual Meeting & Exposition March 4–7, 2016 Baltimore, Maryland Over 300 alumni, students, and PPA members attended the Pennsylvania Reception at APhA’s Annual Meeting on Saturday, March 5th in Baltimore, Maryland. Attendees from all seven Pennsylvania schools of pharmacy were given the chance to network and reconnect with APhA conference attendees! The following are pictures of alumni, students, and PPA attending the Pennsylvania Reception. z
The University of Pittsburgh
Wilkes University
LECOM
Thank you to those who served and were present at one or more of the 2016 APhA House of Delegates sessions: Mayank Amin, Kimberly Carter, Julie Gerhart-Rothholz, Daniel Hussar, Mindy Kozminski, Mary McManus, Julie Olenak, Roshni Patel, Eric Pusey, and Kristal Ross.
Pennsylvania Pharmacist I March/April 2016 I 19
Features
Duquesne University
Jefferson College of Pharmacy
Philadelphia College of Pharmacy
Temple University
Association News
Pennsylvania Pharmacy Legislative Day “NOW Is The Time…” On April 6, more than 400 pharmacists and student pharmacists from all across Pennsylvania converged in Harrisburg to advocate for “NOW is the time…” for Pharmacy Benefit Manager (PBM) oversight, for advancing pharmacists’ role in health care and for protecting patient care! Attendees visited over 160 legislators and staff armed with this message; while also discussing key legislative issues including PBM Registration/MAC Transparency, Pharmacy Audit Integrity and more. The day began with a continental breakfast in the East Wing of the Capitol, along with screenings, displays and information provided by Pennsylvania’s
schools of pharmacy. Legislators, staff and the public learned ways to better manage their prescriptions and overall health by conversing with the students and participating in screenings on the following topics: • Duquesne University Mylan School of Pharmacy: Cardiovascular Health and Smoking Cessation • Lake Erie College of Osteopathic Medicine (LECOM) School of Pharmacy: Collaborative Practice Agreements • Jefferson University School of Pharmacy: Geriatric Simulation
Students held Legislative appointments with State Senator Sean Wiley (D) 49th District.
Pharmacists and pharmacy students attending the meeting with Dr. Rachel Levine, Physician General.
Legislative Day
Legislative Day
Continued on page 22
Pennsylvania Pharmacist I May/June 2016 I 21
Association News
Duquesne University Mylan School of Pharmacy
Jefferson College of Pharmacy
LECOM School of Pharmacy
Philadelphia College of Pharmacy
Temple University School of Pharmacy
University of Pittsburgh School of Pharmacy
22 I Pennsylvania Pharmacist I May/June 2016
Association News • University of Pittsburgh School of Pharmacy: Immunizations • USciences/Philadelphia College of Pharmacy: Diabetic Education • Wilkes University Nesbitt College of Pharmacy: Proper Medication Disposal • Temple University: Interactive OTC Display In addition to meetings with legislators or staff, several special meetings were set up for small groups of attendees at the PPA office. These informal meetings included presentations and/or discussions with: Senator Rich Alloway — a legislator and pharmacy advocate who is the sponsor of PBM Registration/MAC Transparency and Pharmacy Audit Integrity bills in the Senate; Mr. Jason Snyder — Policy and Communications Director, Pennsylvania Department of Drug and Alcohol Programs who spoke about the Prescription Drug Monitoring Program, Naloxone, and other department initiatives surrounding prescription drug abuse and misuse; and Dr. Rachel Levine — Physician General, Pennsylvania Department of Health, who spoke on standing orders for naloxone, Department of Health initiatives and more! Later in the day, attendees filled the grand staircase in the Main Rotunda for the “Now Is The Time.” rally and press conference. The rally focused on the need for oversight of pharmacy benefit managers, along with the maximum allowable cost list transparency, covered by PPA’s President-Elect Eric Pusey, RPh; for fair and uniform auditing practices on pharmacies by Past President Eric Esterbrook, RPh; the role of pharmacists as patient care providers covered by Nicholas Leon, PharmD, BCPS, BCACP and the role of pharmacists’ in patient
Wilkes University Nesbitt College of Pharmacy
care and medication management by President Donna Hazel, RPh. In less than eight hours, we made a huge impact in on legislators and staff. PPA thanks everyone who took the time to travel to Harrisburg for Pennsylvania Pharmacy Legislative Day; and we hope you will consider adding your voice to the more than 400 pharmacists and student pharmacists next year! More photos of the event can be viewed on PPA’s Flickr page. z
Pennsylvania Pharmacist I May/June 2016 I 23
Association News
Pennsylvania Pharmacists Care Network Update Executive manager report Over the last few months I have been working hard to get up to speed with all the great work that has been done to get us to where we are today. Thanks to the efforts of many PPA members and the support of the PPA board, we now have an excellent training program, a web based patient care toolkit available, and a research survey underway to establish our baseline landscape of outpatient and community pharmacists providing clinical services across the state of Pennsylvania. This is truly remarkable! However, there is still much work to be done around continuing to engage and organize our network pharmacists, and successfully market our network to a payer looking to add value and quality to the care their members receive. I am working hard to try and establish a contract, but I need you! The more ready, willing, and able pharmacists we have, the easier it becomes to sell our network. Pharmacists can add significant value to the healthcare system, especially when we join together and practice at the top of our license. PPCN want to be the network that high
performing pharmacists join in order to receive compensation for the clinical services you provide. Goal To be a premier professional network of pharmacists in Pennsylvania collaborating to optimize appropriate medication use to promote positive patient health outcomes. Vision To improve patient outcomes by connecting pharmacists to the patients that need their help and partnering with payers so that this service is fairly reimbursed and sustainable. Ultimately by providing medication management services to those that need them PPCN pharmacists will be able to improve patient outcomes, increase quality measure ratings, and lower overall healthcare costs. Interested? If you have not already, please consider joining the Comprehensive Medication Management Collaborative (CMMC). As a member of the CMMC, you will have immediate access to the training program
in addition to other benefits. We want the CMMC to be a place where we can foster learning and share best practices in order to help others be successful in their effort to provide better care to their patients and advance the profession of pharmacy. Once competing the training, you will have completed the first step to be eligible to participate in any contracts we are able to secure. Do you want to advance the profession of pharmacy? It starts with you! Join the CMMC today! For more information about the training program and to sign up please visit PPA’s website: http://www.papharmacists.com/-Under Resources – click “Join the CMMC.” Not quite ready to join? You can also just let us know your interested by completing the form at the bottom of the page! Please email me with questions, suggestions, or for more information! mkozminski@papharmacists.com
z
Association News
Immunization Grant The U.S. Centers for Disease Control and Prevention (CDC) recently awarded the Philadelphia Department of Public Health (PDPH) a $1 Million grant for a two year project to improve adult immunization rates for influenza, pneumococcal, zoster (shingles), and hepatitis B vaccines. This grant allows the PDPH to expand and improve its current services, while enhancing immunization capacity among its partners. The project will take a comprehensive approach to improving adult immunization rates, which includes partnering with pharmacists and healthcare
providers, enhancing quantity and quality of data recorded in the City’s Immunization Information System, and expanding communications between vaccine providers and the local Immunization Program. One of the main goals of the campaign is to encourage more Philadelphia pharmacists to become certified pharmacist immunizers and to offer continuing education about adult vaccines to Philadelphia pharmacists. PDPH partners in this effort include the Pennsylvania Pharmacists Association (PPA) and the Philadelphia Association of Retail Druggists (PARD).
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Pennsylvania Pharmacist I May/June 2016 I 25
Association News
Important Message — PPA Elections for 2016–2017 PPA Online Voting is now open! Your vote is important and we encourage members to cast your vote for the individuals you wish to represent you and the pharmacy profession. Your vote is confidential and the system is tied to only allow an eligible person to vote only one time and only for appropriate positions on the ballot! To cast your vote – here is what you need to do: 1 – Go to this website: www.associationvoting.com/ papharmacists/ 2 – Login by entering your last name and member ID that were emailed to you — or contact Ashley Robbins at the PPA office if you have misplaced these. Her email is arobbins@papharmacists.com or phone is 717.234.6151 extension 105 3 – Review the candidate options for the categories in which you are entitled to vote (see right), check your selected candidates, and cast your ballot! 4 – Please note that ballots MUST be cast before midnight on May 10. Voting is open beginning now and will continue until Midnight on May 10, 2016. At which time, shortly thereafter the Nominating Committee will certify the results. Your ballot will be matched to your ID and Last name, so you will only be able to vote for the offices for which you are entitled. However, if you believe there is an error in the options you have
26 I Pennsylvania Pharmacist I May/June 2016
— do not cast your vote, exit, and please contact us. If you have any problems in doing this or have any questions, please contact the PPA office at (717) 234-6151 and speak with either Ashley Robbins or Pat Epple. Or email one of these individuals at arobbins@ papharmacists.com or pepple@ papharmacists.com. Any member who prefers to receive a paper ballot, may do so by contacting the office, prior to April 30, 2016 and we will send you one which will need to be returned by May 10.
First Vice President – Richard Demers, RPh, MS, FASHP, Mark Lawson, PharmD, MBA or Lauren Simko, PharmD
The following elections are scheduled for this year and the Nominating Committee announces the candidates for each: Please note that in some cases these positions have more than one candidate. Please carefully review their brief biographical information available on-line at the voting site, to aid you in selecting the best candidate to represent you, the profession, and PPA! In ALL Cases, you can also submit a write-in vote.
Director –Managed Care/ Government/Industry – Julene Vidic, RPh.
PPA Officers: (All of the following are for one-year terms) (Only active pharmacist catego ries of membership vote for these positions) President-Elect – Nicholas Leon, PharmD, BCPS, BCACP
PPA Board of Directors: (All are for two year terms) (ONLY members of the respective practice setting may vote for the Director by choosing one) Director – Community Chain – Stephen Pfeiffer PharmD, MBA, RPh or Sheena Patel, PharmD Director – Community Independent/ LTC – Stephanie Smith Cooney, PharmD
(Only pharmacist members of the respective region may vote for the Director by choosing one) Director – Central Region – Robert L. Killoran, RPh. or Ellen Nastase, MS, RPh Director – Northeast Region – Thomas Franko, PharmD, BCACP. Director – Southwest Region – Corey Krebs, RPh PPA Student Advisory Board (SAB): (Only student members cast their vote for these and only select one in each category: PPA Director East – Jennifer Smith or Rachel von Vital PPA Director West – Marissa Badzik, Dalton Fishel or Carly Malivuk
Association News Foundation Director – Jamie Celento, Kristen Lopatofsky or Rebecca Wytiaz Chair – Jamie Celento or Rachel Richter Vice Chair – Jennifer Fever, Mary Kimmel, Felicia Snyder or Alexis Stinson Corresponding Secretary – Olivia Marchionda Recording Secretary – Nicholette Diehl Allegheny County Pharmacists: (Only ACPA members may vote for these positions. Please choose one) ACPA President Elect – Kyle McCormick, PharmD ACPA Vice President – Nicholas Wytiaz, PharmD ACPA Secretary – Christine Jordan, PharmD or Jacqueline M. Klootwyk, PharmD, BCPS, BCACP ACPA Treasurer – Ashley Firm, PharmD or Ann Johnson, PharmD ACPA Director – Choose two: Michele Hebda, PharmD, TTS or Ravi Patel, PharmD BucksMont Pharmacists: (Only BMPA members may vote for these positions) BMPA Director – (Bucks County) Choose 2: Michael M. Brown, R.Ph, Vaishali V. Rawani, PharmD or Maria Wilde, RPh BMPA Director – (Montgomery County) Choose one: John C. Barrett R.Ph. MBA Lehigh Valley Pharmacists: (Only LVPA members may vote for these positions. Please choose one) LVPA President – Edward Bechtel R.Ph. LVPA President-Elect – Howard C. Cook, Jr., R.Ph., BCNSP, FASHP LVPA Secretary – Kristen M. Hartzell, Pharm.D., BCACP LVPA Treasurer – Gary Fields RPh LVPA Director – Choose four: Erin Fitzgerald, Pharm D or Leslie Johnson, PharmD, BCPS z
Association News
Member News Alan Vogenberg was featured in the Bucks County Medical Reserve Corps Quarterly Newsletter in the BC-MRC Volunteer Spotlight. Eric Esterbrook’s pharmacy, Esterbrook Pharmacy at Reading Hospital, was visited by Pennsylvania’s physician general, Dr. Rachel Levine, to promote the importance of Naloxone.
Dr. Andrew Peterson was elected a Fellow of The College of Physicians of Philadelphia. He joined the ranks of some 1,500 innovative leaders elected for their distinguished contributions to scientific medicine, medical education, and public health. Mayank Amin was awarded the Young Alumnus Award from The University of the Sciences Alumni Association. Alan Vogenberg
Congratulations to the following Immunization programs and immunizers for being recognized through APhA’s Immunization Champion Awards: Corporate/Institution – National Winner: Giant Eagle Pharmacy Individual Practitioner – Honorable Mention: Deanne Hall Community Outreach – Honorable Mention: West Penn Hospital Immunization Clinic Eric Wright, PharmD, Co-Director of the Center for Pharmacy Innovation and Outcomes- Geisinger Health System served as an expert panelist on Senator Pat Toomey’s Opioid/ Heroin Abuse Field Hearing. The March 18th event included testimony from expert panelists who provided a unique perspective on the situation in the region so that Congress can develop specific policy proposals related to opioid overprescribing, diversion, and the quality of treatment for addicted individuals. Charles Kray, owner of Hershey CKC Pharmacy, and Pat Epple, PPA’s CEO, were guests on Smart Talk radio discussing the expanded role of pharmacists. PPA’s CEO, Pat Epple, was inducted as the 2016 NASPA President at the APhA Annual Meeting (pictured at right).
28 I Pennsylvania Pharmacist I May/June 2016
Daniel Hussar was awarded a token of appreciation for his 50 years of service to The University of the Sciences. Coleen Kayden was inducted into the Distinguished Alumni Wall of Honor at Penn Manor High School in Millersville, PA. Robert Maher, NCPA Chapter advisor at Duquesne University, received a Catalyst Research Grant Award for Innovative Practice in Pain Management during the NCPA Foundation Awards Ceremony. Patricia Kroboth, University of Pittsburgh School of Pharmacy Dean, was awarded the distinction of Fellow during the American Association for the Advancement of Science annual meeting in Washington, D.C., on Feb. 13, 2016. On Sunday, March 6, 2016 at the APhA Annual Meeting and Exposition in Baltimore, Maryland, Dylan Atkinson, University of Pittsburgh PharmD Candidate 2017, was elected as the 2016-2017 Speaker of the House by a committee of his peers. z
Association News
ACPA Update Members of the Allegheny County Pharmacists Association have been actively getting out into the community the past few months. On March 22nd, Rachael Richter, Mariah Corso, Michaela Palmero, and Carly Malivuk, pharmacy students from Duquesne, went to St. Irenaeus Pre-School and presented to about 25 pre-school students as part of the Katy’s Kids initiative. They talked about working hard in school to become a pharmacist and explained that pharmacists help people by giving them medications to help them feel better. The group read them the book “Pharmacy and Me”, and then reminded them that they should only take medication from adults they trust, like parents, grandparents, nurses, doctors, and of course, pharmacists. Also on that day, AJ Greco and Stan Jonas presented 144 carbon monoxide detectors to the Pittsburgh Bureau
Marissa Badzik, University of Pittsburgh PharmD Candidate 2018
Alvina Tran, Duquesne University PharmD Candidate 2017
of Fire as part of a $3,000 grant from Highmark for Poison Prevention Week. They also helped coordinate, along with other ACPA members, arranging 15,000 prevention safety checklists and Mr. Yuk Stickers to be provided to the community and independent pharmacies through Allegheny County. ACPA also hosted opportunities for members to network and obtain CE. In March, Susan Lenhart-Herman, PharmD presented on Alirocumab (sponsored
by Sanofi) and in April, Scott Drab, PharmD , presented on Current Approaches to Managing Chronic Diabetes Complications (sponsored by Novo Nordisk/PSMI). A special thank you to those presenters and their sponsors! Looking ahead, our annual President’s Dinner will be in June where we will thank current ACPA President, Maria Osborne, for her hard work and leadership this past year. ACPA will also be awarding two $500 scholarships at the President’s Dinner. Each year, ACPA awards a scholarship to one Duquesne pharmacy student and one Pitt pharmacy student. This year’s winners are Alvina Tran, PharmD Candidate from Duquense, and Marissa Badzik, PharmD Candidate from Pitt. Congratulations to the recipients and thank you to those members who helped fund raise and donate to make the scholarships possible! z
Association News
BMPA Meeting February 25, 2016 On February 25, 2016 BMPA hosted an informational dinner meeting generously sponsored by Sanofi Pharmaceuticals at the Buck Hotel in Feasterville, PA. There was an excellent turnout with over 40 members and guests in attendance. After an hour of networking accompanied with hors d’oeuvres and beverages, attendees were treated to a delicious dinner while listening to an interesting presentation titled “Novel Approaches to Lipid Management-Praluent: the first PCSK-9 Inhibitor” presented by Heather Omlor, PharmD, Sr. Regional Medical Liaison, Cardiovascular. The presentation was very interesting, informative and generated much discussion. Following this, Rob Frankil delivered a brief legislative update and also discussed other matters of interest to pharmacists, stressing the importance of the CE credits in the category of child abuse reporting portion of the new PA state board requirement for license renewal. Following these presentations, an open business meeting was held. The most important matter discussed involved the details associated with BMPA implementing a scholarship award for residents of Bucks and Montgomery Counties. Beginning this year, BMPA will sponsor two $500 scholarships, one for a resident of each county. Students may be enrolled in any full time pharmacy school in the United States and must be members of PPA and BMPA, as well as permanent residents of either county. Looking forward to our next meeting, BMPA is proud to host a meeting that will feature a one hour CE program titled “Back to the Future of Antimicrobial Stewardship” presented by David Ezdon, PharmD, clinical pharmacist at Einstein Medical Center, East Norriton, PA. The meeting is tentatively scheduled for June 2, 2016 and a location is not yet determined. More information about the meeting will be posted on the PPA/BMPA web site as it becomes available. z
30 I Pennsylvania Pharmacist I May/June 2016
Jan Kitzen (left) with Sanofi host and guest speaker Heather Omlor
Pennsylvania Pharmacist I May/June 2016 I 31
Association News
32 I Pennsylvania Pharmacist I May/June 2016
Association News
Pennsylvania Pharmacist I May/June 2016 I 33
34 I Pennsylvania Pharmacist I May/June 2016
Journal
Abstract: Assessing Knowledge,
Barriers, and Attitudes Regarding Pertussis Disease and Immunization
Cara Koerner, PharmD; Lauren Osgood, PharmD; Jamie L. McConaha, PharmD, CGP, TTS, BCACP, CDE; Andrea Pfalzgraf, MPH, PhD Corresponding author: Jamie L. McConaha, PharmD, CGP, TTS, BCACP, CDE Disclosure: At the time the study was conducted, all authors affiliated with Duquesne University Mylan School of Pharmacy, Pittsburgh, PA. The author involved in this paper does not have any conflicts of interest, including but not limited to: consulting fees, paid expert testimony, employment, grants, honoraria, patents, royalties, stocks, or other financial or material gain that may involve the subject matter of the manuscript. Funding for this study was provided through a grant from the Pennsylvania Pharmacists Association Educational Foundation. A portion of this study was presented as a poster at the American Society of Health-Systems Pharmacists Midyear Meeting in Orange County, CA on December 8, 2014. Keywords: pertussis, vaccinations, pharmacist, pediatrician, immunization Abstract Background: Pertussis is a contagious disease whose incidence is increasing. Although pertussis is preventable through vaccination, growing numbers of patients are not receiving the DTaP immunization. Typically DTaP is started during childhood and given in a physician office setting. However, community pharmacists are easily accessible to provide information regarding vaccinations as well as administer the vaccines. This study investigated awareness and knowledge of pertussis and the vaccine among adults in the Pittsburgh area. Current immunization rates and potential barriers to receiving the pertussis vaccine were also assessed. Methods: This study utilized an educational intervention and survey methodology. Results: A total of 139 surveys from adult participants at local pharmacies were completed. The majority of respondents were female (64.9%) with a mean age of 49.1 Âą 17.6 years. The majority
of respondents indicated awareness of the disease state (91.2%) and knowledge of its increase during the last couple years (76.3%). However, 54.1% of the respondents had indicated that they were either only immunized as a child, had not been immunized, or were unsure if they had been immunized. Conclusion Our study indicated that many participants in the Pittsburgh area were aware of pertussis, knew it was contagious, and had received the vaccine. Despite this, many lacked knowledge of the specifics of the pertussis disease and vaccine recommendations. Providing education to patients on this topic is an important opportunity for pharmacists in the region. Access to the full article is available online at http://www.papharmacists.com/page/Articles z
Pennsylvania Pharmacist I May/June 2016 I 35
Industry News
and the Law By: Don. R. McGuire Jr., R.Ph., J.D. This series, Pharmacy and the Law, is presented by Pharmacists Mutual Insurance Company and your State Pharmacy Association through Pharmacy Marketing Group, Inc., a company dedicated to providing quality products and services to the pharmacy community.
New Advances We are entering another period of change in the pharmacy profession. We experienced such a period during the 1990’s when collaborative practice and pharmacist-administered immunizations were new topics of conversation. Now we are seeing an enhancement of pharmacistprovided, patient-centered services. And these changes are dovetailing with the drive for provider status for pharmacists. I remember performing kinetic dosing for aminoglycosides at our hospital in the 1990’s. We were very proud of how progressive and advanced we were. Our results were improving our patients’ outcomes. It was only later that we discovered that collaborative practice wasn’t yet authorized by our state practice act. At the opposite end of the spectrum from those who blindly race ahead are those who resist such changes. These are pharmacists who are comfortable in their existing practices and are worried about the extra liability when exposure performing new patient care services. These extra liability concerns have been
36 I Pennsylvania Pharmacist I March/April 2016
discussed in previous articles. Change and progress are necessary to stay relevant and useful in the modern world. The key to managing change is preparation. Ohio enacted a law at the end of 2015 that enhanced the ability of pharmacists and physicians to enter into collaborative practice agreements. Among the authorities granted to pharmacists are; ordering blood and urine tests, analyzing those results, modifying drug regimens (including ordering new drugs), and authorizing a refill of critical medications. Oregon has a new law going into effect in 2016 which authorizes pharmacists to prescribe self-administered oral or transdermal birth control. California has also passed a law similar to Oregon’s. Typically these statutes authorize pharmacists to expand their practices, but they do not require them to do so. So how do you prepare to expand your (and your patients’) horizons? Examine the new practices open to you in your state. Which of them are you currently competent to perform? Which can you obtain addition training relatively quickly and become competent? Which ones best serve the needs of your patients? Once you know that, you
can assess your liability exposure in performing those services. This is done by reviewing your legal duties to your patients. What duties are required for you to provide the service? What possible ways could those duties be breached? What possible injuries that could result from that breach? In this way, you can evaluate your exposure for providing any new service. Once you have decided to move ahead, the next step in preparation is to examine your insurance coverage. You can’t just assume that new practices are covered. Individual insurance companies can determine what they do and do not want to cover in a policy, regardless of what constitutes the scope of practice in your state. It is never safe to assume that you have coverage for something without first asking and validating that with your insurance carrier. For example, there are policies available in the marketplace that exclude damages resulting from patient counseling – whether or not the counseling is required by law. While we are talking about optional activities and services here, your insurance policy should certainly cover the activities that you are required to perform. To
Industry News avoid problems later, it is a good practice to read your insurance policy to make sure that it provides the coverage that you need. Once you have assessed your possible exposure and verified your insurance coverage, you are ready to begin providing advanced services like those authorized in Oregon, Ohio, California and other states. You are part of the next wave of change in pharmacy practice. The profession of pharmacy has
come a long way in a relatively short period of time. In the 1950’s, it was unethical to tell a patient the name of their prescribed medication. Now pharmacist are engaging in extensive collaborative practices, providing MTM and immunizations; even prescribing medications whose names they weren’t allowed to disclose a few years ago. It is an exciting time to be a pharmacist! © Don R. McGuire Jr., R.Ph., J.D., is General Counsel, Senior Vice
President, Risk Management & Compliance at Pharmacists Mutual Insurance Company. This article discusses general principles of law and risk management. It is not intended as legal advice. Pharmacists should consult their own attorneys and insurance companies for specific advice. Pharmacists should be familiar with policies and procedures of their employers and insurance companies, and act accordingly. z
Pharmacists Mutual Releases Fourth Quarter Financial Results Pharmacists Mutual Insurance Company is pleased to report positive results for the fourth quarter 2015. For the quarter and year ending December 31, 2015, the Company experienced increased membership, net income, and surplus. The financial results will soon be filed with the Iowa Insurance Division. A summary of Pharmacists Mutual’s fourth quarter financial results is shown below. In addition to positive fourth quarter financial results, our member satisfaction ratings throughout 2015 all show improvement over the already strong 2014 measures. On a scale of one to five, with 4 meaning
Agree and 5 meaning Strongly Agree, our average rating was 4.6 for overall member satisfaction and 4.3 for claim service satisfaction. 89% of our members rate us 4 or higher. President and CEO Ed Yorty noted “Through our member surveys, I am delighted to see our members reflect my coworkers’ dedication to service. During 2015, nine out of ten members indicated that they would recommend PMC to a friend of colleague. Our success and growth is built on service. The company’s performance in 2015 helps to ensure that PMC will be there during our member’s time of need.” z
(in millions) Quarter Ending December 31
2015 2014
Direct Written Premium
$28.9
$28.9
Net Earned Premium
22.7
22.1
Net Underwriting Income
3.5
3.1
Net Investment Income
1.4
1.3
Net Income
3.3
2.5
Surplus Change
4.9
3.5
Surplus 105.8 97.8
Pennsylvania Pharmacist I March/April 2016 I 37
Industry News
Who Are They? What Are They Thinking? Offenders and Pharmacy Robbery & Burglary Tara O’Connor Shelley, Ph.D., Center for the Study of Crime and Justice (CSCJ), Department of Sociology, Colorado State University. Pharmacists Mutual has been tracking pharmacy crime statistics for over five years in order to develop effective measures to address a growing problem in the United States. We asked Dr. Tara Shelley to share some findings from her groundbreaking research on pharmacy crime from the offender’s perspective. The multi-year study conducted at 32 prisons looked at the diversion of controlled prescription drugs (CPDs) by burglary or robbery. Her research confirms many of the results we’ve discovered, and provides the pharmacist with information he or she can use when considering protective measures. Information contributed by Pharmacists Mutual Insurance Company
The Offender – Pharmacy robbers and burglars are most oftenwhite (90%), male (96%) and older than the typical offender(i.e., mid-20s to mid-40s, average 34). The majority has a highschool education (40%) and were employed (61%) at the timeof the crime. 78% of offenders had a prior criminal history ofwhich 38% involved a pharmaceutical nexus. How They View Pharmacies – Offenders viewed pharmacies as banks. Given a limited supply and a high street value for CPDs,the rewards that one received from the crime outweighedperceived risks. As one offender put it, “…to be honest withyou, pharmacies are better than banks. They are. They’re betterthan banks. It’s the only place of business in today’s societythat you can go in and steal the product that it offers and getmore than what it’s worth.” The Pharmacies They Target – 42% of the offenders targeted a locally owned or “mom-and-pop” store. The majority (72%) reported they had visited the targeted pharmacy before the crime and most did so while filling a prescription. This is consistent with other research indicating that criminals will visit a pharmacy multiple times before a robbery. For the pharmacist — watch for suspicious behavior, people avoiding eye contact, and folks who have an unusual interest in the cameras, motion detectors and layout behind the counter. – PMC
When asked how they viewed locally owned pharmacies, 62% of offenders reported that a locally owned pharmacy “was an encouraging target”—given their perceived lack of security. Though security at “mom-and-pop stores” was viewed as “lax” by most offenders, there was still a perception among
38 I Pennsylvania Pharmacist I March/April 2016
some (i.e., 22%) that the owners of “mom-and-pop” pharmacies are armed, dangerous and unpredictable: “I wouldn’t hit none of the mom and pops…there’s a possibility that they’d have a gun. I didn’t have a gun, and I definitely didn’t want to get shot.” Conversely, more experienced offenders reported that locally owned pharmacies “do not have enough product” to make it worth their while and if staff were to resist, it would actually escalate the crime “… the way you look at staff is, if they’re stupid, you’re just gonna shoot ‘em.” Several messages here. When criminals visit the pharmacy, they are looking for vulnerabilities. Encountering a “hardened target” with obvious security and alert staff can discourage the criminal. While criminals may fear a gun, be aware of the risks as well as the ability to prevent robberies. – PMC
Security & Deterrence – When asked about alarm systems, offenders were divided regarding their deterrence. Robbers indicated that alarm systems were irrelevant if they can get a quick getaway while alarms are routine procedure for the burglars. Most offenders (97%) viewed the use of bullet-resistant barriers as an effective deterrent. An overwhelming majority of offenders (76%) indicated time-delay safes were an effective deterrent; however, most agreed that they could pose substantial safety risks to staff and customers if an offender was “dope sick” and/or upset. Bottle tracking technology was also an effective deterrent. As one offender explains, “If they could design some kind of sensor on the pharmaceutical bottles, that would be like On-Star in the car. If they could put it on the bottles, and only the pharmacist could remove those from the bottles, and once they
Industry News left that store, that sensor would go off, that would discourage just about everybody, once they knew about that. I don’t see where that would be much of a problem doin’ it with all the technology they’ve got out there now.” Pharmacists Mutual provides discount opportunities for member purchases of verified alarm systems designed to encourage quick police response and tracking devices to apprehend criminals. For additional information, contact us at risk.mgmt@phmic.com. – PMC
Training & Education – The majority of offenders reported that pharmacy staff members were uninformed and untrained to handle robbery and burglary for CPDs. Offenders reported that the staff was often distracted and unaware of their surroundings, did not take offenders seriously and some attempted to confront, chase or even fight off offenders. While some were skeptical about crime prevention training for pharmacists, most pointed out that pharmacy staff is in clear need of it: “It’s a shame that a pharmacist would have to attend classes or do things to prevent crime from happening or even to
turn him from wantin’ to even enter that profession. It’s a twisted situation.” One of the things we’ve learned over the years is that most pharmacies do not provide training for employees in burglary and robbery. Training on what to do in a situation where you are face to face with an armed robber is critical and available at no cost through RxPATROL and at www.phmic.com. – PMC
Interested in reading the full report? Go to RxPATROL, Training Videos and select the report (http://www. rxpatrol.com/TrainingVideos/). Dr. Tara O’Connor Shelley is an Associate Professor in the Department of Sociology at Colorado State University and serves as Co-Director of the Center for the Study of Crime and Justice. She received her Ph.D. in Criminology and Criminal Justice at Florida State University and her MS in Justice, Law and Society from the American University. Prior to joining academia, Professor Shelley worked for the Florida Department of Law Enforcement (FDLE), the Police Executive Research Forum (PERF), and the Justice Research and Statistics Association (JRSA). She has recently been published in Critical Criminology, Social Psychology Quarterly, Deviant Behavior and Violence and Victims. She is also the co-editor of Problem Oriented Policing: CrimeSpecific Problems, Critical Issues and Making POP Work. z
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Industry News
Financial Report Comprehensive Financial Planning: What It Is, Why It Matters This series, Financial Forum, is presented by PRISM Wealth Advisors, LLC and your State Pharmacy Association through Pharmacy Marketing Group, Inc., a company dedicated to providing quality products and services to the pharmacy community. Just what is “comprehensive financial planning?” As you invest and save for retirement, you will no doubt hear or read about it — but what does that phrase really mean? Just what does comprehensive financial planning entail, and why do knowledgeable investors request this kind of approach? While the phrase may seem ambiguous to some, it can be simply defined. Comprehensive financial planning is about building wealth through a process, not a product. Financial products are everywhere, and simply putting money into an investment is not a gateway to getting rich, nor a solution to your financial issues. Comprehensive financial planning is holistic. It is about more than “money”. A comprehensive financial plan is not only built around your goals, but also around your core values. What matters most to you in life? How does your wealth relate to that? What should your wealth help you accomplish? What could it accomplish for others? Comprehensive financial planning considers the entirety of your financial life. Your assets, your liabilities, your taxes, your income, your business — these aspects of your financial life are never isolated from each other. Occasionally or frequently, they interrelate. Comprehensive financial planning recognizes this interrelation and takes a systematic, integrated approach toward improving your financial situation.
40 I Pennsylvania Pharmacist I May/June 2016
Comprehensive financial planning is longrange. It presents a strategy for the accumulation, maintenance and eventual distribution of your wealth, in a written plan to be implemented and fine-tuned over time. What makes this kind of planning so necessary? If you aim to build and preserve wealth, you must play “defense” as well as “offense.” Too many people see building wealth only in terms of investing — you invest, you “make money,” and that is how you become rich. That is only a small part of the story. The rich carefully plan to minimize their taxes and debts, and adjust their wealth accumulation and wealth preservation tactics in accordance with their personal risk tolerance and changing market climates. Basing decisions on a plan prevents destructive behaviors when markets turn unstable. Impulsive decision-making is what leads many investors to buy high and sell low. Buying and selling in reaction to short-term volatility is a day trading mentality. On the whole, investors lose ground by buying and selling too actively. The Boston-based investment research firm Dalbar found that from 1994– 2013, the average retail investor earned 5% a year compared to the 9% average return for U.S. equities — and chasing the return would be a major reason for that difference. A comprehensive financial plan — and its long-range vision — helps to discourage this sort of behavior. At the same time, the plan — and the
Industry News financial professional(s) who helped create it — can encourage the investor to stay the course.1 A comprehensive financial plan is a collaboration & results in an ongoing relationship. Since the plan is goal-based and values-rooted, both the investor and the financial professional involved have spent considerable time on its articulation. There are shared responsibilities between them. Trust strengthens as they live up to and follow through on those responsibilities. That continuing engagement promotes commitment and a view of success. Think of a comprehensive financial plan as your compass. Accordingly, the financial professional who works with you to craft and refine the plan can serve as your navigator on the journey toward your goals. The plan provides not only direction, but also an integrated strategy to try and better your overall financial life over time. As the years go by, this approach may do more than “make money” for you – it may help you to build and retain lifelong wealth. z
Pat Reding and Bo Schnurr may be reached at 800288-6669 or pbh@berthelrep.com. Registered Representative of and securities and investment advisory services offered through Berthel Fisher & Company Financial Services, Inc. Member FINRA/SIPC. PRISM Wealth Advisors LLC is independent of Berthel Fisher & Company Financial Services Inc. Citations. 1 – fool.com/investing/general/2015/03/22/3-common-mistakes-thatcost-investors-dearly.aspx [3/22/15] This material was prepared by MarketingLibrary.Net Inc., and does not necessarily represent the views of the presenting party, nor their affiliates. All information is believed to be from reliable sources; however we make no representation as to its completeness or accuracy. Please note — investing involves risk, and past performance is no guarantee of future results. The publisher is not engaged in rendering legal, accounting or other professional services. If assistance is needed, the reader is advised to engage the services of a competent professional. This information should not be construed as investment, tax or legal advice and may not be relied on for the purpose of avoiding any Federal tax penalty. This is neither a solicitation nor recommendation to purchase or sell any investment or insurance product or service, and should not be relied upon as such. All indices are unmanaged and are not illustrative of any particular investment.
Value Drug Company Announces Partnership with Avella Avella Specialty Pharmacy announced that it is now the specialty pharmacy service provider for Value Drug Company, a wholesale pharmaceutical distributor and a member-owned collective of independent community pharmacies. Avella will manage specialty drug services for Value Drug Company’s member pharmacies, whose patients will receive the same prior authorization support, clinical onboarding, financial assistance and compliance calls that Avella’s own customers receive. Avella will also fulfill those specialty prescriptions that are not accessible to Value’s member pharmacies or Value’s own specialty pharmacy, Value Specialty Pharmacy. Value Drug Company President Greg Drew, RPh, predicted that patient experience will be enhanced. “Patients will be assisted first by their community pharmacist. If the drug can’t be dispensed, the Value Specialty Pharmacy unique model of delivery of a
prescription filled at VSP to the community pharmacy will be used. If VSP is unable to fill as well, Avella will perform their complete fulfillment and patient care experience.” Through the partnership, patients will also receive supplemental education, support and even access to certain medications that are not currently available to be dispensed in the retail setting, according to Nancy McCutcheon, Avella’s senior vice president of strategic sales. The two companies will also collaborate on clinical programs. ”Avella and Value Specialty will work together to identify patients on specialty medications that require a more comprehensive clinical program, tailored to the specific drug they have been prescribed,” said McCutcheon. “Additionally, patient outreach and incorporating compliance calls drives adherence and compliance, improving outcomes.” z
Pennsylvania Pharmacist I March/April 2016 I 41
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Industry News
Script Your Future: Student Driven and Patient Focused with Results Contributed by: Iris Tang and Doreen Foy, University of Pittsburgh School of Pharmacy, PharmD Candidate of 2018 Nearly half of Americans are diagnosed with a chronic health condition, and 40% of the time, those diagnosed are not compliant with their medications. There are many reasons individuals do not take their medications such as forgetfulness, lack of belief in medication effectiveness, fear of side effects, cost of medications, complexity of medication regimens, and social support. However, non-compliance to medications is a costly side effect that causes 125,000 deaths per year in the United States and another one-third of the population are admitted to the hospital due to their worsening disease state. These undesirable consequences can be prevented by reaching out to the community and educating people on the importance of taking their medications as directed to live a fuller and longer life. This is where Script Your Future comes in, a campaign where student pharmacists in collaboration with other health professionals, reached out to the community to help people understand their health conditions and the importance of taking their medications correctly. Second year students at the University of Pittsburgh School of Pharmacy, in collaboration with Dental Medicine, reached out to residents of Allegheny County at UPMC hospitals and community pharmacy sites such as CVS, Rite Aid, Giant Eagle and independents
to start a conversation about medication adherence. The campaign’s main focus is to raise awareness on how vital it is to take medications as prescribed. Each patient encounter began by assessing the patient’s adherence level through a 4-question survey followed by education on medication adherence strategies
based on the patient’s disease states. Script Your Future focused on the three most common chronic health conditions-diabetes, respiratory disease, and cardiovascular disease as these three disease states can lead to other serious health problems if uncontrolled. The patients were able to realize the consequences of not taking their medications and the student pharmacists were able to discuss solutions to the patients. To encourage people to learn about medication adherence, students offered to give free blood pressure screenings, which was an incentive that gave a successful turnout.
In order for adherence to be successful once people go home, Script Your Future provides people with the necessary tools to stay adherent such as free wallet cards to keep track of medication schedules and doses, written advice on how to manage disease states, adherence strategies, and stating a reason why they pledge to stay adherent (as simple as staying healthy or living to see their grandchildren). Patient education is essential for compliance and the second year students at the University of Pittsburgh had a very successful campaign educating patients. The class completed 965 patient encounters, 252 blood pressure screenings, and 569 medication or health condition counseling. Additionally, 689 patients were educated on medication adherence strategies and 688 education materials were distributed. From all the patient encounters, 667 patients took the pledge “I will take my meds because...”, which personalized the patient’s experience and motivated patients to keep their pledge. Tackling the problem of non-adherence in society today is an effort for all health professions and student pharmacists have especially proven that they can make an impact in the lives of patients. Script Your Future. http://www. scriptyourfuture.org/ (accessed March 17, 2016). z
Pennsylvania Pharmacist I March/April 2016 I 43
Departments
Welcome! New Members PPA Welcomes the following New Members who joined the association—January 25, 2016–March 30, 2016. Please make these new members feel welcome and part of Pennsylvania pharmacy! Pharmacists
Student
Heather Chapman, Lake Ariel, CVS Health
Duquesne University – Mylan School of
Steven Goloff, Philadelphia, Caribbean Pharmacy
Pharmacy
Sarah Hoover, Finleyville, Hometown Pharmacy #5
Daniel Brust, Olyphant
Josin James, Philadelphia, Amarin Pharma
Adam Dashner, Pittsburgh
Amy Karlek, Finleyville, Hometown Pharmacy #7
Lindsey Jachim, Mountain Top
Daniel M. Kim, Dallas, Rural Health Corporation
Kristen Kotsenas, Monongahela
Katrina E. Loncar, Carnegie, Curtis Pharmacy
Jefferson
William O’Hara, Philadelphia, Thomas Jeferson University Hospital
Christina Maher, Philadelphia
Joseph P. Sneeringer, Spring Grove, Choice Health Services
LECOM School of Pharmacy
Vaishali V. Rawani, Philadelphia, Mill Street Pharmacy
Ryan Bolden, Indiana Richard Chubirka, Montoursville
Denise Fournier, Bensalem Deirdre Yarosh, Philadelphia Nikki Blattenberger, Girard Kaitlyn Fairlamb, Erie
Richard Charles Riberich, Hummelstown, GE Healthcare
Dalton J. Fishel, Red Lion
Dawn Rochester, Yeadon, CVS Health
Rayann Seager, Erie
Susan Warrington, Philadelphia, Children’s Hospital of Philadelphia
Ohio Northern University
Phyllis Wytiaz, Jefferson Hills, AHN - AGH Apothecary
Nicholas Blaise Bileck, Pittsburgh
pharmacy technicians
Olivia Hines, Altoona
Foud Bahamdain, Ada Samantha Blake, Gibsonia Megan Bookser, Pittsburgh Kaitlyn Bova, Erie
Christian N. Chiaffa, Philadelphia, St. Christopher’s Hospital for Children
Sarah Bova, Erie
Amanda Curry, Croydon, Mill Street Pharmacy
Allison Fye, Reynoldsville
Kristy Fursa, Morrisville, Mill Street Pharmacy
Aliya Hutman-Zahler Conneaut Lake
Sarah Jallen, Harding, CVS Caremark
Mary Komandt, Delmont
Robin Krull, Cassandra, Value Specialty Pharmacy
Danielle Odette Johnson, Gibsonia
Juan Osorio, Philadelphia, Front Street Pharmacy
Elizabeth Anne Matthews, Allison Park
Marc Ost, Philadelphia, Philadelphia Pharmacy Melissa Skiles, Valencia, Giant Eagle Pharmacy
Rachel Edeburn, Pittsburgh
Shannon Nicole Kraus, Pittsburgh Joseph Muscarella, Erie Connor Rowan, Grove City Philadelphia College of Pharmacy Emma Rose Callahan, Medway Matthew Ciavarella, Philadelphia Temple University Melissa Alexandre, Blackwood Alex K. Dinh, Philadelphia Ugochinyelum J. Eke-okoro, Clementon Florance Duong, Philadelphia
44 I Pennsylvania Pharmacist I May/June 2016
Daniel Havemann, Howell Idrees Hazzaa, Philadelphia Mo Hoang, Upper Darby Michael Marasheski, Bensalem Jenna Micallef, Hatboro Kyung Cheol Park, Elkins Park Du Pham, Philadelphia Nam Pham, Philadelphia Maria Qu, Wilmington Anthony Rubino, Philadelphia Carl Schaaf, Ridley Park Seyedshayan Nouri Zamanabadi, Drexel Hill University of Charleston Channing Heath Thacker, Milton University of Pittsburgh Kevin Albert, Pittsburgh Louise Chen, Glen Head Lisa Costantini, Pittsburgh Karen Hoang, Pittsburgh Lindsay Ann Jablonski, Harleysville Rena Jiang, Morgantown Brian Keaton, North Royalton Jack Zhixiang Mao, Ambler Elyssa Resetar, Pittsburgh Marni Rosenwasser, Great Neck Joseph Sergent, Pittsburgh Brandi Walls, Pittsburgh Jacob Wissinger, Windber Bianca Jude Zynosky, Monessen Wilkes University – Nesbitt College of Pharmacy Ryan Bowersox, Milton Alex Shreiber, New Cumberland
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