Pennsylvania Pharmacist January/February 2015

January/February 2015 z Volume 96 z Issue 1

The official publication of the Pennsylvania Pharmacists Association

You’re invited to attend PPA’s 2015 Mid-Year Conference

PRSRT STD U.S. POSTAGE PAID HARRISBURG PA PERMIT NO 533

Join us from February 20-22, 2015 at the Hilton Harrisburg

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View our DEMO NOW!

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PPA Board of Directors PPA Officers: President: Eric R. Esterbrook, RPh President-Elect: Donna Hazel, RPh First Vice President: Eric Pusey, RPh, CDE Second Vice President: Nicholas Leon, PharmD, BCPS, BCACP Immediate Past President: J. Scott Miskovsky, RPh

Our Vision

Pennsylvania pharmacists will be recognized, engaged, and fairly compensated as health-care providers.

Regional Directors: Central: Ellen Nastase, BS Pharmacy, MS Pharmacy Northeast: Thomas Franko, PharmD, BCACP Northwest: Elliott Cook, PharmD Southeast: Mark Lawson, PharmD, MBA Southwest: Lauren Simko, PharmD Academy Directors: Academy of Alternative Pharmacy Practice: Jamie McConaha, PharmD, CGP, BCACP Academy of Chain Pharmacists: Stephen Pfeiffer, PharmD, MBA, RPh Academy of Community Pharmacists: Martin J. Kendra, RPh Academy of Health System Pharmacists: Richard Demers, RPh, MS, FASHP Academy of Long Term Care and Consultant Pharmacists: Brant Gahr, RPh Academy of Pharmacy Industry Associates: Todd Eury Academy of Pharmacy Technicians: Vacant to be filled by the Board of Directors Academy of Student Pharmacists: Benjamin Andrick PPA Office Staff: CEO: Patricia A. Epple, CAE pepple@papharmacists.com Communications Coordinator: Jenna Karge jkarge@papharmacists.com Membership Coordinator: Courtney Box cbox@papharmacists.com Program Manager: Sara Powers spowers@papharmacists.com Government Relations Manager: Donald L. Smith, III dsmith@papharmacists.com PPCN Coordinator: Brandon Antinopolous, PharmD ppcn@papharmacists.com

Ext. 3 Ext. 2 Ext. 1 Ext. 4 Ext. 6

Pennsylvania Pharmacists Association (PPA) 508 North Third Street, Harrisburg, PA 17101 (717) 234-6151 Fax: (717) 236-1618 www.papharmacists.com ppa@papharmacists.com www.facebook.com/PAPharmacy www.twitter.com/papharmacists 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 Kim C. Coley, PharmD, FCCP Stephanie Smith Cooney, PharmDPP Bernard Graham, PhD Brian S. Plager, RPh, MBA Associate Editor: Jenna Karge Editor/Manager: Pat Epple Designed and Published by: Graphtech Sarah DiCello, Publications Manager (717) 238-5751 x118, sarah@thinkgraphtech.com 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” Janet Hart, RPh – Community Chain Robert Frankil, RPh – Community Independent Theresa M. Talbott, RPh – Community Chain Mark J. Zilner, RPh – Community Independent Board of Pharmacy Meeting Dates: January 13, 2015 February 17, 2015 March 17, 2015 April 21, 2015 May 12, 2015 June 16, 2015 On the Cover: Photographs are from our 2014 Mid-Year Conference

Our Mission

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 MAGAZINE

Departments

President’s Message................................................................................... 3 Calendar of Events..................................................................................... 5 Campus Checkup.................................................................................... 22 Member News.......................................................................................... 25 New Members.......................................................................................... 42

Features PPA Foundation Grant Report: Margaret LaBuz.......................................... 6 Pharmacist Provided Medicare Annual Wellness Visits in Collaboration with a Physician Office......................................................................... 14 Every Solution Starts Out with a Question................................................. 14 Pharmacy Technician Profile: Tina A. Gulick, CPhT................................... 16 PPA Members Share Their Most Memorable Moments as Pharmacy Technicians.......................................................................... 16 Fall 2014 Totally Tech Conference............................................................. 17 Pharmacy Spotlight: Bloomfield Pharmacy............................................... 20 Profiles in Pharmacy Innovation: KarenBeth H. Bohan.............................. 26 Member Profile: Jennifer Malinowski, BS Pharmacy, PharmD................... 37 Rx and the Law: Law vs. Ethics................................................................ 40 Financial Forum: IRA Rollovers for Lump Sum Pension Payouts............... 44

Association News Call for Award Nominations...................................................................... 18 Stories from American Pharmacists Month............................................... 19 PPA’s 2015 Mid-Year Conference............................................................. 30 Call for Nominations: PPA Officers and Members of the Board of Directors.......................................................................................... 33 Say Yes to Opportunities, Meet New People............................................. 34

Industry News Small Doses............................................................................................. 11 Health Mart Healthy Living Tour................................................................ 13 Red Flags – Are You Protecting Your DEA License?.................................. 29 ADVERTISERS INDEX American Pharmacy Services Corporation 5 AmerisourceBergen 10 Buy-Sellapharmacy.com 36 Cardinal Health 15 Hayslip & Zost 28 Independent Pharmacy Buying Group 2 The Keystone Pharmacy Purchasing Alliance 32

McKesson 17 Pharmacists Mutual Insurance Company Back Cover PRS Pharmacy Services Inside Front Cover R.J. Hedges & Associates 35 Rochester Drug Company Inside Back Cover Value Drug Company 38

DISCLAIMER — The opinions of the authors reflected in this publication do not reflect PPA’s position in any way.

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Departments

Eric Esterbrook, RPh PPA President 2014–2015

Message from the President Help Us Spread the Word!

I Share the link to PPA's new blog with your patients, family, and friends!

hope everyone enjoyed the holiday season and is MAC pricing and the expansion of immunizations. looking forward to 2015!

On another note, did you know that on December Each Legislative session PPA monitors hundreds 1, the PPA Public Relations Committee started a blog of legislative issues that affect pharmacy in called Pharmacists Care? The purpose of the blog is to Pennsylvania. This past session there werewww.pharmacistscare.net seven promote how valuable pharmacists are to the public pieces of legislation passed involving pharmacy. and to the healthcare team and also to showcase all Topics included: Pseudophederine tracking, pharmacy the services we as pharmacists provide. The blog robberies,Pharmacists protecting access to diabetic shoes,for the public incan be to found at pharmacistscare.net.

Pleasethebe sure Care was a blog created order promote the value of pharmacists, naloxone access, physician dispensing, prescription to share this website.

It is a great tool to provide services they provide, and their role on the healthcare team. monitoring program, and establishment of a Patient education, information, and promote the value of Centered Medical Home Advisory Council. More pharmacists and PPA. information on these can be found on the PPA website. PPA will set a priority list for issues for 2015.

Eric Esterbrook, RPh They will include pharmacy audits, PBM transparency, PPA President 2014–2015 z

Help Us Spread the Word!

Share the link to PPA's new blog with your patients, family, and friends!

www.pharmacistscare.net Pharmacists Care was a blog created for the public in order to promote the value of pharmacists, the services they provide, and their role on the healthcare team.

Pennsylvania Pharmacist I January/February 2015 I 3

Don’t miss out on features such as: Immunization Locator We have a public section of our website dedicated to pharmacists which offer immunizations. If you wish for your pharmacy to be included, please complete the form available on this section of our website. Only pharmacies with at least one PPA member at that location will be included.

Laws & Regulations This section of our website provides you with links to government websites which contain laws, regulations, procedures, and information pertinent to pharmacy practice. From prescribing information to regulations about controlled substances—this portion of the website makes it easy for you to find what you are looking for!

Recorded CE Webinars PPA has been offering free live CE webinars to our members successfully for over a year, and now these webinars are being recorded and provided to PPA members as on-demand home studies! Watch the webinar at a time and place that convenient for you, take a short survey and quiz, and receive CE credit! Recordings are a free member benefit and are posted as they become available.

www.papharmacists.com

Departments Thank You to Our Corporate Partners These companies support PPA activities throughout the year.

DIAMOND LEVEL

Calendar of Events

January

22

BMPA Member Meeting

February

PLATINUM LEVEL

19–22

PPA Mid-Year Conference — Harrisburg, PA

20

PPA Educational Foundation Board of Directors

22

PPA Board of Directors

25–28

IACP Educational Conference — Fort Lauderdale, FL

March

GOLD LEVEL

27–30

APhA Annual Meeting — San Diego, CA

April

SILVER LEVEL

7–10

AMCP Annual Meeting — San Diego, CA

10–14

ACCP Updates in Therapeutics — Rosemont, IL

May

BRONZE LEVEL

7

PPA Educational Foundation Board of Directors

14

PPA Board of Directors

16–19

NABP Annual Meeting — New Orleans, LA

For additional events and PPA committee meetings, be sure to see our Calendar of Events on the PPA website!

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APSC is the resource for you!

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Pennsylvania Pharmacist I January/February 2015 I 5

Features

PPA Foundation Grant 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 2014 awardees, Margaret LaBuz. Reports are also retained on the website under the Educational Foundation section.

Patients’ Perspectives on Healthcare Providers (HCPs) Medication Counseling Authors: Margaret LaBuz, PharmD, Hartzell’s Pharmacy, Catasauqua, Pennsylvania and Wilkes University, Wilkes-Barre, Pennsylvania; and Dominique Cipollone, PharmD and Kristen Hartzell, PharmD, CACP of Hartzell’s Pharmacy, Catasauqua, Pennsylvania

Abstract Medications play a primary role in increasing life expectancy and quality of life in patients.

Misunderstandings associated with prescribing decisions between practitioners and patients have been reported due to lack of participation of patients in the counseling session. This qualitative study utilized focus groups of patients who use a pharmacy to determine their perspective on “best practice” medication counseling by HCPs. Patients were recruited through patient- pharmacy staff interactions at point of dispensing, phone interactions via lists developed in both pharmacy and home medical department, and direct mailers. Patients were provided with a brief explanation of the research project and questioned if meet inclusion criteria. Inclusion criteria included but was not limited to >30 years old or a caregiver and at least one encounter with a healthcare professional within the year. A guided focus group question set was used. Sessions continued

until saturation was reached and were analyzed and coded using grounded theory to elect theses.

1. Introduction 1.1 Background Medications play a primary role in increasing life expectancy and improving quality of life in the United States, especially with the aging population and consequent increase in chronic health problems. Patient’s wellbeing and drug related needs are a primary concern in terms of pharmaceutical care provided by healthcare providers (HCPs).

Their professional responsibilities include identifying and resolving drug related problems, giving appropriate advice, and supporting patients in different ways- with the goal of achieving optimal patient outcomes. This is achieved through counseling.

Studies repeatedly show that effective patient counseling can significantly reduce nonadherence, treatment failure, and wasted health resources1.

Healthcare providers need to adopt a counseling approach

6 I Pennsylvania Pharmacist I January/February 2015

that focuses on the patients’ wants and needs. A patient centered professional explores the patients’ main reasons for the counseling and their need for the information5. This improved communication can improve both patient satisfaction and adherence to counseled information.

Previous studies have a quantitative focus, aiming to explain the extent and type of information provided by pharmacists3.

Qualitative studies have analyzed the medication use process from a patient, physician and pharmacist’s perspective, with a focus on where improvements lie and who are the responsible parties1. This study revealed there was a need for counseling; however, pharmacists were not recognized as a medicationcounseling provider by either patients or physicians. Another study focused on counseling sessions. The aim was to determine counseling behaviors and if they were patient focused by analyzing audio recording of sessions.

Currently there are studies on pharmaceutical care providers’ communication skills and barriers perceived; however, few have focused on patient perspectives of the counseling interventioni.e. what type of medication information patients want with counseling interventions. Knowing what dynamics patients are drawn towards and respond to, could optimize patient care as a whole. In addition, misunderstandings associated with prescribing decisions between general practitioners and patients have been reported due to lack of participation of patient in counseling sessions.

These misunderstandings further highlight the importance of focusing counseling on patients’ wants and needs. Awareness of patients’ drug related needs and provides opportunities to customize counseling and would permit more effective consultations between HCPs and patients.

Improved communication can improve both patient satisfaction and adherence to prescribed therapy. Also, by evaluating the patient’s perspectives, insight may be given to what gaps exist in the counseling process.

1.2 Research Question What are adult patients’ perspectives on medication counseling provided by all healthcare providers (HCPs)?

2. Objectives 2.1 Primary To identify what type of interactions and behaviors patients’ prefer with counseling interventions provided by HCPs.

2.2 Secondary To identify ideal counseling communication strategies as well as reveal the main goals of counseling interventions by evaluating patients’ opinions of HCPs’ medication counseling interventions.

3. Study Design 3.1 Methodology Qualitative research design: This qualitative study utilized focus groups of patients to determine their perspective on “best practice” medication counseling provided

by HCPs. Patients were recruited through patient- pharmacy staff interactions at point of dispensing, phone interactions via lists developed in both pharmacy and home medical department, and direct mailers. Patients were provided with a brief explanation of the research project and questioned if met inclusion criteria.

A guided focus group question set was used (Appendix A).

The lead investigator practiced the question set to help ensure consistency among focus groups.

Further, the focus groups had no prespecified duration and the facilitator allowed participants to talk as long as they liked when responding. The sessions averaged 60 minutes.

Patients who participated in the focus group sessions were asked to complete a written demographic survey. Examples of questions included: “What is your gender?”, and “Do you take any over the counter medications?” (Table 5.1).

All sessions were confidential and performed during a twomonth period from February 2014

through March 2014.Investigators sought to include as many patients as possible during focus group sessions. Patients were assigned to focus group based on medicationsChronic, “PRN”, caregiver- as well as the inclusion criteria. All patients participated in only one focus group session.

Each focus group was conducted in a quiet/private space within the pharmacy. No names were attached to sessions, only the participant category (i.e. chronic medications). Investigators kept a separate record of who participated; therefore, patients did not participate twice. The patient surveys were anonymous. Study investigators provided lunch for all participants as well as a $20 gift card to a local grocery store.

Patients were made aware of the gift card before the sessions.

Study investigators continued focus groups until saturation was reached. Saturation was defined as the time when the focus group sessions resulted in little new information and investigators were relatively confident that the information had reached redundancy. The patient survey was useful to increase our understanding of our study population.

Data collection and analysis: The dialogues from the interviews were audio taped and transcribed.

Session transcripts were read and coded independently by the primary investigator, then reviewed by all investigators to address consistency, gaps, or new interpretations. The investigators kept one list of codes with Continued on page 8

Pennsylvania Pharmacist I January/February 2015 I 7

Features continual edits while reading the transcripts. Pieces of text were assigned a code that best described them. The coded pieces of text were grouped by code to visualize the major themes. Next, the research team met to discuss the content of the coded sessions to collectively identify and agree on themes. Focus group sessions data were stored at Hartzell’s Pharmacy and no identifiers were kept with the data. Recordings were transcribed as the focus group sessions were completed, thereby allowing the study investigators to read, code, and assess for saturation continuously.

Survey data was summarized using descriptive statistics.

Steps were taken to heighten the trustworthiness of our data.

Qualitative researchers who were neither part of the study group nor pharmacists were continually sought for suggestions during design, study and analysis phases.

Co investigators who were not directly involved with data collection, but reviewed the data multiple times during analysis period. This study has been IRB approved as exempt by the Wilkes University IRB.

4. Study Population 4.1 Eligibility Criteria 4.1.1 Inclusion Criteria • Patient or Caregiver of patient( >30 years old) • New prescription(s) filled at a pharmacy within 1 year • New prescription(s) for previous medications if discontinued for > 1 year • Having a recent encounter with a HCP within 1 year

4.1.2 Exclusion Criteria • Refill prescription(s) • New prescription(s) for dose changes of old prescriptions • Delivery prescription(s) • Long term care facility patients

5. Results A total of twenty patients were included in three focus groups conducted February 2014 through March 2014. We reviewed 20 surveys as well. Participants had a mean age 50-75 years old, 20% male and 80% female (Table 1).

This research has shown that regardless of types of medications patients receive, chronic, “PRN” or caregivers, patients desire some kind of medication education.

The qualitative analysis revealed dominant themes that are presented below.

Theme 1- Positives about medication counseling: questions answered and building relationships Patients reported valuing having a conversation with their pharmacists and physicians.

Several patients expressed that pharmacists have an expertise in medication therapy and an opportunity for increased time with patients. Patients also commented being satisfied with their pharmacist interactions and would recommend and encourage seeing their pharmacist to other patients. Below are some responses to the domain “What do you like about receiving medication counseling?”

• “I like to be informed” • “Once I was told to eat fruits because a medication makes

8 I Pennsylvania Pharmacist I January/February 2015

you constipated. I liked that and wish I was told that with all my medicines, like, what to expect.”

• “At first I used to think the pharmacists were too busy to talk to me, but after years of getting my medications filled I realize how much they know about my medicines. I really like coming to the pharmacy to talk to the pharmacist about my medications and my day!”

Theme 2- Medication counseling improvement needs: review information together slowly and provide paper information Patients expressed concern about being involved with their medication counseling interventions. They stated they want their pharmacists and physicians to go over the information with them, as a team, as well as provide some sort of pamphlet information. Responses included the following to the domain “What can be done to improve medication counseling?”

• “Sometimes I wish talking about my medication felt more like a conversation instead of me just answering question after question.”

• “Sometime they (HCPs) don’t let me ask questions, they just run through what they want to say. I wish I felt like they cared what I had to say.”

• “The doctors and nurses should know what I am taking; they put me on these medications. Don’t they remember what they put me on; shouldn’t it be written in a book somewhere? Or are they

• “I’m always told what to make sure I don’t have any the medications are for, questions or issues.”

No. of total Patients 20 • “I think receiving some like my blood pressure, Age (Mean) 50-75 paperwork after the doctor’s but no one ever tells me Gender 20% Male visit like discharge papers how it will help my blood 80% Female summarizing the visit and pressure.

I want to know OTC Supplements Yes at the pharmacy with the how it works.”

Herbal Supplements Yes • “I like when the doctors medication. As well as having Prescription Medications Yes and pharmacists tell me a conversation with both Preferred Pharmacy Chain Independent when to take my pills. It (HCPs) would be ideal.”

No. of Current Medications (Avg.) 10+ makes it less stressful on 6. Discussion me.” just checking on me? They At the onset of the study, we • “I’ve been told I can’t take should say that.” set out to identify what type of grapefruit with certain • “Pharmacists should go over interactions and behaviors patients medications but no one ever the colored stickers on the prefer and the gaps that exist with told me why, or what happens bottle when people pick up counseling interventions provided if I do.” their medications every time, by all HCPs. We also set out to Theme 4- Ideal to communicate it will only take a couple determine the ideal counseling many ways: consultation booth, minutes, and it will explain communication strategy for pamphlets of paper, over the what the pictures actually patients. These results demonstrate phone mean. I also like always the overwhelming want patients Patients have reported a want getting the paper about the have to learn about their to receive information about their medications in my bag.” medication and their acceptance to medications in several ways and Theme 3- Goals of medication learn from all healthcare providers at different times. Some suggested counseling: purpose, during every encounter. Through that having a follow up phone administration, and drug-food focus group sessions, we were call approximately one week after interactions starting a new Patients reported valuing the Figure 5.1: Patients Perspectives on Goal of Medication Counseling Content medication information received during would medication counseling. There encourage them is a lot of information that they to be more receive, however, there is also a open, especially lot of information the patients find because they lacking. Below are some sample have had quotations when analyzing the time to think domain “What do you consider and develop the main goal during medication questions. counseling?” (Figure 5.1) Below are • “I am always told what the some sample medication is for. I know quotations for what medications help my in contact with three different the domain “What do you consider heart and which help my groups of patients. Several aspects the best way to receive medication pain. But I want to know how of the results were of particular education?” they help! That will help me interest, including the similarities • “A phone call after a couple understand why I am taking of opinions. days of starting a new three different medications for medication would be nice just my blood pressure. ” Continued on page 10 Table 5.1: Patient Demographics

Pennsylvania Pharmacist I January/February 2015 I 9

Features To our knowledge, few qualitative analysis studies have focused on patient perspectives of the counseling intervention- i.e. what patients receive and want with counseling interventions. Unlike with those studies, the patient’s feelings of pharmacists not being able to counsel on medications were not reported in the current study1 . This may be due to 10 years having lapsed since the trial, or the increased effort all pharmacists have made to educate patients. We did find several similarities between the studies including that patient’s want to learn about their medications.

In this study, it became evident that patients want to learn about why they are taking their medications and rely on all healthcare providers to educate them during each encounter, in both written and verbal form. It also became clear that patients want an in depth counseling session.

They want to learn more than why they are “taking the medicine.” Based off the results there are currently no defined gaps in the medication counseling provided

by HCPs but it is evident that we should strive to provide our patient more in depth information.

7. Limitations Our research had several limitations. The focus groups were conducted during a 2 month time period with 20 participants. This was a small sample size. In addition, the focus groups sessions were facilitated by a pharmacist, which may have caused some bias.

Participants may have been hesitant to share negative experiences with the facilitator. However, attempts were made during the interviews to elicit negative thoughts and challenges that may have been occurring.

8. Conclusion In conclusion, this study shows the want and need to educate patients about their medications. It displays the patient’s interest to fully understand their medications.

All HCPs should educate their patients about their medicines during each encounter verbally and provide them with written information as well. We as a team should provide our patients an in depth understanding to help gain their trust satisfy their needs. By improving our communication, we can improve both patient satisfaction and adherence to prescribed therapy. z Please see the full report with Appendix, References, and Survey questions on the website under Foundation and Grants.

10 I Pennsylvania Pharmacist I January/February 2015

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Industry News

Small Doses NABP to Begin Sunrise Trademark Registration Period for .Pharmacy Websites The National Association of Boards of Pharmacy® (NABP®) will soon be accepting applications for .pharmacy domain names from trademark holders who are registered in the Internet Corporation for Assigned Names and Numbers (ICANN) Trademark Clearinghouse (TMCH). The sunrise application period, which begins December 19, 2014, precedes the Sunrise TMCH Registration Period, which will be from January 15 to March 16, 2015. NABP launched the .pharmacy Top-Level Domain (TLD) to provide consumers around the world a means for identifying safe, legal, and ethical online pharmacies and related resources.

During the sunrise application and registration phase, eligible trademark holders who have logged their brand names in the ICANN TMCH may apply to NABP for approval to register .pharmacy domain names that exactly match their trademark names in the TMCH. Once approved, these organizations will be able to register the domain with an approved registrar.

The Sunrise period will begin immediately following a special members-only registration period for NABP’s member boards of pharmacy.

Following the Sunrise Period, registration for .pharmacy domain names will be open to pharmacy Continued on page 12

Educational Foundation Advancing Patient Care

My Profession...My Practice...My Philanthropy “As a pharmacist resident, my research--"The Network Project"--was supported in part by the PPA Education Foundation and it's exciting to see it come to fruition in the Pennsylvania Pharmacists Care Network. I whole-heartedly believe in the Foundation's mission and focus of Advancing Patient Care, and my contribution is a way to "pay it forward" for future generations of pharmacists."

The monthly credit card deduction is a simple, convenient way to support our professional future. For the cost of a lunch out, my contribution is added to my monthly bill. At the end of the year, I get a charitable contribution statement for my total contribution for use in preparing my tax return deductions. It’s easy but it does a lot.

Through the Foundation, I am supporting grants, student programs, and fostering the future of our profession. This is MY way of making a difference—join us and support your profession and your philanthropy – the PPA Educational Foundation.”

Maria Osborne, PharmD, BCACP, Clinical Pharmacist, Family Practice, UPMC St. Margaret PPA Educational Foundation Board member and monthly contributor For more information on how you can make a difference, www.papharmacists.com/foundation.

Pennsylvania Pharmacist I January/February 2015 I 11

Educational Foundation

Industry News websites that are accredited through the NABP Verified Internet Pharmacy Practice Sites® (VIPPS®) and Veterinary-Verified Internet Pharmacy Practice SitesCM (Vet-VIPPS®) programs, as well as for pharmacy websites that have received approval through the NABP e-Advertiser ApprovalCM Program. Applications from other dispensing pharmacies will be accepted beginning in mid-2015. General availability will begin in June 2015 at which time all entities providing pharmacy-related products, services, or information that meet .pharmacy eligibility standards will be able to apply to register for the domain.

Except for those already VIPPS or Vet-VIPPS accredited or e-Advertiser approved, entities seeking a .pharmacy domain name must first submit an application, supporting documentation, and an application fee to NABP. NABP will evaluate these materials to ensure compliance with program standards. NABP is establishing a network of international regulatory groups to facilitate evaluation of international domain name applications. Once

approved, applicants will be able to register the domain name through an approved registrar.

Of the tens of thousands of sites selling prescription drugs online, NABP has reviewed over 10,800 and found that nearly 97% do not follow pharmacy laws and standards established to protect the public health.

NABP will grant use of the .pharmacy domain only to legitimate website operators that adhere to pharmacy laws in the jurisdictions in which they are based and in which their patients and customers reside, so that consumers can easily find safe online pharmacies.

The .pharmacy domain application will be available at www.dotpharmacy.net beginning December 19, 2014. Additional information about the .Pharmacy TLD Program, as well as NABP’s most recent research on rogue online drug sellers is also available on the site.

NABP is the independent, international, and impartial Association that assists its state member boards and jurisdictions for the purpose of protecting the public health. z

Mark Your Calendar And

PPA’s 2015 Legislative Day

Save the Date!

Monday, April 13, 2015

Calling All Pennsylvania Pharmacists, Student Pharmacists, and Pharmacy Technicians:

Come make your mark and impact pharmacy’s future!

You have a voice.

You can make a difference.

Join us as we march on the Capitol!

More information will be available soon on our website, Facebook, and Twitter.

You may also contact PPA Government Relations Manager, Don Smith at dsmith@papharmacists.com or (717) 234-6151, ext. 102

12 I Pennsylvania Pharmacist I January/February 2015

Health Mart Healthy Living Tour Provides More Than 250 Complimentary Health Screenings at 11 Pennsylvania Community Pharmacies During September 2014, 11 independentlyowned community pharmacies in Pennsylvania offered complimentary The Health Mart Healthy Living Tour pulled up its 40-foot mobile health screening unit to health Oxford Valley Pharmacy in Fairless Hills, PA screenings on September 2, 2014 to offer complimentary to more than health screenings to the community.

250 customers during stops from the Health Mart Healthy Living Tour. The Tour utilized a 40-foot mobile health screening unit and travels across the country to celebrate and recognize community pharmacists and the important role they play as trusted healthcare providers in their communities.

For Health Mart® pharmacists, these events exemplify Health Mart’s® effort to help independent pharmacies attract new customers and maximize the value of existing customers through marketing support. At each stop, Tour staff can conduct more than 35 screenings per visit, targeting risks associated with high blood pressure, diabetes, high cholesterol and obesity.

Locations in Pennsylvania included; Oxford Valley Pharmacy in Fairless Hills, Frontier Pharmacy in Erie, Waterford Pharmacy in Waterford, Jamestown Pharmacy in Jamestown, Marianna Pharmacy in Shippenville, Rx Xpress Pharmacy in Grove City,

Brighton Health Mart Pharmacy in New Brighton, Towne Drug Health Mart Pharmacy in Aspinwall, Vandergrift Pharmacy in Vandergrift, Martella’s At Park Hill Pharmacy in Johnstown and McCracken Pharmacy in Waynesburg.

The Tour will conduct more than 170 health screening events at Health Mart® Pharmacies across the country. Events are promoted via with Health Mart’s® new Local Marketing Support program, which puts marketing funds and new tools directly in the hands of pharmacists, helping to attract new patients and drive new revenue.

To learn more about the Health Mart Healthy Living Tour, visit http://www.healthmart.com/tour z

During a Health Mart Healthy Living Tour stop at Towne Drug Health Mart Pharmacy in Aspinwall, PA, health screener, Cheryl Graham conducted complimentary health screenings for risks associated with high blood pressure, cholesterol, diabetes and obesity.

Pennsylvania Pharmacist I January/February 2015 I 13

Features

Pharmacist Provided Medicare Annual Wellness Visits in Collaboration with a Physician Office Musselman, Kerri T, PharmD, BCACP: Clinical Pharmacist Specialist, Bon Secours Virginia Health System, Bon Secours Medical Group Zentgraf, Whitney, PharmD: PGY-1 Pharmacy Practice Resident at Campbell University College of Pharmacy and Health Sciences/East Carolina University Plum, Mary-Beth, PharmD, BCACP: Clinical Pharmacist Specialist, Bon Secours Virginia Health System, Bon Secours Medical Group Kelly, David L., MD: Medical Director for Quality, Bon Secours Virginia Health System, Bon Secours Medical Group

This article originally appeared in the 2014 – Vol 98, No 3 issue of Virginia Pharmacist, published by the Virginia Pharmacists Association, Richmond, Va. Reprinted with permission.

With the passing of the Affordable Care Act in 2010, the Centers for Medicare and Medicaid Services (CMS) expanded coverage to include an Annual Wellness Visit (AWV) for Medicare beneficiaries. An AWV is a preventive wellness visit. The AWV includes a Health Risk Assessment (HRA) which encourages the goal of health promotion and disease detection as well as coordinates the screening and preventive services that may already be covered and paid for under Medicare Part B. The AWV provides Personalized Prevention Plan Services (PPPS). PPPS is a 5-10 year written screening schedule given to the patient after the AWV. It is also a separate service from the Initial Preventive Physical Examination (IPPE), also known as the “Welcome to Medicare” preventive visit, that

serves to introduce the beneficiary to Medicare and its covered benefits. The IPPE can only be provided by a physician or qualified non-physician practitioner (i.e. nurse practitioner, physician assistant, or clinical nurse specialist). It is not the same as a yearly physical, which is not covered by Medicare.

Continuation of this article is available on PPA’s website: https://papharmacists.site-ym. com/?page=OtherArticles The full article includes information on who is eligible to provide and receive an AWV, what’s included in an initial and subsequent AWV with PPPS, billing requirements, a pharmacist’s role in AWVs, collaborative practice agreements in practice, and implementation. z

Every Solution Starts Out with a Question By: Tyler Salovin – Pharm.D Candidate 2016, Temple University School of Pharmacy

Going from handouts to handheld, three Temple University School of Pharmacy students and a recent alumnus are looking to bring evidence based treatment algorithms right into the palm of your hand.

We live in an age where mobile technology has become an essential part of our daily lives. Students at Temple University School of Pharmacy have taken this as initiative to use their mobile devices as a peripheral brain with the creation of QuestionMed. Project leader Leon Do (PY4) saw a means to bring what he was learning in the classroom and was able, with the guidance of his clinical faculty, to adapt the evidencebased guidelines for a particular disease state into an easy to follow decision-tree style algorithm. His goal was to take the big picture in a disease state and show his fellow pharmacy students what questions they could ask about a patient in order to determine and suggest an appropriate treatment regimen. With this goal in mind, Do was able to use his app design to

14 I Pennsylvania Pharmacist I January/February 2015

pitch to his peers that they could use this flow-style to reason out why any particular regimen would be best and not rely on brunt memorization.

Do has since been assisted by Temple alumni, Steve Orlando (Class of 2014), and two fellow PY3 students, Forrest Ridgway and Tyler Salovin. With the successful launch of two independent apps, covering Systolic Heart Failure and Upper Respiratory Tract Infections, Do and his QuestionMed team have set their sights on expanding and adding dozens of other disease states to eventually integrate them into one central app.

Their focus is to design these apps in a way that it is helpful for both pharmacy students seeing the material for the first time and practicing pharmacists who may need a quick reference. Along with presenting the material in a logical and simplistic fashion, Do hopes that his apps may allow patients with a curious mind Continued on page 29

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Features

Technician Corner Pharmacy Technician Profile: Tina A. Gulick, CPhT Position: Lead Customer Service Technician, Millennium Pharmacy Systems; 2014 PPA Pharmacy Technician of the Year.

What made you want to be a pharmacy technician?

I wanted to be a pharmacy technician in order to help people, and I was interested in the healthcare field and the way medications affect people’s lives always interested me.

What piece of advice would you give to a new pharmacy technician on their first day? Listen

and pay attention to your patients and pharmacists, as you can learn and benefit from their experience and knowledge. I learn something new every day.

What is your view of the future of the pharmacy technician profession? Our role is constantly changing with increasing responsibilities, it will be very important for a technician to have education and continuing education in order to function adequately, on the job training will be important but not the only part of a technician’s ongoing training and hopefully recognition and pay will reflect the important role we play in day to day pharmacy operations. z

PPA Members Share Their Most Memorable Moments as Pharmacy Technicians!

Denise Tousey, CPhT: Pharmacy Technician Program Director, Great Lakes Institute of Technology: An elderly lady brought in a pill and wanted to know why it didn’t dissolve all the way in her stomach. It turns out that she had looked at her bowel movement and saw that the shell of the medication was still there. The pharmacist explained that the pill had a pin hole which is how the medication is absorbed and it was not uncommon to have the shell pass through in the stool. To this day, I can still remember the conversation and how shocked I was to have this happen.

Thomas Lindeman, CPhT: Pharmacy Technician, Whitehall Pharmacy: As a pharmacy tech in a community pharmacy, the most memorable moments occur when patients express extreme gratitude to us when we are able to provide them with capable medication therapy management AND are able to save them money with their co-pays! They are thankful when we are able to explain why their physician has prescribed a particular medication

16 I Pennsylvania Pharmacist I January/February 2015

therapy regimen – at no cost to them! I always reinforce the fact that the community pharmacy is probably one of the very few places where one can literally walk in, without an appointment, and receive excellent, individualized medical advice from a trained medical professional. It is gratifying to me when patients show true appreciation for the services we provide!

Rachel Russell, CPhT: Pharmacy Technician, Safeway: A shoplifter was trying to steal tooth brushes and steaks. When the manager tried to confront him, the thief pepper sprayed her and ran!

The employees called the pharmacist to get her advice on what product they could use while waiting for the paramedics; she ran up front and right after she left, a massive line formed right in front of me. I had to put half of the waiting customers in our waiting room because they needed C2s out of the safe. I just stood there awkwardly until the pharmacist came back 15 minutes later. That topped my list after the two fires our store had. It’s a pretty interesting job so far! z

Fall 2014 Totally Tech Conference

PPA’s first ever Totally Tech Conference in April was a big success! To accommodate even more pharmacy technicians, the program was offered again on Saturday, November 1. Sixteen pharmacy technicians from across the state came to the PPA office in Harrisburg for a day of CE programming and networking. The Fall Totally Tech Conference featured the same CE sessions as the spring conference, including two hours of pharmacy law. New programming will be introduced for the Spring 2015 Totally Tech Conference! z

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Pennsylvania Pharmacist I January/February 2015 I 17

PPA’s Awards Committee is seeking nominations for several prestigious association awards that are presented annually during the Association’s Annual Conference which will be held October 1 to 4, 2015 at Holiday Inn Harrisburg-Hershey in Grantville, PA. Many pharmacists currently practicing in Pennsylvania are excellent candidates for these awards; individuals whose contributions have made pharmacy a better profession for all of us. Below is a list of the awards and criteria for selection of the award recipient for each.

Criteria for all awards A nominee must be a current member of PPA to be considered.

For all awards except those noted with an *, nominees must be a licensed Pennsylvania pharmacist.

All nominations will be held on file and eligible for consideration for 3 years.

Bowl of Hygeia Award Sponsored by the American Pharmacists Association Foundation and the National Alliance of State Pharmacy Associations (NASPA) with support from Boehringer Ingelheim

Granted to recognize and honor a Pennsylvania pharmacist who has demonstrated sustained commitment to community service, apart from his/her specific identification as a pharmacist, which reflects well on the profession of pharmacy. Specific Award Eligibility:  Nominee must not be currently serving or have served in the  Nominee must be living; awards are not presented last two (2) years as a member of PPA awards committee, an posthumously elected PPA officer or a paid employee of PPA  Nominee must not be a past recipient of the award

PPA Pharmacist of the Year Award

Presented to a pharmacist who has demonstrated dedication to the profession of pharmacy, contributed time and effort to the various professional organizations, furthered the profession of pharmacy through community service and embodied those qualities of attitude and leadership which exemplified the profession.

George S. Maggio Memorial Award

Presented to the pharmacist who has contributed the most to pharmacy in Pennsylvania through his/her work in legislative activities and advocacy.

NASPA Excellence in Innovation Award Sponsored by Upsher-Smith Laboratories, Inc.

Recognizes a pharmacist who is involved in an innovative pharmacy practice resulting in improved patient care. The nomination must include a description of the innovative pharmacy practice which would qualify the recipient for this award. . George H. Searight Community Service Award* Presented to an individual who has shown outstanding devotion and service to PPA, and his/her own county or local association, and for outstanding community service which has enhanced the image of the profession of pharmacy within his/her community. This award may be presented to a pharmacist or a non-pharmacist.

Cardinal Health Generation Rx Champions Award Sponsored by the Cardinal Health Foundation

This award honors a pharmacist who has demonstrated outstanding commitment to raising awareness of the dangers of prescription drug abuse among the general public and among the pharmacy community.

The award is also intended to encourage educational prevention efforts aimed at patients, youth, and other members of the community.

Pharmacists Mutual Insurance Companies “Distinguished Young Pharmacist” Award

Recognizes new pharmacists for their dedication to and participation in PPA, commitment to the practice of pharmacy, and involvement in community activities. Minimum selection criteria:  Licensed to practice for nine years or less.  Has distinguished themselves in the field of pharmacy practice.  Participated in national pharmacy association(s), professional programs, PPA activities and/or community service.

Preceptor of the Year

This award has a separate nomination form for students to use.

Nominees must be PPA members, must be a preceptor for a Pennsylvania pharmacy practice site, and must be nominated by a PPA Student Member.

Pharmacy Technician of the Year*

Presented to an individual who has at least 2 years of experience working as a pharmacy technician in any pharmacy setting, who has demonstrated a professional attitude at their place of employment, and who has shown leadership in the training of their technicians in their practice settings.

J. Allen Duffield Pharmaceutical Industry Award*

Presented to an individual who is associated with the pharmaceutical industry or other pharmacy associated/related business or service, who has contributed time, effort, commitment, and supported and participated in the activities and programs of PPA and who has, through his/her affiliation with the company and industry he/she represents, contributed to the betterment of the profession of pharmacy.

Pauline Montgomery Leadership Award Sponsored by Value Drug Company

The Pauline Montgomery Leadership Award, sponsored by Value Drug Company, is presented annually to a female independent owner, manager, or employee of an independent pharmacy who demonstrates leadership in all of the following areas: pharmacy, politics/advocacy, and community.

Value Drug Company provides a $1,000 check to the recipient.

Nominate a deserving individual for an award and recognize them for all they do for the pharmacy profession!

Find the nomination form at http://www.papharmacists.com/?page=Awards 18 I Pennsylvania Pharmacist I January/February 2015

Association News

Stories from American Pharmacists Month October was American Pharmacists Month; a time to celebrate your profession, recognize your pharmacy staff, and reach out to your patients. During this special month, we collected your 2014 celebration stories and pictures:

Student Pharmacists from Wilkes University attended Media Day in New York City on October 2. They went to the Today Show with “Know Your Medicine, Know Your Pharmacist” posters and brochures educating the public about pharmacy and the role of the pharmacist.

This year, Kristen Motley offered free blood pressure screenings in barbershops to bring awareness to the Silent Killer for African American men.

Pharmacist Tony Ferri took a moment to pose with Stephanie McGrath’s son, Harrison – a future Pharm.D!

Student Pharmacists from Duquesne University hosted a Health and Wellness Fair on October 15 in Pittsburgh’s Market Square.

Pennsylvania Pharmacist I January/February 2015 I 19

Features

Pharmacy Spotlight Bloomfield Pharmacy: Taking Pride in Old Fashioned Personalized Service

By Cassandra Mislyan, Philadelphia College of Pharmacy PharmD Candidate 2015

John’s Story John McClellan, RPh, graduated Philadelphia College of Pharmacy in 1977 with his Bachelors of Science in Pharmacy. During his schooling, John was a pharmacy intern at Milner Apothecary on 44th and Chestnut in Philadelphia.

Upon graduation, John was hired as a full-time pharmacist at Milner Apothecary. John left Philadelphia in 1981 and relocated to Lewistown Pharmacy where he became a certified orthopedic fitter from 1981 to 1985. He really enjoyed his time there because he was able to gain a vast amount of patient interaction by going to the local hospital and fitting patients for all types of braces: back, wrist, leg, etc. In 1985, a friend from college approached John and asked him to work for him and to become the pharmacy manager at one of his stores, The Chemist Shop, in King of Prussia. John accepted, but eventually the drive up 202 from West Chester began to become

too much of a hassle. John began to advertise in local pharmacy association magazines and the PPA journal in an attempt to become an independent pharmacy owner.

In 1991, John finally got the call he was waiting for. A man named Arden Shambaugh contacted him and asked if he had ever been to New Bloomfield, PA. John, not

knowing anything about the area, decided to drive up and check out a pharmacy for sale and to his amazement, he fell in love with both the little rural town and the pharmacy. John agreed to purchase the pharmacy and Arden introduced him to people and other business owners around town. John was amazed at how much the people of the town stuck by him; so much that he was able

20 I Pennsylvania Pharmacist I January/February 2015

to retain his business and put a chain competitor out of business that opened up a year after he started. From then on, he knew he had become a vital member of the community.

Brief History of the Pharmacy The pharmacy was built in the early 1920’s and its current location is believed to be the only location of the pharmacy. Over the years the pharmacy has had only three owners.

First, H Earl Book, also known as Doc Book, owned and operated Book’s Drug Store until 1960. After 40 years of ownership, he passed the torch to pharmacist, Arden Shambaugh who changed the pharmacy name to Bloomfield Pharmacy. In 1991, after 31 years of ownership, Arden sold the pharmacy to its current owner John McClellan, RPh who has successfully operated the pharmacy for the past 23 years.

John has been fortunate enough to collect old fashioned pharmacy antiques over the years. In fact, many of the memorabilia he has was given to him by some of his

patients over the years.

One of his most notable items is his antique show globe, which is the symbol of pharmacy carried from the 17th century. A show globe marked a drugstore in much the same way as a barber’s pole marked a barber shop. It is believed a show globe was dyed different colors to inform the town or travelers of disease. A globe dyed red indicated there was a disease or plague among the town and a greed dyed globe indicated that everything was normal and safe.

Unique Services the Pharmacy Provides “Taking pride in old fashion personalized service” is the motto of Bloomfield Pharmacy. This means that the staff, pharmacist and pharmacy will always take that extra step to provide the best service possible. If you are looking for a specific product and they don’t have it, the staff will first see if they can order it for next day delivery or help you find an alternative product. Also, there is no automated telephone answering service at the pharmacy; every time you call you talk to a real live person. John even offers a store credit service that allows selected patients to charge their medications to an account and pay monthly bills. This is a great feature for many of the elderly patients for whom social security

comes monthly. Lastly, John offers some additional unique services for his patients that many other retail settings do not offer, such as, non-sterile custom compounding for patients and pets, durable medical equipment, ostomy supplies, wound care items, orthopedics, and institutional pharmacy services to the local prison and military institute.

Involvement in the Community Being involved in the community is very important to John. In order to give back he supports everything he can, such as sport teams, senior citizen center, local organizations, sponsorships and fundraisers. He is even an active member of the local Lion’s Club in which he helps out any where he can, including plays, community events and fundraisers.

Rewards of Owning a Pharmacy One of the biggest rewards of owning your own pharmacy is the satisfaction and accomplishment you get from actually helping someone out who really appreciates your efforts. For instance, the other day John compounded suppository for an eight month old baby who was really sick and unable to keep any liquids or foods down. Once John finished the suppositories, he was so happy to see how grateful the parents of the baby were for all of his help. Moments like this remind John why he went into business for himself instead of working for someone else who

does not offer these services to the community. Some other rewards include being your own boss, not having corporate sanctions, not having corporate managers or supervisors, picking your vacation days, choosing holidays to close the pharmacy, not working weekends and being able to hire good employees. Lastly, being part of the community and giving back to each other, by having them support you and you support them is a huge reward in its entirety.

Challenges of Owning a Pharmacy As with owning any business there are always challenges.

A challenge many people are unaware of is the long hours John puts into his business. While the pharmacy is open for business from 9 am to 6pm, John is usually there from 7 am to 7pm, if not longer. Finances are another major component. When it comes to balancing the inventory, it is important John makes sure he is getting paid for what he dispenses and that incoming and outgoing supplies match up. Lastly, customer service is by far the most challenging aspect of owning your own pharmacy. The old saying, “the customer is always right” applies immensely. You would like to retain as many customers as you can and avoid making them angry. It can be very challenging to balance between the customer, the physician, and the insurance company; often times all involved parties don’t realize all of the hard work you are doing because they do not have access to the Continued on page 39

Pennsylvania Pharmacist I January/February 2015 I 21

Departments

Campus Checkup LECOM October and November were very busy months for LECOM! LECOM started the month of October receiving a mayoral proclamation of American Pharmacist Month from the City of Erie Mayor Joe Sinnott. We were very excited to have the mayor recognize the importance of pharmacist as an integral part of the healthcare team. We then began hosting many events for American Pharmacist Month, starting with a rotating health fair at four local Rite Aid stores where we promoted medical adherence and medication safety to the residence of Erie, PA. We continued the month with a visit from APhA-ASP Speaker of the House Loren Kirk where he meet with local leaders in the school to discuss our goals for this year as well as our P1 and P2 class to discuss the importance of advocating for our profession.

During the middle of the month, we held a diabetes awareness health fair at our school’s wellness center which was followed up with a diabetes awareness human blue ribbon in November. To finish off American Pharmacist Month, LECOM students participated at our local mall’s Trail of Treats during Halloween where they handed out Mr. Yuk stickers and explained the importance of poison prevention to children and their families.

We had a very successful American Pharmacist Month and used the momentum we built during October to keep us rolling into November. We began the month with student pharmacist volunteering their time to teach Erie’s

22 I Pennsylvania Pharmacist I January/February 2015

children and teens the importance of good hygiene at a local after school program. Also in November, the pharmacy school at LECOM teamed up with our medical school to participate in Relay for Life at our school’s wellness center. It was a great day full of fun and interprofessional collaboration. We then took our chapter down to Morgantown, West Virginia for APhA-ASP’s Midyear Regional Meeting. Everyone who attended had a great time and we made a lot of new friends with students from all over the country. We had a record high number of students attend the conference and hope to keep that trend going for PPA’s midyear meeting this February.

Finally, LECOM finished the month with an interprofessional event with our medical school, hosting a panel discussion on how pharmacist and physicians rely on each other. We were very excited for this opportunity to meet with our medical students and share how each profession can help the other, and the individual skills sets that we each possess. It was a very successful event and we plan on having more of them throughout the school year. We are very excited about all of the student participation we have had so far this school year and are looking forward to future events! z

University of Pittsburgh The University of Pittsburgh’s PPA chapter has had a busy semester recruiting, fundraising, hosting monthly meetings, and organizing/ participating in events.

Our membership ambassador, Jenn Fever, has done a great job this semester and we are happy to have added 22 new members to our chapter thus far.

One of the events our chapter has been working on is our Dean’s Theme Project that we receive funding from our APhA-ASP chapter to implement. This year’s theme is Operation Self-Care and our PPA chapter is focusing on women’s OTC sexual health products. We organized a Dean’s Theme Committee that has been diligently working to compile pertinent patient counseling information on Plan B, Cranberry supplements, OTC pain relievers, and Monistat in order to create a PowerPoint presentation and posters to educate our fellow University of Pittsburgh students.

We plan to host events at the all girl’s residence hall, our Student Health Pharmacy, and other women’s health organizations/classes on campus.

Throughout this semester we have also partnered with our Student Societies of Health-System Pharmacy

chapter in order to implement Katy’s Kids events.

SSHP has previously hosted poison prevention initiatives at various elementary school and child care centers around Pittsburgh, and next semester we are excited to incorporate Katy’s Kids into their current program.

We also worked with our APhA-ASP chapter to host a student outreach visit with Loren Kirk, our APhA-ASP National Speaker of the House. Our members were excited to learn about APhA-ASP on a regional and national level and were excited to hear about some of the legislative issues currently being discussed.

We are extremely proud of our member, Chelsea Henderson, who was elected APhA-ASP Region 2 Midyear Regional Meeting Coordinator for 2014-2015! Chelsea was elected at the Midyear meeting in Morgantown, West Virginia this November and we would like to formally extend our congratulations to her.

We are also proud of our Phi Delta Chi chapter who raised $5,552 for St. Jude during the St. Jude Gives Thanks Walk. They were able to surpass their intended fundraising goal and placed second in the Pittsburgh area for most money raised!

Finally, we are looking forward to all of our upcoming projects and events next semester, and everyone is especially looking forward to the PPA Midyear Conference in Harrisburg! z

Student members: Did you know you have the opportunity to win $50?

For every new student pharmacist that you recruit to become a PPA member (make sure your name is on the application) you will be entered for a chance to win $50. A winner will be drawn at random and announced at PPA's 2015 Annual Conference. You do not need to be present to win. The competition ends August 31, 2015!

Invite your friends to join PPA today!

Continued on page 24

Pennsylvania Pharmacist I January/February 2015 I 23 Student members: Did you know you have the opportunity to win $50?

For every new student pharmacist that you recruit to become a PPA member (make sure your name is on the application) you will be entered for a chance to win $50. A winner will be drawn at random and announced at PPA's

Departments

Wilkes University At the beginning of the school year, Wilkes University’s PPA chapter had been focused on increasing its membership. We had a booth at the orientation for first year pharmacy students as well as invited Courtney Box to come to Wilkes-Barre to promote PPA during Wilkes’ annual Club day. Wilkes University’s PPA chapter also had a Mocktail Party to encourage first year pharmacy students to join.

After all of our efforts we are proud to say that we had over 40 students join or renew their membership.

Members also had a blast at PPA’s Annual in Mars, PA. Eight students from Wilkes went to the conference and after attending this conference and networking with others; we look forward to Mid-Year in February!

Wilkes University’s PPA chapter also had a t-shirt fundraiser to raise money for PharmPAC. Stephanie Horger, Wilkes University’s Alternate Delegate, came up with the logo of a superman “RX” symbol on the front of the shirt with “Pharmacy Student What’s Your

Superpower?” on the back. We sold over 60 shirts and have donated $230 to PharmPAC. Kristen Lopatofsky, our Community Chair of PPA, has been working on Katy’s Kids events this semester.

So far we have had 3 events at different daycares.

With this program, pharmacy students explain that medication is not candy and interact with the children through activities. Holding up bags of candy and medicine and asking the children which is which helps them understand that medications can look like candy. Overall the programs have been very successful as well as the pharmacy students have enjoyed educating children about medication safety and the role of a pharmacist.

Finally we held our annual first year pharmacy students letter writing campaign to legislators. We look forward to sending those letters out and cannot wait for Legislative Day next year! z

Duquesne University Duquesne University PPA members formed a committee to write a newsletter that will be distributed to all pharmacy students. It is important for student pharmacists to be aware of the legislative issues involving pharmacy. Many students find themselves unable to keep up with the bills that are proposed and the progress of the bills in the House and Senate. Our newsletter, “PharmDispatch”, is meant to summarize

24 I Pennsylvania Pharmacist I January/February 2015

all of the latest bills pertaining to pharmacy and to provide information on legislation that has been passed in the last year. The first newsletter was sent out in early December. After the initial one, two newsletters will be sent out each semester. This is a great opportunity for PPA to spread awareness of legislative issues in pharmacy and promote advocacy among students. z

Member News Peter Kreckel, RPh, the pharmacy manager of Thompson Pharmacy in Altoona, Pa., was named the 2014 National Preceptor of the Year by the National Community Pharmacists Association (NCPA) Foundation at the NCPA 116th Annual Convention and Trade Exposition, held Oct. 18-22 in Austin, Texas. The National Preceptor of the Year Award honors a pharmacist who has made significant contributions to the education of pharmacy students by devoting time, talent, and efforts as a preceptor.

Burmans Specialty Pharmacy was honored with “Shaping Healthcare Delivery” award at AmerisourceBergen’s ThinkLive 2014 Conference. Burmans was selected as the first-ever “Shaping Healthcare Delivery” award recipient for enhancing access to treatment for Hepatitis C patients through an innovative partnership with AmerisourceBergen. In addition to providing improved access to medication, Burmans’ clinical pharmacists, pharmacy technicians, nurses and disease-specific customer service representatives provide ongoing, individualized care to patients and healthcare providers.

Dr. Maria Osborne recently received her CDE (Certified Diabetes Educator) certification from the National Certification Board for Diabetes Educators (NCBDE). The Certification Examination for Diabetes Educators (Examination) is designed and intended for health professionals who have responsibilities that include the direct provision of diabetes selfmanagement education (DSME), as defined by NCBDE. The National Association of State Controlled Substances Authorities (NASCSA) recently presented its President’s Award to Janet Hart, RPh, during its 2014 Annual Conference held at the Hilton Desoto Hotel in Savannah, Georgia. The President’s Award is presented annually to the individual who has contributed the most to NASCSA through his/her work as a volunteer to the organization.

Rob Frankil, RPh, was appointed to the State Board of Pharmacy as a community-independent representative. Mr. Frankil was officially sworn in prior to the State Board of Pharmacy’s meeting on November 12, 2014. A graduate of Temple University School of Pharmacy, Mr. Frankil, is the current owner of Sellersville Pharmacy and Sellersville Pharmacy at Penn Foundation, located on the campus of a mental health facility.

In Memoriam – Paul Hiller, a Temple University graduate and PPA member, active in the Lackawanna Pharmacists Association passed away on November 23. During his pharmacy career, he worked at Rea & Derrick, Mercy Hospital, Geisinger, and with Commonwealth Health. He was active in Kappa Psi and founded the Pocono Graduate chapter and rose to the highest national office of grand regent. z

Pennsylvania Pharmacist I January/February 2015 I 25

Features

Profiles in Pharmacy Innovation Out of the Classroom and into Africa: KarenBeth H. Bohan, Pharm.D., BCPS, Associate Professor of Pharmacy at Wilkes University Education: Pharm.D. from the University of Maryland School of Pharmacy in 1988.

Current Practice Site: Wilkes University with site at Wilkes-Barre General Hospital and Makerere University Department of Pharmacy & Mulago National Referral Hospital, Kampala, Uganda.

Practice Site Description: Wilkes-Barre General Hospital is a 400 bed community hospital. Bohan works with the affiliated Wright Center for Graduate Medical Education – Family Medicine Residency Program.

Bohan also practices and shares her knowledge in Uganda, Africa. There she assists in teaching pharmacy students from Makerere University, focusing on pharmaceutical care skills.

How did you begin your education in pharmacy? Bohan originally started her education at the University of Maryland in the Emergency Health Science

Program. She had been a certified EMT and volunteered during high school with the local rescue squad.

Entering University of Maryland gave Bohan hopes that she would learn how to be a Paramedic as well as the necessary business skills to run an EMS center. “But the more experience I got as an EMT, the more I realized I didn’t have the fortitude to work with critically injured patients at the

scene of the accident.” Bohan immediately began searching other healthcare field possibilities and got overwhelming positive responses from local community pharmacists. University of Maryland also had a pharmacy program, either as a Bachelor’s degree or the then new coming Pharm.D. degree. Once accepted,

26 I Pennsylvania Pharmacist I January/February 2015

Bohan decided to try the more rigorous six year Pharm.D. program.

First EVER innovative experience and how did it make you feel? Fifteen hours away from her family, Bohan’s first feeling of innovation came from when she took the job at a small rural hospital in northern Maine. “I thought I had skills that I wanted to share with a small hospital rather than the normal career goals of those trained with Pharm.D.s at the time.” Back in the early 90’s, it was common practice for the pharmacists with Pharm.D. degrees to pursue large hospitals that already had established “clinical” pharmacists.

Bohan wanted to demonstrate to smaller systems that clinical pharmacists could be essential to the team. “I felt like I was branching out of the normal box, which was both energizing, challenging and scary.”

What are you currently doing now that is innovative, how have you grown? Bohan has just recently finished her fifth

trip to Uganda, Africa since her first started in March 2011. The process began in 2008 when a fellow Wilkes University colleague asked, “How would you like to go to Africa?” Bohan was quite surprised by this question because she had never considered herself one to travel to a place like Africa.

“I have always loved travelling but I pictured it being those places like Australia, England or even Hawaii.” Dr. Jim Merryman was the anthropologist from Wilkes who pursued Bohan because he was following up on a water sanitation project in Africa. Being the anthropologist, Merryman was interested in the socioeconomic impact of the clean water system, but he also needed to study the health impact the new water had on the community. Bohan teaches Infectious Diseases to the pharmacy students at Wilkes University and so Merryman thought she would be a good fit.

However traveling to Africa wasn’t just about packing your bags and boarding a plane, of course they needed the funds for their research. Merryman, Bohan and others from Wilkes University applied for many grants with

no luck for a few years. “The key is to not give up; we continued to try to find ways to fund the research.” In 2011, Bohan had the idea of taking students over for the project as well; which eventually lead to the Dean of School of Pharmacy, the Pharmacy Practice Chair and the Wilkes Faculty Development Committee offering funds for the trip on the premise that nontraditional students were going to study abroad in a nontraditional country. In the summer of 2011 Bohan took her

“I knew I wanted to benefit others with these trips.” Bohan not only wanted to give the opportunity for American students to learn about the Ugandan health system, but vice versa as well.

She had hopes that the Ugandan health care system could benefit from having more of a clinical pharmacist approach. “The students have a different emphasis in school than we do here, they have an excellent core education in the sciences so a lot of students are interested in industry and they don’t focus on patient care skills.” Like in America, most pharmacists in Uganda practice in community pharmacy, however they do not focus on direct patient care; the pharmacy solely

first student to Africa as a Research Advanced Pharmacy Practice Experience (APPE). There was celebrated feedback from that first trip so it was then approved for future students as a Global Health APPE program. Since then Bohan has taken up to four students in their last year of pharmacy school to Uganda as a Global Health APPE.

exists as a means for the patient to purchase their medications.

After some preliminary work, the Global Health APPE is now partnered with Makerere University in Kampala, Uganda, and Bohan works closely with Professor Richard Odoi from the school of pharmacy.

The program has grown since Continued on page 28

Pennsylvania Pharmacist I January/February 2015 I 27

Features is to teach them through casebased problems and help them utilize the QuESTSCHOLAR, I ESCAPED CPR and PQRST approaches to analyze patient scenarios for drug therapy problems.

The students then go in teams to local hospitals 2011, Bohan has been awarded a and use what they learned in the Fulbright Specialist Grant to help real life setting. “They act exactly faculty at Makerere develop a like my students back home! curriculum that includes patient They come back to me and say care skills. This Grant includes ‘But the doctor didn’t listen to Bohan teaching the current us!’ and my response is that it is professors so they can take over okay, we are taking the first steps.” the classroom in the future. Bohan Bohan points out that pharmacists’ developed a class that mimics recommendations may not always the Pharmacy Care Lab at Wilkes be taken, there may be times that and altered it to fit the needs of the other members of the team the Makerere students. The goal have more information than us.

Unlike American and European students, African students do not have many health guidelines Tony Hayslip, ABR/AREP Ernie Zost, RPH to follow.

713-829-7570 727-415-3659 Bohan was Tony@RxBrokerage.com Ernie@RxBrokerage.com surprised to see the books they were

28 I Pennsylvania Pharmacist I January/February 2015

studying from were American and European written texts! “This makes learning more difficult for them because they are following guidelines that do not pertain to African people.” Bohan pointed out that the drugs available in Africa are vastly different than what is available to us here in America; they can’t follow the same steps healthcare providers use here to treat African patients all the time.

The trips to Uganda are thriving and Bohan has been keeping a blog about her trips that is available to the public at http:// pharmacyclassintoafrica.com/ if you would like to read more.

Any innovative or pharmacy advice for others? “I would like to make one point that is most important to this interview, it is never too late to start, if you have an idea, go for it!” She encourages others to find people with similar goals, dreams and desires as themselves and work together.

“Be patient, and take one step at a time.” Change takes time, and you have to learn from your mistakes.

In terms of working in another country, do not try to force the American system on anyone; you should instead lend your skills and time and see what path that leads you to. z Compiled by: Alysha Lopez, 2015 PharmD Candidate, Wilkes University

Industry News

Red Flags – Are You Protecting Your DEA License?

Published with permission from PAAS National® - paasnational.com

On September 18th, 2014 the DEA issued an order to revoke the Certificate of Registration (DEA License) for a Texas pharmacy, effective November 3rd, 2014. This revocation is the direct result of the pharmacy failing to recognize “Red Flags” or suspicious prescriptions and not resolving or verifying these orders. Under the Controlled Substance Act (CSA), particularly 21 CFR § 1306.04(a) and 21 CFR § 1306.05(a), controlled substance prescriptions must be written for a legitimate medical purpose and contain specific information to be valid. The CSA also states that the pharmacist has a corresponding responsibility to ensure the proper prescribing and dispensing of a controlled substance prescription.

Some of the “Red Flags” you should watch for include: • Drug cocktails such as an opioid, a benzodiazepine and a muscle relaxant.

• Multiple drugs in the same class such as Hydrocodone/APAP tabs and Tussionex Suspension.

• Controlled and non-controlled prescriptions where patient only requests to fill the controlled drugs, especially if the prescriber specifies to fill all or none.

• Requests to pay cash for controlled drugs and insurance for non-controlled.

• Quantities that exceed standards of treatment such as a 30-day supply of cough syrup.

• Missing required elements: • Patient full name and address • Prescriber name, address, DEA# and signature (no stamps or pre-printed signatures) • Drug name, strength, dosage form, quantity and directions for use.

• Prescribers that write the same drugs, directions and quantities for every patient regardless of age, weight, gender and medication history.

• Prescriptions that are from other cities or states outside of your usual business area.

• More than one unrelated patient that presents with the same or similar prescriptions within a short time frame.

• State Drug Monitoring reports that show multiple prescribers, pharmacies and/or multiple controlled substances.

PAAS recommends that you be alert to these and other Red Flags and always verify and document that controlled prescriptions are for a legitimate medical purpose and meet all of the requirements under the CSA. Drug abusers and diverters are always looking for new ways to get their drugs. Don’t let a bad prescriber or patient destroy your pharmacy and your reputation. z

Every Solution Starts Out with a Question Continued from page 14

to see how their disease states are being managed and why. In the near future, these Temple students are aiming to add such chronic disease states such as asthma, hypertension, hyperlipidemia, and diabetes.

To check these apps out, they are available for free download in the App Store and Google Play, and via

www.QuestionMed.co as the independent modules “Heart Failure” and “Respiratory Tract Infections”. The development team is available for contact at Leon. do@QuestionMed.co for any questions, comments, suggestions, or interest. z

Pennsylvania Pharmacist I January/February 2015 I 29

PPA’s 2015 Mid-Year Conference In today’s world, pharmacists are becoming increasingly more involved in direct patient care activities, through comprehensive medication management, collaborative practice agreements, Accountable Care Organizations (ACOs), and working in or connecting as part of a Patient Centered Medical Home (PCMH). Additionally, growing emphasis on quality performance measures, Star Ratings, and EHRs are all emerging trends impacting pharmacy. Join us as this year’s Mid-Year Conference focuses on addressing the challenges, opportunities, and exciting nuances of Pharmacists: Providers of Patient Care.

Friday, February 20 Highlights Include:

Continuing Education Immunization Update: 2015—earn Immunization CE Credit!

Improving Patient Safety in the Treatment of Diabetes: Opportunities for Pharmacy —earn Patient Safety CE Credit!

Patient Self-Care and Pharmacy 2015 Student Programming Student Patient Self-Care Competition Networking Opportunities & Social Events: Conference Kick-off Celebration and Welcome Dinner

Saturday, February 21

Highlights Include:

Continuing Education Override, Override, the Pharmacist Cried: A Review of Clinically Significant Drug Interactions—earn Patient Safety CE Credit!

Complex Insulin Management in Patients with Diabetes Know Pain, Know Gain Pharmacy Patient Counseling Competition 2015 Pharmacists: Providers of Patient Care: Exploring the Emergence of Patient Care Practice Student Programming Student Panel on Life After Pharmacy School Opioid Abuse and Misuse and the Naloxone Connection Pain Counseling Competition Student Poster Presentations Networking Opportunities & Social Events Breakfast Buffet, Lunch, Beer & Banter, and Dessert Reception 30 I Pennsylvania Pharmacist I January/February 2015

Sunday, February 22 Highlights Include:

Continuing Education Pharmacy Quality Measures: Action Steps for Improvement Pharmaceutical Poetry: Recent Updates in Clinical Research for the Practicing Pharmacist Student Programming The Propers of Partners for Presentations, Power-Points, and Posters Networking Opportunities & Social Events The Foundation’s Sunnyside Up Breakfast

Silent Auction/ Chinese Raffle Fundraiser

This event will be hosted by PPA’s Educational Foundation. Items will be posted in advance and available for online bidding beginning January 20, 2015. Online bidding will close at 12 noon on February 18 and after that there will be on-site bidding. All bidding will close at the end of the Beer and Banter Reception on Saturday evening. For more information, please visit http://www.papharmacists.com/?page=Auction

For a complete listing of the Schedule of Events and to register, please visit www.papharmacists.com/?page=MidYear2015

Pennsylvania Pharmacist I January/February 2015 I 31

Over $8.5 Million disbursed to participating members in 2013

Association News

Call for Nominations Nominations Being Accepted for PPA Officers and Members of the Board of Directors The following positions are available: President Elect and Vice President Regional Directors – Northwest and Southeast Practice Network Directors – Community-Independent/LTC, Health System/Institutional, Academia, and Student Pharmacists Help lead your profession and pharmacy forward!

Officers: PPA’s Nominating Committee is seeking nominations from our membership for the officer positions of President Elect and Vice President. This is a great opportunity to help lead the profession.

Candidates for the office of President Elect and Vice President must be Active Pharmacist members of PPA. Job descriptions for officer positions and the Board may be found by clicking on the respective position on the PPA website, under About PPA, and selecting Leadership Team.

Regional Directors: PPA is also seeking pharmacists interested in serving as the regional director for their region. The position is a twoyear term and individuals are eligible to serve two consecutive terms. The Director serves on the PPA Board of Directors and generally represents that region. PPA is comprised of five regions and this year the regions that are up for election are: Northwest and Southeast. To see what areas comprise a region – please go to the PPA website, then under About PPA, select Community Groups. On that page, click on Regions. You can also find a job description for the Regional Director.

Practice Network Directors (formerly Academies: The Nominating Committee also needs

individuals willing to lead their practice setting through their Practice Setting Network. A Director is needed for each Practice Network up for election this year. Terms are two years and individuals may serve two consecutive terms, except for our Student Network, which is a one year term. The Director serves on the PPA Board of Directors. The following Practice Setting Networks are electing officers this year: Community-Independent/Long Term Care, Health System/Institutional, Academia, and Students.

Any individual member or group of members may nominate someone for consideration. However, prior to submitting a nomination, the individual’s consent must be secured. Individuals may also nominate themselves. All nominations are to be received at the PPA Office by Monday, March 10, 2015.

Letters/faxes/emails of nomination should be sent to: Pennsylvania Pharmacists Association, 508 North Third Street, Harrisburg, PA 17101-1199, Attention: Nominating Committee or faxed to 717-236-1618.

They may also be sent to the general PPA email to the committee’s attention, ppa@papharmacists.com.

Nominations may initially be a simple statement of interest. Candidates will then be requested to submit photos, additional information, and bios or CVs. z

Pennsylvania Pharmacist I January/February 2015 I 33

Association News

Say Yes to Opportunities, Meet New People

By Alysha Lopez, PharmD Candidate 2015 A wise man once said “Say yes to opportunities and meet new people,” and that’s exactly what I intended to do. I never imagined that I would adhere to the expression so literally when I scheduled my APPE eight months prior to going to the Pennsylvania Pharmacists Association.

The PPA rotation is not a patient care site, it is an elective, but that doesn’t mean I didn’t learn about pharmacy related items while I was there for five weeks. In actuality, I learned more about what’s really going on in pharmacy at PPA than I did at my previous sites.

Students scheduling APPEs through Wilkes University have some flexibility in choosing what time slot, or block, they want to have a specified rotation site.

Having prior knowledge about PPA, I began to contemplate “what block could I get the most out of this rotation?” The choice was easy, the block including a conference and the end of a Pennsylvania government session. If I was going to go to PPA, I wanted the whole excitement package, and that is exactly the opportunity I got!

I jumped into the rotation the week of the 2014 Annual Conference. Just before a conference meeting, the PPA staff works harder than any group I

have ever seen. You can’t imagine the work that goes into planning and executing a great meeting, you can only experience it for yourself like I had the opportunity of doing. I was one of the staff during the conference and helped with registration, scheduling,

continuing education set-up/teardown and communication with the hotel personnel. What did all this lead too? Meeting new people of course! The 2014 Annual was my fifth PPA conference but the most significant and rewarding. I meet someone new at every conference I attend, but this time it meant something more because I was constantly being appreciated by members who noticed me helping

34 I Pennsylvania Pharmacist I January/February 2015

out behind the scenes.

Then there are the weeks after conference is over; the work never ends! Basically the whole month after a conference, PPA staff works hard on cleanup, letters, press releases, interviews and publications. It is vital to reflect on the meeting and spotlight all the special affairs that happened, such as members receiving important awards. This allowed me to, once again, reach out to PPA members, reintroduce myself and personally interview many of them for publication or press release articles. Talk about the opportunity to meet new people!

Even through the entire conference grind, there were still other matters to attend to, grassroots.

This is by far my favorite part of PPA! I love the opportunity to learn about government relations, pharmacy-related bills and how I can help with the course of action. Anyone who has met me knows I am not shy when it comes to giving my opinion, and I love educating my state officials about pharmacy related legislative issues. I was an integral part of lobbying while I was at PPA, especially SB 405 which addressed interchangeable biologic products.

I worked very closely with Continued on page 36

New FDA regulations are making IT harder than ever

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Association News Representative Gabler on SB 405, pharmacists. The gratification one having many personal discussions feels after accomplishing such a around the topic. Gabler even tasks is indescribable; you feel stated that he is overjoyed cultivated and important after when I come to meet with him writing an educational piece on because we can speak together your own. using upper-level government I encourage anyone interested terminology while I teach him in the PPA rotation to not be about upper-level pharmacy afraid of the advocacy aspect; the terminology. Representative Gabler rotation can be done no matter also introduced me to numerous what your prior knowledge. What I important people that work at the do caution is that the rotation is for Capitol Building. There I go again, those who already have or would meeting new people. like to expand on leadership Since I was learning so much qualities. It takes a goal-oriented about biologic drugs, I decided and self-driven student to take on to take the opportunity to write the PPA rotation because there is a continuing education article a lot of work involved. I was so about the “Purple Book.” I did lucky to have the opportunity to some research on my own and intern at PPA and my candle to contacted those that I considered advocate is burning brighter than experts on the topic, to come up ever! I am so excited about all PPA with a fifteen minute knowledgehas to offer that I even joined a BuySell_ads15_Layout 1 11/28/14 4:34 PM Page 7 based article targeted towards few committees; yes, students can

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be involved with committees! It’s an opportunity all students should take to interact and meet new people.

So who’s the wise man that told me to “say yes to opportunities and meet new people”?

Coincidentally, it was someone who said yes to the opportunity of being PPA’s President in 2011, Dr. Adam Welch. I can honestly say that I do not regret selecting the rotation at the Pennsylvania Pharmacist Association during one of their craziest times. I am so ecstatic I had the opportunity to meet so many people and got involved in so many endeavors that will remain with me in the future. So what are you waiting for? Go out there and say “yes to opportunities and meet new people!” z

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36 I Pennsylvania Pharmacist I January/February 2015

Features

Member Profile Jennifer Malinowski, BS Pharmacy, PharmD

Education: University of the Sciences in Philadelphia (USP) 1993, Temple University 1995, The Johns Hopkins Hospital Pharmacy Practice Residency 1996.

Work location: Wilkes University School of Pharmacy and The Wright Center for Primary Care, Mid-Valley Practice.

Job description: Associate Professor, Pharmacy Practice Wilkes University, Tenured- Other than teaching, Malinowski is the community service coordinator for the pharmacy program and has guided student development in unique, interdisciplinary initiatives such as development of public service announcements on Wilkes’s college radio station and supervised student-authored health-related blogs for the university’s newspaper. New partnerships are always welcome!

Malinowski is also the Chair of the Curriculum Committee and is proud of the school’s recent

accomplishment to award the first ever “PharmD with Spanish Concentration” certificate to a 2014 graduate.

Director of Clinical Pharmacy Services Integration, The Wright Center- At The Wright Center, Malinowski takes 18 introductory and advanced pharmacy practice experience (APPE) students who have large involvement with the integrated clinical services offered to the patients. All activities are fully interprofessional, giving pharmacy students the full opportunity to see what integrated clinical services are like. The Wright Center prides themselves on working together as a team; patients appointments are scheduled so they meet with both the doctor and pharmacist on the same day. The Wright Center also hosts many learning modules for patients, such as cooking and nutritional classes.

In 2012, they were awarded a national recognition for pharmacist integration and medication reconciliation processes from the Alliance for Integrated Medication Management and the Patient Safety Pharmacy Collaborative.

Why did you choose pharmacy as a career/degree?

Malinowski had always saw herself as a people-person and truly wanted to make a difference in people’s lives with her career. She

also loved the sciences and says, “I actually chose my profession right, I would never want to leave my job.” She correspondingly always had a passion for teaching others and knew one way or another, she would use that skill. During her studies in pharmacy, Malinowski met many professors that inspired her to continue her pursuit of one day becoming a teacher and now she coordinates and teaches Introductory, Hematology and Joint Disorders Pharmacotherapeutics modules at Wilkes University.

How do you feel about professional pharmacy organizations, what do they mean to you? Malinowski is a member of PPA, APhA, ASHP and AACP to name a few. In APhA she serves as the Chair of Best Practice Committee, Patient Centered Medical Homes and Accountable Care Organizations.

“These pharmacy organizations give us a unified voice; we can grow as a profession more efficiently as a group than we can as individuals.” Malinowski also mentioned that she has met many colleagues through pharmacy organizations, giving APhA as an example because it allows her to communicate with pharmacists outside of the northeast. “Being a member of organizations has allowed me to share information, Continued on page 39

Pennsylvania Pharmacist I January/February 2015 I 37

195 Theater Drive, Duncansville, PA

Is your wholesaler adding directly to your

profits?

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Our approach to business is quite simple, provide our members with excellent service through business consulting, accurate order processing, timely deliveries and exceptional market pricing bringing higher profitability to our members. No matter the size of the business, the cost of goods is the same for each member.

How can Value Drug help my pharmacy?

Our programs for our partner members drive profits back to the pharmacy -they are as follows: • • • • •

Competitive Generic Source Program Authorized 340B Distributor Program Immunization Program Long Term Care eMAR Program Suspicious Order Monitoring (SOM) Value Specialty Pharmacy (VSP) is an option for filling patients’ specialty prescriptions without utilizing mail order. As an Authorized VSP Care Site, your patients’ prescription will be adjudicated and filled by VSP and shipped to your pharmacy so you can provide your patient their specialty medication.

And our latest initiative – 5 Star Rating Program designed to provide our partner member’s new programs and consultative services to improve performance when being evaluated by payers.

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We are confident Value Drug Company will be your “Solution for Profitability.” contact: Karla Moschella at 800-252-3786 ext. 126 for more information

such as research ideas, teaching techniques and ways to guide my students.” Malinowski also spoke of the importance of PPA vs APhA; as PPA keeps her up-to-date on Pennsylvania practices while APhA looks at the U.S. as a whole.

What’s something in pharmacy that has changed drastically since you got your degree? When Malinowski graduated in 1993, there was still a push for critical care and hospital pharmacists, but even still that practice was different. “Back then, it seems like most of my clinical pharmacist role models practiced within inpatient medicine and critical care. I recall a lot of focus on pharmacokinetics and drug information. In the past decade, the movement of strong clinical pharmacists to the outpatient sectors in community and primary care providing medication therapy management is much more robust and creates a low hanging fruit for opportunity to enhance patient care.” Malinowski went on to describe how proud she is of her students’ abilities to use research and evidence to make the best choices for patient care. Something

drug-related that has changed is the use of beta-blockers.

Malinowski remembers learning in school to never give beta-blockers to heart failure patients, and now we know that they help saves lives.

Where do you see the role of a pharmacy and pharmacists in the future? Malinowski discussed here the fact that we need to “close the loop” in healthcare.

It is of the upmost importance that there is a continuity of care, and all healthcare professionals stay up-to-date with the patients’ status. Malinowski sees community pharmacy at the forefront in the future. “Community pharmacists have the ability to continuously monitor patients during changes in their care.” For instance, a doctor will schedule a follow-up appointment with a patient three months later, but the community pharmacist who sees the patient monthly for refills (or more) can easily monitor for adherence, side effects and any other concerns the patient has.

How do you feel about “provider status”? Provider status is the catalyst needed to

transform the future of pharmacy.

Just as Malinowski sees community pharmacists as the future, she sees them being able to “close the loop” if our provider status can change.

Currently the pharmacy job market plateaued partly because pharmacists can’t bill and get paid for their services which may inhibit employers from hiring new employees. If our status changes, pharmacists could continue to grow and offer many more sustainable services to patients, such as MTM or working in a clinic with a full healthcare team.

When you are not working in pharmacy where can one find you? Malinowski has three wonderful children ages 9, 10 and 14. She stays active in their lives and wears many hats; “soccer, lacrosse and cheer-mom.” She is also a sucker for the 80’s hairband music and enjoys going to concerts frequently in the area. z Compiled By: Alysha N. Lopez, PharmD, Candidate 2015 Wilkes University

Pharmacy Spotlight Continued from page 21

behind the scene part of pharmacy. Lastly, working with demanding customers is a huge challenge all in its own.

Value of Professional Organizations To tackle legislative issues you need a voice, voices are better heard when there are more of them and there is

always safety found in numbers. Joining a professional pharmacy organization is critical in making sure pharmacy has a voice.

John’s Advice John wants to remind everyone to maintain your level of patience. He says, “Be careful what you pray for, you may get over loaded.” Everyone needs a good bit of patience to deal with all aspects of owning a pharmacy. z

Pennsylvania Pharmacist I January/February 2015 I 39

Features

and the Law

By Don. R. McGuire Jr., RPh, 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.

Law vs. Ethics

I

recently attended a conference which had some very thoughtprovoking sessions. While the conference was billed as a pharmacy law conference, ethical issues kept percolating to the surface. What is the difference between law and ethics? Why should I care? What impact can ethics have on pharmacy practice?

We should care because law and ethics work together to maintain our society. Law is a rule of conduct that is formally recognized by a society as binding and is enforced by that society. Ethics on the other hand is less structured and less formal. As a professional, pharmacists must use their professional skills for the benefit of their patients. Ethics involves the decision-making process required to treat patients. Many times the choices faced are not dealt with directly by laws.

Some commentators view laws as the baseline for professional conduct. This must mean that there is some advanced mode of practice that exceeds the requirements of the law. For example, if a pharmacist is

required to undergo an annual skills assessment, there would be nothing to prevent the assessment being done every six months if it was thought that it provided better care for the patient. It still complies with the requirement set by law. The cost/benefit analysis and the decision-making process that ensues to decide if every six months is warranted is where ethics comes into play.

Some pharmacists don’t believe that ethical questions will affect

40 I Pennsylvania Pharmacist I January/February 2015

them. They follow the law every day and that will suffice. However, there is a limitation on the effectiveness of the law. Law tends to be reactionary, not proactive.

Law deals with yesterday’s problems, not tomorrow’s. Also, law is limited. There are not laws to address every single issue that comes up in today’s society.

If there were, our code books would be enormous. This is why lawyers are always talking about the “reasonable person”. What

would a reasonably prudent pharmacist have done in your situation? This is the measuring stick for situations where black and white laws don’t exist, which is most of the time. These situations make pharmacists nervous because there may not be one “right” answer. Most likely there will be a best answer.

Many people wish that more laws were simple right or wrong choices, but the reality is that our society is too complicated for such laws. Changing one little factor in a scenario may drastically change your conclusion.

Look at this list of issues if you think that pharmacists aren’t faced with ethical decisions; • Should pharmacists be involved in the dispensing of Medical Marijuana?

• Should pharmacies sell alcohol or tobacco products?

• Should pharmacists take part in executions by lethal injection?

• Should pharmacists have the right to refuse to dispense drugs based on their personal morals?

• Should pharmacists dispense drugs for assisted suicide?

Depending on your state, most of these activities are legal. If following the law is your only criteria, then there is little to debate here. But, ethical questions can arise because of a number of different reasons. It could be a conflict between

the pharmacist’s moral values and the law. It could be competing laws that don’t coincide leaving the individual to try to reconcile the two different laws.

They might also arise when there is no applicable law at all. Ethical questions might also arise when a patient’s needs cannot be met within the legal guidelines.

Chances are that we are all going to be faced with these types of choices at some point in our professional lives. Take time to prepare before you are faced with an urgent decision. There are plenty of references available that explain the principles of ethics and the decision-making process. When you are better prepared, the challenges are easier to handle.

The ostrich approach is not going to prepare you well.

Pharmacists are required to study the applicable laws.

They should also study ethics because law and ethics work hand in hand. Neither alone is sufficient for pharmacists’ practices in the 21st Century. z 1: American Society for Pharmacy Law’s Developments in Pharmacy Law XXV. Thanks to Ken Baker and Bruce White for planting the seeds of this article. © 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.

Implementing Electronic Prescribing for Controlled Substances Update It has been four years since the Drug Enforcement Administration (DEA) published its interim final rule (IFR) allowing electronic prescribing for controlled substances (EPCS). Over the past four years, Surescripts, as the primary network facilitating e-prescribing in the U.S., has worked with the pharmacy and prescriber application vendors that connect to its network to ensure that EPCS is implemented in the ambulatory healthcare setting in a way that is fully compliant with the DEA’s EPCS rules.

Surescripts published an update similar to this two years ago and distributed it to the pharmacy community with the goal of answering the questions that were being asked most frequently about EPCS by a variety of stakeholders, both within and without the industry. Given that Surescripts continues to receive general and technical questions from the field with respect to the adoption and utilization of EPCS processes, this second update seems appropriate, and a question and answer format is being used again as a vehicle to share such information.

This update can be viewed on the Other Information/Issues page on our website or it can be accessed directly at this link: http://c.ymcdn.com/sites/www.papharmacists.com/resource/resmgr/Other_ Information/Surescripts_Second_EPCS_Upda.pdf

Pennsylvania Pharmacist I January/February 2015 I 41

Departments

Welcome! New Members PPA welcomes the following New Members who joined the association – September 27–December 5, 2014. Please make these new members feel welcome and part of Pennsylvania pharmacy!

ASSOCIATES Daniel Cieniewicz 1847 Financial Leesport Cory Thatcher 1847 Financial Coopersburg Julie Malone Value Drug Company

NEW PRACTITIONER 2 Rachel Caggy Rite Aid Imperial

NEW PRACTITIONER 3 Anthony Guarascio Pittsburgh

ACADEMIA CORPORATE Scott Greene Philadelphia College of Pharmacy at USP Havertown Lauren Jonkman University of Pittsburgh School of Pharmacy Pittsburgh Yardlee Kauffman Philadelphia College of Pharmacy at USP Philadelphia Nima Patel-Shori Temple University School of Pharmacy Philadelphia Andrew Peterson Philadelphia College of Pharmacy at USP

ACTIVE PHARMACIST Dana DiMatteo Oakmont Joseph DiMatteo Medicine Shoppe Oakmont Robert Ingoldsby Natrona Heights

Kellie Stauffer Darrenkamp’s Pharmacy Lancaster Harry Balliet Medicap Pharmacy #225 Sefik Guraydin Value Rx Pharmacy Inc. Bindy Mathew Rising Sun Pharmacy Inc. Anna Shamilova Primary Choice Pharmacy, Inc.

RESIDENT Elizabeth Bunk Duquesne University – Mylan School of Pharmacy Pittsburgh Francesca Chieffallo Wilkes-Barre VAMC Scranton Ji Hyui Choi Duquesne University – Mylan School of Pharmacy Pittsburgh Tamika Greenwood Duquesne University – Mylan School of Pharmacy Pittsburgh Molly Livingston Saint Vincent Hospital Erie Natalia Tarasiuk Lancaster General Hospital Lancaster

Michael Gault Maura Harkin Chenxi Huang Christopher Hvisdas Timothy Jacisin Thomas Kelly Greg Kemper Jisoo Kim Jessica Laub Dena Lehmann Jessica Leri Jimmy Liu Nina Lyons Christina Maher Ashley Maister Coleen McCarren David McGain Matthew McGuire Elvis Nkemta Jessica Olsen Jonathan Park Laura Phillips Kathleen Seip Dongwhi Seo Majid Shafi Shadaria Shuler Emily Skanecki Nicholas Stangler Ryan Stockett Le Tran Brittany Tschaen Andres Varilias Jessica Verzella Caroline Vizzi Minki Yang Sarah Yi Tina Zanganeh

Duquesne University Shelby Schott Katie Stollar

LECOM School of Pharmacy Amanda Hydock Emily Petrak Amanda Skal Katelyn Weyand

Jefferson School of Pharmacy Christine Barlow Jessica Burkhart Sarah Carrante Min Qiang Chen Tyler Dally Hanifah Davis Lindsay Fitzpatrick

Temple University School of Pharmacy Michael Abrams Ashiq Ahmed Hasan Alhasani Adaolisa Anaka Justin Andrade Jeffrey Avena Priya Bhimani

STUDENT

42 I Pennsylvania Pharmacist I January/February 2015

Gary Bledsoe Ian Booth Han Chen Matthew Civitello Adeline Cruz Rebecca Davner Kinjal Desai Ta-Seti Donald Courtney Donovan Megan Doran Mansi Doshi Erin Drewniany Anetta Dubinchik Kevin Dunn Andrew Fadimilehin Reem Farah Megan Fasolka Edward Feller Joseph Gaughan Arya George Emily Harvey Idrees Hazzaa Jin Rong Huang Linh Huynh Nikki James Mi Jang Brent Jenkins Yi Cheng Kao Amandeep Kaur Sabah Khatoon Lwin Khine April Kim Lauren Kobren Tatyana Kolyesnik Brittany Koons Matthew Korber Brian Landi Danielle Laprad Grace Lee Jung Sun Lee Zi Li Jihae Lim Joanna Lu Carol Ly Hiba Malik Brendan Mangan John Marasigan Andrew Milewski Katarzyna Mol Harris Nguyen Sydney Nguyen Tam Nguyen Phuong Nguyen Vu Phan Nguyen Mandee Noval Derek Oâ&#x20AC;&#x2122;Neill Stacy Pasciolla Shriya Patel Komal Patel Marvin Pathrose

Jayden Hensley Catherine Knapp Holly Margiotti Cassandra Morey Rachel Petrone Michael Pino Elizabeth Ray Vladimir Russ Tori Sallo Philip Scavo Kara Serfass Felicia Snyder Kristopher Steinert Sydney Stuyvesant Kenzie Teno Heidi Yanoski Richard Yarger

Grace Patterson Ann Marie Porreca Hean Poy Ashley Pregizer Adam Puliti Christina Santiago Leah Scandlen Kuriakose Simon Matthew Sokol Benjamin Thivarath Tho Tran Lin Tran Michael Ujwary Khen Ung Melissa Urian Carmen Vasquez Bobbi Westermeier Yali Xiong Su Xu

PHARMACY TECHNICIAN

University of Pittsburgh School of Pharmacy April Andreen Dylan Atkinson Svetlana Avshalumov Jillian Bowker John Chang Kelsey Collett Gabrielle Dziuba Taelr Eason Karley Fazzone Megan Frazer Harvey He Sara Klebine Alyssa Kunkel Megan Kwiatkowski Olivia Marchionda Alexander Marshall Esther Oder Brianna Thompson William Thompson Meicheng Wang April Wolski Sophia Yang Philadelphia College of Pharmacy at USP Sherri Nye Samarth Parikh Ashley Snow Wilkes University Nesbitt College of Pharmacy Dana Achenbach Margaret Bigart Aeree Choi Amy Davies Keri Diehl Heath Dresch Tara Engel Anthony Fanucci Dominika Foltyn Joshua Fox Christian Giovannini

Andrea Bucher Rite Aid Camp Hill Derek Butters Guardian Pharmacy LTC Brockport Dawn Dunn Aetna Newville Sarah Everingham Rite Aid Harrisburg Youssef Ghobrial Walmart King of Prussia David Gloster Rite Aid Pittsburgh Suleiman Khalifa Sr. Lancaster Amy Knisely Rite Aid York Patricia Nixon Total Home Health Care, Inc. Bushkill Maria Nunez New Cumberland Kevin Otto Americure Rx Schnecksville Tricha Philippe-Grant AmeriHealth Caritas Philadelphia Xinxin Wu Walgreens Philadelphia

Pennsylvania Pharmacist I January/February 2015 I 43

Features

Financial Forum: IRA Rollovers for Lump Sum Pension Payouts Give those dollars the opportunity for further tax-deferred growth.

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.

A big payout leads to a big question. If you are taking a lump sum pension payout from your former employer, what is the next step for that money? It will be integral to your retirement; how can you make it work harder for you?

Rolling it over might be the right thing to do.

If you don’t have substantial retirement savings, that lump sum may be just what you need. The key is to plan to keep it growing. That money shouldn’t just sit there.

Even tame inflation whittles away at the value of money over time. Most corporate pension payments aren’t inflation-indexed, so those monthly payments eventually purchase less and less. Lump sums are just as susceptible: if you receive $100,000 today, that $100,000 will buy 50% less by 2028 assuming consistent 3% inflation (and that is quite an optimistic assumption).1,2 Putting it in the bank might cause you some financial pain. If you just take your lump sum payout and deposit it, all that money will be considered taxable income by the IRS. (There are very few exceptions to that rule.) Moreover, you won’t get the whole amount that way: per IRS regulations, your employer must withhold 20% of it.2,3 Don’t you want to postpone paying taxes on those assets? By arranging a rollover of your lump sum distribution to a traditional IRA, you may defer tax on those dollars. You can even defer tax on a distribution already paid to you if you roll over the taxable amount to an IRA within 60 days after receipt of the payout.3 In doing so, you are keeping those assets in a taxdeferred account. They can be invested as you like,

44 I Pennsylvania Pharmacist I January/February 2015

and that money will not be taxed until it is withdrawn.

(You may only transfer a lump sum distribution from a company pension plan into a traditional IRA – you may not transfer it to a Roth IRA.)4 If you are considering taking a lump sum payout, make sure you position that money for additional taxdeferred growth. Talk to a financial professional who can help you with the paperwork and get your IRA rollover going. z Citations: 1 - money.cnn.com/2012/09/01/pf/expert/pension-payments. moneymag/index.html [9/1/12] 2 - www.kiplinger.com/article/retirement/T037-C000-S002pensions-take-a-lump-sum-or-not.html [9/11] 3 - www.irs.gov/taxtopics/tc412.html [1/4/13] 4 - www.fool.com/retirement/manageretirement/ manageretirement2.htm [1/21/13] Pat Reding and Bo Schnurr may be reached at 800-288-6669 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. 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.

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