Pennsylvania Pharmacist May/June 2018

pennsylvania

PHARMACIST May/June 2018 • Volume 99 • Issue 3

Pennsylvania Pharmacists Networked in Nashville at the APhA Annual meeting!

THE OFFICIAL PUBLICATION OF THE

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CONTENTS PPA BOARD OF DIRECTORS PPA OFFICERS President: Nick Leon, PharmD, BCPS, BCACP President Elect: Lauren Simko, PharmD Vice President: Rick Demers, RPh, MS, FASHP Immediate Past President: Eric Pusey, RPh, CDE REGIONAL DIRECTORS Central: Richard Seipp, PharmD Northeast: Thomas Franko, PharmD, BCACP Northwest: Nickolas Kernich, PharmD Southeast: David Stone, PharmD Southwest: Cory Krebs, RPh PRACTICE DIRECTORS Academia: Nicole Pezzino, PharmD, CDE, BCACP Chain Pharmacists: Stephen Pfeiffer, PharmD, MBA Community Independent Pharmacists: Shawn Nairn, RPh Community Independent Pharmacists: Chuck Kray, RPh Health System Pharmacists: Darryle Tillman, RPh MCO/Industry/Government/Other: John Barrett, MBA, RPh Associates: Greg Drew, RPh STUDENT DIRECTORS East: Amandeep (Amni) Kaur West: Tina Schuler PPA OFFICE STAFF CEO: Patricia A. Epple, CAE pepple@papharmacists.com | Ext. 3 Conference and CE Manager: Linsley Gentile lgentile@papharmacists.com | Ext. 2 Government Relations Manager: Angela Zaydon azaydon@papharmacists.com | Ext. 6 Membership and Marketing Coordinator: Victoria Madonna vmadonna@papharmacists.com | Ext. 5 Membership and Program Coordinator: Rachel Stall rstall@paharmacists.com | Ext. 1 Bookkeeper: Michele Dibble mdibble@papharmacists.com | Ext. 4 PPCN Executive Manager: Stephanie McGrath, PharmD smcgrath@papharmacists.com PPCN Trainer: Brandon Antinopoulos, PharmD ppcntrainer@papharmacists.com Pennsylvania Pharmacists Association (PPA) 508 North Third Street, Harrisburg, PA 17101 (717) 234-6151 Fax: (717) 236-1618 www.papharmacists.com | ppa@papharmacists.com Pennsylvania Pharmacist (ISSN 0031-4633) is the official publication of the Pennsylvania Pharmaceutical Association d/b/a Pennsylvania Pharmacists Association and is published every other month, six times per year. Annual subscription is $100 for non-members; for members it is included in the annual dues. Editorial information should be addressed to the PPA address listed above. Peer reviewed articles accepted according to the stated guidelines available from PPA.

EDITORIAL BOARD Position Vacant Hershey S. Bell, M.D.,M.S.,FAAFP Kim Coley, FCCP, PharmD, RPh, Chair Michael Gionfriddo, PharmD, PhD Yardlee Kauffman, PharmD, MPH, BCACP Associate Editor: Victoria Madonna Editor/Manager: Pat Epple PUBLISHED BY GRAPHTECH Alexis Kierce, Publications Manager (717) 238-5751 x119 alexis@thinkgraphtech.com For Advertising Information: Kristen Bergmaier, Account Manager (717) 238-5751 x129 kristen@thinkgraphtech.com DESIGNED BY GRAPHTECH PHARMACIST STATE BOARD OF PHARMACY MEMBERS Institutional: Gayle Cotchen, BSPharm., PharmD., MBA Independent Community: Rob Frankil, RPh Chain Community: Janet Hart, RPh Chain Community: Theresa M. Talbott, RPh Independent Community: Mark J. Zilner, RPh Board of Pharmacy Meeting Dates: May 22, 2018 July 10, 2018 August 21, 2018 October 2, 2018

ON THE COVER: APhA’s Annual Meeting and Exposition On March 15–19 in Nashville, Tennessee, attendees were given the chance to network and reconnect with APhA conference attendees! Pictured are attendees from Wilkes University Nesbitt School of Pharmacy, University of Pittsburgh School of Pharmacy and the PA Reception.

DEPARTMENTS

ASSOCIATION NEWS

5

Calendar of Events

7

President’s Message

21 Educational Foundation 2017 Annual Report

8

Campus Checkup

28 Staff Update

11

Welcome! New Members

29 Celebrating 140th Anniversary

13 Member News 14 Affiliated Member News

FEATURES 15 Student Member Profiles

30 Our Presidents Reminisce Continues 32 PPCN Update 33 Congratulations to the 2018 PPA Graduating Students!

17 Member Profile

INDUSTRY NEWS

18 Legislator Profiles

34 Financial Forum: Saving More Money, Now & Later

20 Pharmacy Spotlight 26 Patient’s Perceptions on Barriers to Opiod Safety Counseling in Grocery Store Pharmacies

35 Rx and the Law: Death with Dignity

28 Effect of Pharmacist Intervention and Education on Adults with Diabetes Mellitus in a PatientCentered Medical Home

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

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.

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Calendar of Events

Advertisers Index

May 6-8

Smith Drug Company

National Association of Board of Pharmacy/ Pharmacists Mutual 2018 Leadership Conference — Kansas City, MO

5-8

National Association of Board of Pharmacy Annual Meeting – Denver, CO

8 • 12–1pm

CE Webinar — Precepting During Your Rookie Year: A Guide for New Practitioners

8-10

National Council for Prescription Drug Plans Annual Conference — Scottsdale, AZ

10

RDC

2

4

LECOM

6

H.D. Smith 9 PRS Staffing BEEKAN EPIC

10

11

12

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14

17

19 25

Law Review at Philadelphia College of Pharmacy

Value Drug Company

16 • 5–6pm

R.J. Hedges & Associates

CE Webinar – Hit Me With Your Best Shot: Update on Immunizations

June 5-8

27

Independent Pharmacy Buying Group Pharmacists Mutual

39

Back Cover

National Association of Board of Pharmacy Annual Meeting – Denver, CO

8 • 12–1pm

CE Webinar – The Pharmacist’s Role in Promoting Patient Safety in the Treatment Diabetes

8-10

National Council for Prescription Drug Plans Annual Conference — Scottsdale, AZ

10

Law Review at Philadelphia College of Pharmacy

22 • 12–3pm

Pennsylvania Pharmacists Care Network Patient Care Training

25-26

Leadership Retreat

July 21-25

American Association of College of Pharmacy Annual Meeting —– Boston, MA

For additional events including webinars, CE opportunities, and PPA committee meetings, be sure to see our Calendar of Events on the PPA website! www.papharmacists.com 5

President’s Message Over the year, I have used the president’s message as a vehicle to keep our members informed of the progress made on major association initiatives.

We have made significant strides towards our legislative goals by leveraging existing relationships with partners and stakeholders such as Rochester Drug Cooperative, Independent Pharmacy Buying Group, Value Drug Company and Keystone Pharmacy Purchasing Alliance. Together, we crafted, disseminated, and reinforced an image that pharmacy has a clear and unified voice which most recently has resulted in two House co-sponsorship memoranda to address gag clauses and unfair pharmacy reimbursement.

We have executed a first-of-its’-kind contract with Gateway Health which helped patients, created a new revenue stream for pharmacies, and produced value for Gateway — so much so that we have high hopes for a continuation of our relationship with a second contract that will extend to the end of 2018.

We have held two successful conferences with close to 800 attendees who benefited from about 70 hours of CE. We kicked off our association’s 140th anniversary with 10 past presidents who were able to attend our mid-year conference. At that conference, we also announced that PPA’s board of directors donated its’ Harrisburg headquarters to the PPA Educational Foundation and finalized plans to make much needed, comprehensive renovations to the building which will begin soon.

Together, we have done a lot of good work — but there is much more work that needs to be done. While there are numerous ways to help PPA contribute to the future of pharmacy (recruiting members, joining a committee, heeding legislative calls to action, etc.), I cannot think of a more important way to contribute to PPA’s future and the future success of our profession than to be a supporter of the Educational Foundation.

Within Pennsylvania, the PPA Educational Foundation serves as our profession’s innovation lab where pharmacists across the Commonwealth can be supported in their efforts to dream up, implement, and assess novel interventions and services. As an example, look no further than the PPCN, which started as an Educational Foundation funded inquiry regarding what services pharmacists across Pennsylvania were willing and capable of doing outside of traditional dispensing. While not every project funded from an Educational Foundation grant will lead to something like PPCN, the foundation’s efforts are vital to exploring, examining, and extrapolating insights from small, inventive efforts and translating them to larger, more impactful interventions and services.

Additionally, in order continue to protect and advance pharmacy in Pennsylvania, PPA needs to develop a pipeline of skilled leaders — the PPA Educational Foundation houses our Leadership Excellence and Advocacy Development program (LEAD). This program has been designed, developed, and implemented by some of the pre-eminent leaders of pharmacy throughout the state, including multiple PPA past presidents. Last year, we had 4 participants participate in this program and 2 of them now hold leadership positions within the association.

These two examples of Educational Foundation led programs (research grants and LEAD) ensure that the future of pharmacy is not left to chance — that we can be proactive now to be prosperous in the future. Therefore, in my last president’s message I would like to appeal to our members, who care as much about the future of pharmacy as I do, to support the efforts of the Educational Foundation because their success secures PPA’s future.

Nicholas Leon, PharmD, BCPS, BCACP PPA President 2017–2018

Together, we have done a lot of good work — but there is much more work that needs to be done.

While there are numerous ways to help PPA contribute to the future of pharmacy, I cannot think of a more important way to contribute to PPA’s future and the future success of our profession than to be a supporter of the Educational Foundation.

— Nicholas Leon

www.papharmacists.com 7

Campus Checkup Duquesne University School of Pharmacy

University of Pittsburgh School of Pharmacy

Contributed by: Kelly Mazzei, Communication Ambassador

Contributed by: Kelly Jenniches, Communication Ambassador

This month the Duquesne University PPA Chapter is preparing for Pharmacy Legislative Day. We hosted a letter writing campaign for students to write to their legislators about current bills in pharmacy. We are planning to host this event again after Legislative Day to write thank you notes and follow ups to the legislators we meet with. Our chapter will have a strong presence in Harrisburg this year and are excited for the opportunity to change current pharmacy practices within the state!

This semester was exciting for Pitt Pharmacy’s Student Chapter. We have held several new activities that have been successful, in addition to our previous involvement in Katy’s Kids. We held our first Pitchers and Policy event at the Thirsty Scholar Bar and Restaurant in Oakland in late February. This was a fun night of pharmacy, legislation, and Pennsylvania Pharmacists Association-style trivia, food, and drinks. We hope to continue this event in future semesters. In March, we held two Blood Pressure Screening initiatives inside UPMC Presbyterian Hospital.

We were able to provide this screening service to 67 people and educate them on heart health. The last event that our chapter participated in was Legislative Day in Harrisburg.

78 students represented our School of Pharmacy to advocate for provider status, expanding pharmacist immunization opportunities, opposing reimbursement cuts, and to show our support for our profession. This was a productive and rewarding day!

LECOM School of Pharmacy Contributed by: Clare Dyczkowski, Communication Ambassador At LECOM Erie, as we enter springtime, our P1s will be leaving campus to complete their IPPEs. Before leaving campus, we plan to elect from this class our new officers for the 2018-2019 school year. We are excited to see what the new leadership team will accomplish!

Philadelphia College of Pharmacy Contributed by: Brooke Witmer, Communication Ambassador The PPA Chapter at PCP held a general body meeting on March 1st. Students enjoyed crafting their own ice cream sundaes and hearing the E-board share about the upcoming events for this semester. On March 22nd, “GRASP the Pies and Policies” event was held to give students an opportunity to learn more about legislative day and grab some free pizza. Students heard from upperclassmen who previously attended and learned more about the most recent government policies impacting pharmacy.

The chapter is planning another advocacy event to promote letter writing to congressional representatives. It is a crucial time to advocate for federal provider status legislation before the opioid epidemic hearing in April. The PCP Chapter is also planning to hold another fundraising event this semester in order to make a meaningful contribution to the PPA building fund.

8 Pennsylvania Pharmacist • May/Jun 2018

Wilkes University: Nesbitt School of Pharmacy Contributed by: Kara Cooper, Communication Ambassador The Wilkes University chapter of PPA finished the year strong with three different Katy’s Kids Events! At these events, we presented our “Candy vs. Medicine” poster in which we educated children on the importance of recognizing poisons. The children were very interactive and really enjoyed being able to identify candy from medicine.

We also participated in the YMCA’s Healthy Kids Day. Every year, the YMCA holds the nation-wide Healthy Kids Day which is a free event to all members of the public. At this event, children and their parents come out to learn more about various topics that impact their children’s health. Along with presentations, the

children are able to participate in various activities and where we educated children on “Candy vs. Medicine” while they counted out candy on a counting tray!

On campus, Wilkes University held our first Opioid Awareness Walk in which students across campus gathered to walk to raise awareness for the opioid epidemic effecting our local community. During this event, students donated money to the local responders of our area which will be utilized to purchase Naloxone!

This event was a huge success and all students were excited to be able to make an impact on an epidemic effecting our local community!

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Welcome! New Members PPA Welcomes the following New Members who joined the association on February 2, 2018–April 1, 2018. Please make these new members feel welcome and part of Pennsylvania pharmacy!

PHARMACISTS

ASSOCIATES

Charles Adamson, Brave, McCracken Pharmacy Joel Alderfer, Alurtis, Professional Pharmacy Michael Briggs, Chester Springs, Lionville Natural Pharmacy Lauren Donohue, Winchester, VA, Lancaster General Health Benjamin Evans, Collegeville, Paoli Pharmacy Edward Eybs, Doylestown Gina Glancy, Wester Chester, CVIM Suzanne Ha, Ardmore, Thomas Jefferson University Hospital Meaghan Herbick, Johnstown, Conemaugh Hospital Mehran Javadi, Pittsburgh Douglas Kent, Gilbertsville Zachary Leslie, Hartstown, Walgreens Joseph Marasco, Moon Township, Express Med Pharmaceuticals, Inc. Sidney Mbah, Jenkintown, Grace Point Pharmacy Laura McMahon, Greensburg, New Stanton Pharmacy Jamie Moran, Duncansville, Value Drug Co. Kayla Niermans, Lower Gwynedd Millie Rajyaguru, King of Prussia, Reading Hospital Kristi Ross, Tyrone, Value Drug Co. Trisha Rudisill, Mount Wolf, WellSpan Health Kamil Rudzinski, Hartzell’s Pharmacy Tera Lynn Rule, Cedar Knolls, NJ, Frier Levitt, LLC Brooke Sleek, McMurray, Curtis Pharmacy, Washington Michael Steffes, West Chester, Walgreens Christopher Svetcov, Breinigsville, Wegmans Rebecca Swintek, Hollidaysburg, Community Pharmacy David Zora, Belle Vernon, Rite Aid

Alicia Sager, Duncansville, Value Drug Co. TECHNICIANS Melissa Farabaugh, Duncansville, Value Drug Co. Alicia Myers, New Oxford, Brockie Healthcare Inc. Tricia Reilly, Duncansville, Value Drug Co. Hallie Sholtis, Duncansville, Value Drug Co. Elizabeth Triplett, York, Brockie Healthcare Inc. STUDENTS Butler University Jill Argotsinger, Prescott Valley, AZ Marilyn Schoenle, Plymouth, MI Duquesne University School of Pharmacy Andrew Dick, Hollidaysburg Chad Vomer, Bethel Park Jefferson College of Pharmacy Ashling Cook, Nottingham Nicasia Dallesandro, Egg Harbor Township, NJ Julian De La Calzada, Easton Samantha Macko, Philadelphia Jordyn Richman, Philadelphia Danielle West, Thorton LECOM School of Pharmacy Hayley Allen, Jefferson, OH Zeinab Altaher, Erie Emily Baker, Erie Carissa Dolan, Erie Shadiya Howell, Erie Elyssa Johannesen, Erie Nick Miles, Erie

Luiza Sakhibnazarova, Erie Tiffany Vuong, Erie Notre Dame of Maryland University School of Pharmacy Robert Gootz, Hollidaysburg Philadelphia College of Pharmacy Sofia Berardi, Blackwood Karminna Ezpeleta, Manalapan, NJ Paul Fimogna, San Francisco, CA Jenna Januszka, Philadelphia Giancarlo Sicangco, Bayville, NJ

Anisa Sulaj, Lake Ronkonkoma, NY Christina Topalidis, Lake Ronkonkoma, NY University of Pittsburgh School of Pharmacy Taylor Conrad, Hanover Shannon Dudich, New Castle Jordan Kester, Beaver Falls Joseph Rizkalla, Johnstown Tsion Tafesse, Pittsburgh Wilkes University Nesbitt School of Pharmacy Dillon Curry, Wilkes-Barre

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Member News Foote Named PCP Dean

APHA-ASP Honors Dean Kroboth

PPA Member and Professor at Wilkes University Nesbitt School of Pharmacy Edward Foote, PharmD will be returning to his alma mater as dean of the Philadelphia College of Pharmacy at University of the Sciences in July. Congratulations Ed!

Patricia Kroboth, PhD and dean of the University of Pittsburgh School of Pharmacy was given the 2018 American Pharmacists Association-Academy of Student Pharmacists (APhA-ASP) Outstanding Dean Award at the association’s annual meeting in Nashville, Tennessee, on March 16–19. The award recognizes a school or college of pharmacy dean who has made significant contributions to the APhA-ASP Chapter and promoted with distinction the welfare of student pharmacists through various community service, leadership and professional activities.

Pezzino Tapped for National Pharmacy Research Program Our very own Nicole Pezzino, PharmD, BCACP, CDE, and an assistant professor of pharmacy at Wlikes University Nesbitt School of Pharmacy, is one of only six people chosen for the 2018–2019 National Association of Chain Drug Stores Foundation Faculty Scholars program.

Congrats Nicole!

Thank You to Our 2018 APhA Delegates A big thank you to Howard Cook, Tanya Dougherty, Tom Franko, Dan Hussar, Julie Gerhart-Rothholz, Kristal Ross, Melissa Shiner and Lauren Simko who represented PPA at APhA in Nashville this year.

McConaha Receives PA DOH Grant Dr. Jamie McConaha, associate professor at Duquesne University School of Pharmacy, recently received two grants to support work in tobacco cessation throughout the Pittsburgh area, $8,778 from the Pennsylvania Health Department and $4,000 from Tobacco Free Allegheny for a total of $12,778. Congratulations Jamie!

www.papharmacists.com 13

Affiliated Member News ACPA Update The Allegheny County Pharmacists Association (ACPA) started off the spring season with a series of events.

In a joint effort between Duquesne University and the University of Pittsburgh Schools of Pharmacy, ACPA put together poison prevention materials and distributed them throughout the Pittsburgh area. The efforts aimed to highlight March’s Poison Prevention Week.

ACPA also held a handful of educational events on migraine treatment and diabetes management.

Additionally, several members traveled to Harrisburg for PPA Legislative Day. They fought for recognition of pharmacist-provided services and lobbied against bills and issues that threaten the profession.

Looking to the future, we will continue our series of educational events — be sure to check our webpage calendar for those happening throughout the

months of May and June. We will also be volunteering at the Pittsburgh Food Bank and Mission of Mercy Dental Clinic. If you are interested in helping, please contact a board member or PPA for more information.

Lastly, we welcome all members to attend our President’s Dinner in June as we celebrate the incoming board members and thank those leaving the board for their service. Register for the dinner online — we hope to see you there!

Nominate A Deserving Individual Today!

• Bowl of Hygeia • PPA Pharmacists of the Year • Excellence in Innovation

• George H. Searight Community Service • Generation Rx Champions • Distinguished Young Pharmacist • Preceptor of the Year

• Pharmacy Technician of the Year • J. Allen Duffield • Paulin Montgomery Leadership

The deadline for award nominations is June 1, 2018. For more information visit: www.papharmacists.com/Awards

14 Pennsylvania Pharmacist • May/Jun 2018

Student Member Profiles and doing well. I still don’t think GPA is everything, but it certainly felt good to truly comprehend material and view studying as a higher priority.

Anthony Fanucci Moscow, PA

Wilkes University PharmD Candidate 2018 How did you hear about PPA? I first heard about PPA during my freshman year at Wilkes. Although I was not considered a “professional” student at that point, I still became interested in PPA and took part in various activities throughout the semester. It wasn’t until my P1 year that I became an official member, but by then I was already very familiar with the organization.

It was during that year though that I truly became aware of all the tremendous opportunities that existed within PPA. Favorite drug name to pronounce Vinblastine!

Flashback to your first year of pharmacy school; what advice would you give yourself knowing what you know now?

“Surround yourself with friends that are passionate about studying.” In my opinion, extracurricular activities are enormous… the things I have done “outside the classroom” have shaped who I am today. I often viewed studying as a slow, agonizing step that was necessary to take and I wish I made it a more interesting process early on rather than waiting until P3 year. During my 3rd professional year I completely revamped my tactics and changed the students I communicated with regarding class. IT CHANGED EVERYTHING. I began to enjoy studying, truly understanding material

Why did you choose to become involved in PPA? Pharmacy is very much a “front-line profession.” Many pharmacists have direct communication with patients and perform the final check in a patient’s treatment progression. However, I have always been an advocate for the work that pharmacists can do behind the main scene.

What would healthcare look like if we took our patientcentered mindset and applied it to laws, regulations, policies, etc.? In my opinion, this is how we change the system as we know it and PPA was the organization that best aligned with my beliefs and mission.

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

YES!! I know I am biased, but the professors at Wilkes are lights out. I have never seen a team of professionals that meshes so well together and remains committed to students each and every day.

On a scale of 1 to 10, with 10 being “absolutely incredible”, our professors sit at a solid 100. I would need an entire magazine issue to truly detail the influence our professors have had on me and other students.

Where do you think you’ll be in 5 years?

The options are endless but I will be happy to finally be out of school by then (hopefully) as I am attending law school immediately following my graduation from Wilkes. My goal is to take my pharmacy knowledge and patientcentered mindset and apply it to an area where pharmacists are scarcely involved. At this point there are a few outcomes that would be desirable for me. I would love to have the opportunity to

work with the FDA or DEA, or to serve on a legal team for a major health care entity or pharmaceutical company (CVS, MERCK, Lilly, etc).

Putting specifics aside, I hope to be in a position where I can utilize my pharmacy background, combined with my legal skills, in order to positively impact our health care system.

Flashback to your first year of pharmacy school; what advice would you give yourself knowing what you know now?

I would tell myself not to stress so much!!! I know that isn’t very easy advice to take, especially as a student, but looking back now I wasted so much time stressing over things that were silly!

Favorite food you have eaten on campus?

Why did you choose to become involved in PPA? Legislative day, was something I had wanted to as an pre pharmacy student.

I have always wanted to be involved with the laws and see our state capital. I felt by being active in this club was one way to be involved and talk to our legislatures. It was the best decision I made that day to walk into the meeting PY1 year to sign up for legislative day. One piece of Milano’s pizza led to four legislative days, a club officer position, scholarships, multiple fun trips to conferences, and a lifetime of friendships!

I’ve actually never had a meal plan on campus, but I am definitely a “foodie” and love to cook! I enjoy cooking with raw materials the most (the whole farm to table concept) and look for pure ingredients without modification or additives.

Mary Kimmel Boswell, PA

Duquesne University PharmD Candidate 2018 How did you hear about PPA? Ben Andrick, who I had met freshman year, told me that PPA was a great organization.

He gave me great advice that once I got into pharmacy school I should consider going to a meeting and becoming a member! I was always looking for pharmacy advice and always valued his!

Favorite drug name to pronounce Metoprolol! For the longest time when I started interning I had to consistently think of how to pronounce it! So now it’s my favorite!

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

I have been very fortunate to have so many great professors.

Where do you think you’ll be in 5 years?

In five years, I would like to serve my community as a manager in a retail setting so I can implemplemnt some ideas for better patient care and interaction. I also hope to be a board member for ACPA so I can help grow the profession.

Favorite food you have eaten on campus?

There was a food station in Towers, which is basically Duquese’s main cafeteria, that was stir fry. It was always my favorite place to go because you could have them put any vegetables in it that you wanted and everyday they would change the protein too! It was fantastic as long as there wasn’t a huge line! www.papharmacists.com 15

Perspectives on Pharmacist Involvement in STI Prevention and Treatment Counseling for Adolescents and Young Adults

By Olufunmilola Abraham, Mara F. Rubin, Kathy E. Monangai, Alison Feathers University of Pittsburgh, Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, United States

Introduction The high prevalence of sexually transmitted infections (STIs) among adolescents and young Adults (AYA) is a global public health issue. About 20 million STIs are newly diagnosed each year and nearly half of them are contracted by young individuals aged 15 to 24 years.1 Female AYA are more vulnerable to STIs compared to males, as their anatomy is more sensitive to sexually transmitted organisms.2-4 About 1 in 4 sexually active teenage girls are infected with an STI.5 Consequently, young females need more assistance managing their sexual and reproductive health (SRH) during adolescence and young adulthood.

Management of STIs among female AYA requires a multidisciplinary approach to care. The World Health Organization Department of Child and Adolescent Health has expressed that research, policy, and service delivery options for STI prevention and treatment is a healthcare priority.6 This demand for expanding healthcare services allows an opportunity for pharmacists to play a larger role in female AYA STI education.7 Implementing pharmacybased STI educational awareness, prevention, and medication management services for female AYA may significantly improve quality of care and SRH safety.8 Pharmacists in the community interact daily with female AYA and therefore are well positioned to be an integral resource for STI awareness, prevention, and treatment strategies. In the United States, pharmacists are the most accessible healthcare professionals in the community with over 70,000 pharmacies located across the nation.9 Few pharmacies have implemented supportive services to improve STI prevention and treatment among AYA. Services such as routine screenings, proper treatment, and effective STI medication counseling would be beneficial to female AYA, but these services are suboptimal amount this population.8 The National Health Service in England commissions SRH services for pharmacies including

16 Pennsylvania Pharmacist • May/Jun 2018

optional advanced medication use review, provisional screening, and treatment for patients.10 The United States does not currently mandate SRH services in pharmacies, but the rise in STIs among AYAs shows the pressing need for these services. Increasing efforts have been made to improve adolescent SRH; however, these services currently lack an emphasis on STI care.6 The US Department of Health and Human Service’s Office on Women’s Health (OWH) recently launched the “Know the Facts” public health campaign to increase young females’ awareness of STIs and to reduce the number of those infected.9 Though preventative STI educational services have been developed, proper implementation has not been successfully integrated into clinical practice.6 Additionally, STI education has not been the primary focus of these tools.6 Pharmacists can fulfill the OWH’s mission campaign to more actively engage female AYA in STI prevention and treatment education. There is a need to identify suitable approaches to facilitate pharmacistfemale AYA interactions about STI prevention and treatment.7

Objectives This study aimed to (1) understand perspectives of female AYA regarding STIs and preferred approach for pharmacists’ counseling; and (2) characterize pharmacists’ experiences engaging with female AYA about STI prevention and treatment.

This study and report was made possible in part through a grant provided by the PPA Educational Foundation grant in 2017. This report was not submitted through the peer review process and is presented as a report only. The full report may be found under the Foundation Section – Programs – Grant Program – 2017.| http://www.papharmacists.com/?page=FGrantHistory

Member Profile community setting. That certainly has evolved! My focus is now working to protect the community pharmacy profession and the very platform we use to take care of our patients.

Ron McDermott

Senior VP of Operations Hometown Pharmacy Solutions, Community, LTC and compounding pharmacy RPH from Duquesne University What is the most important piece of advice you would give a newly licensed pharmacist on their first day of work?

No matter what you do, always remember that the end goal involves taking care of a patient who needs you.

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

PPA helps to keep you connected to topics important to the profession at the state and federal level. Today, independent pharmacists must be willing to be involved outside of just their own community.

We must have a beat on things going on that our important to keeping pharmacy at the forefront of patient care.

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

My first pharmacy job was working with an awesome group of patient and community centered folks at Stadtlander’s Pharmacy in Penn Hills near Pittsburgh. Luanne, Cynthia and the team there taught me the way to take care of business and take care of the patient at the same time.

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

I’m thinking I might have to change the ‘Ph” in Pharmacy to an “F” and open a Farmacia in Mexico.

Every time we vacation there I consider not coming back (but don’t tell my kids!)

Best thing you ever ate?

Full Italian dinner including a meatball salad at Café Martorano’s at Paris Las Vegas (only thing close is my wife’s homemade Italian cooking!)

Name the number 1 reason why you became a pharmacist?

I became a pharmacist to be able to impact a patient’s health and well being face to face in a www.papharmacists.com 17

Legislative Profiles Sheryl M. Delozier What are the key issues you would like to see addressed in this session?

Right now, we are focused on the Fiscal Year 2018-19 budget process.

The governor introduced his plan in February and proposed over a 3.1 percent increase in spending. House Appropriations Committee budget hearings, which I participated in, Sheryl M. followed. I believe the governor’s Delozier plan is not sustainable. His proposed spending increase is almost three R-88 times the rate of inflation. The final budget must live within our means, fund necessary programs and cut costs where able. Additionally, I would like to see legislation passed that I am sponsoring to amend the Pennsylvania Constitution to add a victims’ bill of rights. Currently, only the accused have statutory protections. Victims should be given the same rights as we have seen in other states. A constitutional amendment is the only way to ensure that victims enjoy equal footing with the accused, and the only way to ensure that victims have some kind of redress when their rights are violated.

We have passed numerous other bills on restitution and PFA policy out of the House that have not made it to the governor’s desk. Marsy’s Law may be the only way for victims to regain their voice in the judicial system. Finally, I am hopeful we can make improvements in laws aimed at tackling the opioid epidemic, including mandating prescribing guidelines for controlled substances.

Tell our members a little about your background and why you are a legislator.

I was elected to the House of Representatives in 2008, but have been involved in different facets of state government for many years. I worked under the administrations of Gov. Tom Ridge and Gov. Mark Schweiker, where my focus was on cost-cutting practices and eliminating duplication in the agencies overseen by the governor. Just prior to my election, I served as an advisor to a commissioner of the Public Utility Commission where I addressed public policy on water, transportation and consumer issues. I have always enjoyed public policy. Now, as a legislator, I get to stay involved in many different policy issues while learning something new every day. I enjoy meeting people and hearing their stories, and using those experiences to create laws that make positive change.

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

People trust their neighborhood pharmacist. Of all health professionals, pharmacists have the most comprehensive education and training in the use of medicines for the prevention and treatment of disease. With an evolving 18 Pennsylvania Pharmacist • May/Jun 2018

health care industry, I think we will begin to see health care providers and pharmacists work together more closely to help patients make better use of their medications and achieve optimal results. Health care consumers will also benefit from pharmacists being authorized to administer more medications and vaccinations. We were able to take a step in that direction with the enactment of the state law allowing pharmacists to offer flu vaccines to children ages 9 and older, with parental permission. I was proud to work with Rep. Seth Grove to get that bill through the legislative process. In addition, with the new Prescription Drug Monitoring Program, pharmacists are even more important in the fight against drug abuse, especially with the opioid crisis that is killing so many. The use of the Prescription Drug Monitoring Program allows a check and balance to doctors prescribing and pharmacists filling only what is needed and limiting the impact of opioids.

Advice for pharmacists about the political process?

It is important for all citizens to stay engaged and informed about the legislative process and current issues affecting Pennsylvanians. If you become aware of a bill that impacts yourself or your profession, contact your legislator by writing an email or letter or setting up a face-to-facemeeting. By expressing your concerns, legislators can better understand the positive or negative impact on our health system that you see every day, before casting a vote.

Hearing your input and how a proposed bill will impact our community is a needed and wanted education for any legislator.

What do you do for relaxation or enjoyment?

There is nothing better than a good book on a beach when life allows. I also enjoy watching my kids do what they love — play lacrosse. And I spend a lot of time watching the Nationals baseball team and cheer them on to win a game!

John H. Eichelberger, Jr. What are the key issues you would like to see addressed this session?

Budget cuts sufficient to balance the budget, my legislation to ask the voters if they want to have a Limited Constitutional Convention, some accountability instituted in our government schools, and Paycheck Protection passed by the House.

Tell our members a little about John H your background and why you are Eichelberger a legislator?

Jr. I was drafted to run for the Senate R-30 in 2005. I was a Blair County Commissioner at the time and owned an insurance agency. Folks thought I had the business and government experience necessary to be successful.

Advice for pharmacists about the political process?

I work on government reform, and use my experience to improve the business climate, effectiveness, and efficiency of government.

You have paid consultants to navigate the process for you, use them and learn from them about how and when to engage your members. I think it is best to form relationships with your members, but strategically contact them only when necessary.

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

As either the repeal or destruction of Obamacare takes place, healthcare providers will be faced with new challenges. Healthcare costs are too high for many people, so pressure will be placed on the healthcare industry to find savings, including other ways to provide services. Specific to pharmacy, I think PBM’s will be looked at first.

What do you do for relaxation or enjoyment?

I’m a runner, I do a lot of home improvement work, play trumpet and drums, and enjoy bird hunting with my Airedale Terrier, Oakley.

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Pharmacy Spotlight: Mainline Pharmacy

By PPA Staff Picture it, its 1980 and Jerry Moschgat just opened the first Mainline Pharmacy in Cresson, PA. Fast forward to present day to Mainline’s now ten locations including a long term care and compounding/infusion facilities all located across Cambria, Indiana and Somerset Counties.

Mainline Pharmacy, with headquarters in Ebensburg, PA is an independent pharmacy that offers a wide variety of services to their patients such as Medication Synchronization, Home Delivery, Point of Care Testing, Durable Medical Equipment, Sterile and Non-Sterile Compounding, group and individual Patient Educational classes and programs for Smoking Cessation, Heart Health and Diabetes.

Across all locations, Mainline currently employs 15 full time pharmacists, six part-time pharmacists, one resident, six interns, 25 technicians, five delivery drivers, and one sales and marketing specialist. Meet partner, Director of Pharmacy Brian Sidone, PharmD and 2011 graduate of Duquesne University School of Pharmacy. Sidone believes that being a partner in running multiple locations requires the ability to adapt to the needs of the patients, changes in the community, and the demands of the industry which are all equally challenging and rewarding. The positive impact that he and his staff have made on patients and the pharmacy is a major benefit they all have enjoyed. This impact gives them the added motivation and competitive edge against other practice settings that do not have as much flexibility.

With these benefits, come daily challenges when owning a pharmacy in today’s society. For any independent community pharmacy, this past year has provided its fair share of tribulations related to reimbursement, contracting and network access, product procurement, and regulatory changes. “I trust that true commitment and sacrifice allows us to remain competitive in an environment that is crowded with national and regional chains, mail order 20 Pennsylvania Pharmacist • May/Jun 2018

pharmacies, and downward pressure from the PBMs. Due to these challenges, the profession is changing more frequently. The present trend across the country is the failure of brick and mortar stores and for Sidone and his team this hits close to home.” Sidone said. When taking a closer look that these industries the mind tends to think about why they failed. Usually the first answer that comes to mind is that they were in the business of providing a product or service that is now available through another distribution channel either cheaper, more efficiently, or with more transparency — and sometimes all three. “Anyone in the pharmacy profession faces similar challenges but there is one aspect that other small failing businesses lack — and that is a pharmacist.” Sidone added.

This idea takes us back to why Sidone decided to become a pharmacist. His interests in the variety and levels of care and delivery of services that a community pharmacist can provide make the daily struggles worth it. Sidone’s belief in providing innovative and enhanced services that the competitors cannot match will in turn continue Mainline’s patients on the path to gaining real value from their business model. Mainline puts their community first by working with local enforcement and anti-drug coalition organizations to host Drug Take Back and Disposal events to help battle the opioid epidemic.

Mainline also sponsors local youth sports teams, donates to local fundraisers, provides two annual scholarships to high school graduates, hosts a spring youth fishing derby and offers a free Children’s Vitamin Program at all of their locations.

Sidone finds it very rewarding to have Mainline Pharmacy be represented by the Pennsylvania Pharmacists Association (PPA) and the Pennsylvania Pharmacists Care Network (PPCN) for independent community pharmacy at the local, state and national levels. Being a part of a professional organization allows for networking and communication on the most critical information in the profession which in turn makes for a better pharmacist and ultimately a healthier patient.

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22 Pennsylvania Pharmacist • May/Jun 2018

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24 Pennsylvania Pharmacist • May/Jun 2018

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Patient’s Perceptions: Barriers to Opioid Safety Counseling in Grocery Store Pharmacies

By Angela DiPaola, PharmD1,2, Melissa Belli, PharmD, BCACP1,2, Patty Melissen, BSPharm1 , Michael Barros, PharmD, BCPS, BCACP, BC-ADM2

Introduction According to the Centers for Disease Control and Prevention (CDC), half of all opioid overdose deaths involve a prescription opioid. The most common prescription drugs involved in opioid overdose deaths are methadone, oxycodone, and hydrocodone.2 Studies have shown that daily use of opioids for more than 3 months leads to tolerance, the need for dose escalation, and increased risk of serious side effects.3 In addition to opioid prescriptions, synthetic opioids have also become a concern. The Philadelphia Department of Health released an advisory warning on August 19, 2016, regarding a sharp increase in fentanyl overdoses.

Prescription drug abuse is a known epidemic, and opioid overdose has become the leading cause of injury death in the United States according to the U.S Department of Health and Human Services. There is an urgent need for all health care providers and pharmacists to improve strategies in educating patients on chronic opioid therapy to prevent overdose deaths. Pharmacists can play a role in advancing opioid safety and preventing overdose deaths through patient education and counseling.

There is existing literature regarding pharmacists’ role in opioid safety. The American Society of HealthSystem Pharmacists (ASHP) issued a statement on the Pharmacist’s Role in Substance Abuse Prevention, Education, and Assistance. According to this statement, pharmacists should be involved in educating patients on the appropriate use, storage, handling, and disposal of mood-altering medications.4 However, this does not address patients’ perspectives and common barriers to opioid education.

The Centers for Medicare and Medicaid Services (CMS) announced a plan to introduce opioid overuse quality measures in 2019. They recommend assessing use of opioids at high dosage in persons without cancer, use of opioids from multiple providers in persons without cancer, and the use of opioids at high dosage and from multiple providers in persons without cancer.5 Pharmacists may soon be encouraged to deliver Medication Therapy Management (MTM) services to those identified as opioid over-utilizers in order to improve patient safety and reduce diversion.

The CDC also recommends expanding naloxone use to reduce drug overdose deaths and save lives.6 However, Boston Medical Center researches published a study showing that some pharmacists avoid conversations about naloxone due to the fear of offending their customers.7 26 Pennsylvania Pharmacist • May/Jun 2018

In the midst of an opioid overdose epidemic, there is an urgent need for healthcare providers to understand the true barriers to opioid safety counseling so that pharmacists can optimize safe opioid use and provide the needed education regarding the availability and usefulness of naloxone.

The results of this research identify patients’ comfort level with naloxone being offered with their opioid prescription, patients’ comfort level discussing opioid safety in the pharmacy and confidence that personal information about their opioid use will not be shared. This research addresses common barriers concerning opioid safety counseling in pharmacies in order to help health care providers’ remove any potential barriers and facilitate important discussions on opioid safety.

This research will aid in the development of best practices concerning opioid safety education in the community setting. We must address any patient concerns with naloxone prescribing, concerns of privacy and confidentiality in order to increase patient reporting of adverse effects, risk factors for harm, and any concerns related to dependence and addiction. Understanding and addressing these barriers will help health care professionals improve safety monitoring in the setting of an opioid overdose crisis.

Objectives The objective of this research is to determine patients’ perceptions of barriers to opioid safety counseling.

Prescription drug abuse is a known epidemic, and opioid overdose has become the leading cause of injury deaths (death from unintentional injury) in the United States according to the U.S. Department of Health and Human Services.1 There is an urgent need for all health care providers to improve strategies in educating patients on chronic opioid therapy to prevent overdose deaths.

This study and report was made possible in part through a grant provided by the PPA Educational Foundation grant in 2017. This report was not submitted through the peer review process and is presented as a report only. The full report may be found under the Foundation Section – Programs – Grant Program – 2017 http://www.papharmacists.com/?page=FBOD0_Grant17 AUTHOR NOTATIONS 1 ACME Sav-on Pharmacy 2 Temple University School of Pharmacy

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Effect of Pharmacist Intervention and Education on Adults with Diabetes Mellitus in a Patient-Centered Medical Home

By Kim Pierce, MS, RD, LDN, CDE; Megan Bookser, PharmD, CTTS; Jenna Mickonis, PharmD Candidate 2018; Abigail Weis, PharmD Candidate 2018; Jamie L. McConaha, PharmD, NCTTP, BCACP, CDE

Objectives This study sought to measure the effectiveness of an interdisciplinaryled group diabetes education class on participant’s knowledge surrounding diabetes through evaluation of pre/post knowledge survey scores.

A secondary outcome of change in hemoglobin A1C following completion of the class was also assessed.

Methods Prospective study that targeted patients aged 18–75 who were on at least one diabetes medication to attend a group disease state management class co-taught by a pharmacist and dietitian.

(11/25 participants). A mean decrease in hemoglobin A1C of 1.79% was observed following completion of the class.

Conclusions Results suggest that a combination of nutrition and medication education in the format of a group class setting are helpful in improving patient’s understanding of diabetes. Future studies that are more longitudinal in nature and account for confounding variables are still needed.

Methods

Results Knowledge on the pre/post diabetes survey either remained the same (14/25 participants) or increased

This prospective and controlled study targeted 50 patients of PPCP ages 18-75 years who were prescribed at least one diabetes medication.

The comparator group consisted of baseline patient understanding scores of the patients from PPCP that enrolled in the diabetes classes,

Staff Update PPA Welcomes a New Government Relations Manager!

Angela Zaydon is PPA’s new Government Relations Manager. She is responsible for developing state legislative priorities and strategies; encouraging membership grassroots activities; and lobbying on behalf of the association. She earned her Juris Doctor from Widener University School of Law and political science degree from Canisius College.

28 Pennsylvania Pharmacist • May/Jun 2018

and the intervention group consisted of the same patients’ post-class understanding scores. This study was funded by a grant from the Pennsylvania Pharmacists Association (PPA) Educational Foundation.

All research was conducted in compliance through the Duquesne University Institutional Review Board and PPCP Quality Committee.

This study and report was made possible in part through a grant provided by the PPA Educational Foundation grant in 2017. This report was not submitted through the peer review process and is presented as a report only. The full report may be found under the Foundation Section – Programs – Grant Program – 2017. http://www.papharmacists.com/ ?page=FGrantHistory AUTHOR NOTATIONS 1 ACME Sav-on Pharmacy 2 Temple University School of Pharmacy

Association News

1940–1959 Continuing to Grow, the Association Finds its Permanent Home Regulation was beginning to impact pharmacy in even more ways. 1940 brought initial child and female labor laws. The Chief Chemist of the State Board of Pharmacy reported on clean-up and improvements in their laboratory. Some of the items discussed at the 63rd convention included: legal problems of a pharmacist, displaying and selling surgical supplies, standardization of medical preparations and marijuana which was becoming a menace to youth.

PRESIDENTS DURING THIS PERIOD: Preston A. Paul . . . . . . . . . . . . 1939–1940 L. Gilbert Rhoads . . . . . . . . . 1940–1941 John J. Hughes . . . . . . . . . . . 1941–1942 W. Thomas Senseman, Jr. . 1942–1943 George L. McMillin . . . . . . . 1943–1944 Martin Bambrick . . . . . . . . . . 1944–1946 John Deans . . . . . . . . . . . . . . . 1946–1947 S. B. Alloway . . . . . . . . . . . . . . . 1947–1948 Willard Allen . . . . . . . . . . . . . . 1948–1949 L. A. Heckler . . . . . . . . . . . . . . . 1949–1950 Ray T. Peffer . . . . . . . . . . . . . . 1950–1951 Michael Pachuta . . . . . . . . . . 1951–1952 Richard M. Bitner . . . . . . . . . 1952–1953 Daniel L. Wertz . . . . . . . . . . . . 1953–1954 John P. Kely . . . . . . . . . . . . . . . 1954–1955 William H. Whitman . . . . . . 1955–1956 Otto L. Koenigh, Jr. . . . . . . . 1956–1957 John M. Wyble . . . . . . . . . . . . 1957–1958 Edward W. Hall . . . . . . . . . . . . 1958–1959

In 1943, as food rationing became prevalent, this effected pharmacies with soda and/or food counters.

There was also a great concern about a shortage of pharmacists then and into the five year future with military deployment and casualties.

As the war drew to a close, there were considerable restrictions and unavailability of many chemicals.

Scarcity of merchandise caused the government to establish many Fair Trade Laws setting maximum prices on nearly all commodities. There was also a great expansion of advertising of over the counter drugs and many radio stars were famously touting their merit.

Later in 1943, plans and fundraising began to find a new permanent home for the Association. Finally, on June 22, 1948, the present Headquarters building was officially dedicated as the home for pharmacists in Pennsylvania.

A model pharmacy bill was adopted in 1951 which after amendment included a provision that the State Board of Pharmacy elect a full-time secretary for $5,000 per year. Dues were increased to $15 of which $2 went towards the publication of the Journal and rebates to county associations.

PPA celebrated its Diamond Jubilee at Galen Hall near Wernersville in 1952 to great success “with spirited debate, enlightening papers, and deluxe entertainment.”

In 1955, a pharmacists received about 45 cents from each typical medical care dollar; the VA increased their fee

IMPORTANT EVENTS 1940 Hitler invades Norway, Denmark, the Netherlands, Belgium, Luxembourg, and France 1941 Japanese surprise attack on U.S. fleet at Pearl Harbor brings U.S. into World War II 1944 Allies invade Normandy on D-Day 1946 First meeting of UN General Assembly 1947 U.S. Air Force pilot Chuck Yeager becomes first person to break the sound barrier 1950 Korean War begins 1954 The Tournament of Roses Parade becomes the first event nationally televised in color 1955 Rosa Parks incites the Montgomery bus boycott 1955 Disneyland opens at Anaheim, California 1955 Jonas Salk develops polio vaccine 1957 Soviets launch Sputnik; “space race” begins 1959 Alaska and Hawaii became the 49th and 50th U.S. states continued on next page

www.papharmacists.com 29

on prescriptions from 50 cents to $1.00 and the OTC fee to about twenty percent.

The 1957 Pharmacy Week celebra­tions were the best ever with county associations using newspaper, radio, and television to call attention to the services provided by a pharmacist.

In 1958 the average salary of pharmacists was $123/week or about 2.40/hour. PPA made available a $10,000 medical insurance plan to its members and their spouses as a member benefit.

ANNUAL MEETINGS 1940 Hotel Schenley, Pittsburgh 1941 Bellevue-Stratford Hotel, Philadelphia 1942 Forest Inn, Eagles Mere 1943 Penn Harris Hotel, Harrisburg 1944 Roosevelt Hotel, Pittsburgh 1945 No Convention was held 1946 Penn Harris Hotel, Harrisburg 1947 Hotel Chelsea, Atlantic City, NJ

1948 1949 1950 1951

Penn Harris Hotel, Harrisburg Hotel Jermyn, Scranton (cannot locate records) Hotel William Penn, Pittsburgh 1952 Galen Hall, Wernersville 1953 Ambassador Hotel, Atlantic City, NJ 1954 Bedford Springs Hotel, Bedford Springs

1955 Ambassador Hotel, Atlantic City, NJ 1956 William Penn Hotel, Pittsburgh 1957 Ambassador Hotel, Atlantic City 1958 Bellevue Stratford Hotel, Philadelphia 1959 Bedford Springs Hotel, Bedford Springs

Our Presidents Reminisce Continues We continue our lookback and the happenings of certain years in PPA’s history by reviewing the recollections of some additional Past Presidents Alan Vogenburg, BPharm, RPh, FASCP 1979–1980 After I was elected to succeed Charles Ditchfield as PPA President, I realized that I only had one year to set goals for PPA and Pharmacy. To that end, I scheduled meetings with Executive Director Stanley Singer asking for his input regarding realistic goals and how to achieve them with existing PPA staff and PPA member support.

During my inaugural address I developed a slogan to lead PPA. I pointed out that there are no easy solutions, but we have 4 ACES to play.

A Positive attitude C Commitment to Pharmacy E Enthusiasm for our Profession S Service to PPA Therefore I asked PPA leaders, including officers, and committee chairpeople to write a report to PPA 30 Pennsylvania Pharmacist • May/Jun 2018

membership in the Pennsylvania Pharmacist, instead of the President so that members were kept informed by the folks actively involved.

A few major goals reached during my Presidency included: 1. The FIRST Legislative Day, and Legislator reception, on September 27, 1979, and the formation of PHARMPAC. 2. Meeting with DPW office of the budget to provide Pharmacy input BEFORE discussions on the Hill.

3. Worked with the Legislature to pass the Stamp Act which mandated that prescribers stamped or printed their names on prescriptions, in addition to signing them (sometimes illegibly).

4. PPA participated in Statewide hypertension screening during May, 1980 in cooperation with the Heart Association.

5. Hired a consulting firm to study PPA and interview and survey Pharmacists in an attempt to make recommendations for improvement of PPA services to members.

Like today, all of those accomplish­ ments occurred while PPA addressed the ongoing, diverse issues such as DPW, insurance, legislation at all levels of Government, and interdisciplinary health care interactions.

But most of all I cherish my relation­ ships with the Pharmacists who served as mentors professionally and as lifelong friends.

The climax of my year as president came at Host Night, when the

Harrowgate String Band brought New Year’s Day to the Poconos. My friend/ Pharmacist/glockenspiel player Jim McKnight brought a Mummer’s costume for me so that I could lead the band into the ballroom as a Mummer, to the tune of “Oh! Dem Golden Slippers” Donna Hazel, RPh. 2015–2016 My year as President started off with the Pennsylvania Pharmacists Association Annual Conference theme: Pharmacists: The Best Bet for Patient Care. What an amazing statement to reflect our role as members of the health care team.

As I gave my speech at the Saturday night banquet I was honored,

humbled, and in awe. I talked about the mission statement of PPA; being the leading the voice of pharmacy and promoting the profession through Advocacy, Communication and Education. (ACE) During my time as President, I spent my time doing what I love, which is spending time with students, our profession’s future. I crossed the great state of Pennsylvania to attend the White Coat ceremonies of all schools of pharmacy. Seeing the students and all those in attendance during these ceremonies solidified my commitment as PPA President and the awesome responsibility I carried with me.

I was able to meet many pharmacists for the first time and was WILD over what many pharmacists are doing for patient care. I was proud to see so many new members step up to work

2002–2003 Executive Council 2003 Annual Conference Installation Standing, left to right: Pat Epple, CAE, Executive Director; Mike Stravaggi, Central Director; Roger Boatwright, Academy of Pharmacy Industry Associates; Dan Wagner, PharmD, RP.h., MEA, Acacemy of Alternative Pharmacy Practice; Dave Smith R.Ph., Immediate Past President; Ron Lewullis, R.Ph., Southeast Director; Michele Musheno, R.Ph., M.S., Second Vice President; Steve Sugarman, R.Ph., Northeast Director, Bob Schreiber, RPh. First Vice President; Gayle Cotchen, R.Ph. Speaker Seated, left to right: Jim Dillon, R.Ph., Academy of Chain Pharmacists; George Haynes, PhD.,, PharmD, Second Vice President; Colleen Kayden, R.Ph., Immediate Past President; D. Scott Himler, R.Ph., President; Tony Colega, R.Ph., Southwest Director; Bonnie Lee Bobbs-DiCello, R.Ph., Academy of Community Pharmacists

on committees, take leadership roles, and advocate for our profession.

Being President of PPA was one of the true highlights of my career.

This is a special year for PPA, celebrating our 140th birthday. As I witness the passion our pharmacists, students, and technicians have for patient care, I can only image what the next 140 years will bring … Happy Birthday PPA. Bill Ferri, RPh. 1995–1996 My “ERA” began in 1987 running, if you can believe it, against two others for then vice speaker of our House of Delegates and i represented Armstrong Westmoreland county. That year I reorganized the county organization and served as president for the next six years while running for speaker, and then PPA Vice President, First Vice President, etc. up through the chairs. The year I was to be presidentelect Bill Fisher could not accept the office, so then Bill Seitzinger and myself shared the duties until my term began in 1995–96.

During my year, I started the Presidents column in the magazine and it continues on to this day.

In addition, I also along with the Executive Council created the scholarship fund which was ultimately the beginning of the Educational Foundation. Another accomplishment was the five year convention rotation of sites which still is basically in affect. Although the sites have been altered, the goal of moving around the state is still happening. My convention was held at the Seven Springs Resort to conclude my term (it was very well attended and with FIREWORKS!). Afterwards, due to lack of leadership, our Armstrong Westmoreland County Association found it necessary to merge with the Allegheny County Association with PPA assistance and leadership.

A few years later, I spent a year or two on the Board at which time I continued on next page

www.papharmacists.com 31

Our Presidents Reminisce Continues served on the steering committee to select our new Executive Director, ultimately Pat who remains in the position today. From this I continue to watch from the sidelines and have seen the organization move forward! I look forward to seeing everyone in Lancaster.

Robert Frankil, RPh PPA President 2012–2013 My experience as PPA President was as rewarding as any in my professional career as a pharmacist. The time spend on

the Board of Directors including the year as President put me in a position to give back to the profession that I love, and to the profession that has given so much to me.

I feel as though I was able to give the perspective of the independent pharmacy owner to the membership, both on the hardships and challenges, and in the rewarding areas as well.

I’d like to believe that I made a difference in keeping pharmacy, and pharmacy ownership, positive and optimistic. I also was, and continue to be, passionate in the legislative arena, always trying to make a difference to make our profession

continued

as good as it can be for today’s pharmacists and for tomorrow’s.

The time spent as President and as a board member also put me in front of some of the best pharmacy minds in the state, and around the country. Leeching knowledge from these leaders has made me a much better pharmacist and a much better pharmacy owner. The relationships I made during my tenure will last me a lifetime!

I hope I was able to help PPA and the profession as much as my time spent with PPA has helped me as both a person and a pharmacist.

PPCN Update 2017 was an exciting year for the Pennsylvania Pharmacists Care Network! We successfully executed a patient care contract with Gateway HealthSM for the provision of medication therapy management. In just 14 weeks, our pharmacists billed for over 1,000 patient encounters!

We saw a growing number of encounters each week from our network pharmacies as pharmacists embraced this opportunity to provide additional care for their patients in an economically feasible way. PPCN pharmacists cared for patients in communities across PA with complex health conditions and medication regimens. Our pharmacists made home visits for patients who were home bound, identified and resolved dangerous drug therapy problems, and kept patients out of the emergency room. Pharmacists were even able to identify patients who were unaware that they had health care cover­ age, refill all of their overdue medications, and get patients back on track.

2018 is off to a tremendous start ­— we are preparing to launch a new, larger contract with Gateway HealthSM, and we have the attention of payers across the state of Pennsylvania. We were pleased by the invitation to present during the Pennsylvania Medicaid Medical Directors’ Meeting in Harrisburg this March, and were welcomed with a very positive response from Medicaid health plans who want to partner with the PPCN. Through these connections established by PPA, we are able to advocate for pharmacists in novel ways that align with the mission of PPA. The PPCN gained national recognition at the Annual Meeting of the American 32 Pennsylvania Pharmacist • May/Jun 2018

Pharmacists Association in March where our team presented on the PPCN and relationship with Gateway HealthSM during a PharmTalk presentation on Sunday of the Conference. Our team also attended the CPESN USA workshop in March where we were able to learn from other state networks and share the success of the PPCN. We are actively and frequently talking with multiple payers who are impressed by the care our network pharmacists provide. Our relationship with STRAND is ever growing as they partner with us to increase the number of billable services that our pharmacists provide, such as diabetes self-management education and support, and tobacco cessation. The PPCN will launch a Pharmacy Locator this year for health plans and patients to find our high quality pharmacies and the enhanced services provided at each location. As the Comprehensive Medication Management Collaborative training is an integral piece of pharmacist participation in the PPCN, we are updating the online portion this year and will continue to offer live training sessions. For information on the training visit: http://www.papharmacists.com/page/ CMMC We are excited to continue on this amazing journey to advocate for pharmacists in PA to practice at the top of their license in a way that supports their business model. To learn more about the PPCN, visit www.papharmacistsnetwork.com or contact Stephanie McGrath, PharmD, PPCN Executive Manager at smcgrath@papharmacists.com.

Congratulations to the 2018 PPA Graduating Students!

PPA wishes the 2018 PPA graduating students all of the best as they embark on their pharmacy careers! Remember to remain a committed member of our state pharmacy association, no matter where you reside! For those staying in Pennsylvania, we invite and encourage you to update your membership as a New Practitioner! This can be done online or by contacting Victoria Madonna, vmadonna@papharmacists.com.

Butler University Jill Argotsinger Marilyn Schoenle Campbell University Carrie Kisch Duquesne University School of Pharmacy Chelsey Adams Brittany Carney Andrew Dick Tracy Eckenrode Emily Fardo Rachael Gerstein Alyssa Gosnell EunJoo Hong Emily Hoover Mackenzie Hughes Zachary Johnson Ettien Kadjo Mary Kimmel Alison Kuhn Nina Madia Nicole Modany Alexa Moss Victoria Nesbitt Sarah Powell Thomas Rajchel Jefferson School of Pharmacy Christine Barlow Maria Budney Toni Campanella Monica Coulson Lindsay Fitzpatrick Gianna Girone Maura Harkin Timothy Jacisin Jennifer Kmetich Jessica Leri Nina Lyons Christina Maher Ashley Maister Matthew McGuire Lloyd McKee Jonathan Park Nicholas Stangler Danielle Vallandingham

LECOM School of Pharmacy Nikki Blattenberger Lauren Bobby Tzveta Bradley Jessica Brown Anh Bui Sara DiLascio Kelly Duan Marcus Ewane Kaitlin Fairlamb Kelli France Ashley Freeman Rebecca Goetz Sally Habusta Hayden Hayward Alyssa Helster Pauline Kang Ariel Korlinchak Tyler Liebegott Arafat Mohamed Anh Ngo Tommy Nguyen Lydia Obeisun Taylor Penpek Patricia Railling Rayann Seager Elikem Selormey James Shoemaker Ashton Simonette Julia Sporer Meseret Tesfamariam Orlando Vargas Olivia Yusz Ohio Northern University Foud Bahamdain Kaitlin Bova Sarah Bova Elizabeth Matthews Temple University School of Pharmacy Marina Abdelmalek Jeffrey Avena Bendita Bakarr Emily Beardsley Stephanie Cheung Michelle Cottino Adeline Cruz Rebecca Davner Mansi Doshi

Anetta Dubinchik Jin Rong Huang Linh Huynh Amandeep Kaur Sabah Khatoon Lwin Khine Tatyana Kolyesnik Matthew Korber Zi Li Joanna Lu Carol Ly Abby McCabe Sydney Nguyen Harris Nguyen Phuong Nguyen Derek O’Neill Marcus Opraseuth Samoela Papa Stacy Pasciolla Hetakshi Patel Komal Patel Du Pham Sharon Pierre Oxana Placinta Christina Santiago Christine Starrs Chanel Tam Benjamin Thivarath Carissa Tirotto Lin Tran Kayla Tuyen Bobbi Westermeier University of Findlay Erin Siegel University of Pittsburgh School of Pharmacy Marijanel Alilio Marissa Badzik Haley Baker Brandon Barry Kristin Baughman Caroline Beck Melanie Beers Kathryn Bress Mariah Brown Louise Chen Jesse Cheng Jessica Cole

Kelsey Collett Nicolette Diehl Kathleen Dillon Doreen Foy Elizabeth Garcia Olivia Goss Matthew Greene Emma Hayes Heather Heiney Phuong Hoang Alexa Hospodar Linda Huang Lindsay Jablonski Dilafruz Khakimova Robyn Konicki Alexandria Lavella Julie Mandel Olivia Marchionda Marc McCann Eleni Mermigas Abby Meyer Sierra Milton Carley Mingone Sneha Mitra Melinda Moran Mara Ott Carly Parris Jessica Pavolko Jesse Quintiliani Shelby Resch Elyssa Resetar Mara Rubin Allyson Seitz Lauren Shirley Jason Sollenberger Meredith Sparks Iris Tang William Thompson Megan Thornberg Elyse Tomaszewski Top Triamwong Holly Unger Kaela-Marie Walsh Harry Wilkinson Rebecca Wytiaz Kelly Xu Lauren Zupsic Bianca Zynosky Philadelphia College of Pharmacy Sophia Abouhossein Isaac Abraham

Sherin Abu Eishdeep Cattry Vivian Chen Matthew Ciavarella Prianka Dadhich Colleen D’Amico Arig El-Sayed Anas El-sayed Erin Fegley Joshua Jo Jessica Kim Julie Ko Mariya Kotova Nathan Kubus Thuong Lam Jesse Lee Thomas Lee Elissa Muller Travis Murray Jeannie Nguyen Mara Oesterle Ami Patel Christian Ruffin Swana Thomas Lisa Varughese Rebecca Vayalumkal Molly Walter Michael West Shifa Zachariah Klarida Zeqollari Klajdi Zeqollari Wilkes University – Nesbitt School of Pharmacy Dana Achenbach Kayla Bardzel Briana Blaisure Katie Bressler Rachel Constant Shane Daugherty Keri Diehl Amber Dietrich Danielle Distefano Tara Engel Anthony Fanucci Dominika Foltyn Joshua Fox Jennalyn Garrity Christian Giovannini

www.papharmacists.com 33

Financial Forum: Saving More Money, Now & Later You could save today and tomorrow, often without that penny-pinching feeling.

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.

Directly & indirectly, you might be able to save more per month than you think. Hidden paths to greater savings can be found at home and at work, and their potential might surprise you.

Little everyday things may be costing you dollars you could keep. Simply paying cash instead of using a credit card could save you four figures annually. An average U.S. household carries $9,000 in revolving debt; as credit cards currently have a 13% average annual interest rate, that average household pays more than $1,000 in finance charges a year.1 The typical bank customer makes four $60 withdrawals from ATMs a month — given that two or three are probably away from the host bank, that means $5–12 a month lost to ATM fees, or about $60–100 a year.

A common household gets about 15 hard-copy bills a month and spends roughly $80 a year on stamps to mail them — why not pay bills online? Automating payments also rescues you from late fees.1 A household that runs full loads in washing machines and dishwashers, washes cars primarily with water from a bucket, and turns off the tap while shaving or brushing teeth may save $100 (or more) in annual water costs.1 How would you like to save hundreds of dollars per month in retirement? If you are saving and investing for the future in a regular, taxable brokerage account, that account has a drawback: you must pay taxes on your investment income in the year it is received. So, you are really losing X% of your return to the tax man (the percentage will reflect your income tax rate).2 In traditional IRAs and many workplace retirement plans, you save for retirement using pre-tax dollars. None of the dollars you invest in those plans count in your taxable income, and the invested assets can grow and compound in the account without being taxed. This year and in years to follow, this means significant tax savings for you. The earnings of these accounts are only taxed when withdrawn.2,3 Then, there are the big things you could do. By saving and investing for retirement using a Roth IRA, that is essentially the potential you give yourself. Roth IRAs are the inverse of traditional IRAs: the dollars you direct into them are not tax deductible, but the withdrawals are tax free in retirement (assuming you abide by I.R.S. rules).

Imagine being able to receive retirement income for 20 or 30 years without paying a penny of federal income taxes on it in the years you receive it. Now imagine how sizable that 34 Pennsylvania Pharmacist • May/Jun 2018

income stream might be after decades of compounding and equity investment for that IRA.4 Many of us can find more money to save, today & tomorrow. Sometimes the saving possibilities are right in front of us. Other times, they may come to us in the future because of present-day financial decisions. We can potentially realize some savings by changes in our financial behavior or our choice of investing vehicles, without resorting to austerity.

CITATIONS 1 realsimple.com/work-life/money/saving/money-saving-secrets [7/13/17] 2 investopedia.com/articles/stocks/11/intro-tax-efficient-investing.asp [8/5/16] 3 blog.turbotax.intuit.com/tax-deductions-and-credits-2/can-youdeduct-401k-savings-from-your-taxes-7169/ [2/7/17] 4 cnbc.com/2017/05/15/personal-finance-expert-do-these-6-thingsto-save-an-extra-700-per-month.html [5/15/17] 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.

Rx and the Law: Death with Dignity

By Don. R. McGuire Jr., R.Ph., J.D. This series, Pharmacy and the Law, is presented by Pharmacists Mutual Insurance Company and your State Pharmacy Association through Pharmacy Marketing Group, Inc., a company dedicated to providing quality products and services to the pharmacy community.

Death with Dignity. Physician-assisted Suicide. Aid in Dying. Nomenclature has evolved in the twenty years since Oregon passed the first Physician-assisted Suicide legislation in the United States. There are now a total of six states plus the District of Columbia that allow the practice. Three of those six states passed their legislation during the last two years. That’s not much data on which to base a trend, but it does raise questions for pharmacists participating in the practice.

Either the attending or consulting physician can refer the patient for a psychiatric/psychological examination.

This exam is also documented on a state form and submitted as above.

Each state is different in detail, but the high level procedures are similar. The patient must make a request for medication with which to end their life. This request may be oral and sometimes requires a second request following a mandatory waiting period. Eventually this request is documented on a state-created form and the patient’s signature is witnessed by at least one disinterested witness.

Typically the patient must have been diagnosed with a terminal illness and facing death within a relatively short time, such as six months.

The first decision by a pharmacist may not be a legal one, but a moral one. How does the pharmacist feel personally about dispensing these medication(s)? Does it feel wrong or run counter to what their career goal has been? These are not questions that can be answered by anyone but the pharmacist involved. One thing to consider is that by the time the patient gets to this point in the process, it is as a result of careful consideration.

The attending physician then has to certify a number of items in order to be compliant with the law. These include the terminal nature of the patient’s condition, an assessment of their mental state, that there doesn’t appear to be any coercive force being exerted on the patient and that the patient has been counseled on risks, benefits and alternatives. This completed form is then forwarded to the appropriate state agency, many times the Department of Health.

If the patient has successfully passed these hurdles and waited for the requisite waiting periods, their physician is ready to dispense the needed medications(s) or write prescriptions for them. Now it is time for the pharmacist to get involved.

CITATIONS 1 Montana’s authority is based on a decision by the Montana Supreme Court rather than by legislation. © 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.

Once the attending physician has certified the patient meets the criteria of the law, many times the patient is required to meet with a second, consulting physician.

This physician then documents their assessment of the patient’s condition on the state form. Finally, the form must be submitted to the state, either directly and/or through the attending physician.

www.papharmacists.com 35

36 Pennsylvania Pharmacist • May/Jun 2018

Saving Our Pennsylvania Pharmacy “Home”

Building Fundraiser Contribution

Honor Our Historic Past, Current Achievements and Build a Foundation for our Future Contributor Name (as you wish to be recognized): ______________________________________________________ Email Address: ___________________________________ Phone: _________________________________________ Mailing Address: __________________________________________________________________________________ City, State, Zip: ____________________________________________________________________________________

Save our Pharmacy Home with a Tax Deductible Contribution to support our needed renovations which total over $700,000. Your generosity is appreciated! ☐ Keystone $5,000 ☐ Charter $1,000 ☐ Historian $140

☐ Foundation $3,000 ☐ Mortar $500 ☐ Donor $50

☐ Cornerstone $2,500 ☐ Pestle $250 ☐ Other $___________

Whatever your contribution level, you can choose how you wish to cover that over a three year period.

Please indicate how you would prefer to be invoiced for this commitment: Please split the selected amount into: ☐ Single Payment: one payment for the full amount ☐ Monthly Payments: _______ # of monthly payments (maximum 36) ☐ Quarterly Payments: _______ # of quarterly payments (maximum 12) ☐ Semi-Annual Payments: _______ # of semi-annual payments (maximum 6) ☐ Annual Payments: _______ # of annual payments (maximum 3) Based on your above selection we will bill you upon receipt for the first payment unless you submit payment below and then regularly according to the frequency schedule. If you have any special requests – such as bill me on April 1 of each year – please note on this form.

Select Payment Method: ☐ I am enclosing check # _______ for my initial payment. PPA Educational Foundation will send invoices for any subsequent payments to the email address listed above. ☐Please charge my credit card based on the selections above, Process first charge: ☐on date received ☐ ______________ (preferred date) Name on Card: _____________________________________________________________________________________ Card Type: ☐Visa ☐MasterCard ☐Discover Card Number: ____________________________________________ CVV Code: _________ Expiration Date: ____/______ Signature for charges: _______________________________ Billing Address: __________________________________ City, State, Zip: _____________________________________ Make checks payable to and mail to: PPA Educational Foundation, 508 North Third St, Harrisburg, PA 17101-1199 Fax to: (717) 236-1618 | Email to: mdibble@papharmacists.com Contributions are to be made payable to PPA Educational Foundation and mailed/faxed to the address/number above.. The Pennsylvania Pharmacists Association Education Foundation has been granted 501 (c) (3) status by the IRS. Contributions may be deductible as charitable expenses for federal income tax purpose. Please consult your accountant or tax attorney. The official registration and financial information of the Foundation may be obtained from the PA Department of State by calling toll-free in Pennsylvania, 1-800-732-0999. Registration does not imply endorsement. www.papharmacists.com 37

2017 Recipients of the “Bowl of Hygeia” Award

Larry Presley Alabama

John McGilvray Alaska

Alan Barreuther Arizona

Sue Frank Arkansas

Pierre Del Prato California

Mary Petruzzi Connecticut

Noel Rosas Delaware

Goar Alvarez Florida

Hewitt Ted Matthews Georgia

Ed Cohen Illinois

Ahmed Abdelmageed Indiana

Tim Becker Iowa

Merlin McFarland Kansas

Melody Ryan Kentucky

Gregory Poret Louisiana

Greg Cameron Maine

Cynthia Boyle Maryland

Anita Young Massachusetts

Dennis Princing Michigan

Denise Frank Minnesota

David French Mississippi

David Farris Missouri

Matthew Bowman Montana

Gary Rihanek Nebraska

Mark Decerbo Nevada

Hubert Hein New Hampshire

Thomas F.X. Bender, Jr. New Jersey

David Lansford New Mexico

John T. McDonald III New York

Steve Caiola North Carolina

Tim Weippert North Dakota

Debra Parker Ohio

Ben Allison Oklahoma

Mercy Chipman Oregon

Jerry Musheno Pennsylvania

Marisa Carrasquillo Puerto Rico

Gary Kishfy Rhode Island

Terry Blackmon South Carolina

Tim Tucker Tennessee

Chris Alvarado Texas

Kurt Price Utah

Pat Resto Virginia

The “Bowl of Hygeia”

In Memoriam: Rob Loe South Dakota Keith Campbell Washington Daneka Lucas Washington DC

Kevin Yingling West Virginia

Thad Schumacher Wisconsin

Joe Steiner Wyoming

The Bowl of Hygeia award program was originally developed by the A. H. Robins Company to recognize pharmacists across the nation for outstanding service to their communities. Selected through their respective professional pharmacy associations, each of these dedicated individuals has made uniquely personal contributions to a strong, healthy community. We offer our congratulations and thanks for their high example. The American Pharmacists Association Foundation, the National Alliance of State Pharmacy Associations and the state pharmacy associations have assumed responsibility for continuing this prestigious recognition program. All former recipients are encouraged to maintain their linkage to the Bowl of Hygeia by emailing current contact information to awards@naspa.us. The Bowl of Hygeia is on display in the APhA History Hall located in Washington, DC. Boehringer Ingelheim is proud to be the Premier Supporter of the Bowl of Hygeia program.

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Pharmacy

Tomorrow.

Imagine That.

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