Pharmacy Journal of New England Fall 2014 by CT Pharmacists Association

Vol 11 No.3 Fall 2014

Fall 2014

Pharmacy Journal of New England

New England Pharmacists

Convention 2014 Photos & Award Winners Inside Important Updates for the Influenza Vaccination What Constitutes a Successful Retirement? Financial Forum

Marijuana â&#x20AC;&#x201D; Medical or ??? Rx and the Law

CPA Members Gillian Kuszewski, Meghan Wilkosz and Crystal Garroshen at the New England Pharmacists Convention

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Pharmacy Journal

Vol 11 • No. 3 Pharmacy Journal of New England • Fall 2014

of New England Stay Engaged on the Front Lines

Editors

David Johnson Margherita R. Giuliano, R.Ph., CAE

Dear Readers,

Managing Editor

As we head into December and the holiday season, the staff of your state pharmacy associations would like to thank you, its memberships, for your continued support and advocacy on behalf of professional associations. In these increasing difficult and frustrating times, amidst political wrangling, reduced reimbursements, and a tilting playing field, it is more important than ever to stay engaged on the front lines.

Ellen Zoppo CPA

What are the front lines these days? Unfortunately, there are many – the continued debate at our State Legislatures about the role of the Pharmacist and the value of their services; the front line defense we are waging against PBMs and mail order; and most importantly, the front line of providing the best patient care we can in all of our practice settings. Please take a moment to read our included articles about what has transpired over the last few months in the New England states. This is also a great time to contact your state association to see how you can make a difference in the upcoming months as the majority of the Legislatures reconvene, CE’s are planned, and members are recruited. Please talk to your colleagues, especially the next generation of pharmacists, so that the state associations continue to be positioned and armed on the front lines to advance and defend our profession.

Sincerely,

Design & Production Kathy Harvey-Ellis MPhA The Pharmacy Journal of New England is owned and published by the Massachusetts Pharmacists Association and the Connecticut Pharmacists Association. Opinions expressed by those of the editorial staff and/or contributors do not necessarily reflect the views or policies of the publisher. Readers are invited to submit their comments and opinions for publication. Letters should be addressed to the Editor and must be signed with a return address. For rates and deadlines, contact the Journal at (860) 563-4619. Pharmacy Journal of New England 35 Cold Spring Road, Suite 121 Rocky Hill, CT 06067-3167 members@ctpharmacists.org

Submitting Articles to the Pharmacy Journal of New England™ The Pharmacy Journal of New England™ is the product of a partnership between the Connecticut Pharmacists Association and the Massachusetts Pharmacists Association. The Journal is a quarterly publication. All submitted articles are subject to peer review. In order to maintain confidentiality, authors’ names are removed during the review process. Article requirements must conform to the Uniform Requirements for Manuscripts Submitted to Biomedical Journals (Ann Intern Med 1982;96 (1part1):766-71). We strongly encourage electronic submissions. PJNE does not assume any responsibility for statements made by authors.

Please submit manuscripts to: Margherita R. Giuliano, RPh Executive Vice President Connecticut Pharmacists Association

Contents 02

08 19 24 26 28

David Johnson Executive Vice President Massachusetts Pharmacists Association

PJNE 35 Cold Spring Rd., Suite 121 Rocky Hill, CT 06067 or email to: ezoppo@ctpharmacists.org

U.S. News New England States New England Pharmacists Convention 2014—Complete Coverage Feature: Important Updates for Influenza Vaccination 2014-15 Pharmacy Marketing Group: Rx and the Law, Financial Forum From the Colleges

U.S. News Heroin overdose deaths increased in many states through 2012 Still twice as many people died from prescription opioid overdoses Heroin deaths increased sharply in many states, according to a report of death certificate data from 28 states published by the Centers for Disease Control and Prevention in this week’s Morbidity and Mortality Weekly Report. Despite these findings, still more than twice as many people died from prescription opioid overdoses as died from heroin in these states in 2012. Though not directly addressed by this study, two things appear to be driving the increase in heroin overdoses: (1) widespread prescription opioid exposure and increasing rates of opioid addiction; and (2) increased heroin supply. While the majority of prescription opioid users do not become heroin users, previous research found that approximately 3 out of 4 new heroin users report having abused prescription opioids prior to using heroin. This relationship between prescription opioid abuse and heroin is not surprising; heroin is an opioid, and both drugs act on the same receptors in the brain to produce similar effects. Heroin often costs less than prescription opioids and is increasingly available. “Reducing inappropriate opioid prescribing remains a crucial public health strategy to address both prescription opioid and heroin overdoses,” said CDC Director Tom Frieden, M.D., M.P.H. “Addressing prescription opioid abuse by changing prescribing is likely to prevent heroin use in the long term.” Key Findings: • This new study examined changes in heroin and prescription opioid death rates in 28 states 1 between 2010 and 2012. The 28 states represented 56 percent of the U.S. population. • From 2010-2012, the overall heroin death rate across the 28 states doubled. • The sharp heroin overdose increase extends the trend observed in the 2011 national mortality data. • Five states had increases in prescription opioid death rates, seven states had decreases, and sixteen states had no change. 2

• Of the 18 states with reliable heroin overdose death rates examined individually in this study, 15 had statistically significant increases in heroin death rates. No state had a decrease in the heroin death rate. • The increases in state heroin death rates from 20102012 were associated with increases in prescription opioid death rates. “This study is another reminder of the seriousness of the prescription opioid overdose epidemic and the connection to heroin overdoses,” said Grant Baldwin, Ph.D, M.P.H, Director, Division of Unintentional Injury Prevention. CDC and other federal agencies are working to promote a smart, coordinated approach to reduce inappropriate prescribing and help people addicted to these drugs.” While addressing prescribing is necessary to prevent opioid and heroin overdoses, it is important to help those already addicted to prescription opioids and heroin. Improving access to medication-assisted treatment is important. Increased use of naloxone, a prescription drug that can reverse an opioid or heroin overdose if administered in time, might also help save lives. CDC’s Injury Center works to protect the safety of everyone, every day. For more information about prescription drug overdoses, please visit www.cdc.gov/homeandrecreationalsafety/overdose. http://www.cdc.gov/media/releases/2014/p1002-heroin-overdose.html

Buying meds online: Most patients unaware of dangers In a new advertisement that runs every hour on a digital screen in the heart of New York’s Times Square, the Alliance for Safe Online Pharmacies (ASOP) informs passersby that 97% of online pharmacies are illegal. More than ever, advocates for safe online pharmacies see the need to get the message out to the public that buying prescriptions online is dangerous. According to the World Health Organization, 50% of the medicines sold online by websites that hide their physical address are counterfeit. Making matters worse, online pharmacies—most of which don’t ask for a prescription from the purchaser—have increased their market footprint over the years.

Pharmacy Journal of New England • Fall 2014

“I don’t think patients realize it’s the ‘wild, wild West’ for online pharmacies,” Libby Baney, JD, ASOP Executive Director, told Pharmacy Today. “There are no specific online pharmacy laws.” Baney can relay dozens of stories about patients who have been harmed—everything from brain damage to death—by medications purchased online. But she said there is equal concern that patients may not be getting the therapeutic benefit from medications they need. As certain drugs become more expensive and some patients take on more of the cost burden, Baney said they have begun to see more cases of patients going online to buy lifesaving medications, such as cancer drugs. On top of all this, patients are risking putting their finances in jeopardy by giving illegal online sellers credit card or PayPal account information, home addresses, and other personal data. Experts agree that more effort should be made to educate the public about the risks of purchasing prescriptions online. Craig Burridge, MS, CAE, CEO of the South Carolina Pharmacy Association, said more needs to be done through mainstream media outlets. Other efforts, like shutting down illegal online pharmacies, have been ineffective because sellers can simply copy a patient’s information into another registrar or URL. “The awareness has really been limited to the pharmacy world, and it needs to be more mainstream going forward,” said Burridge, who was previously Executive Director of the Pharmacists Society of the State of New York. He thinks ASOP’s Times Square ad is a good start. Kenneth McCall, PharmD, President of the Maine Pharmacy Association (MPA), has been fighting a unique battle against online pharmacies in his state. In an effort to make medications more affordable, Maine became the first state to pass a drug importation law that allows residents to buy medications from certain foreign pharmacies. These include Canada, New Zealand, Australia, and the United Kingdom.

“These companies have nothing to do with Canada or the U.K.—they want to portray that so they can sell the image of safety,” McCall said. MPA did its own digging and found that when they ordered from these online Canadian pharmacies, the drugs sent to them were drugs that had not been approved by Health Canada, according to McCall. MPA asserts that Maine’s law goes against federal regulation and is not only illegal, but unsafe for patients. McCall said they remain committed to overturning the legislation, and in the meantime, they will continue educating Maine residents about the risks of buying medications from these pharmacies. As efforts turn to educating consumers, Baney said pharmacists have an important role to play as trusted health care providers whom patients see on a regular basis. ASOP has been urging pharmacists to ask their patients where they get their medications. While the number of active online drug sellers may be known, it’s still unclear how many people are buying certain medications through online sellers. “Collaboration is critical to protecting patients from counterfeit and otherwise illegitimate medicines peddled online. We are all in this together,” said Baney. http://www.pharmacist.com/buying-meds-online-most-patients-unaware-dangers

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Visit MPhA’s Career Site today! http://mpha.associationcareernetwork.com Your destination for exciting Pharmacy job opportunities.

The law has been in effect since October 2013, and since then, two Canadian online brokers have advertised actively in the state. A third, the Great British Drug Store, began offering services this past October. 3

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Liver injury caused by herbal and dietary supplements on the rise Liver injury attributed to herbal and dietary supplements more than doubled over a 10-year period in a U.S. study group, rising from 7% to 20%, with some cases resulting in liver transplantation and death. Many Americans use herbal and dietary supplements. In response to safety data needed for these products, the DrugInduced Liver Injury Network (DILIN) was created in 2003 to track cases of liver injury caused by medications, herbals, and dietary supplements. The current analysis examined hepatotoxicity caused by supplements and medications in 839 patients with liver injury from eight U.S. DILIN referral centers between 2004 and 2013. Of the 839 cases, 85 were attributed to nonbodybuilding supplements, 45 to bodybuilding supplements, and 709 to medications. A significant increase in liver injury cases occurring as a result of supplements was noted, rising from 7% during the initial 2-year period to 20% 10 years later (P = 0.0007). Outcomes related to these cases showed that nonbodybuilding supplements resulted in more severe events, with 13 patients undergoing liver transplantation or dying compared with no patients dying or requiring a transplant in the bodybuilding supplement group. Overall, liver injury as a result of herbal and dietary supplements was associated with a significantly higher proportion of severe cases, as assessed by the DILIN severity score, compared with conventional medications (P = 0.002). The majority of patients in the current analysis consumed products that contained multiple ingredients such as vitamins, minerals, and various botanical extracts. The investigators noted that pinpointing the exact compound that may be causing the liver injury is difficult because of the multiple substances present in these products. In addition, they commented that there have been reports of these supplements being contaminated with microbials, pharmaceuticals, mycotoxins, and heavy metals. The potential for these contaminants further confounds the ability of researchers to identify the exact cause of the liver toxicity. The authors concluded, “All stakeholders, including the 4

dietary supplement industry, regulatory agencies, health care providers, and consumers, must take note of these findings if a culture of safety for herbal and dietary supplement use is to be established.” Pharmacists should inform patients using herbal and dietary supplements that these products do not undergo the same evaluation process for efficacy and safety as do prescription products. Encourage patients interested in using supplements to choose products that are manufactured according to accepted standards, such as those set by the United States Pharmacopeial Convention (USP). Patients should talk with their physician or pharmacist if they have questions about the use of supplements. http://www.pharmacist.com/liver-injury-caused-herbal-and-dietary-supplements-rise

Walgreens pharmacists begin using EHRs As health care moves into a value-based system and pharmacists begin providing more patient care services, the incentive for pharmacists to begin documenting their clinical workflow in order to get paid will be critical. In line with this thinking, Walgreens announced in late August that it has implemented an electronic health record (EHR) system—the Walgreens Cloud EHR—that will give Walgreens pharmacy staff at more than 8,200 locations a single, complete view of a patient’s prescription, immunization, and health testing records. “Most systems in pharmacy have been steered to really fill prescriptions quickly, accurately, and then bill for those prescriptions,” said Nimesh Jhaveri, BSPharm, MBA, Divisional Vice President of Healthcare Solutions Group at Walgreens. “What our Cloud EHR does is really enable Walgreens pharmacists to begin to document clinical interactions and clinical services in a system that is interconnected.” The federal meaningful use EHR incentive program for early adopters of the technology, which incentivizes the use of EHRs through financial payments, did not include pharmacists directly as eligible providers. The health care reform law promotes accountable care organizations (ACOs)—an emerging model that aligns financial incentives to coordinate patient care—but does not explicitly include pharmacists as eligible professionals to form ACOs who can share in an ACO’s cost savings. Still, pharmacists have found ways to

Pharmacy Journal of New England • Fall 2014

participate in ACOs. Walgreens has established ACOs in which Walgreens pharmacists provide medication therapy management services. According to Shelly Spiro, BSPharm, FASCP, Executive Director of the Pharmacy HIT Collaborative, patient interventions performed by pharmacists are currently not codified in the prescription claim. But as a payer, an ACO needs clinical documentation from providers that is standardized in an EHR. “Your basic pharmacy claims–based information doesn’t necessarily equate to the outcomes that can be measurable for ACOs,” Spiro told Pharmacy Today. Although ACOs are growing—there are more than 400 Medicare, Medicaid, and private payer ACOs in the United States—they are not the only reason pharmacists should be using EHRs, or other HIT systems for that matter, to document clinical information. Financial incentives aside, pharmacy stakeholders agree that the move by Walgreens to implement a systemwide EHR is part of a bigger push to align pharmacists with team-based care and ultimately improve patient care and cost savings for the health care system. CVS Health has been using its own proprietary EHR system for some time. But nurse practitioners at the chain’s walkin clinics access the EHR, not pharmacists. This will remain the case when CVS transitions to EpicCare’s EHR, which the company announced earlier this year, connecting them to roughly 274,000 physicians in hospital networks, health systems, and physician groups that use Epic. This year, CVS Health also announced a new clinical affiliation with MedStar Health, which operates 10 hospitals in the Maryland and Washington, DC area. “We are moving quickly to a world in health care where practitioners should have applicable information regardless of where the patient goes,” said Jhaveri. “In order for us to get there, we have to standardize the information so we can transfer and send that information to other practitioners.” To date, the Pharmacy HIT Collaborative has created roughly 300 codes for clinical documentation that will standardize information as it is sent from one system to the next. As in e-prescribing, the information is standardized and embedded in the document using coding.

Hospitals—the entity currently affected most by value-based incentives in today’s health care environment—recognize that patients get discharged, and at some point, they visit their local pharmacy. “There are more hospital administrators who are recognizing that we need to work together, and the best way to do that is to integrate on an EHR level,” Andy Hochradel, PharmD, Director of Specialty Pharmacy at Prescriptions Plus in West Allis, WI, told Today. While independent pharmacists may not be affiliated with a large health system currently, they have an opportunity to be connected with independent physician practices that cover large patient populations. “Independent pharmacists are good at adapting technology within their own workflow. But we are at a point where we have to take a step back and use that same forward thinking and say, ‘How do I create a workflow in my community with the same networking principles?’” said Hochradel. Looking at the bigger picture, if all providers, including pharmacists, focus on better communication, they have a better chance of keeping patients healthy and out of the hospital. Jhaveri said the Walgreens EHR infrastructure is in place so that if they want to send out information to a patient’s provider in the future, they can. http://www.pharmacist.com/walgreens-pharmacists-begin-using-ehrs

Dabigatran: More Bleeds in Practice Than Expected Dabigatran (Pradaxa) was associated with higher risk of bleeding than Warfarin (Coumadin) in a large Medicare population sample, unlike the equal risk seen in the pivotal RE-LY trial. The relative risk was 30% higher for any bleeding with the direct thrombin inhibitor than warfarin and 58% higher for major bleeding (propensity adjusted rate 9.0% versus 5.9%, P<0.001), Yuting Zhang, PhD, of the University of Pittsburgh, and colleagues reported online in JAMA Internal Medicine. By contrast, the pivotal RE-LY trial had shown no difference in major bleeding risk between the two drugs, with an annual rate of 3.36% for warfarin versus 3.11% with the approved 150-mg dose of dabigatran, for a relative risk of 0.93 (P=0.31). The nationally-representative, 5%-sample Medicare analysis 5

U.S. News

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did agree qualitatively with the trial results on higher risk of GI bleeds and lower likelihood of intracranial bleeding than Warfarin. The hazard ratio for GI bleeding on Dabigatran was 1.85 (95% confidence interval 1.64-2.07) versus Warfarin, whereas the hazard ratio for intracranial hemorrhage of 0.32 (95% CI 0.200.50) favored dabigatran over the older drug. In RE-LY, the hazard ratio for major GI bleeding with the 150-mg dabigatran dose versus Warfarin was considerably lower, at 1.50. A prior FDA analysis of Medicare data had agreed with the trial on overall bleeding risk, but Zhang’s group argued that its lack of adjustment for patient factors was a major flaw. “Dabigatran and Warfarin users are very different in several factors that directly affect the risk of bleeding, and failing to adjust would bias the results, as our unadjusted estimates indicate,” they wrote. Their results were propensity weighted to account for demographic variables (age, sex, race, and Medicaid eligibility) and clinical characteristics, including the stroke risk CHADS2 score, chronic kidney disease, hypertension, history of stroke or transient ischemic attack, history of acute myocardial infarction, diabetes, congestive heart failure, acquired hypothyroidism, the number of other CMS-priority comorbidities, and history of bleeding in the year prior to treatment initiation. There was a significantly higher prevalence of chronic kidney disease, congestive heart failure, diabetes, and history of stroke or transient ischemic attack in those who took Warfarin. Propensity score weighting balanced out those characteristics. The retrospective analysis of pharmacy and medical claims from a random 5% sample of Medicare beneficiaries newly diagnosed with atrial fibrillation from Oct. 1, 2010, through Oct. 31, 2011 included 1,302 starting on Dabigatran and 8,102 initiating warfarin within 60 days of initial diagnosis. Clinical Implications “Thus, Dabigatran should be prescribed with caution, especially among high-risk patients,” they cautioned. The risk of major bleeding on Dabigatran was particularly high for African Americans (HR 2.12, 95% confidence interval 1.39-3.24) and patients with chronic kidney disease (HR 2.07, 95% CI 1.66-2.58). 6

The findings were cause for concern, according to an editor’s note accompanying the paper from Rita F. Redberg, MD, calling the bleeding risks of Dabigatran “significantly greater than originally appeared at the time of the FDA approval.” “Dabigatran was approved by the FDA in 2010 via the accelerated pathway after a 6-month review. The haste to approve novel drugs places an increasing importance on post-approval data to help better understand risks and benefits,” wrote Redberg, a cardiologist at the University of California San Francisco. “This study reminds us of the importance of postmarketing data and of having adequate data on risks and benefits to advise our patients accurately.” Judy Mackall, MD, section chief for cardiac electrophysiology at University Hospitals Case Medical Center in Cleveland, was less convinced that the data were influential for practice. “A lot of what’s in this study we were already aware of from RE-LY study,” she told MedPage Today. As far as the increased risk of GI bleeding, Mackall pointed to one theory. “Dabigatran is delivered as a pro-drug,” she said. “About 6% gets absorbed and the rest passes through the GI tract as an inactive anticoagulant.” But the lower risk of intracranial bleeding outweighs the concern about GI bleeds, she suggested. “GI bleed is significant, yes, it’s treatable most often. Getting a lower risk of intracranial bleeding is a big safety concern,” she said. “Intracranial bleeding is the major bleeding that we worry about because that’s not easily correctable.” The researchers urged that because of the GI bleeding risk across all subgroups “it is important for physicians to explain to patients how to detect gastrointestinal bleeding so that it can be controlled as early as possible.” But “intracranial hemorrhage is the most feared complication associated with Warfarin,” they agreed. “Thus, patients at high risk of intracranial hemorrhage may be willing to accept the higher risk of other bleeding events associated with dabigatran for a lower likelihood of intracranial bleeding. Arguably, this is the subgroup in which dabigatran is most likely to be a favorable choice in terms of safety.” http://www.medpagetoday.com/Cardiology/Prevention/48425

Pharmacy Journal of New England • Fall 2014

Hepatitis C vaccine shows promise in early clinical trial Around 3.2 million Americans have chronic Hepatitis C, making it the most common long-term bloodborne illness in the US. But could a vaccine for the disease be in sight? Researchers reveal how a vaccine has shown promise against hepatitis C infection a phase 1 clinical trial. Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). It is transmitted through contact with the blood of an infected individual, most commonly by sharing needles, syringes or other drug-injecting equipment, or through needle injuries in health care settings. Being born to a mother with HCV can also cause infection. In rare cases, the virus can be spread through sexual contact. Around 75-85% of people with HCV will develop chronic hepatitis C infection. Of these, around 60-70% will develop chronic liver disease, and 5-20% will develop liver cirrhosis over a period of 20-30 years. Around 1-5% of people with chronic hepatitis C die from liver cirrhosis or liver cancer. Although the majority of people with HCV go on to develop chronic infection, the research team - including Prof. Ellie Barnes of the Nuffield Department of Medicine at Oxford University in the UK - notes that 1 in 4 people clear the virus from their body naturally on first infection. This indicates that the body is able to produce an immune response to ward off the virus. In their study, published in the journal Science Translational Medicine, the researchers reveal how they developed a twotier vaccine approach that triggers and enhances an immune response to HCV, protecting against infection. Prof. Barnes and colleagues tested the safety and effectiveness of the vaccine in 15 healthy volunteers. Firstly, the volunteers were given a vaccine that “primes” an initial immune response to HCV. A second vaccine was administered 8 weeks later, which “boosts” this immune response and protects against infection.

a strong immune response in the volunteers, which the team says continued over the 6-month study period. What is more, the researchers say the immune responses of volunteers were comparable to those found in individuals who clear HCV naturally. Commenting on these findings, Prof. Barnes said, “The T cell response is really high, and what’s promising is that this is a broad response. A range of different T cells are produced targeting different parts of the hepatitis C virus. This is the first highly immunogenic T cell vaccine developed against hepatitis C. We found it to be safe and well-tolerated in this group of 15 healthy volunteers.” The team says another trial of the vaccine is already taking place in the US, in which researchers are testing its efficacy among intravenous drug users. “We won’t really know if it works - if it is able to prevent hepatitis C infection - until we have the results of the efficacy studies in the US,” notes Prof. Barnes. In August, Medical News Today reported on a study suggesting that current screening and treatments for hepatitis C could make it a “rare” disease by 2036, affecting just 1 in 1,500 people in the US. But the researchers of that study claim that if one-time screening was offered to all Americans - allowing people to receive earlier treatment - hepatitis C could become a rare disease 10 years earlier. “Although recent screening recommendations are helpful in decreasing the chronic HCV infection rates, more aggressive screening recommendations and ongoing therapeutic advances are essential to reducing the burden, preventing liver-related deaths and eventually eradicating HCV,” says senior author Jagpreet Chhatwal, PhD, assistant professor of health services research at the University of Texas MD Anderson Cancer Center. http://www.medicalnewstoday.com/articles/285027.php?print=98e482f811bad891b7 082059e721e435

The researchers explain that the vaccines were developed to trigger a strong response from T cells, which they say are the immune cells that ward off infection in people who are able to clear HCV from their body naturally. Results of the study revealed that the two vaccines activated

New England States Connecticut

President’s Message The New England Pharmacists Convention CPA banquet was wellattended by many past presidents, innovative and accomplished members who were receiving various awards, and outstanding students deserving of their scholarships given by the Connecticut Pharmacists Foundation. I draw inspiraKaren Hoang tion from these amazing individuals, CPA President hoping to have the leadership, motivation, and work ethic to carry on the CPA’s mission of promoting the practice and interests of pharmacy in Connecticut.

I had been a board member for several years before I got elected to 2nd VP and moved up the ladder to president. Over the years I’ve seen the CPA tackle different issues – the introduction of Medicare Part D, pharmacist immunization, and now the Affordable Care Act and medical marijuana. Along with these issues, unfortunately, we’ve also had to talk about waning membership and our decreasing financial reserves. We’ve had to make serious budget cuts, such as going to an online-only version of the Pharmacy Journal of New England and reducing our lobbying services. My primary goal as president is to increase membership and leave the CPA more financially solvent so it can keep providing all of the services so many of us take for granted. How many of you realize: the CPA runs a pharmacy technician training program at 10 community colleges throughout the state; we have an online Refresher Course as well as a CT Law Review and Quality Assurance Course; we have a lobbyist at the state capitol to ensure pharmacists aren’t left out of any healthcare bills; we also choose 5 deserving students each year to receive a $1000 scholarship; and of course, we organize live CE programs throughout the year as well as the Mid-Year in Feb and the annual New England Pharmacists Convention. This barely even skims the surface of all that the CPA does.

I want to change the perception of the CPA. Historically, the CPA membership was largely made up of pharmacy owners.

We know today’s reality is that most pharmacists are employee pharmacists, not owners, and the CPA has broadened its target audience to all pharmacists in the state, regardless of their practice. Pharmacists, your colleagues, may be reluctant to join because they think, “well I’m a hospital pharmacist, I should join CSHP;” “I’m a consultant pharmacist, so I should join CT-ASCP;” or “I’m an employee, not a pharmacy owner.” It’s wonderful that you join your specialty-specific organizations, but the CPA’s mission is different from those of the others’. Our mission is to advance the practice and interests of pharmacy in the State of Connecticut. Pharmacists, especially the more recent graduates, don’t realize what the CPA does to enhance the profession. I hear of past generations of pharmacists joining the CPA because ‘that’s just what you did when you became a professional.’ You joined the professional organizations to support your profession. Somewhere down the line, that sense of duty faded. Pharmacists need to be made aware of what the CPA does and why it’s important that they support their state organization. No one else is looking after their best interest as a pharmacist. During my year as president, I also want to bring some of CPA’s services into the 21st century. We have a beautiful new webpage now, plus Facebook and Twitter presence. I would love to see us have a mobile app and webinar CE programs. I always have my phone with me, and apps make it so easy to get information, like the famous Friday Fast Five. I would also love the option of attending a webinar instead of having to travel across the state. I have big ambitions for this upcoming year, and I hope to energize this wonderful organization. I know there are eager pharmacists out there, wanting to get involved, but who don’t know how. I had been a member for a while before Peter Sposato roped me into attending meetings and joining the Awards and Scholarships Committee. From there I became a board member and now look what happened - I got conned into becoming the president! I want to leave this organization stronger and better suited to handle any obstacles that may come its way. I want to see more pharmacists proud of their profession and proud of CPA. Thank you for this amazing opportunity.

Pharmacy Journal of New England • Fall 2014

Massachusetts President’s Message

I am honored to be installed as your new President for the coming year. I have many goals for the next several months, and look forward to getting to know all of the MPhA members. Just to help you get to know me, here’s my quick backstory: I grew up in Maine with aan Susan Holden awesome family. I went to the MPhA President University of Connecticut and after graduating with my PharmD, I began practicing in community pharmacy. After a couple of years, I met my husband and landed a job at the VA in CT. We eventually settled in Boston in 2008, where I am currently an ambulatory care pharmacist at the VA hospital in West Roxbury. I suppose my love for and my desire to advance my profession started while I was a member of APhA-ASP at UCONN. I wasn’t really any more active than anyone else, but I definitely took an interest. I participated in health fairs, traveled to APhA meetings, and attended the occasional Connecticut Pharmacists Association board meeting with my friends. I made it through pharmacy school – and started working – and somehow still found myself attending the board meetings, even though I wasn’t on the board, just to stay current with the happenings of my profession. I eventually joined the CPA board, and after moving to MA was appointed to the MPhA board. Even more than a decade ago, I knew our profession was on the cusp of amazing opportunities, but also realized it would take a huge amount of work to get there. When it comes to accomplishing huge tasks, I am not one for making giant strides and leaps at once. I’m more for small successes and achievements leading up to something greater. I employ the same philosophy in my own career, attempting each year to go at least one small step beyond my comfort zone. I see the strides that we make here inMassachusetts each year and celebrate our small victories on the

road to greater success. In the years since I left pharmacy school, I am amazed at the strides our profession has made with collaborate practice, medication therapy management, and adult immunizations, to name a few. Given my personal philosophy, I have a couple of goals that I will work to accomplish this year. I want to grow pharmacist and student participation in MPhA while increasing collaboration between the different pharmacy organizations in Massachusetts. As pharmacists, we do so much more than merely dispense medication. As the healthcare industry continues to grow and change, we must expand our skills and clinical abilities to meet the needs of our communities. Pharmacists are closer to becoming true healthcare providers than ever before, but we can only achieve this through greater collaboration. To accomplish my goals, I will rely on my esteemed colleagues on the board who have been tireless for years in their support for our organization and our profession, as well as all of my pharmacy friends and colleagues. I would like to thank the previous presidents of the board whom I have had the pleasure of working with and learning from: Christine Perry, Barbara Perry, Tim Hudd, and of course, Jim Gagnon. They have set an excellent example of leadership, grace, and accomplishment that I will strive to meet. Thank you all for this opportunity, and I look forward to working with you. Here’s to a wonderful year!

Mark Your Calendars MPhA Spring Conference April 30, 2015 Four Points by Sheraton, Norwood, MA

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MPhA Award Winners 2014 Erasmo A. (Ray) Mitrano was named the 2014 Bowl of Hygeia award winner at the MPhA Awards & Installation Banquet at the New England Pharmacists Convention (NEPC) on October 23. This award honors a pharmacist who has shown an exemplary record of community service. As a member of the International Medical Surgical Response Team (IMSuRT), Mitrano deployed to disaster areas, where the team provided medical care in extreme conditions. He spent two weeks in New Orleans following Hurricane Katrina in 2005, and also traveled to Haiti after its devastating earthquake in 2010. “These two deployments are the most rewarding things that I’ve ever done,” said Mitrano. During each deployment, Mitrano and other Boston-based members of IMSuRT designed a cache of medications for the base. Mitrano also created a rapid deployment method to transport and store the medicines, with the capability of assembling a pharmacy in 20 minutes. This system was subsequently adopted as a national standard for IMSuRT pharmacy set-up by the National Disaster Medical System. He received the Mass. Society of Health Systems Pharmacists’ Pharmacist of the Year award in 2004. The American Society of Health System Pharmacists first recognized Mitrano’s service in 2005, when Mitrano was honored with the Courageous Service Award. In June 2014, Mitrano accepted an award for Courageous Service from ASHP on behalf of the Mass. General Hospital. The Pharmacy Department was recognized for treating patients in the hospital’s Emergency Room following the marathon bombings. “I am greatly humbled and honored to receive this prestigious award,” said Mitrano. “The Bowl of Hygeia holds special meaning for me because our role as pharmacists is to help others. It is exceptionally gratifying to have been nominated by my peers and colleagues. Thank you. “ As the Associate Chief of Pharmacy at Massachusetts General Hospital, Mitrano oversees central pharmacy distribution for inpatients, including the operating room and compounding pharmacies. He has worked at Mass General in varying 10

capacities for 35 years. Mitrano holds a B.S. in Pharmacy from MCPHS-Boston and a B.A. in Biology from Boston University. He also earned a Master’s in Hospital Pharmacy Administration from MCPHS. ** Jake Nichols, Pharm.D. was honored as the 2014 Pharmacist of the Year at the banquet. Currently employed as Lead Medical Science Liaison at Orexo, Nichols specializes in addiction medicine and has grown into a leadership role in the recovery field. As a former addict himself, Nichols speaks at pharmacy schools around the country each month to share his experience and hard-won wisdom. When Nichols tells his personal story at pharmacy schools, he finds that he gains as much as the students and the experience augments his personal recovery. The impact on the students themselves is huge. Once Nichols concludes his talk, he says there is often a line of students wanting to speak with him about their concern with a brother, sister, or significant other’s addiction. “Afterward, faculty will thank me and say what a difference I’ve made,” he says. Nichols also has volunteered at patient and parent support groups throughout the Boston area, including Learn to Cope. “I am beyond honored to be given this award. It demonstrates that MPhA truly recognizes the scope of this epidemic and the importance of educating members of our profession,” said Nichols. “It is my hope that the profession of pharmacy can move beyond the judgment and stigma associated with addiction and take an active role in helping patients with this chronic disease achieve long-term recovery.” Nichols currently works as the Lead Medical Science Liaison at Orexo, where he focuses on education and clinical trials for Zubsolv, a medicine developed to treat opioid addition. In his education efforts, he discusses all types of treatment methods, however, and stresses that “there isn’t a one-size-fits-all treatment for this disease.” Prior to his work as an addition specialist, Nichols was employed at UMass Medical Center as the Director of Clinical Affairs for Clinical Pharmacy Services. He holds a Pharm. D. from the MCPHS-Boston and an MBA from UMass, Boston. He

Pharmacy Journal of New England • Fall 2014

is a member of MPhA and the association’s former governor of the Academy of Managed Care. Despite his difficult experience, staying silent wasn’t an option for Nichols. He remembered well the shame and hopelessness many pharmacists expressed during their recovery, and wanted to help take some of that away. “I felt like I could repair it (addiction). I wanted to transform it into something positive.” ** As the Pharmacy Operations Manager for a major healthcare plan, Jim Kenney brings a unique perspective to his volunteer work with MPhA’s Government and Legislative Affairs Committee. David Johnson, Executive VP of MPhA, has valued working with Jim for his “insight into the financial impact of proposed legislative and regulatory policies on the pharmacy profession.” At NEPC, Kenney was named the recipient of the 2014 Nathan Goldberg award, which annually recognizes an MPhA member who has significantly contributed to the association. Kenney has worked as the Pharmacy Operations Manager for Harvard Pilgrim Healthcare for nearly 20 years. In this role, he manages specialty pharmacy contracts and pharmaceutical manufacturer rebate contracts, performs utilization management, and analyzes pharmacy trends. He also reviews pipeline drugs, as well as tracks and monitors legislative activity at the state and federal level. Prior to that, Kenney was employed in purchasing at Harvard Pilgrim, and his tenure with the organization has spanned 34 years. This knowledge of legislative activity has propelled Kenney into a leadership role in his field. He trains nationally on managed healthcare, the Affordable Care Act and healthcare reform, and biosimilars. In October 2013, Kenney was elected to the Board of Directors of the Academy of Managed Care Pharmacy, and will help direct its growth. Kenney earned a B.S. in Pharmacy from MCPHS-Boston and a B.S. in Biology from Providence College. He also holds an MBA from Boston University. “I am delighted to be honored with the Nathan Goldberg award, “said Jim. “As a preceptor for Northeastern University pharmacy students, I worked closely with Nate (Goldberg)

who managed the externship program. Knowing the impact Nate had on the pharmacy profession and the respect he had from his peers, I am truly honored.” The award was established in the memory of Nathan Goldberg, former Executive Secretary of the Boston Association of Retail Druggists, now known as Massachusetts Independent Pharmacists Association (MIPA). He dedicated his career to independent community pharmacy and to the students with whom he worked at Northeastern University. ** Dr. Alicia Mam daCunha received the Pharmacists Mutual Distinguished Young Pharmacist Award. This award recognizes a Massachusetts registered pharmacist who received an entry degree in pharmacy less than 9 years ago and who is actively involved in a state or national pharmacy association and/ or community service. Mam daCunha was nominated for the honor by Diane Martin, the Associate VP of Pharmacy Operations at the Greater Lawrence Family Health Center (GLFHC). Mam daCunha earned a Pharm.D., magna cum laude, from MCPHS-Boston in 2010 and has worked as a Clinical Pharmacist at GLFHC since then. Her role has grown from seeing patients in an ambulatory care clinic to coordinating a pharmacy residency program and implementing a systemwide transformation within the health center. Mam DaCunha manages the clinic’s Visiting Nurse Association (VNA) Coumadin Phone Line; working under a collaborative drug therapy management protocol, she provides direction on how to manage patients who are on this medication. This collaboration helps save the physicians time and enables patients to access medications in a timely manner. “It’s gratifying to know I make a difference in my patients’ lives,” says Mam daCunha. “I love my patients and there’s never a boring day. I’m very fortunate to work with doctors and nurses who value my recommendations and to have great mentors, like Diane.”

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Karen Ryle was honored with the Cardinal Health Generation Rx Champion Award. This award recognizes a pharmacist who has demonstrated excellence in community-based prescription drug abuse prevention. Karen’s interest in combatting prescription drug abuse grew following the untimely death of a friend’s son but states “it was always something that interested me.” Ryle has contributed in many ways to anti-drug initiatives. She is involved with the Charlestown Substance Abuse Coalition, which runs its own “Drug TakeBack Day” in coordination with the DEA and local law enforcement. At this event, Ryle assists as the pharmacist onsite. A leader in her field, Ryle trains other pharmacists on the PMP (Prescription Monitoring Program), which enables pharmacists and prescribers to access a patient’s prescription history over the past year. In addition, Ryle has coordinated a standing order at Massachusetts General Hospital (MGH) to dispense Nasal Naloxone Kits, which reverse opioid overdoses, without a prescription. As President of the National Association of Boards of Pharmacy (NABP), Ryle works with a coalition of healthcare industry stakeholders that is working collaboratively to address the prescription drug abuse epidemic and to help practitioners comply with their legal responsibilities for prescribing, dispensing, and distributing controlled substances. This coalition is currently working on a document that will identify “red flags” for dispensing and prescribing controlled substances for both pharmacists and practitioners. She is also a member of Norfolk DA Michael Morrissey’s Prescription Drug Task Force. Ryle works as the Associate Chief of Pharmacy at MGH. She holds a BS in Pharmacy and an MS in Drug Regulatory Affairs, both from MCPHS-Boston. “I am very excited to be named this year’s Generation Rx Champion, and will continue to work with the pharmacy community to raise awareness about the drug abuse epidemic that is occurring across the country,” said Ryle. ** Joanne Doyle Petrongolo was named the 2014 Upsher-Smith 12

Excellence in Innovation Award recipient. The Upsher-Smith Award honors a pharmacist who has demonstrated innovative pharmacy practice resulting in improved patient care. As the pharmacist for the Integrated Care Management Program at Massachusetts General Hospital, Petrongolo assists in resolving medication management issues for a highrisk Medicare population. Her involvement has contributed to a reduction in hospital readmissions. Joanne loves her job.“My role is unique in that I get to know the patients through all aspects of their continuum of care: home, hospital and rehab,” explains Petrongolo. “There are patients that I’ve known for years, so I understand the big picture for their overall care.” The Care Management Program (CMP) was selected in 2005 by the Centers for Medicare and Medicaid Services to participate in the Care Management for High Cost Beneficiaries Program. The goal was to coordinate care for this high-risk group and reduce the likelihood of hospital and ER visits. After six months, Petrongolo was asked to consult to the program, for which she now works full-time. Petrongolo completes face-to-face MTM visits to assess polypharmacy and adherence issues and resolves patient medication access barriers by mailing out affordable medications through the MGH Outpatient Pharmacy. “I would like to thank MPhA and the nominating committee for selecting me for the Innovative Practice award. I feel blessed that every day I go to work and I have the opportunity to make a difference in patient’s lives,” said Petrongolo. “I’m very fortunate that I have a work environment that encourages professional growth to find new ways to take care of patients.” Doyle Petrongolo has worked at Massachusetts General Hospital for 9 years, with experience in the outpatient pharmacy prior to CMP. She holds a Pharm.D. from the University of Rhode Island and a Bachelor’s of Science degree in Pharmacy from Northeastern University.

Pharmacy Journal of New England • Fall 2014

New Hampshire N. H. Prescription Drug Monitoring Program Goes Live October 16, 2014 The NH PDMP will begin operating on October 16, 2014. Based on RSA 318-B:31, this means that all prescriptions for Schedules II, III, and IV that are dispensed based upon the RSA definition, shall be reported to the program. The intent is to reduce the abuse, overuse, and diversion of controlled substances. It will also assist the practitioner (doctor) and dispenser (pharmacist) in determining the legitimate pain needs of their patients versus the increasing challenges surrounding diversion and abuse. The program will also hit the ground running; data will be loaded into the system back to March 1, 2014. New Hampshire is the 49th state to initiate this type of program, and its operational parameters are somewhat unique to this state. In May, the Board of Pharmacy’s Advisory Council interviewed interested candidates for the Director’s position and unanimously chose Michelle Ricco Jonas to lead the project. Ms. Ricco Jonas brings a wealth of project management skills and experience in health related state and local government initiatives. The PDMP office resides in Concord, NH at the Board of Pharmacy located at 121 South Fruit Street. Its new contact information: Tele. (603) 271-6980 Fax. (603) 271-2856 and Ms. Ricco Jonas can be reached at michelle.riccojonas@ nh.gov. New Hampshire has also contracted with Health Information Designs, LLC (HID) as the vendor to develop a prescription database and help move the project forward. HID is a nationally recognized leader in automated healthcare solutions and also serves more than 20 states including our neighbors in Maine, and Vermont. HID will begin assisting with the registration process of pharmacists this Fall. This process will involve the PDMP (through the vendor, HID) sending out credentials for each pharmacist. The pharmacist will then be assigned a USER ID and initial password, then a change to a personalized password similar to current formats used by online banking, investment, or

other websites. Once established, the pharmacist will be able to access the PDMP during the dispensing process, and use his or her best professional judgment regarding any intervention. Certain chain pharmacies may also have their own IT groups assist with registration centrally, however, that has not been finalized. What’s next? At this point in time, even before the program begins, we need to look at ways to tweak the program due to the ongoing dynamics of the environment. Some grants and funding options dictate certain requirements for extension of the monies needed to sustain the program. This means that we need to look at ways to satisfy those grant requirement by including changes involving, for example, interstate data sharing. Most changes of this type will require the introduction of new legislation and additional rulemaking. The success of this program depends upon one factor and that one factor is using it! If pharmacists use the program as it was intended, then its success is assured.

Legislative Update: The following is a status of bills from the 2014 legislative session related to pharmacy that were finalized or sent to interim study. House Bill 584 – Relative to covered prescription drugs. Sponsored by Representative Cindy Rosenwald, this bill would require insurers to allow covered persons to purchase their 90-day supply of covered prescription drugs at the pharmacy of their choice. Signed by the Governor on June 16, 2014 Effective Date: August 15, 2014

http://www.gencourt.state.nh.us/legislation/2014/HB0584.html

House Bill 1219 – Relative to the work schedules of pharmacists. Sponsored by Representative William Hatch, this bill would establish requirements for the staffing and work schedule for a pharmacy by a pharmacist. Violations would be subject to disciplinary action by the board of pharmacy. 13

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The key provision in this bill is that a pharmacist working longer than 5 consecutive hours in a work day SHALL take a 30-minute rest break. The bill was sent to interim study for more work over the summer. The subcommittee voted to recommend for Future Legislation. The full committee will vote on that recommendation this fall. http://www.gencourt.state.nh.us/legislation/2014/HB1219.html

House Bill 1344 - Relative to the disposal of sharps waste by retail establishments. Sponsored by Representative Andrew White, this bill would require pharmacies and retail establishments that sell sharps to accept and dispose of sharps waste. The bill was sent to interim study for more work over the summer. The subcommittee voted not to recommend for Future Legislation. The full committee will vote on that recommendation this fall. http://www.gencourt.state.nh.us/legislation/2014/HB1344.html

House Bill 1615 - (2nd New Title) relative to allocation from the annual license renewal fee for pharmacists to the impaired pharmacist program and relative to emergency prescriptions. Sponsored by Representative Kermit Williams, and as a request of the committee to study the regulation of pharmacy benefits managers established by 2013, RSA 182:1, this bill would allow the New Hampshire pharmacy board to determine the allocation from the annual license renewal fees for pharmacists to the impaired pharmacist program, allow a pharmacy to dispense a one-time emergency supply of a prescribed medication in certain circumstances, and would enumerate a list of drugs or classes of drugs that may not be dispersed as an emergency prescription. Signed the Governor on August 1, 2014 Effective Date: January 1, 2015

http://www.gencourt.state.nh.us/legislation/2014/HB1615.html

Senate Bill 422 - Relative to the definition of pharmacy benefit manager. Sponsored by Senator Donna Soucy, this bill is a result of the committee to study the regulation of pharmacy benefit man 14

agers established under 2013, RSA 182. This bill would insert a definition of pharmacy benefit manager into the statutes. Signed by the Governor on June 16, 2014 Effective Date: August 15, 2014

http://www.gencourt.state.nh.us/legislation/2014/SB0422.html

New Hampshire Pharmacists Association Scholarship Foundation Names Student Recipients Each year the New Hampshire Pharmacists Association (NHPA) Scholarship Foundation provides NH student pharmacists an opportunity to receive scholarship funds. The scholarship committee places high value on students with the right balance of professionalism, initiative, leadership, insight, and decisiveness, as well as, need and scholastic ability. This year the foundation awarded three outstanding students. The recipients will be honored at the New Hampshire Pharmacy Awards banquet in December. The first 2015 scholarship recipient is Andrew Brueckner. Andrew is currently in his last year of MCPHS UniversityWorcester/Manchester’s Accelerated Doctor of Pharmacy Program. He is the president of the Rho Chi Honor Society and treasurer of the Phi Lambda Sigma Leadership Society. Andrew has a strong passion for pharmacy advocacy and is also a very active member of NHPA, acting as a student Board of Directors Member. The second recipient is Morgan Ratte, a 2016 PharmD Candidate, currently studying at University of Rhode Island’s College of Pharmacy. Morgan is a member of the University’s Rho Chi Honor Society, Phi Lambda Sigma Pharmacy Leadership Society and America’s Senior Care Pharmacists. Morgan has also participated in the College’s mission trip to an orphanage in Jamaica where pharmacy students of provide education to the caregivers about medication adherence and dosing. Morgan is leading the 2015 mission trip where they will revisit this site.

Pharmacy Journal of New England • Fall 2014

The third scholarship recipient is a University of Connecticut 2016 PharmD Candidate, Emily Seamans. Emily is a member of Lambda Kappa Sigma Professional Pharmacy Fraternity as well as the Honor Society, Alpha Lambda Delta. Emily serves as a student ambassador for the University’s incoming students, as well as a Student Mentor and Assistant Program Director for the Nutmeg Big Brother Big Sisters program. Emily has also served as a hospitality volunteer at David’s House, a home-away-from-home for families whose children are being treated at Dartmouth Hitchcock Medical Center. We wish the 2015 scholarship recipients continued success in their education and pharmacy careers. For information about the NHPA Scholarship Foundation scholarship program, please visit our website at www.nhpharmacists.net.

NHPA Holds Annual Spring CE Program at Attitash NHPA offered several educational opportunities at our annual Spring CE program. In addition to 5 live hours of high quality continuing education, NHPS also offered two free dinner speaker programs in the North Conway area. On Friday, May 23, 2014 Sanofi sponsored a dinner program entitled, “Improving Glycemic Control in Type 2 Diabetes: A Stepwise Approach to Initiating and Intensifying Insulin Treatment.”

Fall CE Program Held at SERESC On September 7, 2014, NHPA sponsored a CE program at the SERESC Conference Center in Bedford. Being an election year in NH, NHPA invited several legislators to attend the CE program as our guest. It was a great opportunity for both the legislators and attendees to mingle and learn firsthand some of the issues facing our profession. Save the dates for the following CE programs: May 30, 2015, Attitash Grand Summit Hotel, Bartlett, NH September 13, 2015 & December 6, 2015, SERESC Conference Center, Bedford, NH Details and directions can be found on our website at www. nhpharmacists.net. Also, please join our Facebook page by searching “NHPA”.

NHPA Launches New Website: In October 2014 NHPA launched our new website for our members. The new website gave NHPA a much needed new look, and it is also more user friendly.

The following evening after the CE program, we offered a second dinner speaker program which was sponsored by Bristol Myers Squibb. The program was entitled, “Anticoagulation to Reduce the Risk of Stroke in Patients with Nonvalvular Atrial Fibrillation (NVAF). It was a great way to end our weekend at Attitash. This was our fourth annual spring CE program at this venue, and we will return again next year. From left to right: Mary Lou Douin, Timothy Beaulac and David Douin from the White Mountains area attended one of the dinner programs at the 1785 Inn.

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Maine

MPA Recognizes Individuals for their contributions to the Profession of Pharmacy. The MPA celebrated the contributions of pharmacists, technicians, and students to the profession of pharmacy at the 2014 Fall Convention in Bangor, Maine. The award ceremony recognized 2 pharmacists, John Bastey and John Hebert, for 50 years as dedicated, licensed pharmacists in the State of Maine. The other recipients of national and local awards are as follows: Bowl of Hygeia Award: Mark Polli Distinguished Young Pharmacist Award: Sarah Vincent Cardinal Health Generation Rx Champions Award: Dennis Croteau Upsher-Smith Excellence in Innovation Award: Lisa Darling Maine Technician of the Year: Candace Danforth A highlight of the night was the MPA membership awarding $4,000.00 in scholarships to four outstanding students attending the Maine pharmacy schools of Husson University and the University of New England. The recipients were Lindsey Cashell, Kayla McGrath, Irene Okeke, and Meagan Rusby. The association wishes them a successful academic year.

MPA Elects a New Leadership Team MPA welcomes Gregory Cameron as President and Betty Harris as Vice President of the Maine Pharmacy Association. They both were sworn in at the Fall Convention in Bangor, ME earlier this fall. A big thank you goes out to Mac McCall and Laurie Roscoe for their dedication and contributions to furthering the profession of pharmacy and the growth of the association while they served as officers of MPA for the past four years. MPA appreciates their current support and continued involvement in the organization.

Dr. Kenneth “Mac” McCall Awarded Jim McGregor Government Service Award Dr. Kenneth “Mac” McCall of the UNE College of Pharmacy and the recent president of the Maine Pharmacy Association has been unanimously selected by the Retail Association of Maine Board of Directors to receive the organization’s 2014 Jim McGregor Government Service Award. In 2010, the Retail Association of Maine named this award after its retired director of government affairs, Mr. Jim McGregor. Jim’s decades of hard work in the public policy arena paved the way for setting the standard for an award that recognizes an individual who goes above and beyond in support of Maine’s retail community in the sname of service. The award was presented on October 16th at the association’s 81st annual meeting in Bangor, ME. “The students at UNE College of Pharmacy have a true leader in Mac McCall. His persistence and advocacy on behalf of the pharmacy industry is impressive to say the least. He cares deeply about patient safety and spoke out loudly when safety is compromised,” said Curtis Picard, Executive Director of the Retail Association of Maine. “The Jim McGregor Award recognizes an individual who goes above and beyond just like Jim McGregor did for our members for so many years.” Professor McCall is also the Immediate Past-President of the Maine Pharmacy Association. During his two consecutive terms as MPA President from 2010 to 2014, he was able to successfully advocate for expansion of pharmacy scope of practice to increase access to preventative health services. Notable legislative accomplishments included enhancing immunization services provided by pharmacists to cover all adult CDC-recommended vaccines, enabling pharmacy students to administer vaccines while being supervised by pharmacists, and enabling collaborative practice agreements between a physician and pharmacist which allows the pharmacist to assess patients and modify prescription medica-

Pharmacy Journal of New England • Fall 2014

tions to achieve optimal outcomes. Mac has also helped to operationalize these new laws by training over 350 pharmacists in Maine to become immunizers. Dr. McCall is passionately committed to safe and affordable access to prescription medications. He has volunteered for over five years at the Biddeford Free Clinic in a licensed pharmacy that provides free prescription medications to residents of Maine. He also has provided research support for the Maine Office of Substance Abuse and Mental Health Services. His research on prescription drug overdose deaths and DEA drug take-back data has been presented to state and federal agencies to improve public health policy and has culminated in recent publications in the American Journal of Public Health and Journal of Substance Use. He has also spoken in Washington DC to FDA and CDC officials regarding the public health risks of substandard and counterfeit drugs in light of Maine’s recent ordinance to allow ‘entities’ to facilitate the importation of prescription medications. His service to Maine and the profession of pharmacy have been recognized by the National Community Pharmacy Association Leadership Award in 2011 and 2014.

Maine Pharmacy Association Advocates for Provider Status/HR 4190 One of the most important legislative initiatives for the profession of pharmacy began in March of this year when HR 4190 was introduced in the US Congress. HR 4190 would amend Title XVIII of the Social Security Act to include pharmacists as providers thereby enabling patient access to, and payment for pharmacy services under the Medicare program. Recently, a delegation from Maine Pharmacy Association met with legislative staff at Representative Chellie Pingree’s office in Portland and Representative Michael Michaud’s office in Lewiston to advocate for this important legislation. The delegation emphasized the roles of pharmacists on healthcare teams to help patients use medicines safely and stay healthy. The visit concluded by asking Representatives Pingree and Michaud to support patient access to cost-effective pharmacy services and to cosponsor HR 4190. Shortly after our visit, both Representative Pingree and Represntative Michaud signed on as cosponsors of the bill. There are now 116 cosponsors and growing bipartisan support in the House of Representatives for HR 4190.

Save the Date! MPA Spring Convention, Trade Show, and Award Banquet MPA’s Spring 2015 Convention and Trade Show is a great opportunity to earn continuing education credits by attending sessions with outstanding speakers on topics relevant to the profession. The convention is scheduled to run from March 20-22 at the Hilton Garden Inn, Freeport, Maine. For more information visit MPARX.com. Pictured from L to R: Kenneth McCall, PharmD, Associate Professor UNE; Stephanie Nichols, PharmD, BCPS, BCPP, Associate Professor Husson; Hilary Devine, Husson Class of 2015; and Nicole Chasse, UNE Class of 2015 in the office of Representative Pingree.

2013 Recipients of the “Bowl of Hygeia” Award

Charles D. Sands III Alabama

Martie Lamont Alaska

Kathryn Labbe Arizona

Karrol Fowlkes Arkansas*

Vicki Fowlkes Arkansas*

Helen K Park California

Ronald Kennedy Colorado

Gregory L Hancock Connecticut

David W. Dryden Delaware

Judith Martin Riffee Florida

William Lee Prather Georgia

Selma Yamamoto Hawaii

Mark Johnston Idaho

Garry Moreland Illinois

Patrick Cashen Indiana

Bernard Cremers Iowa

Leland Hanson Kansas

J Leon Claywell Kentucky

Douglas Boudreaux Louisiana

Paul Chace Maine

Angelo C. Voxakis Maryland

John R Reynolds Massachusetts

Nancy J W Lewis Michigan

Harvey Buchholz Minnesota

Clarence DuBose Mississippi

Kenneth W. Schafermeyer Missouri

Carla Cobb Montana

Scott E Mambourg Nevada

Cheryl A Abel New Hampshire

Eileen Fishman New Jersey

Phil Griego New Mexico

James R. Schiffer New York

Jean Douglas North Carolina

Laurel Haroldson North Dakota

Kenneth S. Alexander Ohio

Eric Winegardner Oklahoma

Wayne Kradjan Oregon

Edward Bechtel Pennsylvania

Daniel Mahiques-Nieves Puerto Rico

Linda A Carver Rhode Island

Linda Reid South Carolina

Ann M Cruse South Dakota

Kenneth Smith Tennessee

Leticia Van de Putte Texas

Dominic DeRose Utah

The “Bowl of Hygeia”

Leo H Ross Virginia

Janet Kusler Washington

Russell Jensen Wisconsin

Timothy Seeley 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 Awards Gallery located in Washington, DC. Boehringer Ingelheim is proud to be the Premier Supporter of the Bowl of Hygeia program. *husband and wife co-recipients

New England Pharmacists Convention 2014

Pharmacy Journal of New England • Fall 2014

Susan Holden takes the helm and accepts the Board presidency at the MPhA Banquet.

L to R: Joanne Doyle Petrongolo, Erasmo “Ray” Mitrano and Karen Ryle display their awards at the MPhA Banquet.

From L to R: Brian Ambrefe, Kathleen McTernan and Ronald DeBellis enjoy a visit during dinner.

The attendees listen during an education sesson.

Pictured above L to R: Mark Yorra, Nathan Goldberg award winner Jim Kenney, and Sheri Kenney.

New England Pharmacists Convention 2014

(L-R) Michelle DeFazio, Arrow Alternative Care, Paul Plourd, Cardinal Health and Angelo DeFazio enjoy the NEPC Networking Reception.

(L-R) CT Pharmacists Foundation President Cynthia Huge presents the 2014 scholarships to this yearâ&#x20AC;&#x2122;s recipients from the University of Saint Joseph, David Gardner; and the University of Connecticut students Victoria Stevens, Lauren Croll, Tina Do and Brody McConnell at the CPA Banquet.

Stephanie Hattoy, a professor at the University of Saint Joseph School of Pharmacy, is pictured with her poster presentation.

(L-R) CPA Members Gillian Kuszewski, Meghan Wilkosz and Crystal Garroshen at the NEPC Networking Reception.

The 2014 Award recipients pose following the CPA Awards Banquet. From L-R, Nick Tamborrino, Innovative Pharmacists Award; Peter Sposato, the Daniel C. Leone Pharmacist of the Year; Marissa Salvo, Distinguished Young Pharmacist; Philip Bunick, Bowl of Hygeia, and Ralph Frank, Cardinal Generation Rx award.

Pharmacy Journal of New England • Fall 2014

MCPHS-Worcester/Manchester Claims the Pepto Bowl Four teams from New England pharmacy schools demonstrated their knowledge in the fast-paced, Jeopardy-style “Pepto Bowl” at the New England Pharmacists Convention (NEPC) at Foxwoods Resort on October 24. Regan Savinsky ’15 and Chelsea Sampadian ‘15, the team from MCPHSWorcester/Manchester, came from behind to win the coveted prize in the final round of the competition. While teams from seven schools participated in the preliminary portion of the Pepto Bowl, only the teams from the University of Connecticut, University of Rhode Island, Northeastern University, and MCPHS University-Worcester/ Manchester advanced to the live competition at NEPC, in front of an energized and partisan audience. Jef Bratberg, Pharm.D., Clinical Professor at the University of Rhode Island, enthusiastically performed the hosting duties. The first round began with questions of a modest difficulty level and included such categories as “Abbreviations” and “What Can ‘I’ Take for That.” From the latter category, all teams responded with the correct answer to: “What OTC is commonly taken for aches and pains?” (What is Ibuprofen!) The start of the second round brought questions in categories including “Creepy Crawlies” and “A Sight for Sore Eyes.” Most

teams answered correctly to: “The advantage of this type of formulation is that the retention time is enhanced.” (What are ophthalmic ointments). Though UConn led for most of the game, Northeastern and MCPHS-Worcester/Manchester were able to wrestle control of the board, with URI performing well also. Over the course of the game, each of the teams racked up impressive point totals. “This is the highest scoring ever!” announced Bratberg, entertaining the large crowd. Although UConn held the lead going into the final round, all four teams remained in contention. As in Jeopardy, competitors selected their own wager amounts. This question from the category “Aligning Priorities” determined the winner: “Align, a probiotic that has been clinically proven to benefit patients with Irritable Bowel Syndrome, contains this strain of bacteria.” As the sole team to answer correctly “What is Bifantis,” MCPHS-Worcester/Manchester (Regan and Chelsea) roared from behind to claim the trophy. The other finalists included Kyle Lundgren ’15 and Kathryn Steckowych ’15 from UConn; Kerri Roach ’15 and Katelyn Springer ’15 from Northeastern; and Chelsea Dodge ’15 and Beth Evans ’15 from URI. Congratulations, and we look forward to the Pepto Bowl tradition continuing in 2015!

Pepto Bowl winners Chelsea Sampadian ‘15 and Regan Sevinsky ‘15 of MCPHS-Worcester/Manchester are flanked by Sheila Seed, Pharm.D., Associate Professor of Pharmacy Practice at MCPHS, and Kaelen Dunican, Pharm.D., Associate Professor at MCPHS.

New England Pharmacists Convention 2014 3rd Annual New England Pharmacists Convention Poster Competition “The People’s Choice Awards” Posters were judged by attendees equipped with a grading rubric, and winners were selected in two categories. Category 1: Successful Integration of Pharmacy Students in a Practice Setting. First Place: Collaborating with community-based groups to promote self-awareness, innovation, and professionalism among PY4 Pharm.D. students. Sandra Aziz, Emilie Maloy, Timothy O’Shea - Doctor of Pharmacy Candidates, 2015; Enrique Seoane-Vazquez, PhD; Timothy R. Hudd, BS, Pharm.D., AE-C Abstract: Purpose & Objectives The purpose of this project was to illustrate the utility of a community service based project in promoting attributes such as self-awareness, innovation, leadership and professionalism among PY4 Pharm.D. students. The first objective was to measure the impact and effectiveness of a student led interactive educational session for Resident Service Coordinators enrolled in the Freedom from Smoking training program sponsored by the American Lung Association®. Second, students were asked to reflect on the experience in order to attain a higher level of learning. Methods Three students enrolled in their 4th professional year (PY4) at MCPHS University were invited to deliver a 45 minute interactive educational session on FDA approved smoking cessation therapies for a group of Resident Service Coordinators enrolled in a smoking cessation certificate program. The students were charged with developing a presentation and were asked to create an assessment tool to measure the overall impact and effectiveness of the session. A 9 item questionnaire was prepared and reviewed for clarity. A 5‐point Likert scale (Strongly Disagree = 1, Strongly Agree = 5) was used for 5 of the items to evaluate the content and delivery of the topic (Figure 1). One of the questions was designed to assess the participant’s level of confidence in counseling patients on smoking cessation products after the presentation (Figure 2). 22

In addition, 3 open-ended questions were included to gather additional feedback. Results Thirteen Resident Service Coordinators attended and evaluated the student led portion of the program. The average score on the post-presentation evaluation was (average±standard deviation): 4.77±0.44 interest, 4.54±0.88 relevance, 4.46±0.66 appropriate level, 4.69±0.48 organization, 4.77±0.44 increased knowledge. In addition, 9 (69.2%) participants stated they felt more confident counseling patients regarding proper medication use for smoking cessation after the presentation. Of the remaining, 3 (23.1%) were unsure, and 1 (7.8%) did not feel more confident. Finally all 13 participants stated Pharm.D. student led presentations should be considered for future programs. Category 2: Innovation in Pharmacy Practice First place: Integration of a pharmacy practice in an interdisciplinary geriatric team within a patient centered medical home. Philip Carpiniello, Pharm.D. Candidate 2015 at MCPHS University; Nicholas Heath, Pharm D Candidate, MCPHS; Mark J. Simone, MD; Lisa Padgett PharmD, BCACP Abstract: From 2000-2006, the number of patients receiving at least 10 medications on a weekly basis has doubled from 4.4 - 7.5%. Herein we describe plans to reduce potentially inappropriate medication use in older patients in the Primary Care Center (PCC) at Mount Auburn Hospital (MAH) by integrating pharmacy as a central component of a new interdisciplinary geriatric consult team. The PCC is a Level-3 NCQA certified patient-centered medical home (PCMH) with of professional staff who provide team-based care focused on improving the overall health of their patients. We have identified an at-risk population which makes up 23.7% of the patient panel (about 500 patients). This pilot geriatric clinic will provide one in-person consultation session per week, and will be studied for the first year of its implementation, during which we expect to see improved prescribing practices and improved adherence, which will lead to cost-saving interventions and reduced hospital readmission rates.

Pharmacy Journal of New England • Fall 2014

Efforts to improve prescribing practices will focus on better education of primary care providers and integration of pharmacists in team-based approach to care. The interdisciplinary geriatric team, which is under development in the PCC, aims to meet the demand for geriatric consultative care in this community and will serve as a potential model for similar primary care practices. Working together, geriatricians, medical residents, pharmacists, pharmacy residents, APPE students, nurses, and social workers can evaluate high risk patients, modify complicated medication regimens, and decrease hospital readmission rates, all while improving patient outcomes. Pharmacists, PGY1 residents and APPE students will work together on managing medication interventions, interviewing patient/ caregiver, and following up with patient after their visit to the clinic. Patient education and follow-up phone calls will be provided by residents and APPE students to ensure safe medication use. Pharmacy’s involvement in the clinic will lead to a reduction in pill burden and use of inappropriate medications. Category 1: Successful Integration of Pharmacy Students in a Practice Setting Submissions: Collaboration of MCPHS University-Boston with student and community organizations to promote safe medication use in seniors. Amee Mistry, Pharm.D Analysis of a continuous quality improvement curriculum. Todd Brown, MHP Home health pharmacy: an innovative practice model to improve transitions of care throughout Rhode Island communities. Virginia Lemay, Pharm.D. Motivational interviewing: student feedback to improve the MI skills of a trained clinical pharmacist. Victoria Celetti, Pharm.D Pre-travel consultations in a travel clinic: an opportunity for interprofessional education. Sheila Seed, Pharm.D Collaborating with community based groups to promote self-awareness, innovation, and professionalism among PY4 Pharm.D. students. Sandra Aziz, Pharm.D. Candidate 2015 Model of a multimodal institutional pharmacy rotation at veterans affairs Boston healthcare system (VABHS). Jameson Wood, Pharm.D.

Category 2: Innovation in Pharmacy Practice Pharmacist initiation of post-exposure doxycycline for lyme prophylaxis. Anita Jackson, Pharm. D. Choose your own adventure: a reader based plot selection method for patient case group activities. Stephanie Hattoy, Pharm.D. Implications of Medicare Part D on community pharmacy: a nationwide study. Shamima Khan, Pharm.D Expanding naloxone distribution through community pharmacy practice settings. Leo Lariviere, RPh. Continued tradition of success: critical components of the genzyme/sanofi - MCPHS University post-pharm.d. biopharmaceutical fellowship. Christina Gallagher, Pharm.D. Evaluation of immunization training in the curriculum of first and third year pharmacy students. Brett Feret, Pharm.D. Home-based pharmaceutical reconciliation program (HBPR): a care transitions program for elders. Jacqueline Klee, Pharm.D. Prescribing of proper needle length for patients using insulin in an outpatient institution: a medication use evaluation. Steven Sparkes, Pharm.D. MEDS@Work: Medication education sessions at the workplace. Donna Bartlett, Pharm.D Pharmacist-managed blood pressure monitor lending program. Michelle Jacobs, Pharm.D. Integration of a pharmacy practice in an interdisciplinary geriatric team within a patient-centered medical home. Philip Carpiniello, Pharm.D. Candidate 2015 Pharmacovigilance: development of a pharmacy monitoring program for patients on ipilimumab for metastatic melanoma at the Veterans Affairs Boston Health Care System. Rita El Hachem, Pharm.D. Medicare Part D cost discrepancies across Massachusetts. Alyssa Mulhern, Pharm.D. Candidate 2015. Survey evaluating the practice of children’s hospital having pharmacist collaborative drug therapy management protocols. Chelsea K. Welsh, Pharm.D. Candidate 2016. Impact of an inpatient medication therapy management program on optimizing medication therapy. Liana Nabi, Pharm.D. Innovations in community engagement at the University of Connecticut. Philip Hritcko, Pharm.D. 23

Feature Important Updates for Influenza Vaccination in 2014-2015 By Michael Whitley, PharmD Candidate 2015 and Jennifer Girotto, PharmD

On August 15, 2014 the Centers for Disease Control and Prevention released their influenza vaccination recommendations for the 2014-2015 season.1 The following summarized the updated information for this year’s influenza vaccine for the immunizing pharmacist. For the 2014-2015 season there will again be both a trivalent and quadrivalent versions of the vaccine. A summary of the vaccines available this season are provided in Table 1. All of the available vaccines will contain hemagglutinin (HA) derived from an A/California/7/2009 (H1N1)like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/ Massachusetts/2/2012-like (Yamagata lineage) virus. Additionally, the quadrivalent influenza vaccines will also contain a B/Brisbane/60/2008-like (Victoria lineage) virus.1 The antigenic composition of influenza vaccines this year is the same as it was in 2013-2014. Because of this similarity to last year’s vaccine, patients may wonder if they truly need to receive the vaccine again this year. It is important to counsel these patients that the immunity provided by the flu vaccine wanes after only one year, and that last year’s vaccine will not adequately protect them against the flu this year even though the strains are the same. Although many of the routinely administered IIV vaccines expire after the end of the season (June 30th), pharmacists should be aware that a few other vaccines have much shorter expirations.2,3 Specifically the LAIV has an average shelf-life of 18 weeks2 and the RIV3 has an expiration of 16 weeks from when it was made.3 Patients often have questions regarding allergy and the Advisory Committee on Immunization Practices (ACIP) also addresses these concerns. They advise that the influenza vaccine should not be administered to a 24

patient who had an allergic reaction to a prior influenza vaccine.1 In patients with an egg allergy, ACIP recommends that they may receive the recombinant influenza vaccine (RIV3) if the patient is between the ages of 18 to 49 years old. 1 For patients who are outside of those ages or if RIV3 is unavailable the patient should be asked what type of allergic reaction they had to eggs. If the patient reports a reaction of only hives, they can receive an IIV vaccine by a health care provider who is familiar with potential manifestations of an allergic reaction and who can observe the patient for a half an hour after each influenza vaccine dose. 1 If the patient reports other severe reactions, they should be referred to a physician who has expertise in the recognition and management of severe allergic reactions. 1 For the first time in 2014-2015, ACIP has provided a preference for a specific influenza vaccine. This preference affects children 2 through 8 years old. In these children it is recommended for those who have no contraindications or precautions, when it is immediately available. 1 It is important to note that vaccination should not be delayed to attempt to acquire LAIV. If LAIV is unavailable, IIV3/4 should be used. 1 As in the past, children aged 6 months through 8 years require 2 doses of influenza vaccine (administered at least 4 weeks apart) during their first season of vaccination to opti-

Pharmacy Journal of New England • Fall 2014

mize immune response. 1 The ACIP recommended approach to determining the number of doses necessary is generally the same as past years with the child needing at least 2 doses of seasonal vaccine with at least one of these containing pandemic H1N1 (which has been included in the seasonal vaccine since July 1, 2010). There is however, one important exception: children who only received a single vaccine last year (2013-2014) only require one vaccine dose this year because of the identical strains the dose given last year will act as a priming dose.1 Table 1. Influenza vaccines available for the 2014-15 season Vaccine Category, route

Brand name (Manufacturer)

Ages recommended

Dose

Abbreviations and References;

IIV3, Intramuscular

Fluzone ®* (Sanofi Pasteur)

6-35 mos old

.25 mL

IIV3= Inactivated Trivalent Influenza Vaccine; IIV4= Inactivated Quadrivalent Influenza Vaccine; RIV3= Recombinant Trivalent Influenza Vaccine; LAIV4 Liveattenuated Quadrivalent Influenza Vaccine;

IIV3, Intramuscular

Fluzone ®* (Sanofi Pasteur)

>36 mos old

0.5mL

IIV3, Intramuscular

Afluria®* (CSL Limited)

>9 years old

0.5ML

* Multidose vials contain some thimerosal.

IIV3, Intramuscular

Fluarix® (GlaxoSmithKline)

>3 years old

0.5mL

IIV3, Intramuscular

Flucelvax® (Novartis Vaccines)

> 18 years old

0.5mL

IIV3, Intramuscular

FluLaval®* (ID Biomedical Corporation of Quebec)

>3 years old

0.5 mL

IIV3, Intramuscular

Fluvirin®* (Novartis vaccines)

> 4 years old

0.5mL

IIV3, Intramuscular

FluBlok® (Protein Sciences, RIV3)

18-49 years old

0.5mL

IIV3, Intramuscular

Fluzone® High-Dose

>65 years old

0.5mL

IIV3, Intradermal

Fluzone® Intradermal (Sanofi Pasteur)

18-64 years old

0.1mL

IIV4, Intramuscular

Fluzone ® Quadrivalent (Sanofi Pasteur)

6-35 mos old

.25mL

IIV4, Intramuscular

Fluzone® Quadrivalent (Sanofi Pasteur)

>36 months old

0.5mL

IIV4, Intramuscular

Fluarix® Quadrivalent (GlaxoSmithKline)

>3 years old

0.5mL

IIV4, Intramuscular

FluLaval® Quadrivalent* (ID Biomedical Corporation of Quebec)

>3 years old

0.5mL

References: 1. Grohskopf LA, Olsen SJ, Sokolow LZ, et al. Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP) — United States, 2014–15 Influenza Season. MMWR Recomm Rep. 2014; 63(32):691-697 2. Haber P, Schembri CP, Lewis P, et al. Notes from the Field: Reports of Expired Live Attenuated Influenza Vaccine Being Administered - United States, 20072014. MMWR Morb Mortal Wkly Rep. 2014;63(35):773. 3. Centers for Disease Control and Prevention. Flublok Seasonal Influenza Vaccine: Questions and Answers. Available at: http://www.cdc.gov/flu/protect/ vaccine/qa_flublok-vaccine.htm (Accessed 9/5/2014).

(Sanofi Pasteur)

Pharmacy Marketing Group

Rx and the Law By: Don R. McGuire Jr., R.Ph, JD 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.

MARIJUANA â&#x20AC;&#x201C; MEDICAL OR ?? Marijuana, medical and otherwise, has certainly been in the news for the last several months. As more states legalize marijuana, for medical or recreational use, pharmacists are presented with a unique legal challenge to balance patient needs and legal requirements. It is beyond the scope of this article to examine the literature and clinical research that would support or refute a medical use for marijuana. We will assume there is a legitimate medical use for marijuana, or its components, while we look at the legal question. Some states have passed various laws to address the use of marijuana within their borders. There is not a universal approach. In many states, pharmacists are not involved in the dispensing of medical marijuana. If you were presented with the opportunity to do so, what should you consider? The main question is: how legal is legal? Marijuana remains a Schedule I drug under Federal law. Schedule I drugs are deemed to have no legitimate medical use and have a high potential for abuse. A state has no power to lower this classification. The United States Constitution provides that Federal law is supreme to state law. Generally, states may enact laws that are more stringent than Federal laws, but not more lenient. For example, a state can move a Schedule III up to a Schedule II or move a non-controlled drug into Schedule IV within their borders. But a state is unable to move a Schedule II down to Schedule III. This is a basic tenet in the relationship between Federal and state laws. If this is so, how are the states legalizing marijuana? The answer is a concept called enforcement discretion. This occurs when an agency responsible for the enforcement of a law decides to not enforce that law. An earlier example of this concept was the importation of prescription drugs from 26

Canada. The Food & Drug Administration (FDA) stated that all importation was illegal, but they exercised their discretion and would not prosecute those bringing in these drugs for their own use. In essence, the activity is still illegal, but we choose to do nothing about it. The caveat here is that the agencies always have the ability to change their minds. The Drug Enforcement Administration (DEA) current position is that they have enforcement priorities for marijuana. They are: 1) prevent distribution to minors, 2) prevent revenue from the sale from going to criminal enterprises, 3) prevent diversion from states where it is legal under state law to those states where it is not legal, 4) prevent state-authorized marijuana activity from being used as a pretext for trafficking other illegal drugs or other illegal activity, 5) prevent violence and the use of firearms in the cultivation and distribution, 6) prevent drugged driving and the exacerbation of other adverse public health effects, 7) prevent the growth on public lands, and 8) prevent possession or use on Federal property. The DEA will not take any action in states that have legalized marijuana if the states agree to help with these priorities. Therefore, individuals who possess marijuana for personal use on private property in those states will not face DEA prosecution at this time. Because they do not possess it for personal use, a pharmacist dispensing marijuana is not covered by this exception. A pharmacist would also have to be diligent to make sure their dispensing did not violate one of these enforcement priorities. The DEA has made it clear that it will change its stance if they believe a state is too lax in assisting with their enforcement priorities. So how legal is legal? It is definitely not a rock solid legal foundation. Depending on your point of view, it could be seen as temporarily solid or merely illusory. The uncertainty of this foundation may keep a number of pharmacists from engaging in the dispensing of marijuana. For those who decide to proceed, one would hope that the medical benefit for their patients would far outweigh the risk to the patient and the legal risks for the pharmacist. The actual outcome remains to be seen. ÂŠ Don R. McGuire Jr., R.Ph., J.D., is General Counsel, Senior Vice President, Risk Management & Compliance at Pharmacists Mutual Insurance Company.

Pharmacy Journal of New England • Fall 2014

Financial Forum Pat Reding and Bo Schnurr may be reached at 800-288-6669 or pbh@berthelrep.com.

What Constitutes A “Successful” Retirement? Sustained affluence? Personal growth? A feeling of contentment? How do you know if your retirement is living up to its potential? There isn’t a standard definition of a successful retirement. (Maybe there should be, but there isn’t.) It is interesting to see how different people define it. Maybe income is the yardstick. Make that income replacement. A recent article in Financial Advisor Magazine put it this way: “Successful retirement is defined as the ability to replace current income in retirement.” The Employee Benefit Research Institute, which tracks workplace retirement savings trends in America, defines retirement success in similar, if narrower, terms. To EBRI, “success” equals a combination of Social Security income and 401(k) savings that replace 80% of preretirement income after adjusting for inflation.1,2 Maybe health matters most. Perhaps a successful retirement equates to successful aging – staving off mental and physical decline. In a poll of 768 non-retired investors conducted for the John Hancock Financial Network, 49% of respondents said being healthy best signifies retirement success. (Just 27% said having enough income represented success.) While we’d all like to feel like we are 30 when we reach 80, MarketWatch’s Elizabeth O’Brien notes that physical and mental independence shouldn’t be the only definition of successful aging: “We lionize the person living alone at 95, and while that’s certainly laudatory, we could also celebrate those who remain connected to their communities despite their infirmities, or those who have saved enough to afford whatever care is needed.3,4

learning, via some blend of personal growth and leaving a legacy. Many baby boomers expect nothing less. A successful retirement is ultimately one meeting your expectations. Within months or years after you retire, you will probably consider how things are proceeding – and if your retirement looks something like the life you had in mind or the life you planned for, then you can call it a success. Citations. 1 - fa-mag.com/news/working-with-advisor-important-toretirement--success--study-shows-14074.html [4/25/13] 2 - kiplinger.com/article/retirement/T001-C022-S001automatic-401k-saving-features-no-fail-safe-to-ret.html [5/14/13] 3 - johnhancockfinancialnetwork.com/blog-entry/surveynon-retired-investors [1/11/13] 4 - marketwatch.com/story/successful-aging-protectshealth-and-wealth-2013-05-31 [5/31/13]

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.

________________________________________________

Save the Date Connecticut Pharmacists’s Association Mid Winter Conference Thursday, February 5, 2015 Aqua Turf in Southington

Or maybe our capacity to make a difference or grow matters most. We can make the most of the “second act” in many ways – through service, through adventure, through 27

From the Colleges

University of St. Joseph School of Pharmacy Message from the Dean

Dear Colleagues:

New Appointments:

Sincere salutations from us to you. I am pleased to inform you that the University of Saint Joseph School of Pharmacy has received full accreditation. Our alumni are already positively impacting their various communities through practice and service. I want to express my sincere gratitude and that of the entire School of Pharmacy and University of Saint Joseph for the professional courtesy, encouragement, and support you provided during the entire process. Again, thank

Christine Kohn, Pharm.D., Assistant Professor, Department of Pharmacy Practice and Administration

you! Best, Joseph Ofosu, Founding Dean and Professor, University of Saint Joseph School of Pharmacy

School of Pharmacy Receives Full Accredidation The University of Saint Joseph received word in early July that its School of Pharmacy was awarded full accreditation from the Accreditation Council for Pharmacy Education (ACPE). This completes the final accreditation step for the School, which graduated its first class of Pharm.D. students on May 11, 2014. The University of Saint Joseph School of Pharmacy was founded in 2011 under the leadership of Dean Joseph Ofosu, Pharm.D., R.Ph., and a group of highly-skilled pharmaceutical science and pharmacy practice/administration faculty and staff members. The School is located in the XL Center in downtown Hartford in a 53,000 square foot state-of-the-art facility. With the ACPE accreditation, the University of Saint Joseph School of Pharmacy has completed its full accreditation process, being previously accredited by New England Association of Schools and Colleges (NEASC) and the State of Connecticut.

Dr. Kohn received her Bachelor of Science and Doctor of Pharmacy degrees from the University of Connecticut, where she was an Honors Scholar. She went on to complete a post-doctoral fellowship in Health Economics and Outcomes Research at the University of Connecticut/Hartford Hospital Evidence-Based Practice Center. Dr. Kohn’s research interests center around comparative effectiveness; her work seeks to evaluate the efficacy in medical treatments and interventions, as well as medicine’s impact on quality of life. Corinne Ewing, Pharm.D., R.Ph., Assistant Professor, Department of Pharmacy Practice and Administration Dr. Corinne Ewing completed her Doctor of Pharmacy degree at Massachusetts College of Pharmacy and Health Sciences in Worcester, MA. She also holds a Bachelor of Science degree in Biology from Saint Michael’s College (Colchester, VT). Dr. Ewing’s career has centered on the practice of community pharmacy. Having completed a PGY1 residency program at CVS Caremark, she went on to specialize in Pharmacistadministered immunizations and the promotion of this practice in the retail pharmacy setting. Dr. Ewing continues to practice at Walgreens pharmacy, where her passion for helping patients in diverse and underserved populations is evident. As an Assistant Professor of Pharmacy Practice, Dr. Ewing brings to the University of Saint Joseph her devotion to the practice of community pharmacy, and hopes to inspire that devotion in the next generation of student pharmacists. Associate Director of Admissions: Ms. Meridith Cayer has accepted the position of Associate Director of Admissions at the University of Saint Joseph School of Pharmacy. Ms. Cayer joined the School of Pharmacy four years ago as an Administrative Assistant, became Recruitment Officer and then Senior Admissions Counselor. She earned her Master of Science in Management Degree from University of Saint Joseph in December 2013.

Pharmacy Journal of New England • Fall 2014

Welcome Class of 2017 The Class of 2017 matriculated in August. Eighty-six women and men (69% female) were awarded their White Coats during a ceremony at the Hoffman Auditorium in the Bruyette Athenaeum on the West Hartford Campus. Seventeen states, including Puerto Rico, and 16 countries are represented.

Student Society of Health-System Pharmacy Forms at USJ The University of Saint Joseph School of Pharmacy’s Student Society of Health-System Pharmacy (SSHP) achieved American Society of Health-System Pharmacists Student Society of Health System Pharmacy (ASHP-SSHP) Official Recognition for 2014-2015. The SSHP is an organization of pharmacy students who feel passionately about pharmacy as a clinical profession.

APhA-ASP Receives Grant The student members of the University of Saint Joseph American Pharmacists Association-Academy of Student Pharmacists (APha-ASP) received a grant from the Cardinal Health Foundation for $10,000 for their program, PRxEVENT 2 LEARxN, to help raise awareness in the community about the growing public health issue of prescription drug abuse and misuse as part of the GenerationRx project.

Publications Ezeamuzie CI, El-Hashim AZ, Renno WM, and Edafiogho IO. Antiallergic and Antiasthmatic Effects of a Novel Enhydrazinone Ester (CEE-1): Inhibition of Activation of Both Mast Cells and Eosinophils. Journal of Pharmacology and Experimental Therapeutics, 350, 444-454, (August 2014). Qaddoumi MG, Ananthalakshmi KVV, Phillips OA, Edafiogho IO, and Kombian SB. Evaluation of anticonvulsant actions of dibromophenyl enaminones using in vitro and in vivo seizure models. PLOS ONE 9, issue 6, 1-10, e99770, (June 2014). Laskey D, Pharm.D. wrote a featured article entitled “The Proof is in the Gunpowder” for The History of Pharmacy SIG newsletter (May 2014).

The new class begins at University of St. Joseph.

Vadlapatla R, Kaur S, Zhao Y. Evaluation of student perceptions of concept mapping activity in a didactic pharmaceutics course, Currents in Pharmacy Teaching and Learning, 6, 543–549 (April 14, 2014). Edafiogho IO, Qaddoumi MG, Ananthalakshmi KVV, Phillips OA, and Kombian SB. Synthesis, neuronal activity and mechanisms of action of halogenated enaminones. European Journal of Medicinal Chemistry, 76, 20-30 (April 9, 2014).

Posters and Presentations DeGennaro L, Pharm.D. , BCPS, CDE: “Implementation of a Bariatric Surgery Medication Management Service in a Community Hospital Weight Management Center”, presented at the American Association of Colleges of Pharmacy Annual Meeting, Grapevine, Texas July 26, 2014. Edafiogho I, Ph.D., Pharm.D., R.Ph.: “Anticonvulsant activity of some cyclohexenone enaminones” presented at the American Association of Colleges of Pharmacy Annual Meeting, Grapevine, Texas July 26, 2014. Hattoy S, Pharm.D., BCPS, CGP: “Choose Your Own Adventure: a Reader–based Plot Selection Method for Patient Group Activities” presented at the American Association of Colleges of Pharmacy Annual Meeting, Grapevine, Texas July 26, 2014. Henkel J, Ph.D.: “Changing Answers on Multiple Choice Assessments: Does It Affect Students’ Test Scores?”, presented at the American Association of Colleges of Pharmacy Annual Meeting, Grapevine, Texas July 26, 2014. Vadlapatla R, Ph.D., Zhao, Y and Soldato, D, Ph.D.: “Evaluation of Student Perceptions about Blended Flipped Classroom Model in a Pharmaceutics Course”, presented at the Childress 29

From the Colleges

continued

Association of Colleges of Pharmacy Annual Meeting, Grapevine, Texas July 26, 2014. Vadlapatla R, Ph.D., Rehman A, and Edafiogho I, Ph.D.: “Determination of Physicochemical Properties of Novel Anticonvulsant Compounds Using Simultaneous Thermal Analyzer”, presented at the American Association of Colleges of Pharmacy Annual Meeting, Grapevine, Texas July 26, 2014. Farrokh S, Pharm.D., BCPS: “Characterization of Atypical Antipsychotic Prescribing Practices in the Treatment of intensive Care Unit Delirium”, 4th Annual Meeting of the American Delirium Society, June 2, 2014. Hattoy S, Pharm.D., BCPS, CGP, Eisenhower C: New Drug Update at the Schwarting Senior Symposium, Aqua Turf Club, Plantsville, CT May 13, 2014 Matusik B, Pharm.D., BCPS: Novel Anticoagulants in the Elderly at the Schwarting Senior Symposium, Aqua Turf Club, Plantsville, CT May 13, 2014

Interns Pre and Post Nutrition Support Lecture”. American Society of Perenteral and Enteral Nutrition (ASPEN) Clinical Nutrition Week, Savannah, Georgia, January 18-21, 2014. Childress BC, Hattoy S: “Don’t be Afraid of the Big, Bad Wolf: How to Lead a Journal Club”. American Society of Consultant Pharmacists 2013 Annual Meeting and Exhibition, Seattle, Washington, November 19-23, 2013

Certifications/Appointments Drs. Lisa DeGennaro and Stephanie Hattoy have obtained the Board Certified Pharmacotherapy Specialist (BCPS) credential. Dr. Lisa DeGennaro achieved certification in Physical Assessment in Patient Care Management from Nova Southeastern University. Dr. Dayne Laskey was appointed to the Institutional Review Board at the UCONN Health Center in Farmington, CT.

Tenison E, Douglas J, Stokes M, Lawrence M: “Perceptions and attitudes Surrounding Pharmacy Students and dietetic

Massachusetts College of Pharmacy and Health Sciences – Boston Dear Colleagues, On behalf of President Charles F. Monahan Jr. and Provost Douglas Pisano, I bring you greetings from the School of Pharmacy Boston at MCPHS University. I trust that all of our colleagues, friends, and alumni are doing well. Since I last wrote you in the spring many changes have occurred in the School of Pharmacy on the Boston campus. We have launched some new academic programs and students have been very busy with their courses, labs, and rotations. Our faculty continues to make important contributions in the field both as teachers and researchers.

I would also like to express my personal thanks to all of you for what you do every day out there and for being such wonderful role models for our students as they strive to become the next generation of practitioners. The following are some of the highlights that have occurred since my update in the previous issue of the New England Journal of Pharmacy. Sincerely, Paul DiFrancesco EdD, MPA, RPh, Dean, School of Pharmacy Boston

Pharmacy Journal of New England • Fall 2014

Preceptor Appreciation Day Held in September On September 11, more than 225 adjunct preceptors for MCPHS University gathered for the Office of Experiential Education’s annual Preceptor Appreciation Day at the Doubletree Hotel in Westborough, Mass. The program offered five hours of credit and included presentations on drug tampering, interprofessional education, a preceptor skills session, and updates in experiential education. All who attended enjoyed a day of learning, networking, and the sharing of ideas with their colleagues. Preceptors of the Year Awards were presented to seven preceptors for their outstanding achievements as preceptors. I would like to congratulate the following award winners: Nelson Caetano – Target Pharmacy Watertown, MA Neil Gilchrist – UMASS/Memorial Medical Center Worcester, MA Cecilia Gorospe – VA Healthcare Bedford, MA Judy Magalhaes – Steward Good Samaritan Medical Center Brockton, MA Michaelene McAuliffe – CVS Caremark Specialty Pharmacy Milford, MA James McQuaid – Maine Veterans Home Pharmacy Augusta, ME Andrew Mita – Price Chopper Pharmacy Worcester, MA

Faculty Activities Catherine Taglieri, PharmD, Assistant Professor of Pharmacy Practice, has been appointed as the Associate Editor of the History of Pharmacy Special Interest Group (SIG) newsletter. The SIG’s mission is based on the idea that the history of pharmacy profession is relevant to all pharmacy practice areas, both current and future. The SIG facilitates the exchange of ideas among pharmacy faculty, providing information and resources for teaching, learning and scholarship pertaining to the evolution and history of the pharmacy profession. The newsletter seeks to publish interesting and informative articles that celebrate the history of pharmacy. For an electronic pdf copy of the Newsletter, please visit: http://www.aacp.org/governance/SIGS/history/Pages/ HistoryofPharmacyNewletters.aspx MCPHS University-Boston has a new co-funded residency in collaboration with Greater Lawrence Family Health Center that began on July 1, 2014. This is the eleventh collaborative site that is partnering with the University in fourteen programs consisting of PGY-1 and PGY-2 residencies, and clinical fellowships. There are a total of 30 post-graduate participants in these programs for the 2014-15 academic year. MCPHS University-Boston received notice from the ASHP Commission on Credentialing that all three of its co-funded residency programs were fully reaccredited. Receiving full six year-accreditation were the Beth Israel Deaconess Medical Center/MCPHS University-Boston PGY-1 Residency, the Atrius Health/MCPHS University-Boston PGY-1 Residency, and the Walgreens/ MCPHS University-Boston Community Pharmacy Practice PGY-1 Residency. MCPHS University-Boston presented a poster at the AACP Annual Meeting in Dallas, Texas on July 27 entitled “Collaboration of MCPHS-University-Boston with Students and Community Organizations to Promote Safe Medication Use in Seniors” Authors: Amee Mistry, PharmD, Dhiren Patel, PharmD, Catherine Taglieri, PharmD and Michael Carvalho, PharmD.

Preceptor Award Winners

From the Colleges

continued

MCPHS University Expands Fellowship programs The Boston and Worcester/Manchester campuses have expanded their Fellowship programs. MCPHS presently has three categories of PharmD postgraduate Fellowship Programs: Biopharmaceutical Industry, Academic, and Traditional. The Industry-sponsored fellowship program is the second largest program in the country with 38 biopharmaceutical fellows with six sponsor companies. The academic fellowships are associated with nationally ranked Institutions in the Boston and Worcester areas including Children’s Hospital, St Vincent’s Hospital, and the Brigham and Women’s Hospital. Our tradition fellowships are aligned with compounding pharmacies and a Geriatric Outreach program. The Fellowship programs allow for PharmD students to gain the next level of training in specific areas of Pharmacy practice. Our programs are robust, attract a large number of candidates from across the country and are expanding on an annual basis. MCPHS University sponsors a number of Summer Internship programs which allows selected undergraduate students to work with the Universities faculty to enhance their research skills during the summer. Starting this coming summer the University will be expanding their program to allow students to work at the Center for Biomedical Informatics at Harvard University. This coincides perfectly with our new bachelor’s degree program in Bio-informatics at the Boston campus.

MCPHS Fellows

Pharmacy Journal of New England • Fall 2014

Massachusetts College of Pharmacy and Health Sciences – Worcester/Manchester The faculty and staff are excited to welcome 254 P1s to the Worcester campus and 58 P1s to the Manchester that comprise the class of 2017. It is wonderful to experience the fresh energy that the new students bring as it helps reenergize the faculty as they begin the new academic year. I hope that everyone has a successful semester.

Grant Awards Dr. Chase Smith received a $2,000 grant from Mcule Inc to fund a research project titled “Evaluation of the bromophycolides as potential protease Inhibitors of the hemoglobin to hemozoin formation in Plasmodium falciparum.” Funding Period: 5/2014- 7/2014.

All the best, Michael J. Malloy, PharmD, Dean and Professor

Awards Dr. Timothy Aungst received the “Gamechanger” Award for his submission “Bringing the Doctor to the Patient’s Home: Google Glass in VNA Care.” He was the only pharmacist among the 13 finalists in Medtech Boston’s Google Glass Challenge. Dr. Aungst presented his idea of using Google Glass in the home health care environment in a “pitch off” at the Google Campus in Cambridge, MA on April 23.

Dr. Chase Smith

Dr. Helen Pervanas received a $2,270.77 MCPHS Faculty Development Grant to fund a research project titled “Assessment of an interactive role-play activity to increase awareness about drug and alcohol abuse in the adolescent population.” Funding Period: 1/2014-6/2014.

Presentations Podium Presentations LaMothe A, Horton E, Knee A, Kopcza K, Grewal S. Incidence and risk factors for hospital-acquired venous thromboembolism in pediatric patients. 2014 Eastern Society for Pediatric Research Annual Meeting. Philadelphia, PA. March 23, 2014. Poster Presentations

Dr. Timothy Aungst

Crall W, Cheng S, Nguyen B, Dang C, Campbell R. Development of ceramide liposomes for tumor interstitial and vascular drug targeting. American Association for Cancer Research (AACR) Annual Meeting. April 2014. San Diego, California. 33

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Alkholief M, Campbell R. An evaluation of the role of mucin in nano drug delivery. American Association for Cancer Research (AACR) Annual Meeting. April 2014. San Diego, California.

Publications

research, they were able to address recent concerns regarding prescription drugs that are increasingly being abused by patients and individuals in the country. Training pharmacy students about â&#x20AC;&#x2DC;drugs of abuseâ&#x20AC;&#x2122;

Zheng X, Baumeister T, Buckmelter AJ, Caligiuri M, Clodfelter KH, Han B, Ho Y, Kley N, Lin J, Reynolds DJ, Sharma G, Smith CC, Wang Z, Dragovich PS, Oh A, Wang W, Zak M, Wang Y, Yuen P, Bair KW. Discovery of potent and efficacious cyanoguanidine-containing nicotinamide phosphoribosyltransferase (Nampt) inhibitors. Bioorg Med Chem Lett.

Link: telegram.com/article/20140504/NEWS/305049923/0/SEARCH

2014;24(1):337-43.

Promotions

Ying B and Campbell R, Delivery of kinesin spindle protein targeting siRNA in solid lipid nanoparticles to cellular models of tumor vasculature. Biochem Biophys Res Commun. 2014;446:441-47.

Welcome Back, Dr. Chase Smith! Last year, Dr. Chase Smith was sent as an Individual Augmentee as part of the Combined Joint Task Force -- Horn of Africa (CJTF-HOA) to Camp Lemonnier, Djibouti. The CJTFHOA supports partner nation military operations in East Africa to defeat violent extremist organizations, conducts focused military-to-military engagement to strengthen East African partner nation militaries, and conducts crisis response and personnel recovery in support of U.S. military, diplomatic, and civilian personnel throughout East Africa in order to protect and defend the national security interests of the United States. As part of this, Dr. Smith served as the Djibouti Country Engineer where he was responsible for the oversight of multiple humanitarian aid projects involving the construction of Schools, Medical Clinics and also water distribution systems to mostly remote regions of Djibouti. We are proud of the work that Dr. Smith has done, and are happy to have him back at MCPHS University.

In the Spotlight: Drs. Evan Horton & Matthew Metcalf Recently, Drs. Horton and Metcalf were interviewed by the Worcester Telegram & Gazette about the nature of prescription drug abuse and training future pharmacists on the topic. 34

Due in part to their interests and specialty practice and

The key to the prescription drug abuse fight. Link: www.telegram.com/article/20140504/NEWS/305049921/0/ SEARCH

Dr. Cheryl Abel, promoted to Associate Professor of Pharmacy Practice Dr. Maryann Cooper, promoted to Associate Professor of Pharmacy Practice Dr. Cheryl Durand, promoted to Associate Professor of Pharmacy Practice Dr. Carolyn Friel, promoted to Professor of Pharmaceutical Sciences Dr. Linda Spooner, promoted to Professor of Pharmacy Practice Dr. Michael Steinberg, promoted to Professor of Pharmacy Practice

Class of 2013 NAPLEX Results (First-time Attempts) SOP-W/M pass rate 90.08% (n=252) National pass rate 95.87% (n=12,702)

Pharmacy Journal of New England • Fall 2014

Northeastern University Grants: Life never really slows down in the summer at the School of Pharmacy. While our firstyear students were becoming immersed in our profession on their first co-ops, the rest of our students had full schedules of classes. Our faculty were engaged in their teaching and research, as well as attending conferences where they disseminated their scholarship and represented our program with their colleagues. The summary of our grants and publications below will give you a picture of just how busy we are over the summer months. The transition into fall is an exciting time on any university campus. New students, faculty and staff are joining us, while campus life ramps up with the promise of new opportunities for the coming year. We’d be excited to have you visit us in Boston. As I transition into my new role as acting Dean, I look forward to meeting you and hearing your thoughts about what we can do to keep the School of Pharmacy great for many years to come. Please contact us at schoolofpharmacy@neu.edu or visit us at the New England Pharmacists Convention, the ASHP Midyear Meeting, or other local events. David Zgarrick, PhD, FAPhA Acting Dean and Professor

Faculty News Recent Honors and Recognitions:

Becky Briesacher, PhD, awarded $1,899,846 grant from the NIH-R01 for her work entitled “Gaps in Medicare Part D SelfEnrollment & Nursing Home Residents.” Becky Briesacher, PhD, awarded $1,356,128 grant from the NIH-R01 for her work entitled “Changes in Cardiovascular Care and Outcomes in Eight Years after Medicare Part D.” Margarita DiVall, PhD, Michael Gonyeau PhD, RPh, FCCP, BCPS, Jennifer Kirwin, PhD, BCPS, Jenny Van Amburgh, PhD, CDE, PBS, David Zgarrick, PhD, FAPHA, awarded $10,000 grant, Provost Office, Northeastern University, 2014-2015 for Using ExamSoft assessment software to improve teaching and learning in the Doctor of Pharmacy program. Professor Jong-han Kim, PhD, awarded $50,000 Northeastern University TIER 1 Interdisciplinary Grant for his work in “Immune Complex Elimination by Sinusoid Endothelial FcgRIIb: Mechanism and Disease” Selenium, An Essential Anti-Oxidant Metal, and Cognitive Function in the Elderly. Michail Sitkovsky, MS, awarded $25,000 by DFCI/NU Joint Program in Cancer Development for his work entitled” Chemical Modifications and Preclinical Studies to Repurpose A2A Adenosine Receptor Antagonists from Parkinson ’s Disease to Immunotherapies of Cancer.” Ganesh Thakur, PhD, awarded $2,394,550 by the NIH/NEI-RO1 grant for his work in “Novel Pharmacotherapy for Glaucoma.” Also awarded $160,707 from the NIH/NIMH- SBIR Grant Subcontract for his work entitled “Treatment of Posttraumatic Stress Disorder.”

Publications

Steven Leonard, PhD, Assistant Professor of Pharmacy, received the Society of Infectious Diseases Pharmacists Young Investigator Award in September 2014.

Edwards RA, Kirwin J, Gonyeau M, Matthews J, Lancaster J, DiVall M. A Reflective Teaching Challenge to Motivate Educational Innovation and Improve Teaching and Learning. American Journal of Pharmaceutical Education. 2014; 78 (5)

Recent Hires and Promotions:

Article 103.

Becky Briesacher, PhD, joins Northeastern as Associate Professor in the Department of Pharmacy Practice

Law AV, Bottenberg MM, Brozick AH, Currie JD, DiVall MV, Haines ST, Jolowsky C, Koh-Knox CP, Leonard GA, Phelps SJ, Rao DA, Webster A, Yablonki E. A Checklist for Faculty Mentorship Programs. American Journal of Pharmaceutical 35

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Education. 2014; 78 (5) Article 98. DiVall MV, Kolbig L, Carney M, Kirwin J, Letzeiser C, Mohammed S. Interprofessional socialization as a way to introduce collaborative competencies to first-year health science students. Journal of Interprofessional Care, Published online May 14, 2014 http://informahealthcare.com/doi/abs/1 0.3109/13561820.2014.917403 Jason W. Lancaster, PharmD, MEd, Susan M. Stein, MS,Linda Garrelts MacLean, BPharm, Jenny Van Amburgh, PharmD, and Adam M. Persky, PhD. Faculty Development Program Models to Advance Teaching and Learning Within Health Science Programs. American Journal of Pharmaceutical Education 2014; 78 (5) Article 99. Roger A. Edwards, ScD, Jennifer Kirwin, PharmD, Michael Gonyeau, PharmD, MEd, S. James Matthews, PharmD, Jason Lancaster, PharmD, MEd, and Margarita DiVall, PharmD, MEd. A Reflective Teaching Challenge to Motivate Educational Innovation. American Journal of Pharmaceutical Education 2014; 78 (5) Article 103 Barbara Waszczak, PhD, BT Harmon, AE Aly, L Padegimas, O Sesenoglu-Laird, MJ Cooper. Intranasal administration of plasmid DNA nanoparticles yields successful transfection and expression of a reporter protein in rat brain. Gene Therapy (2014) 21, 514-521, Macmillian Publishers Limited 2014; Published online March 27, 2014.

R. Ortiz, S. Dye, R.B. Campbell. Neurotrophic and Neuroprotectuve /Efficacy of Intranasal GDNF in a Rat Model of Parkinson’s Disease. Neuroscience 2014. 274, 11-23. Published online May 17, 2014. Samuel T. Edwards, MD, Julia C. Prentice, PhD, Steven R. Simon, MD, MPH, Steven D. Pizer, PhD. Home-Based Primary Care and the Risk of Ambulatory Care-Sensitive Condition Hospitalization Among older Veterans with Diabetes Mellitus. JAMA Internal Medicine. Published online September 15, 2014. Hatfield SM1, Kjaergaard J, Lukashev D, Belikoff B, Schreiber TH, Sethumadhavan S, Abbott R, Philbrook P, Thayer M, Shujia D, Rodig S, Kutok JL, Ren J, Ohta A, Podack ER, Karger B, Jackson EK, Sitkovsky M. Systemic oxygenation weakens the hypoxia and hypoxia inducible factor 1α-dependent and extracellular adenosine-mediated tumor protection. J Mol Med (Berl). 2014 Aug 15. Mark L. Yorra, EdD. Self- Efficacy and Self Esteem in Third-Year Pharmacy Students. American Journal of Pharmaceutical Education 2014; 78 (7) Article 134. Published September 15, 2014. Zgarrick DP. Social psychology in an evolving profession: A research agenda for advancing clinical pharmacy services. Research in Social and Administrative Pharmacy 10 (2014) 701-703.

Barbara Waszczak, PhD, Mansoor Amiji, PhD, M.M. Migliore,

Northeastern University Hosts International Social Pharmacy Workshop The 18th ISPW was held at Northeastern University from August 5-8, 2014. The ISPW provides valuable networking opportunities that facilitate collaborations across institutions, systems, and international boundaries. The 2014 conference theme was “The Changing Face of Pharmacy: Engaging across Professions to Advance Health in our Communities.” Northeastern hosted 170 guests for representatives from 29 countries, and featured over 175 research posters, podium and workshops presented. Participants learned about innovative social science research tools and approaches to study pharmacy practice and education. The conference also featured a Teachers Seminar on August 7 that focused on topics 36

related to social pharmacy education. Two plenary sessions featured international experts in patient safety and interprofessional practice and education. One plenary session featured Dr. Barbara Brandt, Associate Vice President of Education at the University of Minnesota’s Academic Health Center. Dr. Brandt serves as Director of the National Center for Interprofessional Practice and Education and is internationally known for her work in health professional education in general and the specific focus in interprofessional education.

Pharmacy Journal of New England • Fall 2014

Another plenary session was given by Dr. Byony Dean Franklin from the Center for Medication Safety and Service Quality of the Imperial College Healthcare NHS Trust, who talked about medication safety. “We were honored to be a part of wonderful opportunity to interact with scholars from around the world on such important topics as medication safety, pharmacy education, patient outcomes, interprofessional health care and a myriad of topics focused on extending pharmacist services around the world. We had a great time networking and learning about one another. Northeastern University was fortunate to be chosen to host this biennial conference as it had not been held in the US since 1194 and was selected through a competitive process. It was a memorable event for all and we look forward to staying connected with our international colleagues,” stated Co-Chair of the 18th ISP, Dr. Nate Rickles. Attendees gathered for a celebratory closing dinner in the

historic John F. Kennedy Presidential Library and Museum overlooking the scenic Boston Harbor. A full listing of events, presentations, and registration information can be found on the conference’s website: http://ispw2014boston.org. For questions or further information, contact Co-Chair of the 18th ISPW, Dr. Nate Rickles at n.rickles@neu.edu.

Northeastern Students Participate in Oral Health Outreach Event

Pictured above is P2 student Anthony Zaki (3rd from right) and P3 students Lucy West and Alycia Gelinas (2nd and 3rd from left) at Susan Bailis Assisted Living with PA students and faculty members from universities around the country.

Continuing Pharmacy Education For more information on our ongoing programs, please visit our website: http://www.rxce.neu.edu

On May 27, 2014 members of Northeastern University’s Phi Lambda Sigma Gamma Kappa Chapter participated in an interprofessional oral health outreach event. Faculty from nursing, dental, and physician assistant programs at universities in Boston and New Jersey organized the event and kindly welcomed participation from students in the School of Pharmacy Bouve College of Health Sciences. The outreach activities occurred throughout the day at three different sites across the city including Boston Health Care for the Homeless, Susan Bailis Assisted Living, and Cambridge Senior Center. At each site students from all areas of study came together to share information on how to maintain good oral health and handed out toothbrushes and toothpaste to community members. The PLS Gamma Kappa Chapter designed a handout on oral health topics including dry mouth and the importance of smoking cessation along with an interactive flashcard game to contribute to the event. The day was a success and a great opportunity for Bouve College of Health Sciences pharmacy students to provide education and engage with the Boston community while also collaborating with and learning from nursing and physician assistant students and faculty. 37

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University of New England UNE Holds White Coat Ceremony UNE’s College of Pharmacy formally welcomed the class of 2018 at the annual White Coat Ceremony on Saturday, September 27. The ceremony was preceded on Friday by an open house, showcasing the wide variety of campus organizations that are available and eager for new student participation. Associate Dean of Student Services, Jean MB Woodward, began the event by highlighting the White Coat’s significance. “White Coat Ceremonies have been used by Schools of Medicine and Pharmacy as an outward sign of a personal commitment to the profession. The White Coat has had a long association with all things medical, scientific, and healing. It is also associated with the attributes of purity and goodness.” Woodward continued with an explanation of the responsibilities and expectations that accompany a profession in patient care. “The profession of pharmacy is one that demands adherence to a set of ethical principles. These high ideals are necessary to ensure the high quality of care our patients entrust us to provide. It is a privilege to be involved with patient care, and with privilege comes many responsibilities.” The first keynote speaker was Alex J. Adams, PharmD, Vice President of Pharmacy Programs for the National Association of Chain Drug Stores (NACDS). He leads the research efforts of the NACDS Foundation, focusing on pharmacy-based

point-of-care testing, medication adherence interventions, and pharmacy services following hospital discharge. Dr. Adams advised students to understand and respect their critical roles in the future of pharmacy. “We must practice every day at the top of our education and the top of our training, not the bottom of our licenses. I don’t know about you but I am fired up about the profession of pharmacy. So, while the times around us are challenging, the opportunities are certainly invigorating.” Jennifer Adams, PharmD, EdD, also joined as keynote speaker. Dr. Adams serves as Senior Director of Strategic Academic Partnerships at the American Association of Colleges of Pharmacy. In this role, she acts as a leader for association partnership development, and oversees national student affairs activities such as PharmCas, PCAT, and student recruitment. At the ceremony, Dr. Adams discussed what it means to be a professional, especially as student pharmacists, “Learn from the both the positives and the negatives that you will experience, and remember that professionalization is a lifelong process that will occur throughout your career.” Alumna Michelle O’Meara, PharmD ’14 wrapped up the speakers’ remarks with sage words of advice, “So remember: get to know your professors, treat every rotation like it’s an interview, and be a team.” Congratulations, and welcome to the Class of 2018!

A UNE students dons a white coat during the ceremony.

Pharmacy Journal of New England • Fall 2014

Awards and Honors Emily Prescott receives Vermont Society of Health-System Pharmacist’s scholarship Emily Prescott, doctor of pharmacy candidate in the class of 2016, is the recipient of the 2014 Vermont Society of HealthSystem Pharmacist’s scholarship award. Emily’s passion for pharmacy and involvement with improving the health care of patients, as well as her scholastic excellence makes her a worthy recipient of this year’s scholarship award. She is the current UNE chapter president of the Student Society of Health-System Pharmacy.

Three pharmacy students receive awards from National Pharmaceutical Association Foundation Three doctor of pharmacy candidates were presented awards by the National Pharmaceutical Association Foundation at the Student National Pharmaceutical Association (SNPhA) national conference in Arlington, Virginia. Winnifred Ampomaah (’16) received the Ms. Ramona McCarthy Hawkins book award. Kendra Ednacot (’15) received the Dr. Craig and Saundra Ruffin Endowed Scholarship and was named runner up for the Rite Aid Community Leader Award. Emily Erpenbeck (’16) was awarded second place for the Walmart/National Pharmaceutical Association Future Leaders in Pharmacy Award. The Mission of the National Pharmaceutical Association Foundation is to support the activities of the National Pharmaceutical Association, including education programs, research projects, and innovative pharmacy practices. Furthermore, the National Pharmaceutical Association Foundation provides scholarships to minority and underserved students that are members of the Student National Pharmaceutical Association.

George Allen and four pharmacy students present at ICAAC in Washington, D.C. George Allen, Pharm.D., associate professor in the College of Pharmacy, and pharmacy students Greta Astrup, Jessica Dizon, Lindsey McIver, and Donna Park, all of the class of 2015, gave a poster presentation at the 54rd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), which was held in Washington, D.C., September 5-9, 2014. The poster was titled “In Vitro Evaluation of Antimicrobial Combinations against Fluoroquinolone-Resistant Neisseria gonnerrhoeae. “ The research arose from independent study coursework that was performed primarily during the spring 2014 semester. ICAAC, the premier conference on antimicrobial agents and infectious diseases, showcases the latest-breaking science and lectures from top researchers from around the world. With 50 percent of its attendees living outside of the United States, ICAAC provides a rare opportunity to bring together the field’s foremost leaders to discuss the state of infection control and prevention on a global scale.

Two SSHP members join ASHP Pharmacy Student Forum advisory groups Two members of the UNE Student Society of Health-System Pharmacists (SSHP) chapter, Elenna Kuhn, fourth-year Pharm.D. candidate, and Ashley Woon, second-year student, have been appointed to the American Society of HealthSystem Pharmacists’ (ASHP) Pharmacy Student Forum advisory groups for 2014-15. Kuhn is a member of the Career Development and Education Advisory Group and Woon is a member of the Community and e-Communications Advisory Group. The UNE SSHP chapter has had at least one member represent the College of Pharmacy on this national level every year since its inception in 2009. The ASHP Pharmacy Student Forum has six advisory groups that provide advice and guidance to the Forum regarding the unique needs of student members and how these needs might be addressed by the provision of resources and programs by ASHP.

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Pharmacy students participate in cultural exchange with University of Granada in Spain UNE’s College of Pharmacy students have a unique opportunity to participate in a global immersion experience. The young UNE College of Pharmacy, established 2008, has partnered with one of the oldest and most prestigious universities in Europe, University of Granada in Spain, in an academic exchange. The exchange allowed seven College of Pharmacy students to spend several weeks immersed in the Spanish culture, language and healthcare system in May and June of 2014. While in Granada, students live with host families who provide housing, meals, and, most importantly, a support system for learning the culture and language. The first two weeks of the experience are spent exploring the Spanish language at the University of Granada Modern Language Centre. In addition to intensive study of language, students attend lectures, visit community and hospital pharmacies, a pharmaceutical distribution company, and the Andalusian Public Health Center.

One program participant from the class of 2015 stated, “I believe that I have learned much about myself during this rotation, in addition to patient care skills. We were all challenged in one way or another and had to deal with both language and cultural barriers. I believe from this we have all learned to be more empathetic to the patients that we serve and try to understand where they are coming from.” The University of New England educates its graduates to be competent global citizens, inspired by the work ethic of Maine, traditions of the United States, and knowledge of the world’s cultures. The global exchange program with the University of Granada helps UNE students become globally aware before becoming practitioners.

An important aspect of the course is daily recitation sessions and writing/reflection exercises during which students integrate and discuss concepts relating to current events, European versus United States healthcare policy, as well as the impact of culture on healthcare decisions and policy making. Recitations are led by UNE faculty who accompany the students to Spain.

UNE College of Pharmacy’s George Allen selected for AACP Academic Leadership Fellows Program The American Association of Colleges of Pharmacy (AACP) has invited George Allen, Pharm.D., associate professor in the Department of Pharmacy Practice, to participate in its 20142015 AACP Academic Leadership Fellows Program. The program is an intensive national leadership and management development program designed to cultivate the nation’s most promising AACP pharmacy faculty members to become future leaders in pharmacy and in higher education. Allen was one of just 30 Fellows nationwide chosen to participate, and the first from the UNE College of Pharmacy. The four-session program includes in-depth leadership develop40

ment; team building, exploration of legislative and public policy issues critical to pharmaceutical and higher education; and self and peer assessments. In addition to the four sessions in residence, Fellows participate in a collaborative group project.

Dr. George Allen

Pharmacy Journal of New England • Fall 2014

Presentations, Publications and More Karen Houseknecht publishes research in ‘Journal of Medicinal Chemistry’ Karen Houseknecht, Ph.D., professor of pharmacology in the College of Pharmacy, in collaboration with Tobin Dickerson (Scripps Research Institute, San Diego) and Garry Smith (Fox Chase Chemical Diversity Center, Doylestown, Pennsylvania), has published the research paper “Identification of clinically viable quinolinol inhibitors of botulinum neurotoxin A light chain” in theJournal of Medicinal Chemistry. Clostridium botulinum neurotoxin serotype A is the most potent toxin known to man and is considered a potential bioterrorism weapon due to its extreme toxicity and ease of production. Despite significant research efforts in the field, there is currently no available therapeutic to treat botulinum toxin poisoning, largely due to chemical properties that are not amenable for human dosing and drug exposure. The research published in this paper highlights the findings of this NIH-funded multi-site, interdisciplinary research team to identify potent inhibitors with physicochemical properties that are amenable for oral dosing and proof-of-principle studies. Christian Teter serves as grant application reviewer for CDC Christian J. Teter, PharmD, BCPP, associate professor of psychopharmacology for the College of Pharmacy, recently served as a grant application peer reviewer for the Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control. He was a member of the Special Emphasis Panel formed to review grant applications submitted for a funding opportunity announcement titled “Research on Integration of Injury Prevention in Health Systems.” Greta Astrup, a pharmacy student in the class of 2015, led a group of UNE Student Society of Health-System Pharmacy (SSHP) members in the design of a program that was selected by the Pharmacy Student Forum’s Student Society Development Advisory Group as an example of SSHP Best Practices. SSHP members have unique opportunities to share expertise with students from other universities and colleges through a

resource called Share and Reapply. This tool, according to the American Society of Health-System Pharmacists (ASHP) website, provides “ideas and projects that have been implemented by student societies on their campuses along with steps to follow to reapply the program” on other campuses. Astrup’s project, “Establishing an Interprofessional Collaboration between Graduate Students of Various Disciplines,” is published online at the ASHP website. Vesna Kravljaca works with Karen Houseknecht to research sleep deficiency and ADHD As part of her elective coursework in the doctor of pharmacy program, Vesna Kravljaca ‘15 worked with Karen Houseknecht, Ph.D., professor of Pharmacology & Drug Metabolism on an independent study of Sleep Deficiency and ADHD. The study not only allowed Kravljaca to participate in a student–faculty research project but enabled her to participate in the spring 2014 Student Research Symposium as well, where she presented a poster and educational brochure written for all audiences. Steev Sutton presents at Controlled and Modified Drug Release Conference Steven “Steev” Sutton, Ph.D., associate professor and chair of the Department of Pharmaceutical Science, presented at the Controlled and Modified Drug Release Conference in Philadelphia in May, 2014. The topic of his presentation was “Predictive Animal Models for Assessing Long-Acting Formulations for Human and Animal Health.” Sutton presented along with distinguished speakers from institutions such as: Janssen Research and Development, Novartis and Johnson & Johnson. According to event host Curtis & Coulter LLC, the conference was designed to connect participants with industry innovators specializing in controlled and modified drug release. Sutton also presented at the kickoff workshop “Predicting and Mitigating the Food Effect on Bioavailability” as part of the 2nd Drug Formulation and Bioavailability West Conference in San Diego in June, 2014.

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University of Rhode Island Alex and Ani donates $1 million to URI Gift to support natural product research in the College of Pharmacy

A new $1-million donation to the University of Rhode Island from Alex and Ani, LLC will support natural product research and the discovery of plant-based molecules to improve human well-being. In recognition of the generous gift, the University will name a research lab in the $75 million, stateof-the-art College of Pharmacy building on the Kingston campus, the Alex and Ani Impact Lab. “We are excited to have an association with a leading Rhode Island and world-class brand like Alex and Ani,” said URI President David M. Dooley. “With our faculty, and our undergraduate and graduate students all contributing to ever expanding possibilities for research, innovation and discovery in this lab, we are confident that the internationally recognized work being conducted here will have a positive impact on our university as well as the state’s economy. We are grateful to Alex and Ani for its support of the University of Rhode Island.” “The University of Rhode Island is one of the crown jewels of our state, as it educates our children, drives local economic development, and conducts ground-breaking research to improve the lives of Rhode Islanders,” said Carolyn Rafaelian, founder, creative director, and CEO of Alex and Ani. “We are honored to be able to support such important initiatives that will positively impact not only the URI students but the people living in our beloved state as well.” Dooley noted that the gift will name an existing lab operated by Biomedical Sciences Professor David Rowley within the Pharmacy building, a 144,000 square-foot, five-story structure that opened on the Kingston campus in September 2012. Built to support pharmaceutical teaching and research, it is the largest academic building at URI and is home to the University’s highly competitive and acclaimed pharmacy program.

“The Alex and Ani gift will enhance the work being done in the lab, such as natural product research and discovery of plant-based molecules for the purpose of improving human health,” according to E. Paul Larrat, interim dean of the College of Pharmacy. It could also support research being translated into products created for commercial use. “This gift will enhance the capability of the laboratory,” said Rowley, who is now working with Ocean Spray to research the beneficial compounds in cranberries. “This will expand the scope and quality of the research being done here, which will ultimately benefit undergraduate and graduate students.” “The discoveries made by researching these molecules could have far reaching effects both at the early discovery phase and at the end use phase, including product usage,” added Larrat.

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MPhA Student Members: Apply for a 2015 Scholarship! Scholarships will be awarded at MPhA’s Spring Conference on April 30, 2015. To apply, download an application from www.masspharmacists.org and go to the Foundation page. Applications are due January 31, 2015.