PJNE winter 2016

Vol 13 No. 1 Winter 2016

Winter 2016

Pharmacy Journal of New England

Opioid Managment Initiative by a State Medicaid Program Disclosures of PHI: Rx and the Law A Pharmacy that Offers Free Medicine? It’s True!

Connecticut Mid-Winter Conference Photos Inside

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Pharmacy Journal

Vol 13 No. 1 Pharmacy Journal of New England • Winter 2016

of New England Look at the Big Picture Dear Readers,

Editors

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

Managing Editor

The latter part of winter can be cruel, especially when your state’s budget writers turn – once again – to the cost of purchasing and delivering prescription drugs to the poor, to state employees and their families, and state retirees as the places to make deep cuts. Our policymakers ignore the big picture and look coldly at these costs, desperate to make the numbers work.

As we would with a patient suffering from a severe case of multiple personality disorder, we counsel these policymakers to take their meds so that they may recall their resolve to demonstrate the value of the face-to-face encounter between patient and pharmacist by funding MTM pilots and adherence grants that have served to prove their own point: pharmacist-patient consultation reduces overall health care costs. We remind them that it was they who argued that the local pharmacy is a valuable public health outpost – the place where millions of Americans go each day – and a place where the masses will flock for a vaccine when the threat of a pandemic rears its head. We read their words back to them regarding the scourge of medication waste that is compounded when we opt for simply mailing meds to our patients through automatic refill programs, never knowing if these meds are being taken appropriately or simply piling up in a drawer, when one day they will be put out in the trash or flushed down the toilet and into our water supply. “Look at the big picture,” we urge them, “so that you do not use the state budget to undermine the presence of local pharmacists assisting patients in our communities.”

Strikingly similar is the state of support for state pharmacy associations. Their value is unquestionable in the policy arena, and yet when we look at our own budgets, we fall into the same short-sighted temptation to make cuts in places that will hurt us in the long run.

Support your state association, and urge your colleagues to do the same. If you have the time, in addition to your dues, offer your time and energy. We are, as you well know, stronger together.

Sincerely,

Ellen Zoppo CPA

Design & Production Kathy Harvey-Ellis 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

05 18 20 21 33

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

US News New England States Feature: Implementation of an Opioid Management Initiative by a State Medicaid Program Pharmacy Marketing Group: Rx and the Law From the Colleges Continuing Education for Pharmacists 1

U.S. News Substantial Decline in Hydrocodone Prescribing

Here’s the Other Zika Problem Experts are Worried About

DEA’s move to put more stringent regulations on hydrocodone combination analgesic products resulted in more than 1 billion fewer tablets dispensed and 26.3 million fewer prescriptions for the drugs in the year after rescheduling. The drugs were involved in nearly 100,000 abuse-related emergency department visits in the United States in 2011.

Researchers are studying a possible link between Zika and Guillain-Barré syndrome

In October 2014, DEA reclassified hydrocodone combination products as Schedule II substances, instead of Schedule III. In a research letter to JAMA Internal Medicine, federal researchers present an analysis of data from before and after the rescheduling, using information from the IMS Health National Prescription Audit. The data show that in the 12 months after rescheduling, dispensed hydrocodone combination product prescriptions fell by 22%, compared with the 12 months before rescheduling, while dispensed hydrocodone combination product tablets dropped by 16%.

The decline was largely due to refills, which are prohibited under the new regulations. Meanwhile, dispensed prescriptions for nonhydrocodone combination product opioid analgesics rose nearly 5% in the year after hydrocodone combination product rescheduling, and dispensed tablets rose by 1.2%. The researchers note that the reductions in dispensed hydrocodone combination products were seen in most health care professional specialties, particularly among primary care physicians and surgeons.

While other actions may contribute to the reductions, “the abrupt change in dispensing of hydrocodone combination analgesic products immediately after rescheduling suggests a primary role for this intervention in the observed change,” the authors write. Further study is needed to determine whether the effects are long-term and whether they have helped to reduce abuse and overdose.

But there’s another disorder that has U.S. public health authorities concerned. In addition to the abnormally small heads and associated brain damage that characterize microcephaly, experts from the U.S. Centers for Disease Control and Prevention (CDC) recently completed the initial stages of a trial looking at the connection between Zika and Guillain-Barré syndrome (GBS). With GBS, the immune system goes array and starts attacking the body’s nerves, which leads to weakness that can snowball into temporary paralysis. Sometimes the disorder can disrupt breathing.

https://www.pharmacist.com/substantial-decline-hydrocodoneprescribing

2

President Obama announced February 8th that he is asking Congress for more than $1.8 billion in emergency funding to expand the United States’ efforts to combat Zika. The virus has sparked fears amid its rapid spread through the Americas, and its link to the birth defect microcephaly.

The Brazil Ministry of Health has reported higher than normal cases of GBS, which kicked off the investigation. Some experts knew that amid a Zika outbreak, they should be on the lookout for GBS. Dr. James Sejvar, a neuroepidemiologist at the CDC, told TIME in an interview that back in 2013, the CDC and other public health groups like the World Health Organization started hearing reports of Zika in the South Pacific. In French Polynesia, Sevjar said, clinicians were also seeing an uptick in GBS cases.

“We tried to get in contact with French Polynesia, but for whatever reason, it proved difficult to get solid and objective information,” Sejvar said. “So, because of these earlier reports, the association was already on our radar. After Zika got into Brazil, doctors again started reporting higher than normal numbers of GBS. For us, this was the last straw. We had to investigate.”

Between April and July of last year, there was an increase in GBS cases in the Brazilian city Salvador that was substantially above expected rates, Sejvar said — more than a seven-fold difference.

Pharmacy Journal of New England • Winter 2016

Sejvar and a small team of CDC workers recently enrolled in their trial more than 40 people with GBS in the Bahia state of Brazil, as well as 80 control subjects who live in the same area and likely have similar levels of exposure to the Zika virus but did not develop GBS. The researchers used a list of people provided by the Brazilian Ministry of Health and the Bahia state. The goal is to determine if having Zika increases the odds of getting GBS. The findings are still preliminary, but so far, Sejvar said researchers have observed an interesting pattern. Typically, the incidence of GBS increases with age. While the disorder is rare on its own, it’s especially rare among people in their 20’s and 30’s and is more common among people in their 60’s and 70’s. But what experts are seeing is unusual. “One thing that has struck us is the cases have tended to be disproportionally young and relatively healthy,” Sejvar said.

“We are seeing quite a few 20, 30, 40 year olds who are otherwise healthy.”

In addition, the cases appear particularly severe. “Over time people often get better, but one thing that we have noticed is that even among otherwise healthy people, six months later they are still having neurological problems,” Sejvar said.

“Some can’t go to work or need help with daily activities.

That’s something we found peculiar.”

-- and one of just a handful nationwide.

As with anything that comes for free, there are a few catches.

Because the pharmacy relies on donations, there’s no guarantee it will have the drugs you need when you need them. Patients can check an online list for available drugs, or call the pharmacy directly before they show up. If a drug’s not available, patients are put on a waiting list and contacted if and when the right donations arrive. For now, the pharmacy’s open only for a few hours each day, four days a week.

And another caveat: The pharmacy dispenses no hard-core painkillers like Vicodin or OxyContin, or any other controlled drugs.

Still, the current supply includes everything from inexpensive asthma and diabetes medications to a pricey, brand-name stroke prevention drug called Eliquis.

The pharmacy has dispensed more than 8,400 prescriptions since opening quietly in August in Suite 202 at 725 East Santa Clara St., said Johanna Silverthorne, a spokeswoman for the county public health department.

On February 16th, the pharmacy hosted a grand-opening celebration, and Santa Clara County supervisors presented a formal commendation to its staff and volunteers. The county had chipped in $90,000 to fund the pharmacy’s startup costs.

As with microcephaly, it could be some time before researchers come to a definitive conclusion about the link between GBS and Zika, but the consequences continue to play out. In Colombia, three people reportedly died recently after contracting GBS.

That a free pharmacy is needed in San Jose speaks volumes about economic disparities here.

http://time.com/4209612/zika-guillain-barre-syndrome-cdc/

An estimated 7 percent of people in Santa Clara County don’t have health insurance. Seniors face Medicare’s dreaded “doughnut hole,” a gap in coverage of prescription drugs that forces out of pocket spending. And working people with health insurance feel strapped because of the region’s high housing costs, Silverthorne said.

San Jose: New Pharmacy Offers Free Meds There’s a pharmacy in downtown San Jose where the drugs are free. No copays, no deductibles, no proof of income or ID required -- just a doctor’s prescription.

Tucked away in a spartan government building, the Better Health Pharmacy is staffed by volunteer pharmacists and run by the Santa Clara County Public Health Department. The drugs it dispenses are donated, mostly by nursing homes, and intended for people who can’t afford their prescribed. medcications. The pharmacy is the only one of its kind in California

Bloomberg Business recently dubbed the San Jose metropolitan area the richest in the nation. But the city’s homeless population is among the country’s largest.

“Because of how expensive things have gotten here,” she said, “people are making decisions like: Do I pay my heating bill, or do I get my prescription?”

Rommy Garcia, 32, couldn’t believe it when a doctor at a community health clinic told her there was a place she could get her diabetes medication for free, no questions asked. The 3

U.S. News

continued

single mother of two couldn’t afford to buy her own insurance, and her immigration status under President Barack Obama’s executive order protecting young undocumented immigrants from deportation doesn’t allow Garcia to qualify for any kind of government health insurance except emergency Medi-Cal.

founded by Stanford University students. The nonprofit serves as a matchmaker, offering logistics and record-keeping tools that allow health facilities, manufacturers, wholesalers, and pharmacies to safely donate unused medicine to safetynet clinics and pharmacies, avoiding the cost and hassle of destroying it properly.

Recently diagnosed with Type 2 diabetes, Garcia, who needed a drug called metformin, was thrilled to hear about the pharmacy.

At first, the donated medications were distributed at a number of county-run pharmacies, but then health officials realized they could create a stand-alone pharmacy to dispense the donated medicines.

“I was thinking: How am I going to get the money for this?”

Garcia said. “I was so relieved.”

Jinky Balane, of San Jose, heard about the pharmacy from a fellow shopper at Walmart, so she went there to fill a prescription for her 8-year-old son’s asthma inhaler. She and her son have been uninsured since January, after she decided that she could no longer afford the family health insurance policy she bought after she was laid off last year from her job as an electronics buyer. At roughly $700 monthly, her premiums and co-payments were too high, Balane said.

“This place is awesome,” said Balane, 52. “Once people know about it, the pharmacy is going to be bombarded.”

The Better Health Pharmacy is possible because of a California law passed in 2005 that allowed counties to accept and redistribute previously sold, unexpired and unopened prescription medications to people in need. (Drugs can’t be donated by individuals.) Typically, these drugs would be thrown away or destroyed after patients died or no longer needed them.

Santa Clara County Supervisor Joe Simitian, who sponsored the law when he was a state senator, said Stanford students entered the prescription recycling idea in his “There Oughta Be A Law” contest.

“It makes sense in terms of health care, and it makes sense environmentally,” Simitian said. “It also makes sense from a fiscal standpoint: If you can reuse these drugs, then those are drugs that the taxpayers don’t have to pay for.”

Other states have passed similar laws, including Iowa, which is believed to have the nation’s largest prescription drug reuse program.

Nursing homes from across the state donate drugs to the Better Health Pharmacy through Palo Alto-based Sirum, 4

The Better Health Pharmacy now receives donations from about 150 health facilities, said George Wang, Sirum’s cofounder and director.

Khanh Pham, the public health pharmacist-in-chief who oversees the Better Health Pharmacy, said she’s not worried that well-off patients will inundate the pharmacy for free meds.

“This is like a dream come true for pharmacists,” Pham said.

“Our goal is to bridge the gap -- to help people get access to the medicines they need, without having to ask how they’re going to pay for it.”

For more information on the pharmacy and a list of medications available this week, see www.betterhealthrx.org. www.times-standard.com/health/20160213/new-san-jose-pharmacyoffers-free-meds

Don’t miss MPhA Foundation’s Wine Tasting Social!

Thursday, April 7th from 6:00-8:00 p.m. at the Boston Winery, 26 Ericsson St., Boston Enjoy the company of

friends and colleagues as you sip five 2 oz pours of featured wines ($8 per glass after that) and munch on a variety of appetizers.

And, you’ll be supporting the work of the MPhA Foundation! All for $49!

Visit www.masspharmacists.org

New England Connecticut

President’s Message

As I write this the snow is falling and we are getting our first real taste of winter. Late January.

Go figure!

Our thoughts start to turn to the legislative session at the Capitol.

Our legislative committee is hard at work, deciding what bills we hope to have introduced, and waiting to see which bills might affect the practice of pharmacy.

One of the concerns is always Jacqui Murphy CPA President, 2015-16 the budget, and what types of reductions in dispensing fees and reimbursement rates we might see. This affects all pharmacists as the less money we get from insurance companies, the less money available to pay salaries for pharmacists and technicians. It becomes a vicious circle, as with less help, it results in more workload for those who are working. Which brings up concerns about errors.

Pharmacy Journal of New England • Winter 2016

and its effect on pharmacy; do you think ANYONE else really believes that is what happens? Help us explain our profession.

We are also working with CSHP and CT-ASCAP to present a collaborative CE program. More details to follow.

Thank you to everyone who helped make the recent CE programs a big success. Starting with our foray into Patriot country and an exciting New England Conference at Foxboro last fall, through the 3 Fall Series CE programs to the MidWinter Conference, our CE committee has been doing a tremendous job getting us cutting edge programs to enhance and further our knowledge of new medications and trends.

I look forward to seeing what exciting changes spring and summer will bring.

Hope to see many of you at the Connecticut Pharmacists Foundation 6th Annual Wine Tasting in May. Watch the Friday Fast Five for more details.

Jacqui Murphy President

Another area we are looking at is re-introducing legislation to pay credentialed pharmacists for MTM in Medicaid. We have shown that we can save the state money and the CPA is leading the coalition of organizations across our profession and the schools of pharmacy to get this important legislation passed. So I ask you to support our activities. When we ask you to contact your state representatives please do so. We supply talking points; just make it your own. Call. Write. Be pro-active. Be involved.

The CPA has been working with CSHP and CT-ASCAP to collaborate on Pharmacists Day at the Capitol. We plan to spend the day there visiting legislators and explaining issues that affect pharmacy. We understand the advantages to MTM; could you explain it in simple English to your legislators so they understand it? We understand MAC transparency; could you give examples of how it affects patients coming into your pharmacy? We understand Medicaid audit and extrapolation

CPA President Jacqui Murphy chats with CPA Life Member and Chair of the Pharmacy Committee Billy Summa at the Mid-Winter Conference.

5

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continued

Connecticut Mid-Winter Conference February 4th The Mid-Winter is a great gathering point of all generations of pharmacists from newly licensed to retired.

Over 200 pharmacists attended the Mid-Winter Conference, receiving up to 8 live credits on a clear but chilly February morning.

Dr. Sean Jeffrey from UConn presented on COPD and brougt his pharmacy students on rotation with him (right).

McKesson supported the Mid-Winter Conference as a Gold Sponsor (below).

University of St. Joseph School of Pharmacy Faculty Bahar Matusik and Dora Wiskirchen presented programs at the Mid-Winter (above).

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Pharmacy Journal of New England • Winter 2016

Things are Happening in Connecticut!

Each year at this time we present our members with a midyear report on the “state of the association.” I would also like to take a moment to recognize the efforts of the Connecticut Pharmacists Foundation. This committed group of volunteers work to raise funds from our members as well as through grants and fundraisers in order to provide scholarships to pharmacy school students. In addition, they have promoted community involvement and volunteer at a variety of events with CPA including the NBC Health and Wellness Fair. I would like to acknowledge Cynthia Huge, president of the Foundation, and board members for their efforts.

One of the things I most often hear from our students that do their rotations in our office is that they were not aware that CPA was involved in so much. I guess we don’t do a good job of sharing all we do. So I am going to share a few initiatives we are currently involved in. All of these efforts are to ensure that pharmacy has its rightful place at the table and that we are integrated into areas that require our expertise.

Last year CPA sought out and was awarded a contract with the Quality Improvement Organization in our state, Qualidigm. Qualidigm is primarily a federally funded organization with a mission to Improve the quality, safety, and cost-effectiveness of healthcare through transformational change.

The Centers for Medicare and Medicaid Services or CMS contracts with the QIOs on various scopes of work that encompass a variety of safety issues. Historically, Qualidigm works with hospitals, nurses and physicians to achieve their goals. The latest scope of work includes addressing the huge impact that adverse drug events have on our patients, especially during care transitions. The focus of this work centers on three classes of medications that have been identified as high risk: Anticoags, diabetes medications and opioids.

I have been working with pharmacists across all practice settings to engage them in this issue. We are in year 2 of a fiveyear contract. During this time we will be attempting to track ADEs, implement interventions and measure outcomes. A couple of lessons learned: There are many medication safety

initiatives that are occurring and a lot of these initiatives are not involving pharmacists. Pharmacists state although they would like to be involved they don’t have the time or the resources. It is critical that we invest the time in this initiative. The QIO has the analysts to show and measure our good work. We should embrace this opportunity to demonstrate to our quality departments and our CEOs how engaging pharmacists on medication safety initiatives is the most effective means of addressing this issue. I hope you will all get involved if/when I come knocking at your door. I want to thank all of the health system pharmacists that are engaged in a collaborative we have established to assist in this effort.

Another exciting initiative is our partnership with Yale University School of Medicine in a feasibility study of the medical marijuana program in our state. We just received notice of IRB approval on Monday. Connecticut and CPA have been on the leading edge of this emerging industry. While philosophically we might not all agree on the issue, scientific studies will either support the trend or dismiss it. That remains to be seen. But know that your state pharmacy association is engaged to ensure if there are alternatives for our patients and opportunities for our profession, our members will be aware.

CPA has also submitted a proposal to the Administrative Services Organization for state Medicaid, to provide a MTM program for selected Medicaid patients. Yes…we have heard about this type of initiative for the past few years and it has not yet come to fruition. The reason that we have a good feeling this time is that CHN came to CPA to help make this happen. They did not go to any employer group or any other organization. They came to us because they know that we will do it and we will do it right. We have some very talented pharmacists that have graduated and are looking for alternative practice opportunities. This can be exactly that opportunity.

CPA has also been appointed to the Governor’s Healthcare Cabinet. There is a Cost Containment Study in process to look at what other states have implemented to successfully contain costs and what might work in our state. The entity that is doing the study is interviewing each of the cabinet members to discuss cost saving initiatives. Again, CPA is at the table sharing ideas and making recommendations on 7

New England States

continued

behalf of pharmacy. This could have a huge impact on the legislative session that just began. As we already know, there will be a huge budget deficit to fill.

The last item to share with you is about the Workplace study that began last year. In November 2014, the CPA, representing a group of member pharmacists, brought a complaint to the Connecticut Commission of Pharmacy. The complaint’s basis was that pharmacists’ ability to fill prescriptions is becoming unsafe due to inadequate workplace staffing levels. Although the focus was on community pharmacy, we heard from all of our members that work in various practice settings about their concerns and we will be addressing those in time. The pharmacy commission established a workplace taskforce to address the complaint.

The taskforce held a couple of focus groups where pharmacists from various corporations came together to discuss the issues. The meetings were very productive where possible solutions were considered to the many practices that were challenging. A survey was then sent out to as many pharmacists as possible. The University of Connecticut School of Pharmacy designed the survey to ensure there would be no bias. We want to thank Lauren Schlessleman for that work.

The results of the survey were shared with our membership and Dr. Schlessleman presented her findings to pharmacists in September at the New England Pharmacists Convention. I want to share a few of the outcomes identified: Of those pharmacies that use metrics, 91.4% had cited metrics related to time guarantee to fill a prescription or the number of prescriptions that must be filled as a concern. When considering patient safety, 63.1% of pharmacists felt the time requirement significantly impacted patient safety, while 22.4% felt it moderately impacted patient safety. When considering the possible role of state boards of pharmacy in prohibiting the use of pharmacy metrics that would negatively impact patient safety, 72.7% of pharmacists were in favor of such regulations, while 2.9% opposed such regulations, and 5.8% did not know if they supported such regulations. Only 0.1% felt it should not be the role of state boards of pharmacy to interfere with pharmacy metrics. The next step for the taskforce is to discuss the results of the survey with the corporations. As the chair of the pharmacy commission stated, now that the Pharmacy Commission is fully informed about the impact this has on patient safety, they are obligated 8

to address the concerns our pharmacists have raised.

These are pretty big initiatives. As a reminder, there are only two staff people at CPA. I challenge any of you to say that we are not using our resources efficiently. We work for all of you…. .and we need everyone’s support to get the job done.

You’ve heard of patient-centered care? We are a membercentric organization. What we do, we do for the good of our members and the advancement of our profession.

Membership is the cornerstone of our success and the irony is all pharmacists benefit by our advocacy whether they join or not. On behalf of the CPA, please reach out to your colleagues.

Let them know what we are doing. Ask them to become a part of the movement to get professionalism back in our jobs.

There are many legislative initiatives that we expect to be involved in this year. At the federal level, Provider Status remains a priority. We have established a collaborative with the other pharmacy organizations in the state to strategize how we can use our resources collectively to advance this initiative. We are excited about the possibilities.

On the state level we have heard about another year of devastating state budget cuts. CPA continues to be at the table offering solutions with programs that will yield savings.

We wil promote allowing credentialed pharmacists to provide MTM services to Medicaid patients as well as ensure that pharmacies are reimbursed appropriately. We know there will be bills that will affect the Medical Marijuana industry and bills to tax anyone involved from the manufacturing of to the dispensing of opioids. As you know last year CPA was instrumental in the legislation that now allows pharmacists to prescribe Narcan. The door is now open and the opportunities are endless.

CPA remains a relevant organization for its members infinding solutions to advance our profession. We ask that you — as we have seen others — provide us with the financial support we need to make things happen. Pharmacy traditionally has lagged behind in this area. It’s time to put your money where your mouth is and join the CPA. We are looking for the leaders who will be the face of our organization and hope that it will be you.

Margherita R. Giuliano, RPh, CAE Executive Vice President, CPA

Pharmacy Journal of New England • Winter 2016

Massachusetts President’s Message Dear Colleagues, In 2015, Massachusetts had nearly 1,100 confirmed opioid overdose deaths, representing a 21% increase over the previous year. Unfortunately, this epidemic shows no sign of abating and will continue to plague the Commonwealth in the foreseeable future. In response, MPhA will meet this challenge head on. We Karen Horbowicz created a new committee this MPhA President, 2015-16 past November, Operation Prevention, that is charged with recruiting pharmacists to help address the opioid crisis, educating the public about the dangers of prescription drug abuse, promoting naloxone rescue kits, and engaging membership in partnering with local opioid addiction coalitions. Operation Prevention has already made significant progress. The committee plans to make the following available within the next three months - a contact list of opioid addiction coalitions for pharmacists to partner with and a toolkit to assist members in filling controlled substance prescriptions, preventing diversion, and preparing for DEA inspections. We plan to make these resources available on our website. Please accompany us in our fight against the opioid crisis by joining Operation Prevention today! Together we can help put an end to this epidemic.

Legislative Update There is very little to report regarding the progress of bills supported by MPhA. At the federal level, The Pharmacy and Medically Underserved Areas Enhancement Act (H.R. 592/S. 314) has gained new sponsors - Massachusetts Congressmen, Rep. James McGovern, Rep. Niki Tsongas, Rep. Joseph P. Kennedy, Rep. William Keating, and Rep. Stephen Lynch have all signed on to the bill as cosponsors. However, no action

has been taken and a hearing has not been scheduled. At the state level, H.2041, An Act recognizing pharmacists as healthcare providers; the MAC transparency bill, H.870, An Act to ensure access to generic medications; the specialty drug bill, S.581, An Act to ensure access to medications; and a bill that would authorize pharmacists to administer drugs via injection by order of a physician, S.1031/H.1910, An Act relative to improved medication adherence, all remain stuck in the committees to which they were sent a year ago. MPhA staff and members continue to meet with legislators on each of these bills. We remain optimistic that several of these bills will make it out of their initial committees with favorable recommendations. We will turn up the heat during the Face of Pharmacy, March 30, 2016 at the State House. Learn more about this event, these bills, and please register to attend at www.masspharmacists.org

Events Registration for the MPhA Spring Conference is now open.

The schedule of presentation is available on the following page.

In addition, we will hold a Fall Conference on November 2, 2016 on the campus of Western New England University (WNEU) in Springfield. Special thanks to WNEU College of Pharmacy Dean Evan Robinson and Kim Tanzer, Assistant Dean Experiential Affairs for helping to make this happen. MPhA plans on making this an annual event and increasing our presence in the Springfield area.

Plans are underway to make the 12th Annual New England Pharmacists Convention the best yet. We are returning to Foxwoods this year and have scheduled the event for September 22nd & 23rd.

Finally, the MPhA Foundation is holding a wine tasting fundraiser Thursday evening, April 7th from 6:00-8:00 p.m. at The Boston Winery, 26 Ericsson Street, Boston, MA 02122.

Don’t miss this chance to kick back with friends and colleagues — and taste some great wines! Registration is now open.

9

Friday, April 29th Four Points by Sheraton Boston Providence Highway 1125 Boston-Providence Turnpike, Norwood, MA 02062

Register Online at: www.masspharmacists.org Here's the Lineup: 8:00 am - 9:00 am Pipeline Preview 2016 (0.1 CEUs)

by Maria Lowe, PharmD, Clinical Pharmacist, PatientsLikeMe UAN: 0106-9999-16-004-L04-P, 0106-9999-16-004-L04-T 9:05 am - 10:05 am PCSK9 Inhibitors: A New Option for Hyperlipidemia Z (0.1 CEUs)

by Michael Gonyeau, PharmD. BCPS, Clinical Professor, Director of Undergraduate Education Programs, and Interim Chair of the Dept. of Pharmacy and Health Systems Sciences, Northeastern University School of Pharmacy UAN: 0106-9999-16-005-L01-P, 0106-9999-16-005-L01-T Break 10:05 am - 10:15 am 10:15 am - 11:15 am Update from the Board of Pharmacy (0.1 CEUs Law)

by David Sencabaugh, RPh, Executive Director, Massachusetts Board of Registration in Pharmacy UAN: 0106-9999-16-006-L03-P, 0106-9999-16-006-L03-T 11:20 am - 12:20 pm The Current and Future Roles of the Pharmacist to Maximize Safe Opioid Use: Focus on Naloxone (0.1 CEUs Law)

by Jeffrey Bratberg, PharmD, University of Rhode Island, and Traci C. Green, PhD, MSc, Deputy Director, Boston Medical Center Injury Prevention Center & Boston University School of Medicine, Department of Emergency Medicine UAN: 0106-9999-16-007-L03-P, 0106-9999-16-007-L03-T 12:20 pm - 1:40 pm Lunch & Exhibits 1:40 pm - 2:40 pm Herbal Supplements: all natural or profit factories (0.1 CEUs)

by Nancy Balch, PharmD, Senior Attending Pharmacist, Emergency Department, Massachusetts General Hospital UAN: 0106-0000-16-008-L01-P, 0106-0000-16-008-L01-T 2:45 pm - 3:45 pm Critical Review and Practical Guide to Optimizing Oral Anticoagulation (0.1 CEUs)

by Snehal Bhatt, PharmD, BCPS, Associate Professor of Pharmacy Practice, MCPHS University, Boston UAN: 0106-9999-16-009-L01-P, 0106-9999-16-009-L01-T 3:50 pm - 4:50 pm Risks and Benefits of Pharmacotherapy in the Treatment of Pediatric Depression (0.1 CEUs)

by Michael Angelini, BSPharm., M.A., Pharm.D., BCPP, Associate Professor, MCPHS University UAN: 0106-9999-16-010-L01-P, 0106-9999-16-010-L01-T

The Connecticut Pharmacists Association is accredited by The Accreditation Council for Pharmacy Education as providers of continuing pharmacy education. Pharmacists in attendance who complete an evaluation will receive up to 0.7 CEUs (7 contact hours).

10

Pharmacy Journal of New England • Winter 2016

New Hampshire President’s Message

There is a pharmacy-centric saying that I’ve heard on more than one occasion that basically states, “If you put three pharmacists in a room and they have one thing in common, they’ll undoubtedly form a pharmacy organization centered around that one commonality.” While this statement cannot be taken literally, there are some truths embedded in it. Below is a listing of the national and international pharmacy organizations that I was able to identify after Christopher R. Lopez, PharmD, CDE a brief internet search. I apologize if I’ve left some out: Academy of Managed Care Pharmacy Accreditation Council for Pharmacy Education American Association of Pharmaceutical Scientists American Association of Colleges of Pharmacy American College of Clinical Pharmacy

International Society for Pharmacoeconomics and Outcomes Research National Association of Chain Drug Stores National Community Pharmacists Association The National Institute for Pharmaceutical Technology and Education National Pharmaceutical Association Pediatric Pharmacy Advocacy Group Society of Infectious Diseases Pharmacists Student National Pharmacy Association Maybe you’re a member of one or more of these organizations. By no means am I trying to discourage membership in national pharmacy organizations. I am a huge proponent of advocacy and the advancement of pharmacy practice. What I am doing is trying to illustrate a point. Because pharmacy practice is so diverse and fragmented, as a profession we are often not great at aligning with each other in an effort to better serve our patients and advance our profession.

Because of this point in part, as well as the intricacies surrounding pharmacy practice in the state of New Hampshire, the state pharmacy organizations of New Hampshire have come together to advance two separate, but affiliated, initiatives within our state.

Board of Pharmacy Specialties

In June 2015, the Intra-Organizational Council (IOC) of New Hampshire State Pharmacy Organizations was formed.

The IOC consists of members from The New Hampshire Pharmacists Association (NHPA), the New Hampshire Society of Health-Systems Pharmacists (NHSHP), the New Hampshire Independent Pharmacy Association (NHiPA), and the New Hampshire Board of Pharmacy.

College of Psychiatric and Neurologic Pharmacists

The IOC has three main missions:

Hematology/Oncology Pharmacy Association

1. Advancement of Pharmacy Practice through coordination and alignment of legislative initiatives.

American Pharmacists Association American Society of Consultant Pharmacists American Society of Health-System Pharmacists

International Society of Oncology Pharmacy Practitioners

2. The establishment of, and participation in, initiatives which promote public and population health 11

New England States

continued

within the state of New Hampshire.

3. Assistance in the education of future pharmacists.

It is important that all of the member organizations within the IOC maintain their unique perspectives and infrastructure, so this initiative is by no means an attempt at unification or consolidation of the organizations. It is a way though to ensure that appropriate legislation that is good for all of Pharmacy is backed by all of Pharmacy within our state.

Another new pharmacy-based initiative in New Hampshire, which is an offshoot of the IOC, is the State Pharmacy- Public Health Coalition (SPPHC). This Coalition consists of members of the state pharmacy organizations as well as a multitude of state public health officials. This initiative is still in its nascent stages, but the thought is that, by aligning with the state public health officials, the state pharmacists can work to really improve the health of the population that we currently serve. In addition, this grassroots initiative will allow many of our state’s residents to better understand what we, as pharmacists, really bring to the table through increasing the visibility of pharmacy practice.

the Manchester Country Club in Bedford, New Hampshire.

The celebration was also supported by the NH Pharmacists Association (NHPA), the NH Society of Health-System Pharmacists (NHSHP) and the NH Independent Pharmacy Association (NHiPA).

2015 Gold Certificate Award This year, the NH Board of Pharmacy recognized one New Hampshire Pharmacist who has been licensed in the state for 50 continuous years. The gold certificate is a replica of the recipient’s license which is engraved with his/her name, as well as a signed citation from the Honorable Governor Maggie Hassan. The gold certificate of licensure was presented by Robert Stout President, NH Board of Pharmacy to Thomas Borysek, BSP, RPh (pictured below).

Tom’s father was the owner of a grocery store. Tom’s interest in chemistry was discovered at the young age of 6 when he was given a chemistry set for Christmas.

We are currently in the process of forming four specific SPPHC workgroups which, hopefully, will begin furthering public health initiatives within our state in the upcoming year. These current workgroups are as follows: 1. Chronic Disease 2. Smoking Cessation 3. Immunization/Vaccination 4. Syringe Access and Disposal More to come… I encourage other New England states to explore opportunities to advance pharmacy practice within their states. I look forward to keeping you all up to date on these new and exciting initiatives.

Best, Christopher R. Lopez, PharmD, CDE President: New Hampshire Pharmacists Association

New Hampshire Pharmacists are Recognized at Annual Holiday Party

12

The MCPHS University Annual NH Pharmacy Awards Reception was held on Wednesday, December 16, 2015 at

While in grammar school, Tom got his first job working in a local drugstore, throughout high school and college he worked both in community drugstores and hospital pharmacies. Tom graduated from the Massachusetts College of Pharmacy – Boston in 1965 in the first years of the 5-year BSP program.

With his newly minted NH pharmacist’s license, Tom went to work for Lucien Coll at Coll’s Rexall Pharmacy, then located on Elm Street, almost directly across from the current MCPHS University – Manchester campus.

In June 1966 Tom began a long professional career with the Food and Drug Administration in Boston. That led to his first Veteran’s Administration Hospital position in Dayton, Ohio; then to Togus, ME and next to the Boston VA Outpatient Clinic. Tom then accepted a position at the VA Marketing

Pharmacy Journal of New England • Winter 2016

Center in Hines, IL followed by an assignment to the VA’s Office of the Inspector General in Washington, DC. Throughout his career with the VA, Tom has served the Veterans with government in 38 states and has lectured on Quality Assurance in England, Spain and Egypt.

Starting in 1980, Tom has established several scholarships at MCPHS University. Also, because of his generosity, the University dedicated The Thomas Henry Borysek Living and Learning Center in Worcester, MA.

many calls and letters sent by the pharmacists of NH, the Congressman signed on to co-sponsor the national pharmacist provider status bill, which will improve access to health care for the medically underserved.

The recipient of the 2015 New Hampshire Pharmacist of the Year Award is Tonya Carlton, (pictured below left, with Cheryl Abel on the right).

In Tom’s words, “along the way, I learned time takes everything but memories. I have worked hard, but also know, as Plato said . . . “Life should be lives as play.”

2015 New Hampshire Pharmacist of the Year - Tonya Carlton The NH Pharmacist of the Year award is co-sponsored by NHPA, NHSHP and NHiPA. The award is presented annually to a pharmacist licensed and practicing in New Hampshire who demonstrates professional excellence, good citizenship and dedication to the profession.

The 2015 New Hampshire Pharmacist of the Year has worked as a clinical hospital pharmacist at Wentworth-Douglas Hospital in Dover, NH for 11 years and has a passion for both education and the profession of pharmacy. As an educator, she has precepted over 35 students from MCPHS University on their clinical rotations, and in March of this year, was promoted to residency director for Wentworth Douglass Hospital’s PGY1 residency program.

Our Pharmacist of the Year piloted a quality improvement program whereby staff pharmacist provide counseling to patients being discharged. This program has resulted in a significant decrease in patient readmissions. The success of this program led to the addition of 2 full-time positions in order to facilitate more pharmacist-provided discharge counseling.

She is a member of the NH Society of Health System Pharmacists’ legislative committee and recently testified in Concord on legislation surrounding NH’s fight on opioid addiction. She also organized a visit for NH Congressman Guinta in July to visit Wentworth Douglass Hospital in order for him to get a better idea of the vital role of hospital pharmacists in patient care. Given his visit, along with

2015 Bowl of Hygeia Award - Richard Crowe The “Bowl of Hygeia” Award is presented annually by participating pharmacy associations in each of the fifty states, the District of Columbia, Puerto Rico, and the ten Canadian provinces. The recipients are selected by their respective associations for their outstanding record of community service. The Bowl of Hygeia award is sponsored by the American Pharmacists Association Foundation and the National Alliance of State Pharmacy Associations.

In December, a pharmacist was honored in recognition of his service to the community and to the profession.

A 1987 graduate of the University of Rhode Island College of Pharmacy, Rich Crowe is the 2015 Bowl of Hygeia award recipient. Rich hails from the quintessential New England town of Harrisville, NH, where he and his wife, Eileen, raised their two children, Jenn and Robb. For much of the past 30 years, Rich has devoted countless hours to a number of local and national organizations. The following are a few examples of the time that Rich has given to his Country and community: • 23 years serving in the US Army, Army Reserve, and Army National Guard • Red Cross swim instructor • Big Brother mentor • Past PTA President for the Wells Memorial School in Harrisville, NH 13

New England States

continued

• Wells Memorial School Ski Club chaperone All of the above activities pale in comparison to the 17 years Rich has been involved in the Cub Scouts and Boy Scouts of America.

Though Rich’s sons have been out of scouting for a few years, he continues to be very active in the organization. He spends many of his weekends and evenings serving as a mentor to both new and veteran scouts, and training the next generation of scout leaders.

Pictured to the right, Rich Crowe and David Lacoste.

This year’s distinguished young pharmacist, Jay Calabro, is a graduate of Northeastern University, receiving his PharmD in 2008.

While attending Northeastern he was appointed to the Massachusetts Pharmacists Association’s board, as its “governor of students.” Upon graduation this recipient moved to NH and quickly immersed himself into the pharmacy culture of this state. He serves as a regional leader for “Partners in Prevention,” a state-funded group that helps to eliminate drug and alcohol abuse. He has organized several health fairs at his pharmacy in an effort to serve the uninsured.

In 2012, he was named Wal-Mart New England Corporation’s pharmacist of the year. He has served as the President of NHPA since 2013, after having served 2 years as VicePresident. During his tenure as President, he testified before the NH State House regarding pharmacist’s workload issues.

This recipient is very passionate about this initiative and seeks to improve the quality of life for the pharmacists in our state.

2015 Excellence in Innovation Award

2015 Distinguished Young Pharmacist Award The Distinguished Young Pharmacist Award is sponsored

by Pharmacists Mutual Companies. This award is presented annually to a pharmacist licensed in New Hampshire who has practiced ten years or less, practices in a community, institutional, or consulting pharmacy and who has actively participated in national pharmacy associations, professional programs, state association activities and/or community service.

The Excellence in Innovation award is a national award coordinated by the National Alliance of State Pharmacy Associations, and generously sponsored by Upsher-Smith Laboratories, Inc. to recognize and honor a qualified pharmacist who has demonstrated significant innovation in their respective practice, method or service directly or indirectly resulting in improved patient care and/or advancement of the profession of pharmacy.

L to R, Gary Wingate and T.J. Parker.

This year’s recipient of the Excellence in Innovation Award is TJ Parker. above, Jay Calabro and Lorraine Radick

14

Growing up in a family that owned and operated an independent pharmacy, this year’s award recipient witnessed

Pharmacy Journal of New England • Winter 2016

first-hand how difficult it can be for patients to manage multiple medications. Therefore, in early 2013, after graduating from MCPHS University-Boston in 2012, he cofounded Pillpack.

Born in 1930 in Framingham, MA, Norm graduated from Wayland High School and then went on to earn his Bachelor of Science Degree from the Massachusetts College of Pharmacy in 1953.

Pillpack is a full-service pharmacy that makes it easy to manage multiple medications through a combination of convenient packaging, modern technology, and personalized service. PillPack has led to a paradigm shift in the landscape of personalized medication management.

Patients who utilize PillPack receive their medications in an individualized recyclable dispenser that is sent to the patient’s home every two weeks. Any items that cannot be placed into packets, like liquids and inhalers, are sent separately. The medications are placed into individualized, tear-off packets containing all of the medications based on the time of administration. The patient simply tears off the labeled packet each time a dose is due. Patients do not need to fumble through multiple bottles or worry about accurately filling a pill box. This not only eases administration but also improves medication safety and adherence to complicated schedules.

A job opportunity in Laconia, NH brought him to NH in 1954 where he worked at Story Drug, an independent pharmacy, for 5 years. Norm then decided to try hospital pharmacy and went to work at the Laconia Hospital.

PillPack currently serves customers in 47 states and employs 125 people. Mr. Parker has been recognized with numerous awards including Time Magazine's Top 25 Inventions of 2014. TJ has been named as one of Forbes Magazine’s “30 under 30” in Healthcare and has been featured in USA Today, on NBC News, and The Wall Street Journal.

2015 Lifetime Achievement Award - Norm Rhodes, Sr. The Lifetime Achievement Award is co-sponsored by the NH Pharmacists Association, the NH Society of HealthSystems Pharmacists and the NH Independent Pharmacists Association. The award is presented in recognition of exceptional commitment, loyalty and dedication to the practice of pharmacy in the State of New Hampshire. The recipient must have demonstrated a career-long performance record of substantive, measurable impact and/ or benefit to his/her practice setting and/or the practice of pharmacy in the State of New Hampshire.

The recipient of the 2015 Lifetime Achievement Award is Norman Rhodes.

Later, Norm was hired as Chief Pharmacist at the 2,000-bed NH Neuropsychiatric Hospital in Concord, NH. Over the years that followed Norm worked as a consultant pharmacist at the Merrimack County Nursing Home as well as Hannaford Pharmacies and Target and Shaw’s Pharmacies.

For his country, Norm was Commanding Officer of the Medical Detachment, 744 AAA Battalion of the NH National Guard earning an Honorable Discharge as 1st Lieutenant in 1959. He is also a past president of the U.S. Air Force Academy Parents Association.

Locally, Norm is a SHRINER and for 20 years participated in summer parades to raise money for the 22 Shriners Hospitals throughout the country.

Professionally, Norm is past president of the NH Society of Hospital Pharmacists and has served as a Concord Hospital Volunteer for Senior Wellness Programs. Norm is also a past president of the MCP Alumni Club of NH. At 85 years young, Norm and his wife Sandy have been married for 48 years and have raised 8 children (all boys) and currently enjoy 17 grandchildren and 3 great-grandchildren.

above L to R, Norman Rhodes and Paul Boisseau

15

New England States

continued

Vermont

President’s Message Annual membership letters have been sent out and I look forward to those of you renewing and to new members bringing their knowledge, experience, and vision of the future to our association.

Provider status for Jim Godfrey, RPh pharmacists took President, Vermont Pharmacists Association center stage at the annual Pharmacy Day at the statehouse in Montpelier on January 22nd, as we gave testimony before the Senate Health and Welfare and House Health Care committees. Faculty and students from Albany College of Pharmacy and Health Sciences Colchester, VT

campus joined us, as did representatives from Vermont Retail Druggists and Vermont Society of Health-Systems Pharmacists to promote this important recognition for our profession. We also had the opportunity to hear United States Congressman Peter Welch address Vermont legislative committees on his work with the Drug Pricing Task Force in Congress. To paraphrase the Congressman, at a time when medication therapies can so greatly improve and extend life, “drug prices are killing us”.

Save the date of Sunday April 3rd for the VPA Spring meeting at the Holiday Inn in Rutland. The continuing education topic will be Opioid Epidemic: What Community Pharmacists Need To Know; Myths, Truths, Actions. Visit the VPA website www.vtpharmacists.com for membership and continuing education information.

Jim Godfrey, RPh President

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.

2015 Recipients of the “Bowl of Hygeia” Award

Dan McConaghy Alabama

Tom Van Hassel Arizona

Nicki Hilliard Arkansas

Robert Shmaeff California

Sherman Gershman Connecticut

Kevin Musto Delaware

Fritz Hayes Florida

Ron Stephens Georgia

Kerri Okamura Hawaii

Steven Bandy Illinois

Jane Krause Indiana

Richard Hartig Iowa

Robert Nyquist Kansas

Larry Stovall Kentucky

Lloyd Duplantis Louisiana

Kenneth McCall Maine

Butch Henderson Maryland

Paul Jeffrey Massachusetts

Derek Quinn Michigan

Jenny Houglum Minnesota

Robert Wilbanks Mississippi

Richard Logan Missouri

Gayle Hudgins Montana

Heather Mooney Nevada

Richard Crowe New Hampshire

Edward McGinley New Jersey

Amy Bachyrycz New Mexico

Benjamin Gruda New York

David Moody North Carolina

Kevin Oberlander North Dakota

Danny Bentley Ohio

Gordon Richards, Jr. Oklahoma

Ann Zweber Oregon

Thomas Mattei Pennsylvania

Deborah Newell Rhode Island

Sharm Steadman South Carolina

Renee Sutton South Dakota

Mac Wilhoit Tennessee

Jim Cousineau Texas

Marvin Orrock Utah

John Beckner Virginia

Gregory Hovander Washington

Terri Smith Moore Washington DC

David Flynn West Virginia

Brian Jensen Wisconsin

Randy Harrop Wyoming

The “Bowl of Hygeia”

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.

17

Feature Implementation of an Opioid Management Initiative by a State Medicaid Program J Manag Care Spec Pharm. 2014 May;20(5):447-54.

Authors: Garcia MM1, Angelini MC, Thomas T, Lenz K, Jeffrey P.

Background

Compared with 2002, the overall number of LAOA unique utilizers declined 17.8% (P < 0.0001), and the

To examine the impact of a two-year stepwise initiative to reduce utilization and therapy costs of long-acting opioid analgesics (LAOA) by addressing issues of high dose, daily dose, and preferred therapeutic alternatives.

overall number of claims declined by 4.1% (P < 0.0001), while Medicaid pharmacy benefit member enrollment remained relatively stable. Average daily dose declined in methadone and morphine ER and increased in oxycodone ER and fentanyl transdermal system. The 2005 overall cost of LAOAs decreased 8.0% compared with the overall cost in 2002. The per-member-per-month (PMPM) cost for opioid users in 2002 was $110.57 ($120.04 when adjusted to 2005 dollars) compared with $123.75 in 2005. In comparison, the overall PMPM for all members in 2002 was $3.52 ($3.82 when adjusted to 2005 dollars) compared with $3.59 in 2005.

Methods:

Conclusions

Utilization data from the Massachusetts Medicaid pharmacy program for LAOAs were reviewed and compared for 2 time periods. The calendar year prior to the initiative, 2002, was used as a base year and represents a time period when there were no restrictions in place for members to obtain longacting opioids. The calendar year 2005 was the comparison year representing a time period after the multiple steps of the initiative had been implemented. A retrospective claimsbased analysis was performed to determine the impact of restrictions on LAOAs, defined as brand and generic versions of oxycodone ER, morphine ER, methadone, and fentanyl transdermal system. The primary measure was the percentage of change of unique utilizers, paid claims, and average daily dose for each LAOA following the implementation of the opioid management initiative.

Secondary measures included a cost analysis.

Our study successfully demonstrated that a state Medicaid program initiative can result in a significant overall decrease in opioid class utilization specifically for the targeted, more costly agents. This was achieved via the implementation of a Therapeutic Class Management multidisciplinary workgroup that established a prior authorization process implementing limits on dose, as well as identified preferred less costly agents. It further facilitated the direct opportunity for pharmacy-prescriber collaboration for LAOA medication management.

The utilization of prescription opioids has increased over the last 2 decades. Associated with this is the misuse of prescription opioids for nonmedical purposes. Medicaid programs have struggled with developing strategies that balance best practice models, appropriate utilization, and reduction in costs associated with the opioid medication class.

Objective

18

Results

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Rx and the Law

disclosures to a coroner or medical examiner to help identify a person or help determine the cause of death.

By: Don R. McGuire Jr., R.Ph, JD

Regulations also permit disclosures for cadaveric organ, eye or tissue donations; or for research purposes. There are a number of specific conditions regarding disclosures for research purposes.

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.

Disclosures of PHI Uses and disclosures of Protected Health Information (PHI) are allowed under the Health Insurance Portability and Accountability Act (HIPAA) as needed to perform transactions for treatment, payment, or healthcare operations (TPO). This is well known to pharmacists, but not always by patients. Patients are aware of HIPAA and some of them think that HIPAA prohibits all use and disclosure of PHI. Patients have reported claims alleging that the pharmacists violated HIPAA by contacting the prescriber to clarify a prescription.

Pharmacists know that they can disclose PHI to another treating health professional under TPO. Pharmacists may be less aware of other uses and disclosures permitted under HIPAA that are not included under TPO. These can be found in the Code of Federal Regulations at 45 CFR 164.512.

These uses and disclosures are not absolute. Many have conditions that must be met prior to the use or disclosure being made. The length of this article wonâ&#x20AC;&#x2122;t allow a complete listing of all the conditions for each. The regulations may also restrict the parties to whom the disclosure may be made. The first permitted use and disclosure is for public health activities. This allows disclosures to public health authorities, FDA and other persons in certain circumstances. One of these is an agency authorized to receive reports of child abuse or neglect. This connects to a second permitted disclosure about victims of abuse, neglect, or domestic violence. There is some overlap in these permitted uses, so caution is needed to make sure your situation fits into the parameters.

There are three related disclosures that involve law enforcement. The first allows disclosures to law enforcement officials about victims of crime or about criminal conduct.

Disclosure is also permitted to avert serious threats to health or safety, either to a person or to the public. This could even include disclosing PHI that would help police identify or apprehend escapees. The third permitted use here is 20

There are two exceptions involving the legal and regulatory system. The regulation provides for disclosures to a health oversight agency if the agency is performing their oversight activities. This would include audits, inspections, investigations or disciplinary actions. These are not audits conducted by third party payers. There is also an exception for court orders and subpoenas. There are conditions to be met for the subpoena exception to be valid, so use caution when responding to a subpoena.

The last two exceptions are in specialized areas. The first is for specialized government functions. These include uses and disclosures for military and veterans activities, national security activities, protective services for the President, correctional institutions or to the National Instant Criminal Background Check System. The last exception is the disclosure of PHI to workers compensation programs as required by law. Workers compensation is a statutorilycreated system that regulates the care of injured workers.

The lesson for pharmacists is that there are many situations other than TPO where use or disclosure of PHI is permitted without the patientâ&#x20AC;&#x2122;s authorization. All of the exceptions are subject to conditions and are not absolute. Also, the pharmacist should remember that they are only allowed to disclose the minimum amount of information necessary to fulfill the purpose of the disclosure. These exceptions are not authorizations to disclose all PHI concerning an individual.

When presented with a request for PHI, the pharmacist should investigate if the request is permissible under TPO or some other exception. If the request is permissible, the pharmacist should verify that all conditions have been met.

The Department of Health and Human Services has a useful page on its website to help the pharmacist navigate rules and conditions. It can be found at: http://www.hhs.gov/hipaa/for-professionals/faq. As always, the pharmacist should reach out to their local attorney if they need assistance in navigating the HIPAA waters.

From the Colleges

Pharmacy Journal of New England • Winter 2016

University of Connecticut School of Pharmacy As we continue the celebration of our 90 years of excellence in pharmacy education, our focus in this edition is on a select group of alumni who have chosen a career in hospital pharmacy. Many UConn graduates are working in hospital pharmacy across the state and nation. In fact, the majority of directors of pharmacy at hospitals in Connecticut are UConn alumni. Thanks for all you do for your patients every day!

Robert J. Bepko, Jr. ’77, did not attend his graduation ceremony.

He was working at Norwalk Hospital where he has spent his entire 39-year career. He is currently the administrative director of network pharmacy services for the Western Connecticut Health Network of Danbury, New Milford, and Norwalk Hospitals. While working full-time, he also earned a Master of Health Administration from Western Connecticut State University.

Bepko is active in many professional organizations. He is a member of the Connecticut Pharmacist Association, Connecticut Pharmacy Services Corporation, Connecticut Society of Health System Pharmacists, American Society of Health System Pharmacists, the National Council for Prescription Drug Programs, and the UConn School of Pharmacy Advisory Board. He is a former member of the Board of Directors the UConn Pharmacy Alumni Association, McKesson’s Health System Advisory Board and Bergen Brunswick’s Health System Advisory Board. Bepko is an ambassador for the school, often speaking to high school and undergraduate students interested in pursuing a career in pharmacy. He allows these students to shadow his work and often presents in UConn pharmacy courses.

Christopher R. Fortier ’01, ’03, is the chief pharmacy officer at Massachusetts General Hospital -- the youngest person to ever serve in this capacity. While at UConn, he distinguished himself as a leader serving as chapter president of the American Pharmacists Association Academy of Student Pharmacists and on the executive committee of the Connecticut Pharmacists Association. Fortier completed a PGY-1 Pharmacy Practice

residency and a PGY-2 Health-System Pharmacy Administration residency at the Medical University of South Carolina in Charleston, continuing at MUSC for 8 years.

He was a state chapter representative to the ASHP House of Delegates and served as secretary of the chapter and chair of the Education/ CE Committee. He also held adjunct faculty appointments at the South Carolina College of Pharmacy, MUSC Campus.

He is active in the Massachusetts Society of Health-System Pharmacists and is a preceptor for PGY-1 and PGY-2 residency programs with Massachusetts General Hospital. He has published in journals such as Annals of Pharmacotherapy and the American Journal of Health-System Pharmacy and has traveled extensively for invited presentations at national and international meetings. He is a fellow of the American Society of Health-System Pharmacists and an adjunct professor at Northeastern University, the Massachusetts College of Pharmacy, and UConn.

Gregory C. Gousse ’71, ’75, is a senior consultant in the Performance Services pharmacy area of VHA, Inc., a nationwide network of not-for-profit hospitals and academic medical centers. He previously served 17 years as director of hospital pharmacy at Hartford Hospital and also worked in both long-term care pharmacy and in pharmaceutical consulting. While at Hartford Hospital, he established a general practice residency program and mentored over 30 graduates. He is honored with an annual Connecticut residents/preceptors conference that bears his name. He credits Charles Nightingale, a former UConn faculty member and director of pharmacy at Hartford Hospital, with much of his success in decentralizing the pharmacy and getting them on the medical 21

From the Colleges

continued

team. Gousse’s dedication to the value of residency programs has helped to develop programs at the UConn School of Pharmacy.

Gousse is a member of the American Society of Health Systems Pharmacists and the Connecticut Society of Health Systems Pharmacists. He Is a past president of the CSHP and the New England Council of Hospital Pharmacists, served as a member of ASHP’s Council on Legal and Public Affairs, was program chair for the Eastern States Conference for Residents and Preceptors, chaired the Connecticut VHA Pharmacy Director’s Council, and is an emeritus member of the School of Pharmacy Advisory Board. He has authored over 30 publications and is a frequent presenter at national meetings. He is a recipient of the state’s highest award for institutional pharmacy practice, the Paul G. Pierpaoli Lecture Award.

Janet Kozakiewicz ’79, is the director of pharmacy services at Yale-New Haven Hospital.

She also serves as the program director for the PGY2 Residency Program in Health System Administration as well as an adjunct assistant professor of pharmacy practice for the UConn School of Pharmacy.

In addition to her bachelor’s from UConn, Kozakiewicz earned a Doctor of Pharmacy from the Massachusetts College of Pharmacy and Health Sciences, and a M.S. in healthcare management from Rensellear. She is also a fellow of the American Society of Health System Pharmacists.

Kozakiewicz credits many mentors in her career who

challenged her to think of practice in new ways. One of the most influential was former UConn faculty member Dennis Chapron. Throughout her life she has taken on new challenges — as a clinical instructor, a psychiatric pharmacist, and a consultant. She built programs from the ground up and developed the first hospital “bedside discharge program.” Bedside filling coupled with patient counseling, said Kozakiewicz, “greatly increased patient satisfaction for outpatient surgery.”

Michael Rubino ’75, director of pharmacy services at Hartford Hospital, has a broad range of experience in pharmacy administration, operations, clinical services and teaching, with over 25 years of health system pharmacy leadership in academic and community hospitals. His executive health-system pharmacy management positions include director of pharmacy for a large teaching hospital, a mid-size medical center, and a university hospital, as well as residency preceptorship and academic appointments at the level of associate clinical professor.

Rubino is working to integrate pharmacists into more direct patient care in the hospital and to provide continuity of care after discharge. As more hospitals and care facilities join the Hartford Health network, he is concentrating on developing seemless practices across the sites. This will be essential as the system migrates to new, electronic health-record software.

After earning his bachelor’s degree in pharmacy at the University of Connecticut, Rubino completed two American Society of Health System Pharmacists accredited residencies

Did You Know?

That the Connecticut Pharmacists Association offers a 2-Week Online Course for CT Law? www.ctpharmacists.org 22

Pharmacy Journal of New England • Winter 2016

Husson University School of Pharmacy Pharmacy Practice Faculty Earn Board Certification in Fall 2015

something special about this man and could see the passion and love for the profession of pharmacy as well as the patients he cared for. . .”

Four clinical faculty have successfully earned Board of Pharmacy Specialties certification effective December 2015.

Drs. Gwen Bartlett and Sandy Bartlett successfully attained Board Certified Critical Care Pharmacists (BCCCP) status to complement their Board Certified Pharmacotherapy Specialist (BCPS) certification. Dr. Alla Fabrikant passed the Psychiatric Pharmacy Board Examination and is now a Board Certified Psychiatric Pharmacist (BCPP) in addition to her existing credentials as a BCPS. Dr. Ying-Tang Ng met success in passing the Board Certified Pediatric Pharmacy Specialists (BCPPS) exam. This was the inaugural certification examination for both the BCCCP and the BCPPS.

Director of Experiential Education Receives Terminal Degree Frank McGrady graduated December 2015, from Idaho State University with the Doctor Pharmacy (Pharm.D.). Dr. McGrady previously earned a Bachelor of Science degree in Pharmacy from the University of Rhode Island. To further his knowledge base he pursued the non-traditional Pharm.D. through Idaho State University, completing his experiential requirements this past fall through Sebasticook Valley Health and Eastern Maine Medical Center Family Practice, Orono.

Pictured above, L to R: Distinguished Young Pharmacist Jason Berube accepts his award from Greg Cameron, MPA President.

How can you influence the direction of the pharmacy profession?

Join us at the

Pharmacy Alumnus Selected Maine Distinguished Young Pharmacist for 2015 Jason Berube, Pharm.D. (Class of 2013) was selected as the Distinguished Young Pharmacist of the Year at the Maine Pharmacy Association Fall 2015 meeting. Pharmacists Mutual Companies designed this program to acknowledge young pharmacists in each state for individual excellence and outstanding contribution to their pharmacy association and community. The nomination from Tim McCall, former director of Pharmacy, Maine Coast Hospital, epitomizes the award when he said “[MCHP was] blessed to have this future pharmacist do an APPE rotation. You could tell there was

Massachusetts Face of Pharmacy March 30, 2016 State House, Boston 10 a.m. - 1 p.m.

The Face of Pharmacy is an opportunity for you to make a difference. Share stories of what you do, talk about the impact pending legislation will have on your profession, and take your legislator to view displays about the variety of important work that pharmacists do.

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From the Colleges

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Massachusetts College of Pharmacy and Health Sciences â&#x20AC;&#x201C; Boston Dear Colleagues, On behalf of President Charles F. Monahan Jr. and Provost Douglas Pisano, I wish you all a happy and successful New Year. The new semester is well under way here at MCPHS University, and as usual our faculty and students in the School of Pharmacy Boston are doing very well. I would like to provide you with following key updates concerning their achievements.

Paul DiFrancesco, EdD, MPA, RPh Dean and Associate Professor MCPHS School of Pharmacy Boston

Faculty Research Grants Michele Matthews, PharmD, Associate Professor of Pharmacy Practice, is currently a co-investigator on an NIH Pain Consortium grant which was recently awarded in September 2015 in the amount of $985,250 to develop pain management training and educational resources for medical, dental, pharmacy, nursing, mental health, physical therapy and other health professionals to advance the assessment, diagnosis, and safe treatment of pain. This grant was awarded as a collaborative effort between MCPHS University and the following institutions: Harvard Medical School, Harvard School of Dental Medicine, Regis College of Nursing, Tufts Medical School, and the Massachusetts General Hospital Institute of Health Professions.

Director of the RAHP program and Stephen Kerr, Chair of the Pharmaceutical Sciences Department) from the School of Pharmacy Boston visited the Novartis facility in Hyderabad to offer the newly enrolled students a workshop in graduate education and online learning.

PLS National Student Leadership Society On January 20, Phi Lambda Sigma (PLS) honored 16 new members with an Induction Ceremony at the Hampshire House in Boston. PLS is regarded as a national pharmacy leadership society with the focus of promoting the development of leadership qualities, principally among pharmacy students. PLS honors leadership with member selection based on peer recognition. Recognition is designed to instill and enhance self-confidence, promoting the advancement of pharmacy.

PLS welcomed 14 new student members and 2 distinguished faculty. All were recognized for their active involvement in advancing the profession through exemplary actions and leadership. Abimbola Cole, Anusha Sekhar, Catherine Behret, Derek Matthies, Divyani Patel, Jenny Mullakary, Kristine Wong, Mallory Mouradjian, Nikhil Sangave, Niyati Butala, Rachelle St. Fleur, Stefano Torkos, Thomas Simjian, and Tucker Ward were all honored as new student initiates. Dr. Dorothea Rudorf, Professor of Pharmacy Practice, and Dr. Lisa Padgett, Assistant Professor of Pharmacy Practice, were recognized and inducted for their leadership and contributions to the profession as distinguished faculty.

International Collaboration In December, MCPHS University signed an agreement with Novartis Healthcare (India) to enroll 20 Novartis employees at its Hyderabad (India) facility to the online MS Drug Regulatory and Health Policy (RHAP) program.

As part of this initiative, faculty members (Lynn Squillace, 24

PLS National Student Leadership Society

Pharmacy Journal of New England • Winter 2016

ASHP Midyear Conference A total of 31 research posters were presented by students and faculty form the School of Pharmacy Boston at the 50th Annual Midyear Clinical Meeting in New Orleans in December 2015.

Center for Sustainability and the Environment On January 22, a team of Doctor of Pharmacy students from the MCPHS University Boston Campus were awarded a grant through the Colleges of the Fenway (COF) Center for Sustainability’s 2nd Mini-Grant Competition. The Center aims to support and recognize student led research, projects and/or initiatives which promote sustainability.

This year 18 applications were submitted and the COF was able to award a total of $3,000 to the 6 winning applicant teams. The money awarded will be used by the winners to further their projects.

The winning student teams from MCPHS were:

• Kevin Brecken and Anna Guo: The goal of this project is to evaluate if automatic utensil dispenser will help to decrease utensil waste at MassArt/MCPHS cafeteria.

• Laura Dalcomine, Shawn Silva and Nicole Young: Installation of motion-sensor lightning – the goal of this project is to implement motion-sensing lighting in the University wherever possible.

• Crisamar Martinez : Green Laboratories Certification – The goal of this project is encourage laboratories at the University to participate in certification and make laboratories green • Team Orvosi led by Christopher Morse and Briana Colizzi.

The goal of this particular project is to begin research and development of a medical device that can be used with multi-dose inhalers to prevent waste of inhaled medications. Many thanks go to their faculty mentors including Dr. Lana Dvorkin, Dr Joe Ferullo, Professor Frank Melaragni, and Adjunct Professor Nancy Stern for successfully guiding these students.

Massachusetts College of Pharmacy and Health Sciences – Worcester/Manchester Dear Colleagues, We are in full swing into another busy semester and the P1 students have adapted well into our accelerated Program. They are just beginning to explore their options that our wonderful profession offers and are already joining various clubs and professional organizations. The current P2 students are finding out just what taking classes in Pharmacology and Therapeutics means. Meanwhile the P3s are finishing up rotations and deep into their search for employment. I wish everyone a successful academic year.

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

Timothy Dy Aungst, PharmD, Assistant Professor of Pharmacy Practice was invited to attend and participate at Stanford Medical School annual MedXEd program, which is dedicated to the advancement of digital technolgies and innovation in medical practice, patient communication, and medical education. He was also invited to present at the BIG DiP USA in Boston on the role of digital technologies and informatics in the pharmaceutical industry, where he presented his topic, “The impact of data from wearables, sensor technologies and mobile apps on the future of pharma” along with Lisa Gualtieri, PhD (Tufts University) 25

From the Colleges

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and his research rotation student Steven Khov, PharmD Candidate 2016.

Timothy Aungst, Lisa Gualtieri, Steven Khov. â&#x20AC;&#x153;The Impact of Data from Wearables, Sensor Technologies and Mobile Apps on the Future of Pharma.â&#x20AC;? BIG DiP USA 2015: Analytics and Insights for Pharma, Boston, MA.

Student Recognition Congratulations to Christopher Rochon and Meghan Amaral who competed in the 20th annual National Clinical Skills Competition (CSC) at the ASHP Midyear meeting in New Orleans, LA this past December! One-hundred twenty-nine student teams from pharmacy schools across the country competed in this competition. The ASHP CSC is an interactive, team-based analysis of clinical scenarios for hospital/healthsystem pharmacists. Although a team from Rosalind Franklin University came in first place, we at MCPHS University are incredibly proud of a job well done by Chris and Meghan.

Poster Presentations 41 different students and 20 different faculty members worked together to present 29 posters at the 50th ASHP Midyear Clinical Meeting and Exhibition that took place in New Orleans, LA December 6-10, 2015.

Among those presenting posters:

MCPHS Continuing Education: Your Connection to Lifelong Learning

-WA Coyne, CW Goldsmith. Energy drinks: a survey of pharmacy student and faculty consumption and knowledge of ingredients

The MCPHS CE Department offers a variety of ACPE-accredited live and online activities throughout the year. Check out www.alumni.mcphs.edu/CE for complete information. Stay engaged and become a lifelong learner!

-N Rebrin, D Ge, MR Cooper, CW Goldsmith. A pilot study of the effects of yoga practice intervention on sleep outcomes and quality-of-life in cancer patients undergoing treatment.

Upcoming live pharmacy activities include the signature 76th Annual Reed Conference (March 10, Gillette Stadium in Foxborough), CE Evenings at Baystate (May/June, Whitney Center in Holyoke), Preceptor Appreciation Day (September 8, Doubletree Hotel in Westborough), 7th Annual Stoklosa Symposium (October 20, Holiday Inn in Peabody), and Pharmaceutical Care Days (December 3-4, Worcester campus).

The online library currently features 22 sessions on a variety of topics, including the newly-required areas of sterile and complex non-sterile compounding.

Faculty Recognition Linda M. Spooner, PharmD, BCPS (AQ-ID), FASHP was invited to become a member of the American Society of HealthSystem Pharmacists Antimicrobial Resistance Task Force, which will began meeting in January. She has also served as Chair of the Section of Inpatient Care Practitioners Educational 26

Steering Committee since September 2015.

-Brian Tran, David Fun, Xiao Ma, Sun-Min Lim and Chase Smith, Ph.D. Design and synthesis of analogs of Bromophycolide A as novel antimalarial agents.

-Exchange Protein Directly Activated by cAMP (Epac) as a Novel Regulator of Airway Smooth Muscle Functions in Asthma. A. Alhubaishi, R. Alsaffar, A. Gardner.

-Trinh L. and Friel C.J., Isoniazid Overdose: Rationale for 1:1 Pyridoxal Antidotal Therapy.

Awards Linda M. Spooner, PharmD, BCPS (AQ-ID), FASHP received the 2015 Adult Medicine PRN Mentoring Award from the American College of Clinical Pharmacy at the Annual Meeting in San Francisco, CA in October 2015.

Pharmacy Journal of New England • Winter 2016

University of New England UNE Researchers Explore Oxytocin Influence on Psychological Disorders University of New England researchers are embarking on a three-year study into the effects of oxytocin on patients suffering from psychosocial distress, thanks to an Academic Research Enhancement Awards (AREA) grant through the National Institutes of Health’s (NIH) National Institute on Aging.

Oxytocin, a naturally produced chemical in the human body, influences how we process and respond to emotional stimuli. Clinicians have long been administering pharmaceutical oxytocin to patients with certain psychiatric disturbances, including autism, schizophrenia and depression, with the goal of alleviating some of the negative symptoms associated with these disorders; however, researchers are now interested in learning more about naturally-occurring oxytocin levels, with the hope that such information will allow them to manipulate these levels to improve the quality of life for patients.

Srinidi Mohan, Ph.D., assistant professor in UNE’s Department of Pharmacy, will serve as co-primary investigator for the study along with Nancy Koven, Ph.D., associate professor of psychology at Bates College.

“Little is known about the psychosocial correlation of naturally-occurring oxytocin levels,” Mohan explained. “This grant will provide us with the opportunity to administer assessments and behavior tests to better understand how this chemical affects how we process and respond to emotional stimuli. Ultimately, our goal is to help improve people’s emotional well-being and the quality of social relationships.”

UNE Pharmacy Students Conduct Blood Pressure Screenings at Maine Medical Center Outpatient Pharmacy In celebration of National Pharmacy week, the StudentSociety of Health-Systems Pharmacy (SSHP) conducted blood pressure screenings at Maine Medical Center’s newest 24

hour outpatient pharmacy on October 19, 2015.

At the event, thirdyear Pharmacy students, L. Amaka Ugbome, Brandon Kong, and Ashley Woon helped educate patients and increase awareness about the dangers of high blood pressure.

Students also informed patients about a new life-saving program called the “Vial of Life.” This program allows individuals to fill out their complete medical information on forms that they can store in vials in the refrigerator, which will help emergency responders readily locate pertinent medical history during urgent situations.

UNE College of Pharmacy Welcomes Class of 2019 with Annual White Coat Ceremony UNE’s College of Pharmacy formally recognized the Class of 2019 at its seventh annual White Coat Ceremony on Saturday, September 26, 2015. This event is an honored tradition that welcomes first-year students to the profession of pharmacy. An open house was held on Friday, providing an opportunity for new students to familiarize themselves with UNE’s full range of campus organizations.

The ceremony began with remarks from Associate Dean of Student Affairs and Admissions, Jean MB Woodward, Ph.D., R.Ph., who reminded students of their responsibility to the profession by explaining the significance of the White Coat. “White Coat ceremonies have been used by Schools of Medicine and Pharmacy as an outward sign of a personal commitment to the profession,” she stated. As a student of pharmacy, professionalism means to practice with excellence and accountability, and to always act with respect, honor and integrity.

“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.”

Marie Chisholm-Burns, Pharm.D., M.P.H., M.B.A., FCCP, FASHP, dean of the College of Pharmacy at the University 27

From the Colleges

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of Tennessee Health Science Center, joined this year’s ceremony as keynote speaker. Dean Chisholm-Burns is on a mission to “make a difference” in the lives and health of others through research, writing, clinical care and teaching.

Her efforts have been recognized with the 2014 Research Achievement Award, presented to her by the American Pharmacists Association (APhA).

Chisholm-Burns said, “The White Coat symbolizes healing. It represents a contract between you and each patient under your care. The contract means that we as pharmacists will provide the best evidence-based practice that science has available in a compassionate and supportive environment in order to facilitate optimal health, thereby promoting the professionalism of pharmacy.”

Congratulations, and welcome to the Class of 2019!

College of Pharmacy Faculty and Students Present Posters at the American College of Clinical Pharmacy Global Conference Several faculty members and students from UNE’s College of Pharmacy traveled to San Francisco, California to present posters at the 2015 American College of Clinical Pharmacy Global Conference, held October 17–21: • Kenneth McCall, B.S.Pharm., Pharm.D., associate professor and chair of the Department of Pharmacy Practice, and Leslie Ochs, Pharm.D., Ph.D., M.S.P.H., assistant professor, were co-authors on a poster, titled “Prescription monitoring program trends among individuals arrested in Maine for trafficking prescription drugs in 2014.” Their presentation was recognized as the “First Runner-Up Best Paper” at the conference.

• Cathy Ng, Pharm.D. ’18 and Olgun Guvench, Ph.D., assistant professor in the Department of Pharmaceutical Sciences, presented their poster titled, “Molecular modeling studies on the tetrasaccharide linker of proteoglycans.”

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UNE Student Society of Health-System Pharmacy Provides Wellness Services to Community UNE’s Student Society of Health-System Pharmacy (SSHP) chapter coordinated with the Visiting Nurses Association (VNA) to host a wellness event at the Sacred Heart Church in Portland on Sunday, October 25, 2015.

During the event, SSHP conducted 55 blood pressure screenings and counseling sessions, while the VNA provided more than 70 flu vaccines.

Third-year College of Pharmacy students Ashley Woon and Ryan Dang represented the SSHP at the event by serving as volunteers.

UNE Students Hold Fall Festival at Portland Boys & Girls Club On October 28, 2015 UNE’s Westbrook College of Health Professions Office of Service Learning partnered with students and faculty leaders for the second fall festival at the Boys and Girls Club in Downtown Portland.

The students, representing the Health, Wellness and Occupational Studies, Physical Therapy, Pharmacy, Nursing, Physician’s Assistant, Applied Exercise Science, and Psychology programs served approximately 120 kids ages 7-12 at the event. Students worked together in interprofessional teams to design activities for the kids that stimulated their imaginations and promoted healthy living. The Boys and Girls club relies on food pantries and donations for its nightly meals, so student volunteers brought donations of non-perishable food items and helped prepare and serve dinner.

College of Pharmacy Alumna, Rachel Naida, Joins UNE as Faculty Member Rachel Naida, Pharm.D. ’13, returned to UNE’s College of Pharmacy, this time as an assistant professor, in November.

Naida is the first COP graduate to join the College as a faculty member.

Naida earned her bachelor’s degree in pre-pharmacy at UNE and stayed with the University until she graduated with her Doctor of Pharmacy in 2013. As a member of the inaugural

Pharmacy Journal of New England • Winter 2016

Pharmacy class, Naida had the unique opportunity to grow with the program as it evolved.

225 sponsors in the United States House of Representatives and 34 sponsors in the Senate.

“The Pre-Pharmacy program was just getting started and the pharmacy school had not yet been built when I began at UNE,” she recalled. “However, the faculty at the College of Pharmacy kept in close contact with the prospective students and made us all feel connected to the process of the school coming together.”

Robinson and Kany were selected from a competitive application process that offers only 50 seats nationally.

After being trained on the policy-making process, effective communication and pharmacy issues, these two students will put their education into action during their Capitol Hill meetings.

After graduation, Naida completed her Post Graduate Year One (PGY1) residency at the Veterans Administration Healthcare System at Togus in Augusta, Maine. She then went on to become a clinical pharmacy specialist with the same organization, practicing ambulatory care in a variety of clinics including hepatitis C, diabetes and anticoagulation.

These experiences will be an asset to UNE’s students as she embarks on her newest faculty role.

“My whole experience at UNE has been wonderful, from my time during the Pre-Pharmacy program up through the doctorate program. I am very excited to begin a career in education and even more thrilled to be doing so at UNE!”

College of Pharmacy Students Selected to Advocate for Pharmacy Legislation on Capital Hill UNE College of Pharmacy students Chantelle Robinson ’16, and Erin Kany ’17, have been selected from a national pool of applicants to represent the profession of pharmacy at the 2016 National Association of Chain Drug Stores (NACDS) RxIMPACT Day on Capitol Hill in Washington, D.C., March 16 –17, 2016.

This event will provide Robinson and Kany the opportunity to meet with legislators to advocate for HR 592/S314, the Pharmacy and Medically Underserved Areas Enhancement Act. HR 592/S314 aims to increase access to pharmacist services, thereby improving healthcare and advancing the profession of pharmacy to provider status. It currently has support from

“Advocacy for patients and the profession of pharmacy is important because it serves as the intersection of professionalism and citizenship,” says Kenneth McCall, B.S.Pharm., Pharm.D., associate professor in the Department of Pharmacy Practice at UNE. “Student participation in these Capital Hill visits culminate in specific legislative ‘asks’ such as sponsorship of HR 592 and the delivery of supporting documentation; however, what students take away from these meetings could be more important than what they leave behind. This experience enables them to expand their own personal viewpoints through interactions with legislators and legislative staff, and to better articulate the value that a pharmacist provides to the health of society,” said McCall.

University of New England Holding “Cram the Van” Event to Benefit Milestone’s Home Team UNE held its first “Cram the Van” event to benefit the Milestone Foundation’s Homeless Outreach and Mobile Engagement (HOME) Team. The event, which took place Wednesday, November 18 on the UNE campus, encouraged students to drop off socks, backpacks, thermal underwear, gloves, hats, hand warmers and boots for Milestone’s homeless client population. UNE aims to fill the HOME Team’s van with donations.

A collaboration between Milestone, the City of Portland and the Portland Downtown District, the HOME Team provides outreach and community supports to those with chronic health, mental health and substance use disorders living on the streets of Portland. The HOME Team proactively engages with individuals who may be exhibiting disruptive or unsafe behaviors and helps them relocate to the safety of the shelter 29

From the Colleges

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or, if needed, access more intensive services.

UNE, which offers undergraduate, graduate, and professional degree programs in the health sciences, has shared a strong partnership with Milestone for over three years. This mutually beneficial relationship provides UNE students with an opportunity to serve their community while learning about the specific health needs and challenges of Portland’s homeless population. Milestone orients UNE students to the shelter and provides training on ways to best serve this population through meetings with shelter staff and a chance to shadow the HOME team. This fall, over 40 UNE students attended the orientation.

“UNE and Milestone work together to provide students with the opportunity to reach out to the community and make a difference,” said UNE nursing student, Ashlee Klemczuk ’16. “It gives us the opportunity to build strong ties with the community and become better healthcare professionals with an understanding and appreciation for the diverse population we serve in the Portland area.”

Twice per month, interprofessional teams of UNE students and faculty (from Nursing, Physical Therapy, Physician Assistant, Dental Hygiene, Occupational Therapy and Pharmacy) host health clinics at Milestone, providing services such as neuropathic foot checks, foot soaks, blood pressure screenings, fluoride varnishes, stretching and gait analysis, medication education and awareness, and games.

“I go to Milestone thinking that I have the capability to help their clients, and I leave Milestone realizing that they have helped me,” said Dennis Leighton, P.T., D.P.T., associate professor of Physical Therapy. “I have a greater realization of how life circumstances happen, often unintended, and how those of us who can need to bring a good day or hour to these men and women. When I see a Milestone client smile after putting on a new pair of socks, it makes me wonder about the last time he smiled. In that moment I know that we have done a good thing.”

Among the more than one hundred UNE students who have volunteered at Milestone, some have gone on to either work or continue to volunteer at the Milestone Shelter after they graduate.

“We are thrilled with the partnership between Milestone and 30

the University of New England,” said Bob Fowler, Milestone’s Executive Director. “We are grateful for the support UNE provides to the vulnerable individuals served by Milestone, and we’re excited for a successful ‘Cram the Van’ event!”

Hospital Pharmacist Appointed to MeSHP Board of Directors Maria-Ausilia Evans, PharmD, a pharmacist at Franklin Memorial Hospital (FMH), has been elected to the 11-member board of directors of the Maine Society of Health-System Pharmacists (MeSHP). Evans is the Region 2 director representing Androscoggin, Franklin, Oxford, and Sagadahoc counties. She has been a member of the nonprofit organization since 2009.

MeSHP’s leading goal in 2016 is to attain “provider” status and it is working closely with the American Society of Health-System Pharmacists and the Maine Pharmacy Association to accomplish this.

Achieving provider status gives patients access to the valuable care that pharmacists provide. Becoming a provider also means that pharmacists can participate in Part B of the Medicare program and bill Medicare for services that are within their state scope of practice to perform.

Evans earned her doctor of pharmacy degree in 2013 from the University of New England College of Pharmacy. A resident of Carrabassett Valley, she has been a pharmacist at FMH since May 2014.

The Maine Society of Health-System Pharmacists is a professional organization consisting of pharmacists, pharmacy technicians and other related professionals who practice in health system and community pharmacy settings. MeSHP strives to provide an interactive statewide environment so its members can achieve their full potential in scope of knowledge and quality patient care.

Pharmacy Journal of New England • Winter 2016

University of St. Joseph School of Pharmacy Message from the Dean Dear Colleagues: Greetings to All! The faculty, staff, and students here welcomed 2016 with great expectation. We look forward to the implementation of the various new guidelines that seek to keep our profession current. And, as always, we remain grateful for your support.

Happy New Year!

Dean Joseph R. Ofosu

Preceptor of the Year Award Ceremony The University of Saint Joseph School of Pharmacy hosted its annual Preceptor of the Year Award Ceremony on October 6, honoring Ginger Croxall, R.Ph. and Edgar Albuja, R.Ph. The ceremony honored and awarded experiential education professionals/pharmacist preceptors who teach students the practice-related skills needed to provide quality pharmacist care. In addition to serving as educators, pharmacist preceptors mentor student pharmacists while promoting personal and professional growth.

Ginger Croxall, R.Ph., is a staff pharmacist at Day Kimball Hospital in Putnam, where she works in the main pharmacy and the Oncology Clinic. Croxall is currently developing an Antibiotic Stewardship Program and working to improve the Medication Reconciliation process. She is a 1990 graduate of the University of Connecticut School of Pharmacy, and has been a preceptor for 20 years.

Edward Albuja R.Ph., received his degree from the University

of Connecticut School of Pharmacy. He is a clinical pharmacist at Cornell Scott Hill Medical Center, where he oversees the Anticoagulation Clinic, Direct Observation Therapy, and Diabetes Clinic. Albuja has more than 22 years of experience serving community and hospital settings.

Posters and Presentations Sibicky SL and Luciano J, “Comparing Virtual Patient Cases to Traditional Patient Cases in a Geriatrics Course;” ASCP’s 46th Annual Meeting and Exhibition, Las Vegas [October 2015] Salinger LM, McKay C, Laskey D et al. “Lessons Learned from a Brodifacoum Case Exhibiting Prolonged Morbidity.”

Annual Meeting of the North American Congress of Clinical Toxicology, San Francisco, CA [October 2015] Laskey D, Neavyn M. “APAPxAT as a hepatotoxicity predictor in patients with acetaminophen ingestions of chronic, subacute, or unknown time.” Annual Meeting of the North American Congress of Clinical Toxicology, San Francisco, CA [October 2015] Laskey D, Vadlapatla R, Hart K. “Sixteen unit/mL is a stable and practical solution for administration of high dose insulin for treatment of beta blocker and calcium channel blocker toxicity.” Annual Meeting of the North American Congress of Clinical Toxicology, San Francisco, CA [October 2015] Levine AR, Banka S, Thachil R, Lin H, Lee J. “Comparison of the incidence of flushing with immediate release niacin in combination with various aspirin formulations.” 26th Annual Catch the Wave Conference. Waterbury, CT [November 2015]

Pictured from L to R: Mr. John Parisi, Director of Experiential Education; Mr. Edward Albuja; Ms. Ginger Croxal; Dean Joseph Ofosu, Dean of the USJ School of Pharmacy: and Ms. Noreen Todd, Coordinator of Experiential Education.

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Kohn CG, Rozjabek H, Fermann GJ, Peacock WF, Crivera C, Schein JR, Coleman CI. “Does the Timing of Vital Sign Measurements Affect Simplified Pulmonary Embolism Severity Index (sPESI) Risk Determination?” 57th American Society of Hematology Annual Meeting and Exposition, Orlando, FL [December 2015] Invited Oral Presentations: Laskey D. “SOP Medicine Garden: A Sustainable Teaching Tool.” University of Saint Joseph Community Lecture [October 2015] Laskey D. “The Opioid Abuse and Misuse Epidemic.”

University of Saint Joseph School of Pharmacy Annual Preceptor CE and Awards Program [October 2015].

Riccardi M. “Drug Abuse and Misuse in Older Adults.”

Bloomfield Senior Center Lunch and Learn Program [October 2015] Leschak A. “Avoiding Medication Interactions with Ethanol.”

Bloomfield Senior Center Lunch and Learn Program [October 2015] DeGennaro L. “Working the Case: Role of Newer Agents for T2DM.” Connecticut Pharmacist Association Fall CE Series, Trumbull, CT [November 2015] Summa MA. “Updates on GLP-1 Receptor Agonists and SGLT2 Inhibitors for the Treatment of Type 2 Diabetes.”

Connecticut Pharmacist Association Fall CE Series, Trumbull, CT [November 2015] Luciano J. “Antidepressant Withdrawal Symptoms.”

MidState Medical Center Grand Rounds [November 20, 2015].

Kohn CG. “Optimizing the Construction of Indirect Treatment Comparisons to Reflect Country-Specific HTA Requirements.” International Society for Pharmacoeconomics and Outcomes Research, Milan, Italy [November 2015] Levine AR, Banka S, Thachil R, Lin H, Lee J. “Comparison of the incidence of flushing with immediate release niacin in

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Catch the Wave Conference. Waterbury, CT [November 2015] Ewing C. “Prevnar13 and Pneumovax23: A Practical Guide for Pharmacists.” Connecticut Pharmacist Association Fall CE Series. Rocky Hill, CT [December 2015] Publication: Stephanie Graham, Ryan Rogers, Richard Alper. “An Automated Method to Assay Locomotor Activity in Third Instar Drosophila melanogaster Larvae.” Journal of Pharmacological and Toxicological Methods 77, 76-80, 2015

Save the Date!

12th annual

New England Pharmacists Convention September 22 & 23, 2016 Returning to

Foxwoods Resort Casino Ledyard, CT More information to follow

Continuing Education

Pharmacy Journal of New England • Winter 2016

Ask the Experts: Incorporating Biosimilars in the Medication-use Process A Live Webinar Tuesday, March 1, 2016

Faculty

12:00 p.m. - 1:00 p.m. ET

Edward C. Li, Pharm.D., M.P.H., BCOP, Activity Chair

Register:

Associate Professor

www.ashpadvantage.com/go/biosimsnow/webinar Qualfies for Pharmacy Law CPE

Target Audience This continuing pharmacy education activity was planned to meet the needs of pharmacists in all practice settings with an interest in drug development, new drug therapies, healthcare policy, law, medication safety, pharmacovigilance, and leadership.

Webinar Overview In this activity, the faculty will discuss approaches for integrating biosimilars into the medication-use process, using practical examples to illustrate factors to consider in the decision-making process. The content for this activity is based on questions raised by participants in a recent educational symposium on this topic.

Learning Objectives At the conclusion of this application-based educational activity, participants should be able to • Apply operational principles to the review of a biosimilar for formulary consideration.

• Describe the clinical data paradigm used to review a biosimilar for formulary consideration.

• Examine the issues related to switching between a biosimilar and the reference product.

Department of Pharmacy Practice University of New England College of Pharmacy, Portland, Maine James G. Stevenson, Pharm.D., FASHP Professor, Department of Clinical Pharmacy , University of Michigan College of Pharmacy President, Hospital and Health System Services Visante, Inc. , Ann Arbor, Michigan

Accreditation & CPE Information The American Society of Health-System Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

ACPE Activity Number: 0204-0000-16-442-L03-P Activity Type: Application-based CE Credits: 1 hour (0.1 CEU), no partial credit Activity Fee: Free of charge Participants must participate in the entire presentation, submit an enrollment code (announced during the webinar), and complete the course evaluation to receive CE credit.

Follow the prompts to claim or view the statement of credit.

Per ACPE, CPE credit must be claimed no later than 60 days from the date of the live activity or completion of a homestudy activity.

For complete activity information including system requirements, as well as privacy and copyright policies, visit www.ashpadvantage.com/go/biosimsnow/webinar.

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