Academic Pharmacy Now: 2018 Issue 2

Academic Pharmacy

The News Magazine of the American Association of Colleges of Pharmacy

NOW

Volume 11 2018 Issue 2

E G A DAM L O R T N O C Last year’s fierce hurricanes put pharmacy schools’ disaster planning to the test and brought these resilient communities together to support each other. 12

Also in this issue: Light-Up Learning 5 Precision Medicine Taps the Pharmacist 7

Pharmacists Help People Live Healthier, Better Lives.

who we are @AACPharmacy

Academic Pharmacy The News Magazine of the American Association of Colleges of Pharmacy

Pharmacists Help People Live Healthier, Better Lives.

1400 Crystal Drive, Suite 300 P Arlington, VA 22202 703-739-2330 P www.aacp.org

Founded in 1900, the American Association of Colleges of Pharmacy is the national organization representing the interests of pharmacy education. AACP comprises all accredited colleges and schools of pharmacy, including more than 6,600 faculty, approximately 63,800 students enrolled in professional programs and 4,800 individuals pursuing graduate study.

Letters to the Editor

We welcome your comments. Please submit all letters to the editor to communications@aacp.org.

NOW

CEO & Publisher

Lucinda L. Maine

Editorial Director

Lynette R. Bradley-Baker

Editor

Maureen Thielemans

mthielemans@aacp.org

Editorial Assistant

Kyle R. Bagin

kbagin@aacp.org

About Academic Pharmacy Now

Academic Pharmacy Now highlights the work of AACP member pharmacy schools and faculty. The magazine is published as a membership service.

Art Director

Tricia Gordon

tgordon@aacp.org

Change of Address

For address changes, contact LaToya Casteel, Member Services Coordinator, at lcasteel@aacp.org.

Advertising

For advertising information and rates, visit http://go.networkmediapartners.com/aacp-mediakit or contact Tabbetha Marron, AACP Media & Event Sales, at tmarron@networkmediapartners.com Š2018 by the American Association of Colleges of Pharmacy.

All rights reserved. Content may not be reprinted without prior written permission.

Design Assistant

Sean Clark

sclark@aacp.org

Senior Advisor, Outreach and Communications

Stephanie Saunders Fouch sfouch@aacp.org

Freelance Writer

Athena Ponushis

Freelance Writer

Jane E. Rooney

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Academic Pharmacy NOW  2018 Issue 2

Volume 11 2018 Issue 2

@AACPharmacy a look inside

campus connection

5

Lightboard Tech Illuminates Learning Shenandoah’s Bernard J. Dunn School of Pharmacy integrates new method for delivering video instruction.

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Pressing Play on Better Patient Care A series of videos created by practitioners at Ohio State aim to help autism patients understand what to expect at an appointment, not only improving the healthcare experience for Ohioans but for patients across the country.

Precision Medicine, Made for Pharmacists No more one-size-fits-all drugs. As genetic screening becomes more affordable and pharmacogenetic research diversifies, pharmacists look to implement the therapeutic benefits.

community impact

10

Breathing a Sigh of Relief

ROL T N O C E G A M 12 DA

New UConn study identifies effective treatments for persistent asthma.

Last year’s fierce hurricanes put pharmacy schools’ disaster planning to the test and brought these resilient communities together to support each other.

@AACPharmacy

21 “IN” the Know in Long Beach

Inspiration abounded at this year’s INterim Meeting, as attendees heard from expert speakers on leadership and took home fresh methods of driving progress in their careers and at their institutions.

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#PharmEd18: Declare a New Beginning in Boston Connect with experts in education, science and leadership at the Academy’s premier event: Pharmacy Education 2018.

Register for the meeting before the early-bird deadline of May 17 and save more than $100!

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community note publisher’s impact

Dear Colleagues: It seems like year after year time goes by ever faster. We blink on New Year’s Eve and suddenly find ourselves in May, the second quarter of 2018. I’ve pledged to stop complaining about how fast the year progresses. It’s a simple fact of life.

Likely not so for those that have experienced the disasters reflected in this issue of Academic Pharmacy Now. If you are still without electricity seven months after a major hurricane or are still wrangling with the insurance company after your home burned or was buried in a landslide, time drags on. Faculty and students are among those that have experienced these disasters personally, yet they find the fortitude to serve others in these times of serious need and loss. You are our heroes.

The second quarter of each year is the time for the release of a great deal of volunteer effort that began in the fall of the previous year. Our standing committees meet in person in October and begin their analysis of the key questions assigned to them by the serving president. Dr. Steve Scott of Purdue University brought his passion for our learners and the quality of education into focus in assigning charges to six standing committees. This results in proposed policy statements that will soon be sent to delegates during 2018 AACP House session. In addition, there will be many recommendations suggesting action for AACP consideration and suggestions for member institutions. I encourage you to read one or all of these reports for their timely and substantive review of the issues that impact the Academy.

The Argus Commission is comprised of the five most recent presidents of the Association. This year the Commission met with six experts from outside pharmacy education to help assess the implications for pharmacy and pharmacy education of the “Vital Directions for

Read the Report Visit http://bit.ly/VitalDirections to read the “Vital Directions for Health and Health Care” report of the National Academy of Medicine.

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Health and Health Care” report of the National Academy of Medicine. This NAM report was aimed at the new administration and provided expert guidance on the primary forces at play in healthcare—consumerism, informatics, payment reform and the implications of all of these forces on the future health workforce.

Among the Argus recommendations is a throwback to a faculty development program used decades ago—a discipline-specific teachers’ seminar. AACP still offers an annual teachers’ seminar as a pre-session of the Annual Meeting. But back in the 1960s, when most faculty did not attend the Annual Meeting, faculty responsible for substantive components of the curriculum (e.g., pharmaceutics, medicinal chemistry) would gather for three or four days of programming that offered material on significant new aspects of the field. Together, participants would share their approaches to incorporating new material, including laboratory experiments and new pedagogical methods, with their peers.

The Argus Commission believes there are areas in our curricula today that could benefit from bringing this model of faculty development back to the Academy.

Precision medicine, informatics, and quality measurement and improvement are just three examples of areas highlighted in the NAM and Argus reports that must have enhanced coverage in the Pharm.D. curriculum if our graduates are to be the practice and research leaders of the future. We recognize that there is not currently sufficient faculty depth and breadth of expertise across all member institutions in such areas.

Fortunately, there are colleges and schools of pharmacy where such expertise has been cultivated. AACP will seek to partner with them in designing 21st Century Teachers Seminar to accelerate change in pharmacy education.

And the result will bring us closer to the AACP vision of achieving a world of healthy people.

Sincerely,

Lucinda L. Maine, Ph.D., R.Ph. CEO and Publisher

campus connection

Lightboard Tech Illuminates Learning Shenandoah’s Bernard J. Dunn School of Pharmacy integrates new method for delivering video instruction.

By Leigh Bauserman

The Bernard J. Dunn School of Pharmacy at Shenandoah University introduced lightboard learning technology last summer. The lightboard originated at Northwestern University, where its inventor, Michael Peshkin, created an open source repository to share with others how to build and use a lightboard for teaching, lightboard.info/.

it out, rather than already having a picture up on a PowerPoint and labeled.

When you draw it, it comes together much easier.”

Dr. Jeremy Fox, chair and associate professor of pharmacy practice, plans to create lightboard recordings in his spring Renal course. Fox has

incorporated “flipped’ classroom recordings in past versions of the course, but said he looks forward to using drawing and annotations to create richer learning materials for the students. P Leigh Bauserman is Senior Web Developer at the Bernard J. Dunn School of Pharmacy.

Article originally appeared in Shenandoah University News.

In a lightboard video, the instructor is not just a voice over slides or a disembodied hand writing out equations. Using lightboard technology, the instructor faces the camera and is more “present” while sharing content such as diagrams, equations, formulas, or processes with students in a visually compelling way. By incorporating a computer into the setup, slides and other content, such as 3D models, can be overlaid on the video for the instructor to annotate or demonstrate.

Professor of Biopharmaceutical Sciences Jennifer Bryant, Ph.D., has been an early adopter of creating “flipped’ classroom videos for P1 students in a fall foundational science course. Bryant found that while it took a little time to learn how to present information effectively using the board, it grew easier with each recording.

“When you draw it, it comes together much easier,” a P1 student said of Dr. Jennifer Bryant’s “lightboard” video lessons. Using lightboard technology, the instructor faces the camera and is more “present” while sharing content such as diagrams, equations, formulas, or processes with students in a visually compelling way.

Early feedback she collected from students who watched the video was generally very positive. A P1 student responded in a survey: “I loved seeing the processes drawn out. Visualization is really important for me, and it’s easier to connect and watch you draw

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campus connection

Pressing Play on Better Patient Care A series of videos created by practitioners at OSU aim to help autism patients understand what to expect at an appointment, not only improving the healthcare experience for Ohioans but for patients across the country.

By Skylar Fought According to the CDC, more than 3.5 million Americans live with an autism spectrum disorder (ASD), with autism in children increasing by 119 percent in 2014. Little has been reported on how healthcare providers, including pharmacists, can improve healthcare access and delivery for adolescents and adults living with these disorders. With this in mind, the team at the Center for Autism Services and Transition (CAST) at The Ohio State University decided to take matters into their own hands and create videos that help their patients.

Created in 2014, the CAST program offers specialized primary care services for teens and adults who have been diagnosed with autism spectrum disorders and other complex disabilities. It is the only place in central Ohio, and one of the few places in the nation, where

patients can access multiple services in one setting from experienced physicians who provide comprehensive care for individuals with complex healthcare needs. Dr. Debra Barnette, a clinical pharmacist at the College of Pharmacy, was one of the first pharmacist providers in the CAST program.

Barnette played an integral role in moving patient care forward by securing “Our team wants the work coming out grant funding for the project through of our clinic to be seen as a resource for Autism Speaks, which led to the anyone who cares for patients with ASD creation of three videos for the CAST and needs this type of information,” clinic. The videos include information Barnette said. on what to expect when visiting the As for pharmacists who counsel paclinic, getting blood drawn and testing tients with autism or other complex blood pressure. Each of these areas can disabilities, Barnette sees medication present significant barriers to effective as an important piece of the patient primary care for patients with ASD. care puzzle.

The CAST team worked with patients and caregivers to identify information and content that would help them “From this experience, I know what to expect before, during learned more about autism and after their visit.

“My team supportive role was to collaboratively conceptualize typical problems our patients face when receiving care and break them down in a way that is easier to understand and address,” Barnette said. “These videos aren’t only beneficial for patients, but for their caregivers and our practitioners. They provide insight for everyone involved.”

The CAST program at The Ohio State University prepares autism patients for healthcare interactions by using videos detailing what happens when they visit a clinic, get blood drawn and more.

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The CAST clinic aims to help providers across the country make the healthcare experience better for patients with autism. Looking forward, Barnette hopes the clinic can create more videos to help those with autism receive the care they deserve in a way that suits their needs.

Medication administration including insulin pen use is an area of need.

Spreading the Word The videos are not only shared with visitors of the clinic, but with local and state primary care providers as well.

and how pharmacists can make a difference in caring for patients with ASD.”

­— Dr. Debra Barnette “This project showed me that even if something seems challenging, as pharmacists we should still go after it. We need to see the need and step up to help. I am so proud to have been an integral and respected part of this amazing forward thinking team.” P Skylar Fought is Marketing Coordinator at The Ohio State University College of Pharmacy.

campus connection

Precision Medicine, Made for Pharmacists No more one-size-fits-all drugs. As genetic screening becomes more affordable and pharmacogenetic research diversifies, pharmacists look to implement the therapeutic benefits.

By Athena Ponushis The promise of personalized medicine paints a utopia, where scientists would understand the genetic variations responsible for diseases and be able to prescribe drugs aimed at those genes. Medical records would contain information unique to patients’ genomes—genetic features that may predispose them to disease, variations that might predict a drug or dosing response—along with environmental and lifestyle factors, such as poverty or diet. All this data would be in the face of a provider, at the moment of prescribing, to tailor treatments for better patient outcomes.

Such a visionary tomorrow leaves much work for today. Pharmacogenetic research needs to be diversified, to improve drug response and decrease drug toxicity for all people, not just those of European descent. And the medical community must keep an open mind—precision medicine does not have to save the market a lot of money to be of good value.

As the cost of genetic testing goes down, it may make good economic sense for a consumer to have a genetic test (the amount of health you’re buying for the amount of money you’re spending falls in line with what’s considered good value), making widespread implementation of

precision medicine potentially feasible in 10 years.

Therein lies a call to pharmacists and schools of pharmacy, to increase pharmacogenetic research and education. “I really think pharmacogenomics is going to be the expertise of the pharmacists,” said Dr. Erica Woodahl, associate professor at the University of Montana.

“Pharmacists know the most about drugs and their usage, so it makes perfect sense for this to fall within a pharmacist’s job. As we move toward implementation, hopefully we’ll have a model where most hospitals have a clinical pharmacist who has specific training in pharmacogenomics to review the records and offer consultations to providers, to really facilitate the pharmacogenetics of personalized medicine.”

Diversifying the Research For more than a decade, Woodahl has been working with the Confederated Salish and Kootenai Tribes living on the Flathead Reservation in Montana.

Precision medicine is most commonly used in large, urban centers, in academic medical hospital settings, which led to the genesis of Woodahl’s project: “If we are going to implement pharmacogenetics, but all the relevant research is based on people

of European descent, how can we be confident those genetic tests are going to be applicable to populations where we have no information?”

Woodahl’s work includes the characterization of genetic variation and environmental factors that predict drug response and toxicity within the indigenous community. Woodahl and her research partners recently earned a $2.1 million grant from the National Institutes of Health to study precision medicine to help American Indian and Alaska Native people. The project will address how precision medicine research may benefit tribal people and align with tribal health priorities, as well as address the issue of data stewardship to support the participation of tribal communities in research.

Before they began their work, Woodahl and her colleagues made sure they had the consent of the community—partnering with the tribal health department, presenting to tribal council, forming a community advisory board, holding genetic education workshops.

“I tell the community that we are using their genetic information to target drug delivery and drug dosage, so hopefully we can get the prescription right sooner so that they can feel better,” Woodahl said. “My long-term goal

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campus connection

“Hopefully we’ll have a model where most hospitals have a clinical pharmacist who has specific training in pharmacogenomics to review the records and offer consultations to providers, to really facilitate the pharmacogenetics of personalized medicine.”

—Dr. Erica Woodahl is to move the relevant data we discover into the clinics, to help implement pharmacogenetics in a tribal health setting, with information specific to the people here.”

She hopes her work will encourage other pharmacists to think about strategies to diversify their work, “to make sure we have diversity in pharmacogenetics research studies, so we can be more inclusive as we move toward implementation.”

Putting Savings in Perspective Dr. David Veenstra does not see any obvious cost savings to the larger healthcare marketplace from personalized medicine. Veenstra, professor, Comparative Health Outcomes, Policy & Economics (CHOICE) Institute at the University of Washington, studies the clinical, economic and policy implications of using genomic information in healthcare. “The expectation on precision medicine to save money overall, it’s unusual, it’s exceptionalism,” Veenstra said. “This technology should be viewed and approached just like many of the other technologies that we have in healthcare.”

With most new technologies developed to improve patient outcomes, Veenstra says oftentimes there’s an increase in cost, so he thinks it’s a misconception that precision medicine is going to save money. “I guess there’s an important ‘bigger-picture’ misconception that in

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order to provide good value, something has to be cost-saving, and that’s just not the case,” Veenstra added. “Anything that improves patient outcomes at a reasonable cost is a good value.”

Precision medicine can mean a number of different things—making a molecular diagnosis and giving a targeted treatment; or taking a genomic screen of a population, looking for disease risks; or it could mean pharmacogenomics. “So if someone asked, ‘Oh, is precision medicine a good economic value?’ that’s like asking, ‘Well, are drugs a good economic value?’” Veenstra says. “And the answer, of course, is it depends.”

A gene panel for a few hundred dollars, that’s a good deal

macogenomic screens, and that such activity could be common in 10 years.

What’s the value to the patient? Let’s say you had a pharmacogenetic screen, that information would be available to your provider and pharmacist, so if you’re prescribed a new medication that just so happens to have some kind of pharmacogenomic affect, the drug would be flagged to avoid an adverse reaction. Or a drug a little more likely to be effective would be chosen or the dose would be modified. Those are the kind of cases that pharmacists would help manage at the point of care, making adaptations to personalize medicine.

In that sense, it’s not like every person will have some tremendous benefit, but more so, a lot of different people will have a lot of small benefits for a relatively low cost.

The current economic story Veenstra sees in precision medicine would be the dropping cost of genetic tests. “Let’s “I think of it as the equivalent of knowsay it used to cost two or three hundred ing ahead of time what drugs you would bucks just to look at one particular be allergic to—what’s the value of mutation or two mutations in one gene, that? That could be valuable to know,” and now for that price, you can look Veenstra said, “instead of having a bad at 100 genes and thousands of genetic experience or poor outcomes, if the variants,” he says. “The actual costs of drug could potentially be avoided.” these genetic assays have dropped far enough that implementation at a broad- Calling All Pharmacists er level, combined with an increasing As cost becomes less of an issue for the evidence base, makes widespread use implementation of precision medipotentially feasible in the near future.” cine, other barriers linger: Technology, particularly data storage. Ethics—who Veenstra predicts people, or their insursees it, what do they do with it? And ance, are going to start paying for phar-

campus connection

“I guess there’s an important ‘bigger-picture’ misconception that in order to provide good value, something has to be cost-saving, and that’s just not the case. Anything that improves patient outcomes at a reasonable cost is a good value.”

—Dr. David Veenstra then there’s education—schools of pharmacy must boost pharmacogenetic training, so pharmacists can increase physicians’ knowledge of pharmacogenomics.

“I really do see pharmacogenomics as being the purview of pharmacists,” Woodahl said. If a graduate student was interested in a research opportunity to pursue personalized medicine, Woodahl says the student would not have to look very far. Most schools of pharmacy have faculty members in-

volved in some aspect of pharmacogenomics research.

“The majority of pharmacogenomics research is probably done in schools of pharmacy in this country,” Veenstra added, so there are great opportunities there, in institutions with long histories of funded research programs.

As far as career opportunities for Pharm.D. students, Veenstra sees pharmacists, particularly specialty pharmacists, assessing the evidence to

try and understand when it makes the most sense to use certain drugs based on genetic tests.

“There’s a real morass of uncertainty there,” Veenstra said, “but I think pharmacists have good training to spend the time to provide guidance to clinicians and committees.” P Athena Ponushis is a freelance writer based in Ft. Lauderdale, Fla.

Coming Soon: 2018 Preceptor of the Year Recognition Program In June, AACP will be launching a search for 2018 Preceptors of the Year to be identified by colleges and schools of pharmacy, who will receive a 2-year complimentary AACP individual affiliate membership.

Our goal is to provide programming, resources and tools that will enhance the professional development of adjunct/affiliate preceptors, who are key members of the educational and patient care team.

Benefits to the Preceptors include: •

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The ability to network with other adjunct/affiliate preceptors across the nation via AACP Connect, the AACP online engagement platform; Access to programming, resources, and tools developed specifically for the preceptor educational responsibilities;

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AACP member rate for all AACP-programs, including the Interim and Annual Meetings; and

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Access to the latest information pertaining to teaching, practice, and research in academic pharmacy via Academic Pharmacy Now, the American Journal of Pharmaceutical Education, and other AACP resources.

Schools can identify up to 3 adjunct/affiliate preceptors to be eligible for the 2-year complimentary membership by completing an online submission form that will be provided to experiential education departments in June.

(AACP defines adjunct/affiliate preceptors as those who are neither full-time employees at a college or school of pharmacy nor have a primary employment commitment (receiving 50% or more of their salary) from a college or school of pharmacy.)

If you have any questions about the Preceptor of the Year program, please contact membership@aacp.org.

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community impact

Breathing a Sigh of Relief New UConn study identifies effective treatments for persistent asthma.

By Colin Poitras, UConn Communications When it comes to treating teens and adults with persistent asthma, simpler is better, according to an analysis led by University of Connecticut researchers.

Findings that appear in the Journal of the American Medical Association show that using a single corticosteroid and long-acting bronchodilator treatment for both daily asthma control and for rescue relief during sudden asthma attacks is more effective than taking separate medications for daily control and rescue.

Standard treatment guidelines for persistent asthma in the United States currently suggest using different medications for daily control and rescue relief. Patients use an inhaled corticosteroid, with or without a long-acting bronchodilator known as a long-acting beta-agonist or LABA, for daily asthma

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control. Patients usually carry a second inhaler containing a short-acting betaagonist (albuterol) for rescue relief when they have symptoms of wheezing, coughing, or a full-blown asthma attack.

For patients 12 and older with persistent asthma, the researchers found that Single treatment for Maintenance and Reliever Therapy, also known as SMART, resulted in significantly fewer asthma attacks, hospitalizations, and emergency room visits, compared to patients following the current standard of separate medications for control and rescue.

Rescue and Relief The UConn findings are part of a larger comprehensive review of asthma-related medical practices conducted for the federal Agency for Healthcare Research and Quality (AHRQ) at the request of the National Institutes of Health, National Heart, Lung and Blood Institute.

The complete AHRQ report is available on the AHRQ website.

The UConn-led review encompassed 16 randomized controlled trials involving more than 22,700 patients to evaluate the effectiveness of SMART. The formulation used for the SMART approach was almost exclusively a single inhaler with a dry powder formulation of budesonide (a corticosteroid) and formoterol (a longacting beta-agonist).

Asthma is a chronic lung disease that inflames and narrows the airways.

About 25 million people in the U.S. have asthma; 7 million of them are children.

While some individuals may only expe- “The use of the corticosteroidrience asthma when they exercise bronchodilator treatment for daily or in certain weather conditions, control is well established. The whole those with persistent asthma concept behind SMART is to use the struggle to control their same treatment for quick relief when symptoms it is necessary, eliminating the need every day. to carry another different medication,” said UConn Assistant Professor of Pharmacy Practice Diana Sobieraj, Pharm.D., the study’s principal investigator. “These studies found that the corticosteroid-formoterol mix is effective not only when used for daily control, but also for quick relief. However, we did not review the evidence about side effects related to Read the full report: this practice.” https://bit.ly/2HwyxUo.

community impact

Photo Credit: Peter Morenus/UConn Photo.

Dr. Diana Sobieraj, assistant professor of pharmacy practice, and Dr. William Baker, associate professor of pharmacy practice, at the University of Connecticut Pharmacy/Biology Building.

New LAMAs Reduce Risk of Exacerbations

classes of long-acting bronchodilators may be better than the other.”

In a separate review also appearing in JAMA, a UConn-led analysis found that a new class of long-acting bronchodilators—known as long-acting muscarinic antagonists or LAMAs—significantly reduced the risk of exacerbations in people over 12 years with uncontrolled asthma when added to an inhaled corticosteroid, compared to a placebo.

Commonly used to treat patients with chronic obstructive pulmonary disease or COPD, LAMAs are not currently incorporated into national treatment guidelines for asthma. The LAMA studies reviewed in the current metaanalysis focused almost exclusively on the long-acting muscarinic antagonist tiotropium.

However, LAMAs were not associated with a significant reduction in asthma exacerbations when compared to the use of long-acting beta-agonists or LABAs, when used along with an inhaled corticosteroid, the researchers said.

The comprehensive scientific reviews reported in the two studies were led by a multidisciplinary team from the UConn School of Pharmacy’s Evidence-based Practice Center. The center is one of 13 nationally supported by the Agency for Healthcare Research and Quality, which is part of the U.S. Department of Health and Human Services. The centers review scientific evidence surrounding common medical conditions and new medical technologies to improve the quality and safety of national health care.

“The available evidence does not suggest that there is a significant difference in the way the newer type of long-acting bronchodilators (LAMAs) impact asthma exacerbations, asthma symptoms, or lung function compared to the long-acting bronchodilators (LABAs) that have been used for years” Sobieraj said. “But the studies we reviewed are not robust enough to determine whether one of these two

The AHRQ conducted its review of asthma treatments and protocols at the request of the National Heart, Lung and Blood Institute (NHLBI). The

Institute sponsors national asthma treatment guidelines. The Guidelines for the Diagnosis and Management of Asthma (Expert Panel Report-3) was published in 2007.

Evidence-based practice centers at Johns Hopkins University, the Mayo Clinic, and the ECRI Institute also contributed to the AHRQ review, providing scientific analysis on three other asthma-related topics.

UConn co-investigators on the systematic reviews were Dr. William Baker, Dr. Erin Weeda, Dr. Elaine Nguyen, Dr. Craig Coleman, and Dr. C. Michael White. Also serving as co-investigators were Dr. Stephen Lazarus of the University of California, San Francisco; Dr. Jason Lang of Duke University; and Kathryn Blake of Nemours Children’s Specialty Care.

The research reviews were sponsored by the National Heart, Lung and Blood Institute. They were awarded by the Agency for Healthcare Research and Quality through Contract No. 2902015-00012-1. P Article originally published in UConn Today.

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community impact

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community impact

E G A M DA L O R T N O C

Planning for the unexpected is a smart strategy for any institution. Last year’s fierce hurricanes put pharmacy schools’ disaster planning to the test and brought these resilient communities together to support each other.

By Jane E. Rooney

Most leaders in academia have undoubtedly devoted many hours to thinking about disaster planning.

Institutions must have procedures in place to ensure personal safety and maintain campus operations in the event of an emergency. But when the emergency comes in the form of a natural disaster such as a weather-related event, even the most diligent planning can’t always prepare students, faculty and staff for the worst-case scenario.

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community impact

Last August, Hurricane Harvey dumped an estimated 27 trillion gallons of water on Texas and Louisiana. A few weeks later, Hurricane Irma battered Florida and Puerto Rico, and then Hurricane Maria devastated Puerto Rico.

The catastrophic event there caused widespread destruction, leaving the territory without potable running water in addition to impacting more than 80 percent of the island’s power grid. According to The New York Times, early estimates indicated that the island suffered a loss of $780 million in agriculture yields. As of March, there were still 15,000 federal civilian personnel and military service members in Puerto Rico and the U.S. Virgin Islands working on recovery operations, according to the Federal Emergency Management Association (FEMA). The agency’s website notes that more than 1 million Puerto Rican residents registered for FEMA assistance.

Despite enduring personal loss and having their lives interrupted by the hurricanes, faculty and students at pharmacy schools in Texas, Florida and Puerto Rico stepped in to help their communities where they could, demonstrating great resiliency amid harrowing circumstances.

University of Houston College of Pharmacy students box donated school supplies at the college before being transported to Harvey-devastated communities.

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HARVEY The University of Houston College of Pharmacy had little lead time when Hurricane Harvey approached Texas last August. “We do have emergency management procedures and policies in place that we enacted,” said Dean Dr. F. Lamar Pritchard. “But I don’t think there’s any preparation in the world that could have prepared us for Hurricane Harvey. It just rained and stormed and we thought it would never end.

I’ve never seen anything like that before. That was a storm of tremendous proportion.”

The college’s Texas Medical Center facility, which housed the P3 and P4 segments of the program, sustained so much damage that the building had to be dismantled, Pritchard explained. “We had to move all faculty, staff, students and research that took place in that building to our main campus building. Fortunately we were in the process of finishing a new building, which we’re still in the process of moving into.

It’s been very busy logistically and we are still dealing with the effects of the storm.”

community impact

Top: Three students and a faculty member from UHCOP man the makeshift pharmacy at the first emergency shelter set up in downtown Houston.

Middle: Donated school supplies were unloaded at a damaged Rockport school gym for sorting and distribution.

Bottom: APhA-ASP school supply relief drive volunteer Callie Downs, co-organizer Kaycie Rathburn and family members transport the donated supplies directly to the impacted communities.

It took about a week after the hurricane to get everything up and running on campus. Making sure that students, faculty and staff were safe was the administration’s top priority, but communicating in the storm’s aftermath was a challenge.

“Many people lost access to the Internet, to electricity, to clean water, or lost their computers and cell phones, so communication was an ongoing issue,” Pritchard pointed out. “We did everything possible to create different channels of communication. It’s one of those situations where it’s going to be difficult no matter what you do ahead of time with a storm of that magnitude. Everything is a challenge— communication, financial support, emotional support.”

Pritchard said that another key focus for the college was ensuring that students could stay and continue their studies.

“Some lost everything they had,” he said.

“Those students took a little longer to recover and we’re still working with them to ensure they’re able to come back once their lives and finances are stabilized to allow them to continue their studies. The vast majority of students were able to deal with everything and continue with their studies.”

There was a great groundswell of support from the pharmacy community locally and beyond for students who were directly impacted. Some students lost textbooks or laptops while others lost vehicles or their entire home. Two colleges of pharmacy reached out to help by

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community impact

“When most people think of a disaster, they think of it being over in a few days,” he added. “We’re still dealing with Internet issues six months later and it’s still very haphazard. It’s not a quick fix where, say with a snowstorm, you may just cancel classes for a few days. In a territory you can’t generate all the support you would be able to get in the [mainland] United States. It was very difficult to get support to our San Juan campus. Overall everyone did a great job.” ­— Dr. Robert McGory

IRMA

holding fundraisers and sending gift cards. And despite dealing with the storm’s disruption to their own lives and studies, two University of Houston College of Pharmacy students initiated a drive to collect classroom supplies for schools in the Rockport and Aransas Pass school districts, which were When Hurricane Irma made landfall in Florida and partially hardest hit by Harvey. The drive raised more than $40,000 hit Puerto Rico in early September, it was the first Category in supplies and benefited 150 teachers and more than 5,100 4 storm to strike the state in more than a decade in Florida. students.

Nova Southeastern University College of Pharmacy, which has campuses in Fort Lauderdale and Palm Beach, as Students gave back locally as well, Pritchard noted. “We well as in San Juan, had several layers to the recovery proprobably have one of the most active student bodies, especess. “In Fort Lauderdale, we were closed for six days,” said cially from a community service standpoint. There are 19 student organizations that interact with health fairs, elemen- Dr. Robert McGory, associate dean, professional program. tary schools, annual immunizations…it continues all year. An “The storm got everything a little off schedule and we had to do some weekend classes. Our San Juan campus was down event like this does create tremendous need, but our faculty for almost five weeks. We had to postpone classes there. and staff and students were already very experienced with There were maybe two or three we had to cancel and we kept community engagement and community relationships.” teaching the others through the first week of January. We Even with emergency processes in place, everything will not basically took the fall semester and divided it in two.” While go according to script. Pritchard said that while it’s difficult the Fort Lauderdale campus was able to end the semester on to prepare for an unpredictable event like a hurricane, “you time, first- and second-year students in San Juan will take learn from each episode that comes forward. You make courses this summer to get back on track. adjustments and hope you’ve done the best job possible.

Within 24 hours of opening the Fort Lauderdale campus, We have added more counselors both at the university and McGory said the registrar and upper administration held a college levels to help students emotionally and financially. meeting to focus on San Juan and how to proceed without We’re bringing in more financial aid officers. Alumni have having a way to communicate with that campus. “We knew contributed money to help with scholarships.” He acknowlPuerto Rico was devastated [after Hurricanes Irma and Maedged that recovery takes time, but said of the UH student ria] but we didn’t know about the building students were in pharmacists: “Their resilience and work ethic is just incredor if they could get back and forth to campus,” he explained. ible. They are doing everything possible to move forward.”

“We didn’t know when the power or water would come back on. We started planning in terms of how we wanted to apWatch a special video that illustrates the giving proach students and how we were going to teach. We were spirit of the University of Houston College of trying to generate donations of food, money and clothing Pharmacy APhA-ASP chapter: https://bit.ly/2qxCiiP. that we could send to the campus. We had a good outpouring of aid from other colleges of pharmacy.”

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Communication with San Juan faculty remained hit-or-miss for several weeks. McGory said they resorted to using the radio station in San Juan to try to make contact to find out whether it was safe for students to return to campus. Fortunately, the main building sustained only minimal damage and recovered power and water quickly due to its close proximity On Sept. 20, Hurricane Maria, which achieved Category to a hospital, but it took several weeks before people could 5 strength, reached Puerto Rico and caused catastrophic travel safely. damage to the island, wiping out vegetation and almost de“Students were trying to come into the college to get water stroying the electrical grid. The University of Puerto Rico and electricity and just to have some security,” he continued. School of Pharmacy was relatively unscathed, suffering “We found a company that could provide hot meals so we barely any damage to its physical structures, and power was were doing that once a day for the students. The experiential restored fairly quickly thanks to the school being adjacent staff worked to get students to volunteer to do rotations.” to the medical center. Classes restarted two weeks after the McGory said about eight students moved to the Palm Beach storm hit. “We resumed activities fairly quickly consideror Fort Lauderdale campuses to complete their rotations as ing the magnitude of the event,” said Dr. Wanda Maldonado, the situation in Puerto Rico remained unstable. dean, University of Puerto Rico School of Pharmacy. “We were able to complete the semester on time doing addiMcGory recommends that institutions have some kind of tional hours in between. We decided not to honor any of the technology ready as a backup plan to keep students engaged remaining holidays except Thanksgiving and Christmas day, in their studies during an emergency. “I asked the president and we ended the semester on Dec. 28.” of the university if we could purchase jump drives and put lectures from last year on those, and we sent those down for Even though power was restored to campus promptly, many students to pick up,” he said. “Students could come in and use people did not have Internet access, cell phone signals or the computers on campus so they could stay involved with power at home. “It was a challenge to communicate with their education.” He also said that getting satellite phones to faculty and students and personnel to find out everybody’s the San Juan faculty helped facilitate communication. status,” Maldonado acknowledged. “That’s when we became

MARIA

Hurricanes can increase or decrease in force overnight and change course quickly, McGory pointed out, so while everyone had a good idea that Puerto Rico would be affected, the university did not have a formal plan because of all the unknowns. “When most people think of a disaster, they think of it being over in a few days,” he added. “We’re still dealing with Internet issues six months later and it’s still very haphazard. It’s not a quick fix where, say with a snowstorm, you may just cancel classes for a few days. In a territory you can’t generate all the support you would be able to get in the [mainland] United States. It was very difficult to get support to our San Juan campus. Overall everyone did a great job.”

creative with WhatsApp groups and starting a chain of communications. Some people had to come to the San Juan area to get a cellular signal. Gasoline became scarce because the demand increased significantly as many were using gasolinepowered generators at home. There was a lot of caution in terms of how people moved from one place to the other to save gasoline, and to avoid debris from the hurricane that had fallen on the streets. We went back to other methods we have of communicating: We posted one of those flip charts and posted handwritten announcements in front of the school that said, for example, ‘We will have a faculty meeting on X day,’ or to let students know when we would start classes.”

Far left: Faculty and students from the University of Puerto Rico assisted with care and medication issues for hemodialysis patients transferred from St. Thomas after Hurricane Irma.

Left: When Claudia Hilera Botet found out her rotation was going to be canceled after Hurricane Maria, she helped a professor start an initiative to get other student pharmacists whose rotations had been canceled to come together to collaborate with a clinic that was providing free healthcare services. She and other students helped the clinic create an inventory of donations they had received, establish a workflow for dispensing free medications and provide patient education.

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University of Puerto Rico faculty and students worked in a Rio Piedras clinic after Hurricane Maria (above) as well as in clinics in Carolina, PR (right).

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Because many students lacked power in their residences, the administration allowed them to stay in campus buildings later than usual. “We extended the hours they could be in our building and have Internet, be able to study, have power and air conditioning, so they could comply with their academic obligations,” Maldonado added. “Students could stay until 10:30 at night. It provided them with a place with power and basic necessities.” Faculty also supported students several times by providing them with lunch; additional water and food donations were also distributed.

that.” Other schools of pharmacy immediately volunteered to provide opportunities for several students and multiple rotations, like the University of Maryland arranging for five students to complete their practicums there. Students were also hosted by the University of Colorado, Sullivan University, Thomas Jefferson, Michigan, Western New England, Johns Hopkins Bayview, and the Miami VA, among others.

Claudia Hilera Botet, Pharm.D. candidate 2018, one of the students who traveled to the mainland to complete a rotation after the hurricane, said the professors and administration went the extra mile to help P4 students. She completed a Be Prepared and Have a Plan B rotation at the University of Michigan but needed to get an The school provided extra support to P4 students, in some ambulatory care rotation done that was not ready just after cases finding places for students to complete their APPEs the hurricane in Puerto Rico. Professors and the administrastateside. “We also developed a platform to collect donations tion at both Michigan and Puerto Rico helped arrange the and support them financially for the travel since that was opportunity for her. “I will be graduating on time,” Hilera something they hadn’t anticipated,” Maldonado said. “We Botet noted. “That’s one of the most important things that received a substantial contribution through that platform so everyone kept in mind when arranging new rotations and we can provide support for those students. More than half of finding solutions. Everyone had that as a priority—to not afour students did their practices here. We only had one student fect students’ course of studies so students could graduate on who left the program and that was because of family issues.”

Out of the 45 graduating students, 20 completed their experi- time. It was tumultuous but we are going to graduate.” ences on the mainland. But, Maldonado pointed out, before When she found out her rotation was going to be canceled, the hurricane hit Puerto Rico, 16 students were already schedHilera Botet—one of the few students who had good phone uled to go to the states through collaboration agreements service and could communicate with her peers—helped a with other schools of pharmacy. Many of those institutions professor start an initiative to get other student pharmaoffered assistance and support after the storm, and many cists whose rotations had been canceled to come together to others followed. “There was a very generous offering from collaborate with a clinic that was providing free healthcare pharmacy academia in general,” she said. “They really reached services. She and other students helped the clinic create an out to help us in that moment of need, and we really value inventory of donations they had received, establish a work-

“There was a very generous offering from pharmacy academia in general,” said Dr. Wanda Maldonado, pictured far left, dean, University of Puerto Rico School of Pharmacy. “They really reached out to help us in that moment of need, and we really value that.”

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flow for dispensing free medications and provide patient education. “Our attitude was: let’s try to apply what we’ve learned so far as students and help the community. During my free time, my priority became just helping others and putting myself out there to lend a hand to those in need.”

Born and raised in San Juan, Hilera Botet does plan to return to Puerto Rico after completing a residency on the mainland.

“We need our people to come back and help the community and bring practices and all the things they learned back to Puerto Rico, in both the pharmacy and medical fields,” she emphasized. “We need pharmacists to come back to continue to develop that culture.”

Maldonado credits the administration’s robust preparedness procedures with minimizing damage to campus facilities.

“Every year we have hurricane scares,” she noted. “We know the drill regarding preparedness. We know how to prepare the buildings, offices and classrooms to make sure the computers are not damaged. We take everything away from the windows.

We do all those safeguards and we have done them numerous times. We know when to send students, faculty and staff home so they can prepare. We have a team with the chancellor and deans who know what to do and when to do it.”

She said that assessing building security should be a top priority when schools think about emergency preparedness. “Just before the hurricane I called the architect that designed the building to ask about the building code,” she continued. “Not a single window broke in the building. We didn’t have any flooding. I think what’s most important is the knowledge of the building codes if we’re talking about a hurricane, knowing what areas are prone to flooding, knowing how the IT infrastructure is secured on campus and making sure it is well protected. We have a water tank in our building that provides extra water in case water is scarce, and we have a generator that partially lights up certain areas in the building.”

The other key piece to disaster preparation is having a well-thought-out communications plan. “Have a protocol in place to let faculty, students and staff know about when to go home,” Maldonado advised. “Establish a communication chain by which after the event occurs people can know who to call or where to meet to establish a plan. Those things have to be clear. We had a high degree of certainty only a day before that the hurricane was really going to make landfall in the Island, so preparations have to be made well ahead of time, and in a timely manner.” P Jane E. Rooney is a freelance writer based in Oakton, Virginia.

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Claudia Hilera Botet said of working in the clinic: “Our attitude was: let’s try to apply what we’ve learned so far as students and help the community.

During my free time, my priority became just helping others and putting myself out there to lend a hand to those in need.”

@AACPharmacy

“IN” the Know in Long Beach Inspiration abounded at this year’s INterim Meeting, as attendees heard from expert speakers on leadership and took home fresh methods of driving progress in their careers and at their institutions. New programming in research leadership and rapid-fire microsessions gave the meeting a new dimension, allowing members more opportunities than ever to get INspired.

February 24–27, 2018 Long Beach, California

Following are some of the highlights of the meeting as told through social media snapshots.

Kirsten Block, @kfblock

Great reminder from @umsop’s Dr. Andy Coop: “Giving a workshop is not the end, it’s just the beginning” of accelerating healthcare solutions #INterim18 Research Symposium

Tim Bloom, @BJDSOP_ADAA

Attended an interesting and useful session on “Leading from the Middle” at #INterim18 for assistant and associate deans.

I’m looking forward to using what I learned when I get back to @bjdsop

David D. Allen, @DavidDAllen

Leadership can come from anyone and anywhere. Anthony Caprio. #INterim18 #Keynote

Karen Sando, @sandok03

Self-analysis is key for leaders to do. It’s never fun, but necessary! Keynote speaker - Anthony Caprio, PhD @AACPharmacy #INterim18

Conrad Dhing, @ConradDhing

Affable, optimistic, visionary, and detail oriented are qualities of good leaders, says Anthony Caprio of WNEU #INterim18

Tara Jenkins, @DrTJenks

Should administrative appointments be term limited? Youthful faculty arguing yes with seasoned admin arguing no. Way to add in an extra dimension to the debate! #INterim18

AACP, @AACPharmacy

“Any time I can get students to work long-term with the community,” it both serves the community & reinforces the university’s role in it, says @onu_pharmacy’s Dr. Michelle Musser. #INterim18

Jennifer Athay Adams, @jlaadams

Resilience is not always the ability to bounce back, but is sometimes the ability to bounce forward. @LouisAlloro #INterim18 #resilience #moveforward

Heather Petrelli, @TweetTheADean

“Passive disagreement is not acceptable. If you have a problem with whatever is being discussed, then your view needs to be on the table before leaving the meeting”. #INterim18 @ AACPharmacy

Top: Attendees gather during the Town Hall for an update on the Strategic Plan, student recruitment, PharmCAS and more.

Bottom: “Clearly this table is up to no good,” Dr. Daniel Malcom, Sullivan University, tweets (@loukydawg) from Long Beach.

AACP greatly appreciates the support from our meeting sponsors, whose contributions made this event possible: Educational Day Sponsor

Bronze Sponsors

Save the Date: 2019 INterim Meeting

February 23–27, 2019

Tampa, Florida Academic Pharmacy NOW  2018 Issue 2

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@AACPharmacy

#PharmEd18: Declare a New Beginning in Boston Connect with experts in education, science and leadership at the Academy’s premier event: Pharmacy Education 2018.

Proven Lessons from Expert Leaders Opening General Session

How to Be Happy at Work: The Power of Purpose, Hope and Friendship Annie McKee, Ph.D. Best-selling author, academic and speaker Annie McKee is a sought-after advisor to leaders of Fortune 500 companies, governments and NGOs around the globe. She has co-authored groundbreaking Harvard Business Review books on the power of emotional intelligence to change how we lead and engage with one another.

A Senior Fellow at the University of Pennsylvania, Dr. McKee teaches and leads the PennCLO Executive Doctoral Program and the Penn MedEd Master’s program, as well as teaching at the Wharton School’s Aresty Institute of Executive Education. Dr. McKee’s book, How to be Happy at Work: The Power of Purpose, Hope and Friendship, delivers a hands-on guide with practical exercises and instructions for how to be happy at work—no matter what job you have.

At the Opening General Session, McKee will share vivid and moving real-life stories that illustrate how to use purpose, hope, and friendship to create and sustain happiness and ensure a healthy, positive climate for teams and throughout organizations. Annie is committed to helping good leaders become better and to creating vibrant workplace cultures where people and their institutions thrive.

Plant Your Flag in Boston Visit www.aacp.org/PharmEd18 to reserve your room at the Sheraton Boston, Marriott Copley Place or Hilton Boston Back Bay, before exploring all the city has to offer at www.bostonusa.com.

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Science Plenary

Sex as a Biological Variable in Drug Approval: Translation to Pharmacy Education Marjorie Jenkins, M.D. and Rebecca Sleeper, Pharm.D.

Join Dr. Marjorie Jenkins and Dr. Rebecca Sleeper as they provide an overview of the regulatory history of the inclusion of women in research activities and clinical trials, discuss the evaluation of potential sex differences in preclinical review throughout drug development, as well as in clinical review of investigational new drugs (INDs) and new drug applications (NDAs). The importance of expanding women’s health education beyond reproductive health will be addressed.

The session will conclude with a discussion of resources and models available to integrate clinically relevant sex and gender evidence into pharmacy school curricula.

Dr. Jenkins joined the FDA Office of Women’s Health (OWH) in 2015. In her role as OWH director of medical initiatives and scientific engagement, Dr. Jenkins provides sex and gender science expertise within research, health education, and communications programs.

Dr. Sleeper joined the TTUHSC SOP faculty in 1999 and is currently a professor of pharmacy practice in the geriatrics division and is the associate dean of curriculum for the school.

At the Health Sciences Center level she also serves as the vice chair for the TTUHSC Institutional Review Board, and is a member of the TTUHSC Sex and Gender Specific Health program.

@AACPharmacy

AACP Annual Meeting Boston, Massachusetts July 21–25, 2018

Register for the meeting before the early-bird deadline of May 17 and save more than $100!

Visit https://www.aacp.org/pharmacy-education-2018-registration.

Tuesday General Session

The Opioid Crisis: Made in America...

Fade in America?

Bertha Madras, Ph.D. In the Tuesday General Session, Dr. Bertha Madras will describe the root causes of the opioid epidemic, including the role of private and government entities that failed to protect the public.

Strategies to reverse the root causes, including those that can be addressed by government funding, government regulations and the criminal justice system alone cannot reverse the tide. As healthcare systems become increasingly engaged, the potential of pharmacists to make a positive difference is significant.

Dr. Madras is a professor of psychobiology at Harvard Medical School (HMS), and with a cross-appointment at the Massachusetts General Hospital in Boston. As an HMS faculty member and neuroscientist for 30 years, her research on psychoactive or therapeutic drugs, brain imaging, and others is published in more than 200 manuscripts, articles, books, book chapters and commentaries.

AACP greatly appreciates the support from our meeting sponsors, whose contributions make this event possible: Platinum Sponsors

Educational Day Sponsor

Gold Sponsors

Silver Sponsors

Bronze Sponsors

On a national level, she currently serves as a key member of the President’s Commission on Combating Drug Addiction and the Opioid Crisis. Formerly, she was appointed deputy director for demand reduction (prevention, intervention treatment) in the White House Office of National Drug Control Policy, Executive Office of President, a presidential nomination confirmed unanimously by the U.S. Senate.

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Pharmacists Help People Live Healthier, Better Lives.

1400 Crystal Drive, Suite 300 P Arlington, VA 22202 703-739-2330 P www.aacp.org

Turns 1!

Time Flies When You’re Connected!

Over the past year, AACP Connect has become a robust engagement tool for members to share, collaborate and explore.

If you still haven’t signed into Connect, simply visit http://connect.aacp.org and log in with your AACP member username and password. Don’t miss out on important communications and professional development opportunities shared with members through AACP Connect!