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Contents
COVER STORY
President's Message 3
AzPA News
2025-2026 Board of Directors 2
Welcome New Members 4
Az-ASHP State Affiliate News 5
University & Alumni News
New Interim Dean of R. Ken Coit College of Pharmacy 7
Meeting the Moment: Creighton’s Phoenix Pharmacy Pathway 8
Creighton University Graduate Spotlight 8
Midwestern University September 2025 Update 9
Editorial
AzPA Naloxone Program 10
Preceptors Corner 11
PAAS National: Illegible Signature? Auditors Are Taking Note! 13
Advocacy
Legislative Update 15
Editorial
Editor’s Note: Any personal opinions expressed in this magazine are not necessarily those held by Arizona Pharmacy Association. “Arizona Journal of Pharmacy” (ISSN 1949-0941) is published quarterly by the Arizona Pharmacy Association at: 1845 E. Southern Avenue, Tempe, AZ 85282-5831
Association of Social Factors and Comorbidities with Poor Physical or Mental Functioning 18
PRESIDENT’S MESSAGE
Jaime von Glahn, Pharm.D. President, Arizona Pharmacy Association
Jaime von Glahn is a seasoned pharmacy leader with over 32 years of experience at Fry’s Pharmacy, where she currently serves as a Pharmacy Supervisor overseeing 27 locations across the Phoenix and surrounding regions. Throughout her career, she has held a variety of roles, each contributing to her deep knowledge of pharmacy operations and her commitment to excellence in patient care.
Driven by a passion for clinical pharmacy services, healthcare policy, and advocacy, Jaime is a dedicated champion of patient safety and improved health outcomes. Her work is centered on detailed medication assessments and advancing pharmacy's role in the broader healthcare system.
Jaime has been deeply involved in professional leadership through her work with the Arizona Pharmacy Association (AzPA), where she has served as Director-at-Large for Community Pharmacy, chaired the Membership Committee, and now holds the position of President. Her dedication to advocacy extends beyond the profession through her volunteer work with the Phoenix Children’s Hospital Family Advocacy Committee, where she collaborates with providers, staff, and families to enhance patient and family experiences.
Welcome Statement from the President of the Arizona Pharmacy Association American Pharmacists Month – October 2025
Dear Colleagues and Friends,
As President of the Arizona Pharmacy Association, I am deeply honored and grateful for the opportunity to serve in this esteemed role. As I’ve stepped into this new leadership position, I’ve had the chance to reflect on the many changes happening in both my professional and personal life. Change often arrives as a challenge, but it also offers us a powerful opportunity — to refocus on our priorities, nurture meaningful connections, and embrace new perspectives. In this season of change, I’ve found renewed purpose in serving this community and advancing our shared mission.
We are entrusted with the responsibility of impacting the health of our communities, not only through the care we provide daily but also through the power of advocacy. As we continue to expand the reach and recognition of pharmacy professionals in Arizona, I want to highlight our ongoing legislative efforts, especially our push for Standards of Care. These efforts are critical to empower pharmacists to practice at the top of their license and better serve our patients statewide. Your continued support and engagement in these initiatives are vital and deeply appreciated.
Looking back on our incredible Annual Convention, themed “FEARLESS: Inspiring New Horizons in Pharmacy’s Next Era,” I’m reminded just how bold, innovative, and united our profession truly is. With a fun nod to Taylor Swift, this convention was more than a gathering — it was a celebration of our collective resilience, growth, and vision for the future of pharmacy.
As we celebrate American Pharmacists Month, let’s honor the impact we make each day — in every prescription filled, every consultation given, and every life touched. Let’s also look ahead with courage and confidence, knowing that together, we are shaping the future of pharmacy in Arizona.
Thank you for your dedication and your FEARLESS dedication to our profession.
With gratitude and pride,
Jaime von Glahn, Pharm.D. President, Arizona Pharmacy Association
WELCOME
New AzPA MEMBERS!
Thomas Burkey
Jason Rodriguez
Aimee sullivan
Emily Evans
Samantha Sutton
Kiana Arab
Jesus Botiller
Austin Brian
Tacheena Coicou
Paige foltz
Amreece Gill
Susan Karoubi
Edgar Leon
Abel Martinez
Caleb pearce
Favi Rodriguez
Yaniss Rodriguez
Tammy Tran
Halle Zadro
Michael Erstad
Gloria Setayesh
Saya Taslimi
ASHP Policy Week Report: Advocacy and
Engagement in Pharmacy Practice
Introduction
I am thrilled to introduce myself as your new Director-at-Large for Health Systems. As I embark on this exciting role, I am eager to share my recent experiences and insights from participating in the American Society of Health-System Pharmacists (ASHP) Policy Week. This annual event provides pharmacy professionals with an invaluable opportunity to advocate for critical issues affecting our practice and patient care.
Representing Arizona Pharmacists at Policy Week
During Policy Week, I had the honor of representing Arizona pharmacists and engaging directly with lawmakers to advocate for key legislative priorities. The event allowed me to interact with policymakers and share our perspectives on issues that impact pharmacy practice statewide. I am excited to share the highlights of this event and encourage your participation in our ongoing advocacy efforts to shape the future of pharmacy.
Advocacy in Action: Legislative Day Highlights
ASHP Policy Week serves as a vital forum for pharmacy professionals to influence policy and engage with lawmakers. Alongside Kellie Goodlet from Midwestern University, I participated in discussions with the offices of Senators Mark Kelly and Ruben Gallego and Representative David Schweikert. We advocated for legislative priorities that are essential to our profession and patients.
During Legislative Day, our focus centered on three critical pieces of legislation:
Ensure Community Access to Pharmacist Services Act: We requested co-sponsorship to expand Medicare patients’ access to testing and treatment services provided by pharmacists in Arizona.
Rebuild America’s Health Care Schools Act: This act aims to clarify CMS requirements for Medicare reimbursement to health systems that operate pharmacy, nursing, and allied health residency programs, while also preventing potential fund clawbacks.
340B PATIENTS Act: We advocated for this legislation to prohibit restrictions on where patients can access medications. This includes access through contract pharmacies, which helps preserve community access to medications via the 340B program.
Policy Development Through ASHP Councils
As a member of the Council on Pharmacy Practice, I participated in formulating policy recommendations designed to guide our profession. ASHP Councils play an essential role in developing strategic initiatives and shaping the direction of pharmacy practice. In addition to the Council on Pharmacy Practice, other councils include:
• Council on Education and Workforce Development
Council on Public Policy
• Council on Therapeutics
• Council on Pharmacy Management
Sarah Stephens, PharmD, CPPS, FASHP Director-at-Large for Health Systems Arizona Pharmacy Association
CONT.
HEALTH SYSTEMS
“ Participating in council activities and advocacy is a powerful way to help shape the future of our profession.”
The policies developed by these councils are reviewed by the ASHP Board of Directors and, upon approval, move forward to the House of Delegates. There, they have the potential to become official policies, ensuring that our advocacy efforts remain aligned with the profession’s standards.
Get Involved: Council Membership and Advocacy Opportunities
Participating in council activities and advocacy is a powerful way to help shape the future of our profession. Here’s how you can become involved:
• Council Membership: Apply during the annual application period, which is open now. Detailed instructions are available on the ASHP website: https://www.ashp.org/aboutashp/our-leadership/councils-and-committees
• Advocacy Opportunities: Subscribe to ASHP updates and participate in grassroots campaigns. ASHP also offers training sessions to help you develop your advocacy skills.
• The deadline to apply for council membership is November 14, 2025. Please submit your application by this date to be considered for the 2026-2027 term.
Conclusion and Next Steps
ASHP Policy Week is more than an event, it is a movement dedicated to redefining our role in healthcare. I encourage each of you to get involved, advocate for the changes you wish to see, and help us set new standards in pharmacy practice for the state of Arizona and nationally.
Additionally, we will soon be sending out invitations for our Health System Special Interest Group (SIG) calls. If you are interested in attending, please reach out.
Thank you for your continued dedication to the profession.
Warm regards,
Sarah Stephens, PharmD, CPPS, FASHP Director-at-Large for Health Systems Arizona Pharmacy Association
Brian Erstad Announced as Interim Dean of R. Ken Coit College of Pharmacy
As of July 1, 2025, Brian Erstad, PharmD, is now serving as the interim dean of the University of Arizona R. Ken Coit College of Pharmacy.
Erstad received his Doctor of Pharmacy degree from the University of Arizona in 1987 and joined the College of Pharmacy faculty in 1988 following completion of a residency at the local academic medical center. He went on to lead the Department of Pharmacy Practice and Science for more than a decade, serving in that role until 2024. Throughout his career, Erstad has held many leadership roles, most notably as president of the American College of Clinical Pharmacy, serving on the Board of Directors of the American Society of HealthSystem Pharmacists, and currently serving on the Board of Directors for the Board of Pharmacy Specialties.
“I am grateful to Provost Prelock for the opportunity to serve as interim dean. It’s an honor to be entrusted with this responsibility,” said Erstad. “I’m humbled to work alongside our outstanding faculty and staff as we continue to deliver academic excellence for our students and the college. As we approach the completion of the accreditation process, I look forward to accomplishing such an important milestone together.”
Erstad has earned national and international distinction for his work in pharmacy education, clinical practice, and health outcomes research. In recognition of his career-long impact, he has been awarded the Lifetime Achievement Award by the American Association of Colleges of Pharmacy in 2025.
As a PharmD, Erstad offers extensive expertise in clinical training and clinical pharmacy advancement. In this interim role, he seeks to extend the College’s duration of accreditation and continue to foster excellence in teaching, scholarship, and service by faculty.
Sarah Stephens, PharmD, CPPS, FASHP
Director-at-Large for Health Systems Arizona Pharmacy Association
In addition to his academic contributions, Erstad is a respected and celebrated faculty member, colleague, and mentor. Dedicating over 30 years to educating the next generation of pharmacists led him to receive the Robert K. Chalmers Distinguished Pharmacy Educator Award from the American Association of College of Pharmacy in 2021.
“I am thrilled to welcome Dr. Brian Erstad as interim dean of the R. Ken Coit College of Pharmacy,” said University of Arizona Senior Vice President for Academic Affairs and Provost Patricia Prelock. “Dr. Erstad brings an extraordinary legacy of academic excellence, national leadership, and unwavering commitment to pharmacy education. His deep institutional knowledge and dedication to student success position him perfectly to lead the college during this important transition. I am confident that under his guidance, the college will continue to thrive and advance its mission of excellence in teaching, research, and service.”
The nationwide search for the next permanent dean begins late fall 2025.
Brian Erstad, PharmD Interim Dean
R. Ken Coit College
Meeting the Moment: Creighton’s Phoenix
Pharmacy Pathway Expands to Address Regional Workforce Needs
by Molly Garriott
In response to Arizona’s growing need for healthcare professionals, Creighton University launched its Phoenix Pharmacy Pathway, a hybrid Doctor of Pharmacy program that allows students to complete their didactic curriculum online while engaging in hands-on learning and clinical experiences in Phoenix.
Creighton’s investment in Phoenix is already bearing fruit. Most of the students in the most recent Phoenix cohort call Arizona home. The remaining students bring regional diversity, coming from California, Texas and Washington.
The program’s regional recruitment strategy intentionally focuses on the West—with special attention to Arizona. Creighton actively engages students across the state and throughout the region, with many drawn to the Phoenix location for its proximity to family and strong ties to local support networks.
Equally important, the location enhances students’ ability to build meaningful connections within the Arizona pharmacy community— setting the stage for a seamless transition from classroom to career. Most graduates across Creighton’s Pharmacy programs—whether from the Omaha, Distance or Phoenix Pathways—receive one to three job offers upon graduation. In May, the Phoenix Hybrid Pathway celebrated its first graduating class, further solidifying the program’s role in shaping the future of healthcare in the Southwest.
Amy Friedman Wilson, PharmD Dean School of Pharmacy and Health Professions
Student Spotlight
Sharon Ruditser PharmD ’24
For Sharon Ruditser, PharmD, a recent graduate of Creighton’s Phoenix Hybrid Pathway, her pharmacy education was only the beginning. Now in a one-year pharmaceutical industry fellowship at Eli Lilly, she’s channeling her interest in innovation into developing diagnostics and therapies that improve patient care.
“Leading a research project (at Creighton) sparked my passion for research, innovation and addressing gaps in scientific knowledge,” Ruditser says. “That passion grew during my rotation at Eli Lilly, where I … saw the potential to impact patients globally.”
Each day of her fellowship brings new challenges, from hands-on lab work and project management to creating educational materials on disease states. “The variety keeps the role dynamic and allows me to continue learning new things,” she shares.
Ruditser credits Creighton with preparing her to succeed. In addition to serving as lead on research, she says her clinical and service experiences grounded her in patient-centered care, and “together, those experiences gave me the confidence and perspective to step into this fellowship.”
Looking ahead, she hopes to grow into a leadership role where she can help guide treatments from concept to clinic: “I want to help bring forward therapies that reach more patients and improve how medicines are discovered, developed and delivered.”
Mitchell Emerson, PharmD Dean and Professor College of Pharmacy
Midwestern University September 2025 Update for the Arizona Journal of Pharmacy
Greetings from the College of Pharmacy at Midwestern University. As we say goodbye to summer and welcome fall, we are reminded of the amazing community we’ve created here at the College of Pharmacy! We’re excited to welcome cooler temperatures and share an update with everyone.
The College would like to welcome the new Midwestern University President and CEO, Dr. Joshua Baker. Dr. Baker was the former Chief Academic Officer for Pharmacy, and we know through his leadership we will continue to thrive. We would also like to recognize Dr. Kathleen Goeppinger for her dedicated service to MWU and support of our program. We wish her well in her retirement.
Thank you to all the amazing alumni and students who joined us on Tuesday, August 26th at 5pm, for the CPG Alumni/ Student Ice Cream social. It was great to see so many connections and conversations as we enjoyed sweet treats from Rita’s.
We’re pleased to announce that Dr. Laura Hanson, Pharm.D., Class of 2010 has joined the CPG Alumni Council. Welcome Dr. Hanson! And, THANK YOU to everyone on the Council- Dr. Travis Shelton, Dr. Tiffany Golz, Dr. Alison Sutton, Dr. Cassandra Anderson, Dr. Ladan Talebi, and Dr. Kaveh Oloumi.
We’re working on another event planned for late October that will be bring CPG alumni and students together for an evening of mentoring. Look for more information in the coming weeks as we finalize the evening’s details.
For those of you planning to attend the annual ASHP Midyear Meeting, December 6th-10th in Las Vegas, we look forward to catching up with you there. We’re planning an Alumni and Friends reception at La Libertine! In the Mandalay Bay Hotel on Sunday, December 7th. All are welcome and look for invitations via AzPA and our Alumni network soon.
It’s hard to believe but 2026 will be here before we know it. As we welcome the new year, we’re happy to share that in spring, we’re planning the infamous CPG CE Alumni and Preceptor reception. This event has been a huge hit and we’re happy to bring it back. We’ll be offering one free hour of CE and plenty of time to connect and enjoy appetizers and drinks. Look for more details to come with a link to RSVP.
We are looking forward to catching up with all of you and connecting at a future event. If you’re in the Glendale area, please reach out and stop by the campus. So much has changed, but still remains the same welcoming place.
Did you know we have a Midwestern University Job Board? If you’re looking to hire or looking for a new opportunity, please click here for more information https://www.midwestern.edu/alumni/alumni-jobfinder.
If you’ve recently moved or relocated, please ensure we have your updated contact information. Please email updates to your Manager of Alumni Relations, Kimberly Hastings at KHastings@midwestern.edu
To follow us and learn more about our events and wins, join the MWU Pharmacy social media community: Like us on Facebook: MWUpharmacy Follow us on Twitter: MWUpharmacy And Instagram: MWUpharmacy
Naloxone Champions at Work: Advocacy and Engagement in Pharmacy Practice
“ The Fountain Hills Crisis Response Team is comprised of dedicated community volunteers who provide immediate emotional and practical support to individuals and families facing various crises whether it be from overdoses and mental health emergencies to accidents, suicides, and domestic violence situations”
The Arizona Pharmacy Association received a grant in 2023 to start the Naloxone Pharmacy Distribution Program (NPDP). The NPDP has 43 pharmacies throughout Maricopa County that provide naloxone kits, at no cost, educational material, and resources to anyone in the community. Each pharmacy has a Naloxone Champion that attends monthly meetings and shares their outreach to the community and success stories. This community event was submitted by Maryam Alizadeh, PharmD of Wellness Pharmacy in Fountain Hills, AZ.
Wellness Pharmacy recently partnered with the Fountain Hills Crisis Response Team to host an important community education session focused on overdose prevention and naloxone use. The event, held at the local community center, aimed to empower first responders and volunteers with the knowledge and tools to save lives during opioid emergencies. During the September session, Wellness Pharmacy’s clinical team provided an interactive presentation on recognizing the signs of an opioid overdose, proper naloxone administration techniques, safe medication and naloxone storage, and crucial steps to take until emergency medical services arrive. To further support the team’s efforts, the pharmacy dispensed 21 naloxone kits to Crisis Response Team members for use in the field.
The Fountain Hills Crisis Response Team is comprised of dedicated community volunteers who provide immediate emotional and practical support to individuals and families facing various crises whether it be from overdoses and mental health emergencies to accidents, suicides, and domestic violence situations. These compassionate volunteers work closely with local law enforcement, fire departments, and other agencies to ensure that people in crisis receive support during their most difficult moments.
Wellness Pharmacy is proud to support these selfless volunteers by equipping them with lifesaving tools and training. Through ongoing collaboration and community education, we hope to continue strengthening the safety net for our Fountain Hills neighbors and promoting a healthier, safer community for all.
Conferences as Catalysts: Building Connections and Advancing Advocacy
Suzanne Larson, PharmD, Director of Experiential Education, Midwestern University College of Pharmacy, Glendale AZ Campus
Janet Cooley, PharmD, Director of Experiential Education, University of Arizona College of Pharmacy
In the Spring 2025 issue of the Arizona Journal of Pharmacy, in collaboration with student pharmacists, we discussed the importance of advocacy and how preceptors can model and teach this principle. In this article, we hope to expand upon these ideas and explore how attending professional meetings can be another way to advocate for yourself and the profession of pharmacy.
Within the span of one week in June 2025, we attended the American Society of Health Systems Pharmacists (ASHP) Pharmacy Futures Meeting in Charlotte, NC (referred to as “Pharmacy Futures” through the rest of the article) and the Arizona Pharmacy Association (AzPA) Annual Convention in Tucson, AZ. Attending these two meetings in a short amount of time has ignited our passion and sparked some reflection about the importance of meeting attendance on wellbeing, professional development, connection with others, and our development as preceptors, mentors, and role models. In this article, we share some insights from these experiences that apply to our roles as preceptors.
The ASHP Pharmacy Futures hosted the National Pharmacy Preceptors Conference, which was previously a stand-alone annual meeting. With the decision by ASHP to combine their Summit on Advanced Therapeutics, Sterile Compounding Training and National Pharmacy Preceptors Conference, the Pharmacy Futures meeting offered an extensive variety of programming. Here, we attended sessions on the use of artificial intelligence (AI) in practice and precepting, heard insights from award-winning preceptors, and visited preceptingspecific poster sessions. The exhibit hall hosted countless exhibitors sharing ideas and a variety of products and giveaways. We were able to connect with professionals from many practice settings across the United States. One of our favorite memories was from the “Precepting Gems’ session where we were invited to serve on a panel offering 10-minute gems. Here, we learned from our co-panelists and many of the audience members who offered their thought-provoking discussion questions for our group. We later learned that this session was the most widely attended session of the entire conference!
CONT.
PRECEPTORS CORNER
“ We emerged from this conference with ideas and inspiration. We filled our professional development buckets.”
At the AzPA convention we re-connected with colleagues and friends that we rarely see in person. We felt the energy, excitement, and passion of the group. We witnessed pharmacists and preceptors supporting students and residents, as well as colleagues who were presenting content and exhibit hall booths. We exchanged business cards, smiles, congratulations, and handshakes. We emerged from this conference with ideas and inspiration. We filled our professional development buckets. We returned to our regular jobs with a renewed sense of camaraderie with our fellow pharmacists and technicians in Arizona.
So, what does our summer of professional meeting attendance have to do with precepting? How can attending professional meetings improve your precepting practices? We offer a few considerations.
1. Attending a professional meeting is a great way to remind ourself that we are part of something bigger. Pharmacy practice (and precepting) can both be lonely jobs. Remembering that we are part of something bigger helps our mindset when our jobs are isolating and difficult. We have found inspiration and energy from the speakers and people we meet at these meetings. That can be re-energizing.
2. Professional meeting attendance helps to amplify our voice. When we belong to and contribute to a professional organization, its advocacy efforts are amplified. Find associations that align with your own perspectives and support those organizations. Find opportunities to serve on committees or as a delegate to amplify your passions further.
3. Professional meetings help infuse our practice with new ideas, collaborators, hot topics, and perspectives. Maintaining a perspective that shifts with the changing healthcare landscape is essential to providing timely mentorship for our learners.
4. Attending a professional meeting helps us lead by example. It allows learners to see that we are invested in our own professional development and making our growth a priority.
5. Practically speaking, participating in professional meetings offers an opportunity for continuing education and continuing professional development. Networking at professional meetings helps us learn how others solve similar problems (big and small). We can hear presentations about law updates, new drugs, and teaching techniques. Finally, consider the value in presenting a poster or hosting a round table to share an innovation from your site.
We hope this reflective article inspires you to check out some upcoming professional meetings.
Illegible Signature? Auditors Are Taking Note!
By Trenton Thiede, PharmD, MBA, President at PAAS National®, expert third party audit assistance, FWA/HIPAA and USP 800 compliance.
A recent audit trend shows that some major PBMs are challenging the perceived legitimacy of patient signatures. In particular, Humana and OptumRx have been citing signature logs as discrepant when there is only a line, squiggle, printed first or last name, or initials in lieu of a “proper signature”. The auditor asserts that the pharmacy, not the patient, signed these prescriptions out, negating the proof that the patient confirmed receipt of the medication.
Humana uses the discrepancy code “ISL” and notes that the “signature log sent does not contain a signature.” OptumRx uses the discrepancy code “2B” and notes that “no signature…present on received receipt/log.” While some avenues exist for appeal, it’s predicated on the PBM and best to avoid this nuisance altogether.
PAAS National® also continues to see audit trouble when pharmacy staff sign “delivery/DEL/mail” when delivering or mailing out the prescription to a patient or “DT/drive thru” when the patient picks up their medication from the drive thru (or curbside). If a pin pad needs to be signed out in this fashion to complete an electronic transaction, it’s advisable to collect a manual signature from the patient for your records. Many POS systems allow you to scan these signatures back into the system for electronic recordkeeping.
PAAS Tips:
Remind staff that signatures are required for all in-store pick-up and delivered prescriptions
Obtain complete signatures from patients/representatives whenever possible
• If a patient refuses to sign with a complete signature, consider the following:
• Explain that their insurance, not the pharmacy, requires a legible signature for proof of receipt
This can be an opportunity to highlight (in a non-disparaging way) that PBMs are ruthless on audits and that a missing signature means you could be out hundreds or thousands of dollars each time they refuse to sign
• If a patient still refuses to sign for expensive medications, you could offer to reverse the claim and bill it without their insurance
Signature logs should contain four elements:
1. Prescription number
2. Date of service or refill number
3. Date of pick-up/date received
4. Patient’s/Patient representative’s signature
EDUCATION
Pharmacy staff should NOT sign/print the patient’s name for them, use their initials, or jot a line or squiggle to give the appearance of the patient signing
If delivering a prescription, delivery logs should contain:
• Patient’s name
Prescription number
• Date of service or refill number
• Date delivered (handwritten by the person receiving the delivery or electronically time-stamped when signing)
From shifting regulatory frameworks and aggressive payer practices to legislative gridlock and pharmacy closures, the profession is under attack on all fronts. Worse yet, these challenges are present at both the state and federal levels, meaning pharmacy professionals in Arizona and across the nation are facing an unprecedented number of obstacles. While advocacy has always been core to our mission, the Arizona Pharmacy Association (AzPA) has stepped up its advocacy efforts, representing and supporting our members on key initiatives.
Federal Advocacy: Fighting for Pharmacist Services and Payment Reform
At the federal level, AzPA leaders—including Board members Sarah Stephens, Justin Brock, and Chief Executive Officer Garet Turner—joined forces with the Alliance for Pharmacy Compounding (APC), the American Pharmacists Association (APhA), and the American Society of Health-System Pharmacists (ASHP) during a single week in Washington, D.C. this September. Their mission - make Arizonan voices heard through championing the ability to compound Desiccated Thyroid Extract, the Equitable Community Access to Pharmacist Services (ECAPS) Act, and defending the current operation of the 340B Drug Pricing Program. All of these efforts are critical to the patients you serve, their access to care and the survival of community pharmacies and rural hospitals.
“ The challenges facing pharmacy are real and growing. But AzPA’s advocacy—at the Capitol, in Congress, and in coalition with national partners— demonstrates a steadfast commitment to protecting and advancing the profession.”
According to APC - “Compounders on Capitol Hill (CCH) was huge. More than 250 compounding professionals attended. Collectively they made almost 200 visits with members of Congress, all in one day.”
During ASHP’s 2025 Legislative Day, pharmacy advocates including the Health-System Special Interest Group leader Sarah Stephens, met with 108 Congressional offices to push for expanded patient access to pharmacist services, increased funding for residency programs, and protection of vital programs like 340B. However, several Arizona Congressional representatives—including Eli Crane, Yassamin Ansari, Greg Stanton, Andy Biggs, Juan Ciscomani, Adelita Grijalva, Abraham Hamadeh, and Paul Gosar—were not reached during these visits. AzPA in partnership with ASHP is calling on its members to contact your local offices directly and share the urgent need for legislative action.
APhA’s CEO, Michael Hogue, has linked the ECAPS Act to the ongoing crisis of pharmacy closures, emphasizing that ECAPS would provide a stable payment stream for pharmacist services—not just drug dispensing. This financial support is essential as remaining pharmacies shoulder increased burdens in communities hit by closures. Garet Turner spoke with advisors in the offices of Representative Stanton, and Senators Gallego and Kelly. While understanding the issues, all have openly requested that something be passed at the state-level before they express co-sponsorship support. Their hope had been that Test & Treat would have passed in the 2025 Legislative Session.
AzPA’s unified presence in Washington, D.C. alongside national pharmacy organizations underscored the urgency of federal action to protect compounding rights, expand pharmacist services, and preserve the 340B program. While momentum is building, Arizona’s Congressional delegation remains a critical gap. Continued grassroots advocacy is essential to ensure these priorities translate into policy that sustains patient care and community pharmacy viability.
State Advocacy: Legislative Wins and Ongoing Battles
As the lobbyist reminds me, the 2025 Arizona legislative session was one of the longest and most contentious in recent history, with a record number of bills introduced and vetoed. AzPA proactively ran two priority bills:
This bill would have allowed pharmacists to independently order, perform, and interpret FDAauthorized tests and initiate treatment for certain conditions. Despite bipartisan support and extensive negotiations, the bill was blocked from a final vote in the House. AzPA is committed to overcoming these obstacles in the next session and will work to create a Standard of Care framework from which pharmacists can exert full practice authority.
This bill, which permits pharmacists to order and administer emergency medication for acute allergic reactions, was signed into law with overwhelming support—a significant win for pharmacy practice.
Due to the gridlocked legislature, only HB 2628 passed, while SB 1214 was caught in a game of partisan politics that left it unread for its required, third, and final reading/vote. AzPA also supported or opposed numerous other bills impacting pharmacy, including:
Prohibits non-medical switching by Pharmacy Benefit Managers (PBMs), ensuring patients can maintain access to previously approved medications throughout their plan year. AzPA played a key role in negotiating this bill to a neutral position with PBMs, resulting in its passage.
HB 2208: Pharmacists; Pharmacies; Reimbursement
Costs; Appeals
Sought to establish fair reimbursement and appeal processes for pharmacists, but was blocked in committee due to opposition from PBMs. We will continue to build relationships and find a path forward on this important issue in collaboration with the Independent Pharmacy Coalition.
SB 1291: Health Insurers; Provider; Payment; Claims
Requires insurers to credential providers within 60 days and provide clear communication about discrepancies. AzPA supported this bill, which was signed into law. Let this also serve as an an important reminder that pharmacists have been recognized as providers through Blue Cross Blue Shield of Arizona (BCBSAZ) where credentialling is possible and encouraged.
AzPA monitored, supported, or opposed dozens of other bills affecting pharmacy operations, patient care, and professional regulation. The association’s strategic engagement—sometimes working behind the scenes—ensured that the voice of pharmacy was heard even when direct victories were elusive.
Looking Ahead: Standard of Care and Full Practice Authority
AzPA is preparing to run a major legislative initiative in 2026: switching to a Standard of Care framework for pharmacists operating with full practice authority. This model, discussed at AzPA’s Fall Conference by Dr. Nicki Chopski, promises to modernize pharmacy practice and improve patient outcomes. AzPA is collaborating with stakeholders and learning from other states like Idaho, Iowa and Alaska - who have already enacted laws of this kind, to ensure Arizona pharmacists are empowered to practice at the top of their education. Pharmacist authority for practice benefits patients because of their direct and easy access to care.
Conclusion: United for the Profession
The challenges facing pharmacy are real and growing. But AzPA’s advocacy—at the Capitol, in Congress, and in coalition with national partners—demonstrates a steadfast commitment to protecting and advancing the profession. As CEO Garet Turner said after recent Hill visits, “I am privileged to be a state association leader and couldn’t be more happy to represent the profession of pharmacy AND the great state of Arizona in all that I do in coalition with national organizations with whom we partner for success.” AzPA urges all members to stay engaged, contact their legislators, and support the association’s efforts. Together, Arizona pharmacists are stronger—and can meet every challenge head-on.
Association of Social Factors and Comorbidities with Poor Physical or Mental Functioning
Authors and Affiliations: Reina Wrinkle Student, PharmD Candidate 2026; Gabriela Rajic Student, PharmD Candidate 2026; Suzanne Larson, PharmD Office of Experiential Education; Kathleen A. Fairman, MA, PhD, Department of Pharmacy Practice, Midwestern University College of Pharmacy, Glendale, AZ.
Corresponding Author: Kathleen Fairman
Introduction
Adults living with cancer frequently face physical and mental health challenges that negatively impact quality of life. Social determinants of health (SDOH), such as income, education, and emotional support, significantly influence health outcomes among adults living with cancer.1-3 For example, studies have shown that factors such as household income, educational attainment, and access to care are associated with differences in cardiovascular health and selfperceived health status in this population.1-3 Adults living with cancer often carry a significant burden of comorbid conditions, such as cardiovascular disease, chronic obstructive pulmonary disease (COPD), and depression, which can further compromise physical functioning.4,5
Functional disability, defined as limitations in mobility, daily activities, or self-care, was prevalent among adults living with cancer in a large population-based study.5 This was particularly evident among older adults, those with lower socioeconomic status, and those from racially or ethnically minoritized populations. A study of adults living with gynecologic cancer highlighted the association between functional impairment and reduced adherence to physical activity guidelines.4 In this study, functional impairment was more common among patients with additional comorbidities and limited emotional support, suggesting a complex interplay between physical health and social context.
Recent efforts have been made to better describe the social landscape of cancer diagnosis, including using census-tract-level data to assess neighborhood disadvantage.2 Researchers have also explored the biological pathways by which social stressors, such as chronic stress or social isolation, can affect tumor biology and overall prognosis.6 However, there is limited research specifically examining how multiple
SDOH factors and comorbidities collectively influence poor physical or mental functioning in adults living with cancer.
Interestingly, while functional decline is often associated with advanced age, emerging data indicate that younger adults living with cancer may report a higher burden of perceived poor health compared to their older counterparts. For example, in national surveys, young adults report a high rate of experiencing poor mental health, a finding that has accelerated over time.7 Poor physical health and frailty are also common among young cancer survivors.8 This pattern may reflect differences in social roles, psychological expectations, or support systems that uniquely affect younger adults. Younger patients often face greater demands from family responsibilities, social expectations, and career pressures, which can intensify perceived poor health and make recovery after cancer more challenging.
This study investigates associations between social factors, comorbidities, and perceived poor functioning in U.S. adults living with cancer using nationally representative data.
Methods
De-identified, publicly available data from the 2022–2023 Behavioral Risk Factor Surveillance System (BRFSS) were used in this crosssectional study. The sample included adults (age ≥18 years) who reported a cancer diagnosis. The dependent variable was perceived poor health, defined as ≥15 days of poor physical or mental health in the past month. Independent variables included demographic characteristics (age, sex, income, race/ethnicity), chronic disease burden (diagnoses of angina, asthma, COPD, depression, diabetes, kidney disease, myocardial infarction, stroke), and social support factors (frequency of loneliness, emotional support).
Statistical analyses included Pearson chi-square tests for bivariate associations and logistic regression for multivariate modeling. Sampling weights were applied; variance adjustments for clustering were not used. An alpha of 0.05 was used for statistical significance. IBM SPSS version 30.0 (IBM SPSS, Armonk, NY) was used for all analyses. This study was conducted in compliance with Midwestern University Institutional Review Board/Human Subjects Research Committee requirements for analysis of de-identified data.
Results
Among 21,020 U.S. adults living with cancer surveyed, 15% reported ≥15 days of poor physical or mental health in the past month. The likelihood of having ≥15 poor health days increased with lower income (43% earning < $15,000 vs. 6% earning > $200,000; P < 0.001), more reported chronic diseases (6% with none vs. 43% with ≥ 4 conditions), and lack of consistent emotional support. Emotional support was reported as always available by more than half (52%) of respondents overall but by only 39% of respondents who reported >15 poor health days.
Multivariate analysis revealed that higher perceived poor health was associated with feeling lonely (OR for never feeling lonely=0.32, 95% CI=0.24-0.41), lacking emotional support (OR=1.62, 95% CI=1.361.92), and having >4 chronic conditions (OR=7.52, 95% CI=6.13-9.24). Older age (>65 years) was associated with lower odds of reporting poor health (OR=0.68, 95% CI=0.61-0.76). Race/ethnicity was not significantly associated with perceived poor health (OR=1.07, 95% CI=0.94-1.23). The Nagelkerke R² value of 0.201 indicated moderate model fit.
Discussion
This study found that poor physical or mental functioning was more prevalent among adults living with cancer who had low income, high comorbidity burden, and limited emotional support. These findings align with prior research identifying SDOH as critical drivers of health disparities in cancer outcomes. Functional limitations can hinder adherence to treatment and lifestyle recommendations, emphasizing the need for care that addresses socioeconomic and psychosocial needs. Contrary to some literature, race and ethnicity were not significant predictors in the present study, which may reflect measurement limitations or sample-specific effects.2,5
Pharmacists, particularly those embedded in oncology or ambulatory care settings, are well-positioned to help mitigate these disparities. Through medication therapy management, pharmacists can optimize regimens for patients with multiple comorbidities, improving treatment tolerability and adherence. Pharmacists may also play a critical role in screening for depression, providing brief interventions,
and connecting patients to supportive services. By identifying patients with unmet social needs, such as lack of transportation, food insecurity, or insufficient emotional support systems, pharmacists can initiate referrals and collaborate with interdisciplinary teams to address barriers that affect quality of life and functional outcomes.
An emerging trend to further expand the pharmacist’s impact involves utilizing pharmacy technicians as community health workers (CHW).9 With proper training, pharmacy technicians can help bridge gaps in care by identifying social determinants of health, performing outreach, and connecting patients to essential resources. This model supports the pharmacist’s clinical role while increasing the capacity of pharmacy teams to serve vulnerable populations. Technicians acting as CHW may also provide culturally appropriate education and followup, helping to build trust in underserved communities and improve adherence to care plans. This approach can be especially beneficial in community pharmacy settings, where patients often have frequent interactions with pharmacy staff. Integrating trained pharmacy technicians into the care team may be a cost-effective and scalable strategy to enhance the reach of pharmacists and reduce disparities in cancer outcomes.9
Interestingly, this study also found that younger adults living with cancer reported higher levels of perceived poor health compared to older adults. Specifically, those aged 25–34 had the highest proportion of respondents experiencing poor health for 15 or more days per month, whereas older age (65 years or older) was associated with lower odds of perceived impairment. These findings suggest that younger adults living with cancer may face unique psychosocial stressors, such as disrupted employment, social isolation, or unmet expectations regarding recovery and productivity. Cancer care programs should consider age-specific challenges and incorporate support services tailored to the needs of younger adults navigating life with cancer. Additionally, during active cancer treatment, younger adults may experience heightened strain as they balance treatment schedules with work obligations, manage side effects while caring for dependents, and navigate the financial and emotional instability that can accompany a cancer diagnosis at a younger age.
Limitations
This study relied on self-reported data, which could yield potential bias and recall inaccuracies. The cross-sectional design precludes causal inference. Comorbidity severity, cancer stage, and treatment details were not available, which may confound associations with functional health.
MANUSCRIPT
Conclusion
Among U.S. adults living with cancer, lower income, higher comorbidity burden, and limited emotional support were associated with greater odds of poor physical or mental functioning. Targeted interventions that address social disadvantage and multimorbidity are needed to improve outcomes for adults living with cancer.
Pharmacists have a unique opportunity to contribute to these interventions by integrating social needs assessments and care
coordination into routine pharmacy practice. As accessible healthcare providers, pharmacists can support adults living with cancer through medication optimization, emotional support counseling, and connections to community resources, ultimately helping reduce disparities in cancer outcomes.
References
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2. Bhattacharya M, Cronin KA, Farrigan TL, Kennedy AE, Yu M, Srinivasan S. Description of census-tract-level social determinants of health in cancer surveillance data. J Natl Cancer Inst Monogr. 2024;2024(65):152-161.
3. Su LJ, O’Connor SN, Chiang TC. Association between household income and self-perceived health status and poor mental and physical health among cancer survivors. Front Public Health. 2021;9:752868.
4. Nayak P, Vernon SW, Savas LS, et al. Functional impairment and physical activity adherence among gynecologic cancer survivors: A population-based study. Int J Gynecol Cancer. 2016;26(2):381-388.
5. Cao C, Kim DD, Zheng Z, et al. Prevalence and cancer-specific patterns of functional disability among US cancer survivors, 2017-2022. J Clin Oncol. 2024;42(19):2257-2270.
6. Goel N, Hernandez A, Cole SW. Social genomic determinants of health: Understanding the molecular pathways by which neighborhood disadvantage affects cancer outcomes. J Clin Oncol. 2024;42(30):3618-3627.
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9. Yoon HS, Teshome BF, Eisenbeis A, Micek ST. Pharmacy technicians trained as community health workers: a prospective multicenter cohort study. J Am Pharm Assoc (2003). Published online 2023. doi:10.1016/j.japh.2023.08.022. PMID: 37673283.
