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The Journal of the Iowa Pharmacy Association | A Peer-Reviewed Journal

The PBM Priorityâ€Ś Important to:

patients pharmacists prescribers employers pharmacy owners you! NEW! ONLINE FEATURES Read additional online only features and articles in our electronic Journal edition!

JAN.FEB.MAR 2014 IPA Legislative Day & Midwest Pharmacy Expo Board of Trustees Election Prescriber Column on Rx Drug Abuse

JAN.FEB.MAR 2014 | Vol. LXVIV, No. 1

TABLE OF CONTENTS 8515 Douglas Avenue, Suite 16, Des Moines, IA 50322 Phone: 515.270.0713 Fax: 515.270.2979 Email: ipa@iarx.org | www.iarx.org

PUBLICATION STAFF Lynndi Koester, Managing Editor lkoester@iarx.org Kate Gainer, PharmD kgainer@iarx.org Anthony Pudlo, PharmD, MBA, BCACP apudlo@iarx.org Laura Miller lmiller@iarx.org Joan Stover jstover@iarx.org

OFFICERS Chairman Julie Kuhle, RPh, Indianola 515.273.8876, jwkuhle@aol.com President Michele Evink, MS, PharmD, CGP, FASCP, Osceola 641.342.5322, mevink@clarkehosp.org President-Elect John Swegle, PharmD, BCPS, Mason City 641.428.7182, john-swegle@uiowa.edu Treasurer Steve Firman, RPh, Cedar Falls 319.277.7540, steve@pmgrx.com Speaker of the House Randy McDonough, PharmD, MS, CGP, BCPS, Iowa City 319.337.3526, mcdonough9@mchsi.com Vice Speaker of the House Connie Connolly, RPh, DeWitt 563.652.5611, conniejconnolly@hotmail.com

TRUSTEES REGION 1 Steven Martens, PharmD, Grundy Center 641.366.3440, steven@nucara.com REGION 2 John Daniel, PharmD, Fort Dodge 515.573.3431, jfdaniel@frontiernet.net REGION 4 Ashley Dohrn, PharmD, Le Claire 563.324.5004, ashley.dohrn@me.com REGION 5 Pat Thies, RPh, MS, FACHE, Cedar Rapids 319.265.3647, thiespw@crstlukes.com AT LARGE Marilyn Aldrich, RPh, Urbandale 515-276-4845, marilyn.aldrich@dahlsfoods.com Cheryl Clarke, BPharm, RPh, CHC, Des Moines 515-271-3899, cheryl.clarke@drake.edu Felix Gallagher, PharmD, Des Moines 515.334.4293, fgallagher@pharmservstaffing.com Justin Rash, PharmD, CGP, Ankeny 515.331.2594, rash.justin@gmail.com HONORARY PRESIDENT Mark Jones, RPh, Davenport jonesma@genesishealth.com, 563.421.4458 PHARMACY TECHNICIAN Michelle Garvin, CPhT, Wilton 563.732.5238, mgarvin@westerdrug.com STUDENT PHARMACISTS Matt Farley, University of Iowa matthew-farley@uiowa.edu Kelsey Lawfer, Drake University kelsey.lawfer@drake.edu

FEATURES

CEO Editorial . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 President’s Page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 IPA Legislative Day . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 PBM 101 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Board of Trustees Election . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Midwest Pharmacy Expo . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Prescriber Column on Rx Drug Abuse . . . . . . . . . . . . . . . . . 22

IN EVERY ISSUE

Health Care Hot Topics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Iowa Pharmacy News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IPA Foundation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Public Affairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Peer Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Member Section . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Technician’s Corner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . College of Pharmacy News . . . . . . . . . . . . . . . . . . . . . . . . . . Student Section . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Last Laugh . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Calendar of Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

24 26 32 36 38 48 52 54 56 64 64

ONLINE ONLY FEATURES Board of Trustee Candidates Personal Statements . . . . . . 20 Pharmacist Perspective on Rx Drug Abuse . . . . . . . . . . . . . 23 Advocacy as a Student-Pharmacist in Iowa: Why We Are Important? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

ADVERTISERS

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The Journal of the Iowa Pharmacy Association is a peer reviewed publication. Authors are encouraged to submit manuscripts to be considered for publication in the Journal. For Author Guidelines, see www.iarx.org. “The Journal of the Iowa Pharmacy Association” (ISSN 1525-7894) is published 4 issues per year: January/ February/March issue; April/May/June issue; July/August/September issue; and October/November/ December issue by the Iowa Pharmacy Association, 8515 Douglas Avenue, Suite 16, Des Moines, Iowa 50322. Periodicals postage paid at Des Moines, Iowa and additional mailing offices. POSTMASTER: Send address changes to: The Journal of the Iowa Pharmacy Association, 8515 Douglas Ave., Suite 16, Des Moines, IA 50322. Published quarterly The Journal is distributed to members as a regular membership service paid for through allocation of membership dues. Subscription rates are $100 per year, single copies are $20. Printed by ColorFx; Graphic Design done by Iowa Pharmacy Association.

Jan.Feb.Mar 2014

CEO editorial

2014: IPA’s Goals for the New Year

A Kate Gainer

PharmD IPA Vice President & CEO

s the calendar turns from December to January every 365 days, it provides an opportunity to reflect on the year behind us. Some would say it’s been the best of times, while others the worst of times. But through it all, the leadership and members of the Iowa Pharmacy Association has remained dedicated to our mission and positioning pharmacists in a dynamic and evolving health care system of the future.

And with a new year, comes a new opportunity to continue the work of IPA’s leadership agenda and strategic plan. The major focus areas for IPA include: Patient Care, Safety, and Health Outcomes; Membership; and Advocacy for the Profession. With that, there are several foreseeable – and achievable – goals that I am confident IPA will achieve in 2014. (Drumroll, please….. ) • Pass PBM legislation providing greater authority to the Iowa Insurance Commissioner to regulate PBMs in the state of Iowa, creating a more level playing field for Iowa pharmacists to take care of patients, practice pharmacy, and operate pharmacy businesses across the state. • Update and unveil IPA’s new website, creating a better member-experience and presenting content that is easy to navigate and informative. • Launch IPA’s New Practice Model pilot project evaluating tech-check-tech in the community pharmacy setting and allowing pharmacists to spend greater time providing clinical services to their patients. • Create a Health-system Leadership Team, comprised of Pharmacy Directors, that will guide IPA and health-system pharmacists on ASHP’s PPMI (Pharmacy Practice Model Initiative). • Work with the Iowa Board of Pharmacy and the telepharmacy task force on establishing guiding principles for

| JAN.FEB.MAR jan.feb.mar 2014

implementing telepharmacy practices in the state of Iowa. • Host an expanded, 8-state, Midwest Pharmacy Expo, drawing attendees, presenters, and exhibitors from the upper Midwest region to IPA’s wellestablished Educational Expo. • Expand pharmacist delivered MTM and patient care services through projects with state agencies and health systems, such as the Medicare Pioneer ACO and the Iowa Primary Care Association care coordination grants. • Promote pharmacist-delivered immunizations through a public education campaign and toolkit for Iowa pharmacists. • Create additional opportunities for IPA to engage with members across the state – and across the country – with new AV equipment that will be installed in the IPA Board Room for enhanced audio and video conferencing capabilities. • Increase membership relevance of IPA to pharmacists across the state of Iowa. Though increasing membership to 1,000 pharmacists and 400 technician members are objective goals within IPA’s strategic plan, on a broader scale the IPA Board and staff look at opportunities first and foremost to remain relevant and serve all pharmacy professionals across the state – whether or not they are currently members. While not a comprehensive list, the goals listed above highlight parts of IPA’s strategic plan – as well as operational goals – that I believe are achievable in 2014. As I’ve reflected on 2013 and thought about the new year that is before us, I’d like to thank you for all you do in the profession of pharmacy. It is the work of pharmacists across the state and the support from all pharmacy professionals that allows IPA the opportunity to serve and advance our profession.

Jan.Feb.Mar 2014

President’s Page

change is in the air

T Michele Evink

MS, PharmD, CGP, FASCP IPA President

here are several reliable things about winter. In Iowa, we can rely on some crazy days of ice, snow and freezing cold. We can also rely on some key things in our profession.

our communities and our state. These meetings are an excellent opportunity to acquaint yourself with the larger issues, and, more importantly, introduce yourself in person.

The first is the onset of the influenza season. As I mentioned in my last note, we are in a unique place to assist our patients with the management of that season by encouraging them to receive their flu vaccine. Regardless of our setting, we are uniquely positioned to promote good use of this life saving medication.

All of these things set the stage for my third request. The profession needs you to be informed about issues. A primary issue is legislative changes needed to give our insurance commissioner additional authority in the regulation of pharmacy benefit managers. The attorney general’s office determined these legislative changes were needed. Understand the issue and talk to your legislator.

We will also see the legislative session kick off in January and we have a very important role there. There are three things I’d encourage you to put on your to do list.

“Let them know you’re an engaged member of your community, your profession and, most importantly, their district.” First, know who your legislators are. Each of us has a representative and senator and they play an important role in the development of legislation. Each one holds positions on committees that craft and guide legislation prior to it being introduced to the larger bodies. Know not just the names of your legislators, but the committees they work on. This will help you be proactive in informing them about issues. Second, introduce yourself to them. Start with the easiest way to reach out and email them. Let them know you’re an engaged member of your community, your profession and, most importantly, their district. Each of them host get-togethers to meet with the public in their home district. Attend these open meetings and get familiar with the topics they are dealing with. Issues outside of our profession have a huge impact on what happens to

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“...further proof of Iowa’s ability to lead the profession with creative excellence.” The Iowa Pharmacy Association has a list of legislative priorities and you can familiarize yourself with them on our website. Another great way to engage yourself in the process is to attend our annual Legislative Day. This year it will be held on February 20th. The day is a great way to ease into the process if you’re new to it as you’ll have people around you that are very familiar with working at the capitol. The other reliable part of winter is our Educational Expo, to be held February 7th thru the 9th. This year, we have expanded to a Midwest Pharmacy Expo and have welcomed seven additional states into this collaboration. The increase in attendees year after year is indicative of the incredible quality of this program. It is further proof of Iowa’s ability to lead the profession with creative excellence. Thank you so much for all you do each day for your patients and for our profession. Enjoy the adventures of winter. I hope to see you in February at some of our fabulous events!

Jan.Feb.Mar 2014

ipa legislative day

iPA LEGISLATIVE DAY - February 20TH Embassy Suites, Des Moines / Iowa State Capitol

**New features

•

New agenda

•

2.5 hours of Pharmacy Law CPE**

IPA’s Annual Legislative Day serves as a cornerstone to the Association’s legislative and public policy efforts. Most importantly, it is the one day each year when IPA members engage in face-to-face grassroots advocacy with legislators; attracting nearly 200 members of our profession to the state capitol! Student pharmacist and first time attendees have the opportunity to pair up with pharmacist mentors and visit the capitol in small groups. Contact Joan Stover at jstover@iarx.org to serve as a one-day mentor or to be placed in a group. Themed ‘Paint it White’, please remember to bring your white coat to the Capitol!

CLICK HERE TO REGISTER

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LEGISLATIV E DAY AGENDA PAGE 11

BRING YOUR WHITE COAT!

pbm 101

help keep iowa pharmacies open! *support patient access to local pharmacists After owning an independent pharmacy in Hartley, Iowa, for 40 years, I had to make the difficult decision to close the pharmacy in 2013. My life’s work and passion has been serving the community and our pharmacy’s patients, but pharmacy benefit managers (PBMs) have created an unlevel playing field such that my local pharmacy business was unsustainable. ~Wally Tschopp, RPh

PBM practices driving local pharmacies out of business: • Force take-it-or-leave-it contracts with NO negotiation • Use pharmacy claim data to contact patients and steer them into PBM mail-order pharmacy • Charge health plan/employer one price (x) and reimburse pharmacy at a lower price (y) and profit on the x-y spread • Fail to update prices, reimbursing pharmacies below their purchase price

In 2013 alone

41 Iowa Pharmacies closed Many Citing PBM Practices as the Reason

PBMs: Interfering with Patient Care We have a patient with a significant history of mental illness, who is stable on clomipramine. This patient has been in and out of the hospital so medication changes are a “big deal”. Unfortunately the price of the clomipramine increased by almost 8000%—costing us $9.10 for a 30 day supply and increasing to $728.35 the following month. We only received $10.33 as our total reimbursement from Catamaran when we filled this prescription after the price increase. I called the PBM and spoke with a representative, and he informed me where to send the price dispute and he further informed me that I would hear back in 72 hours. In over two weeks I heard no response. ~Randy McDonough, PharmD, MS, CGP, BCPS

pbm 101

AMENDMENT TO IOWA CODE CHAPTER 510B: PHARMACY BENEFIT MANAGERS Language drafted by the Iowa Insurance Division

Pharmacy Benefit Managers

Pharmacy Benefit Managers (PBMs) serve as middlemen between pharmacies, health plan sponsors, and drug manufacturers. The three largest PBMs manage drug benefits for approximately 95% of Americans with prescription drug coverage. Each of these companies has annual revenues exceeding $15 billion. Some revenue generating strategies include: • Payment (rebates) from pharmaceutical manufacturers for including the manufacturer’s drugs on the PBM formulary. • Reimbursement to pharmacies at one rate for dispensing a medication but charging a higher rate to the plan sponsor for that medication – and keeping the ‘spread’ between the prices. • Ownership of mail order pharmacies and financially penalizing patients that choose a local community pharmacy.

Bankrupting Iowa Businesses

In 2013, 41 pharmacies in Iowa have closed due to unregulated PBMs who engage in unfair business practices that impacted community pharmacies and their patients. IPA’s PBM Regulation Bill addresses two of the main issues affecting Iowa pharmacies: (1) lack of transparency; and (2) undisclosed reimbursement methodology for generic prescriptions. • Lack of Transparency--PBMs use contract language that allows “sole discretion” to arbitrarily change reimbursement rates. Since January 1, the PBM Catamaran reduced reimbursements to Iowa pharmacies by up to 50% without notice or explanation. • Generic Pricing --MAC (maximum allowable cost) Reimbursement--a MAC list is an arbitrarily generated list of drugs that establishes the maximum amount a PBM will pay a pharmacy. There is no industry standard for inclusion of drugs on MAC lists or for the methodology as to how it’s changed or updated. Local, Iowa pharmacies are often unable to purchase the medications to stock at their pharmacy at the MAC rate.

Legislative Initiative

The Insurance Division conducted an exhaustive nine month investigation into PBM practices, referencing over 300 pharmacist complaints from around the state. The result was an amendment to existing administrative rules (IAC 191 - Ch 59) and draft legislative language to address transparency problems and MAC pricing. The bill language is consistent with steps other states have taken. Fifteen states have laws regulating PBMs through registration, licensing, transparency, and reporting systems. Twenty states have adopted or strengthened audit laws since 2012 and several more have passed MAC transparency legislation. The Insurance Division does not guarantee pharmacies will stay in business and make a profit--rather, the proposed changes address a serious problem by presenting a balanced approach that injects fairness into the existing system.

ipa legislative day

IPA Legislative Day

iPA LEGISLATIVE DAY - agenda 7:30-8:30am Capitol Breakfast with Legislators (by invitation only)

IPA members will showcase pharmacists’ role in the healthcare system while educating legislators on the 2014 legislative priorities. This event will set the stage for legislative visits!

8:00-9:00am Registration at Embassy Suites 9:00–10:00am Welcome & Legislative Briefing Pharmacist and student pharmacist attendees will group together, pairing up in advance of Capitol Hill visits. During this briefing, IPA’s Legislative Counsel will provide an overview on the issues that IPA members should discuss with their legislators at the Capitol.

10:00-10:20am An Insider’s View

Attendees will hear from newly elected House of Representative member, pharmacist John Forbes.

10:30am – 1:00pm Capitol Visits

Attendees will travel by bus to the Iowa State Capitol to meet with their state senator and state representative. **All attendees are encouraged to contact their legislators in advance to schedule a meeting and/or lunch during this time block. Pharmacist mentors will be introduced to form small groups prior to departing. **Box lunches available in Capitol Rotunda.

10:00-1:00pm Student Screenings

Student pharmacists from Drake University and the University of Iowa will provide screenings and education to legislators and hill staff members on hypertension, high cholesterol, immunizations, osteoporosis, and pharmacists’ role in today’s health care system.

1:15pm IPA Group Photo on Rotunda Stairs

Meet at the stairs of the Capitol Rotunda for a group picture 1. White Coats Encouraged 2. Photo taken at 1:15 SHARP - please arrive five minutes early!

1:45-2:30pm *An Update on PBM Regulation

Nick Gerhart, Iowa Insurance Division, Commissioner A follow-up presentation from the Iowa Insurance Commissioner on the activity of the Division over the past 12 months, since Comm. Gerhart’s appointment. Hear about the progress and setbacks encountered as Iowa tackles PBM regulations. Plenty of time for Q&A will be provided.

2:30-3:00pm *Prescription Drug Abuse/ Enhancing the Youth of PDMPs

Nicole Russell, NCPDP Government Affairs Specialist NCPDP PDMP solution for a national problem. Reduce prescription drug misuse and overdose in the United States by enabling health care providers to make more informed clinical decisions through more timely, effective and convenient access to PDMP data.

3:15–3:45pm *Drug Quality and Security Act – Implications to Pharmacists How does the federal compounding legislation passed in 2013 impact pharmacists and their patients. Whether you are a pharmacy owner or pharmacist at a large healthsystem, the implications of this new law are important to understand.

3:45–4:30pm *State-based Provider Status Laws Bill Doucette, Veale Professor in Healthcare Policy & Division Head, University of Iowa California has sparked excitement through passage of a ‘Provider Status’ bill. Learn how they achieved this legislative victory, what the bill means, and how it compares to Iowa’s ‘Provider Status’ opportunities. *Pharmacy Law CPE details and program learning objectives available at www.iarx.org.

Click here to REGISTER for 2014 Legislative Day

Jan.Feb.Mar 2014

board of trustees election For the Office of President John Swegle, PharmD, BCPS, Mason City

John Swegle received his Bachelor’s degree from Drake University College of Pharmacy and Health Sciences in 1992 and worked for two years a retail pharmacist in eastern and central Iowa. He attended the University of Iowa College of Pharmacy and received his Doctor of Pharmacy degree in 1996. He completed a pharmacy residency in Family Medicine at the University of Iowa Hospitals and Clinics in 1997. The following year, John joined the faculty at the University of Iowa College of Pharmacy and is currently an Associate Professor (Clinical). His practice site is in Mason City where he serves as a clinical pharmacist with the Mercy Family Medicine Residency Program. In addition, he works with Hospice of North Iowa where he is a consultant pharmacist and as a faculty member for the Palliative Medicine Fellowship and Pharmacy Practice Residency at Mercy Medical Center – North Iowa. John served on the IPA Board of Trustees from 2002-2004. He is a past participant of Leadership Pharmacy and has served on numerous IPA committees and task forces including the Medicaid Advisory Committee and Professional Affairs Committee where he served as chair. He has been active in various roles for the Educational Expo including planning, peer reviews, and presentations. John is currently serving as a representative of IPA on the Iowa Department of Public Health Medical Home and Prevention and Chronic Care Advisory Council. In addition, he serves on numerous committees through the University of Iowa College of Pharmacy and Mercy Medical Center – North Iowa. John is a member of the Iowa Pharmacy Association, American Pharmacists Association, American College of Clinical Pharmacy, American Academy of Hospice and Palliative Care, and the North Iowa Area Pharmacy Association. He is Board Certified as a Pharmacotherapy Specialist through the Board of Pharmacy Specialties. In his free time, John and his wife Sarah keep themselves busy by raising three children and participating in a variety of school, community, and church activities.

ELECTRONIC BALLOTs WILL BE SENT monday, february 3RD.

Each candidate’s personal statement and bio will be available online with the electronic ballots. All IPA Pharmacists members vote for all elections. Ballots will close Friday, February 14th at 12:00 midnight. To request a paper ballot, contact the IPA office at 515.270.0713.

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Statement: I am grateful for the opportunity to run for President of the Iowa Pharmacy Association. Our Association has always been a strong voice for pharmacy and an advocate for patient care. The strength of this association comes from members like you. I’m proud to be a member of IPA and a pharmacist in the state of Iowa. Most of my days are split between direct patient care and education of medical residents and student pharmacists. We may have different practice settings yet the common goal for all of us is to provide quality patient care. It’s what you do with your practice and for your patients that matters the most. There are many challenges ahead of us. The landscape of healthcare is changing with many unknowns moving forward. Coordination of care and alignment of healthcare services are at the top of the list. Numerous initiatives have been developed in Iowa and our state is ready to be a leader in healthcare transformation. We will be held accountable for providing quality care to our patients. One of the key elements in this whole process is pharmacy. I have heard many leaders in the medical community state that pharmacy is a vital member of the team as we move forward. There will clearly be bumps in the road along the way. Regardless of whatever barriers we encounter, pharmacy will continue expanding our role in the medication decision process and influencing prescribing practices. My vision for the future of pharmacy is this: we as a profession need to continue making strides that positively impact patient care. Our ability to align ourselves with other professions is critical in this process. We are included as members of the healthcare team. Our visibility and access to the public is undeniable. Patients look to us for many of their healthcare and personal needs because they trust our input. This is a direct result of the patient relationships we have built over the years. Collectively, I feel that our profession is poised to make an even bigger impact on patient care in the years to come. This requires us to listen, provide a voice, and act as the opportunities present. I will do my best to serve as a voice for all of pharmacy as we navigate through the challenges ahead.

ONLINE ONLY FEATURE Read Each Candidates Personal Statements Now!

board of trustees election For the Office of PresidenT-ElECT Bob Greenwood, RPh, Waterloo

Bob Greenwood, Waterloo, is a 1977 graduate of Creighton University’s School of Pharmacy. Bob is the owner of three community pharmacies (Greenwood Pharmacy, Greenwood Compounding Pharmacy and Denver Drug) and is a partner in Reinbeck Pharmacy and Martin Health Services. Bob has been an active member of the Iowa Pharmacy Association for over thirty years; serving on the Board of Trustees, the Legislative and Medicaid Advisory committees, and as a House Delegate. On a national level, Bob is actively involved in both the American Pharmacists Association and the National Community Pharmacists Association. Within APhA, Bob served on the CPPA Standards Oversight Committee and the 2011 APhA Policy Committee. Bob joined NCPA in 1987, serving on many committees before being elected as an officer for NCPA and serving as the organization’s president in 2010-2011. In 2011, Bob was the recipient of IPA’s Bowl of Hygeia and in 2013 was awarded APhA’s Hubert Humphrey award. Bob also served his community as a City Councilman for the past twelve years. Bob Greenwood is a native of Farley, IA, and has been married for 31 years to his wife, Chery. The couple has three children, Joe (Torie), Tim, and Abby, and one granddaughter, Amelia.

Statement First I would like to thank the nominations committee for nominating me for the office of President-Elect. Our profession will always face challenges, and I know I do not have all the answers. However, I believe that my past experiences serving on various committees, and as NCPA’s president , will give me a unique perspective on issues that affect our profession. Iowa has risen above most other states in our ability to organize and unite pharmacy stakeholders. Iowa Pharmacists Association, Drake University, The University of Iowa, and the Iowa Board of Pharmacy have maintained a great relationship throughout the years, and the result has been very rewarding for the practice of pharmacy in Iowa. We’re fortunate to have innovative pharmacists working to advance and protect our profession, and we need to be sure these innovations are being recognized, rewarded and implemented to better serve our patients. I believe there is now more opportunity than ever for the pharmacist to be an integral part of the team that leads to the better utilization of the healthcare dollar. I am reassured with every pharmacy student I meet that our schools are training highly capable, innovative pharmacists who will continue to ensure that pharmacy remains a viable and sustainable profession. Everyone nominated is more than qualified to serve. If I am elected, I will lead by example. I will be sure decisions made under my leadership are for the benefit of the profession. Knowing that I cannot do it alone, I will encourage innovation and collaboration. Only if we stand together, united as one profession, can we effectively advocate for our profession, and more importantly, our patients.

Cheri Rockhold Schmit, PharmD, Ames

I am a graduate of the University of Iowa College of Pharmacy and currently a staff pharmacist at the Medicap Pharmacy in Ames and the clinical coordinator for all the GRX Medicap Pharmacies. I serve as an adjunct assistant instructor for Drake College of Pharmacy and as an adjunct assistant professor in the University of Iowa Department of Pharmacy Practice and Science, College of Pharmacy. I have certifications in diabetes, smoking cessation, and lipid education. I am also immunization certified and an instructor for the CEI Immunization Administration Training for Pharmacists. I have been active in the Iowa Pharmacy Association since graduation and have served on various committees and boards. I have served on everything from the Patient Education Committee, to attending the Leadership Pharmacy Conference, to chairing the Policy Committee on Public Affairs to serving on the Board of Trustees both as an at-large member and as Speaker of the House of Delegates. I have also served on various task forces such as the Governor’s Office of Drug Control Pseudoephedrine Task Force and the New Practice Model Task Force. Locally, I help organize and coordinate the Ames Community Diabetes Support Group and have been a speaker for various organizations on multiple topics related to pharmacy and health care. I am involved in school and church programs and activities including currently serving as the Vice President of the Ames Youth Football League.

Statement It is truly an honor to be nominated for President-Elect of the Iowa Pharmacy Association and I am humbled to even be considered in the same group of pharmacists that have held this position. As you can see from some of the positions I have held within IPA, I have been an active member and I feel very strongly and passionately about the work that IPA does; not only in the state of Iowa, but in the nation. I truly believe that no other pharmacy organization is better prepared or positioned to lead the profession of pharmacy than the Iowa Pharmacy Association. The motto “One Profession, One Voice” says it all. We are one profession represented by one voice. The previous and current leaders of IPA have created a reputation of thoughtful and insightful leaders that others look to for guidance and direction. These leaders have been progressive but mindful of the tradition and the role of the profession. They have moved the profession forward without forgetting where we have come from and who we all serve-the patient. Honestly, I feel a bit daunted by the task of filling the shoes of President of the Iowa Pharmacy Association; but I would look to the leadership of those who have held the position before me for guidance and wisdom. If elected, I would serve with passion for the profession and to the best of my ability. As I said in my address to the House as Speaker, I believe that the practice of pharmacy is a journey and not a destination. I know that the profession faces many problems and threats and we always have and always will. I believe that working together, the pharmacists of this state can and will find solutions and opportunities for the profession to grow and evolve and be better tomorrow than it is today. I look forward to traveling on this journey with you and if you so choose, to serving as President of the Iowa Pharmacy Association.

Jan.Feb.Mar 2014

board of trustees election For trustee - region 1 Bryce A. Jackman, RPh, BCNSP, Oxford

Bryce graduated from the University of Montana with a BS in Pharmacy in 1989. He went on to complete a 2 year residency program at Kansas University Medical Center in Kansas City, KS. Following his residency program, Bryce became the Ambulatory Care Pharmacy Supervisor at University of Iowa Hospitals and Clinics, in 1991. Since 1993 Bryce has held the position of Director of Pharmacy for CarePro Home Infusion. Bryce has also served as an Adjunct Faculty Member for the University of Iowa College of pharmacy since 1995. Bryce became a Board Certified Nutrition Support Pharmacist in 2000. In 2012 Bryce began a three year term on the Board of Directors for the National Home Infusion Association (NHIA). His participation at IPA includes Pharmacy Leadership Conference and service on several IPA committees, including the Iowa Medicaid Advisory Committee. He has served several years in the House of Delegates. In addition to his involvement in IPA, Bryce is a member of the National Home Infusion Association (NHIA), American College of Clinical Pharmacy (ACCP), American Society of Parenteral and Enteral Nutrition (ASPEN), the American Society of Health Systems Pharmacists (ASHP), the American Pharmacists Association (APhA) and National Community Pharmacist Association (NCPA). Statement: “In any moment of decision the best thing you can do is the right thing, the next best thing is the wrong thing, and the worst thing you can do is nothing.” Theodore Roosevelt. As I advance through my career I have been blessed by working in an organization surrounded by health care professionals whose primary goal is to do the right thing in caring for our patients. Working in the Home Infusion / Specialty Pharmacy setting affords a unique perspective on interdisciplinary care teams of nurses, dietitians, pharmacy technicians, pharmacists and prescribers. CarePro Home Infusion is part of a larger “Employee Owned” company, CarePro Health Services. CarePro serves Cedar Rapids and surrounding communities with Community Retail Pharmacy, Non-sterile Compounding, Home Health, Respiratory Therapy and Durable Medical Equipment, and Worksite Wellness. Now is an exciting time to be involved in health care. There are many challenges at both the national and state level. With new compounding legislation and track and trace at the national level and navigating the development of new rules at the state level for transparency of PBM audits and pricing. Failure to interact with your elected officials invites a system that provides no benefits for our patients or for us as health care providers. I encourage everyone to be involved in this process. If elected to the Board of Trustees I will be committed to serve the pharmacists of the state of Iowa and do my best to represent the pharmacists from Region 1. I would like to thank the nominations committee for giving me this opportunity and look forward to serving the pharmacists of Iowa.

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Kristin Meyer, PharmD, CGP, CACP, FASCP, Marshalltown

Kristin holds an appointment as Associate Professor of Pharmacy Practice at Drake University College of Pharmacy and Health Sciences. After she earned her PharmD from Drake in 2000, she went on to complete a geriatric specialty residency at the Central Arkansas Veterans Healthcare System and University of Arkansas for the Medical Sciences in Little Rock. She returned to Drake in 2001 and has maintained a geriatric pharmacy consulting practice at the Iowa Veterans Home (IVH) in Marshalltown since that time. In addition to classroom teaching, Kristin precepts pharmacy students on specialty clerkships at IVH. She involves students in many aspects of direct patient care, including warfarin management by collaborative practice protocol. Kristin is a Certified Geriatric Pharmacist (CGP), a Certified Anticoagulation Care Provider (CACP) and a Fellow of the American Society of Consultant Pharmacists (ASCP). Her IPA involvement has included serving as IPA house delegate several times, legislative day participant, and current Chair of the Long-Term Care/Senior Care Advisory Committee. Kristin was honored by IPA in 2010 with the Distinguished Young Pharmacist award. She has served ASCP as past Chair of Pharmacy Educators Council and current member of the Geriatric Pharmacy Researchers Council. Kristin is also currently completing a second term of appointment to the CGP Exam Development Committee.

Statement I am honored to be nominated for the IPA Board of Trustees and I want to sincerely thank the nominating committee. Professional service has been a strong focus of my career and something from which I derive a great deal of satisfaction. I believe the Iowa Pharmacy Association to be one of the premier state associations in the US. While I know there are many competing priorities, I have three main focuses for my involvement this term, should I be elected. We are fortunate to have an actively involved membership, including student pharmacists and technicians and I am enthusiastic about promoting growth in membership. IPA has been successful in cultivating relationships in the Iowa legislature and in Washington, D.C. in order to advance our profession. We must continue to support these efforts. It is with these assets in mind that I think we will be successful in demonstrating the value of the pharmacist in the healthcare team and ultimately achieving provider status in the near future.

board of trustees election For trustee - region 3 Erik Maki, PharmD, Johnston

Erik is an Associate Professor at Drake University and a Clinical Specialist at Mercy Medical Center in Des Moines. At Drake, Erik teaches and co-coordinates the Pharmacotherapeutics course and serves on the University IRB. At Mercy, Erik enjoys precepting for 3rd and 4th year pharmacy students as well as Mercy’s PGY-1 residents. Erik and his students serve as consultants for both Mercy’s Hospitalist Program and Internal Medicine Teaching Service. Erik’s practice and research interest focus on transitions of care and he is currently working on a project whose aim is to develop collaborative relationships between health-systems and community pharmacies. Erik has been an active IPA member and has served on numerous IPA committees. He has been a speaker for the Bill Burke Student Leadership Conference and a participant in the Leadership Pharmacy Conference. He currently serves as Vice–Chair for the Legislative Advisory Committee.

Statement I remember as a student taking medication histories from patients. I will admit, I often perceived this task as busy work and felt as if I was just duplicating the efforts of my nursing and physician partners. I was naïve and blindly trusted information documented in the medical record. Now, ten years later, I am angry. I do not understand why most providers don’t seems to care (based on their actions) whether or not our patients’ medication list are accurate. Providers see this as just another task to check off their “to do list” and often take the path of least resistance to completion. Getting people excited about medication reconciliation is like trying to get my kids excited to eat their vegetables… If I only knew how to mix some bacon with medication reconciliation. When these issues occur and transmitted to the patients’ primary care provider, they may be perceived as intentional. It’s like playing the game “telephone” where a phrase is whispered, student to student, from the front to the back of the classroom. Fidelity is lost when we don’t clearly communicate. My personal mission is to infuse some bacon like enthusiasm into the medication reconciliation process during transitions of care. Pharmacists are, no matter the setting, best suited for this role. I would like to see community pharmacists develop collaborative practice agreements with health-systems (hospitals, primary care, specialty clinics) enabling them to be medication list stewards. In my utopian scenario, as pharmacies received medication orders, they would also be responsible for updating medication lists and keeping providers abreast of the patients’ adherence. Demonstrating value in these collaborations will be the first step towards developing another new potential revenue stream... more bacon… everyone needs more bacon.

Holly Randleman PharmD, Des Moines

Holly has practiced pharmacy for six years since graduating from Drake University with a Doctorate of Pharmacy in 2007. She went on to complete a residency at Mercy Medical Center in Des Moines in 2008, and then worked at Mercy as a clinical staff pharmacist. Currently she is a pharmacist at Iowa Methodist Medical Center in Des Moines where she has practiced pharmacy since 2011. Holly serves as a preceptor for second, third and fourth year student pharmacists from Drake University. She has also served as chair of the HealthSystem Liaison Board for IPA, is on the Iowa Medicaid Pharmacy and Therapeutics Committee, and served on the Board of Pharmacy-Iowa Pharmacy Association Patient Safety Task Force.

Statement I am honored to be nominated for a Board of Trustee’s seat with the Iowa Pharmacy Association. With the changing face of healthcare, I believe pharmacists today are in a unique position to enhance our role in patient care. I believe that this movement for our profession is possible across all practice sites and is not isolated to community or hospital based practitioners. To truly move the profession of pharmacy forward, we need a united group of pharmacists across all practice sites-community, hospital, long-term care, academia, and administration. I am excited about where our profession is heading, but am even more excited to be on the forefront of the changes. Working as a front-line hospital pharmacist in a large institution, I am in a position to not only discuss changes and ways to move pharmacy forward in professional meetings, but to put these suggestions into action and encourage colleagues to do the same. I also work with student pharmacists throughout their academic experience acting as both a preceptor and mentor. I continually find new approaches to integrate them into the everyday work of a pharmacist in ways that enhance practice for both the pharmacist and the student pharmacist. I believe in leading by action and example, and am continually committed to advancing the profession of pharmacy. I hope to bring this grassroots leadership approach to IPA by serving on the Board of Trustees.

Jan.Feb.Mar 2014

board of trustees election For trustee - at large David B. Weetman, RPh, Iowa City

Dave currently serves as the Director for Acute Care Pharmacy Services at the University of Iowa Hospitals and Clinics (UIHC), a position he has held for 14 years. A 1991 graduate of the University of Iowa College of Pharmacy, Dave completed his pharmacy practice residency at The Johns Hopkins Hospital in 1992 and received his Masters degree in Business from Johns Hopkins University in 1995. Dave also has experience with rural healthcare, providing leadership and consultation services to several Critical Access Hospitals in Eastern Iowa.

Dave serves an Adjunct Assistant professor at the University of Iowa College of Pharmacy and coordinates and teaches the Hospital Pharmacy Management class. Dave is the program coordinator for the PGY2 Health-System Administrative Residency program. For the past six years Dave has served as the faculty advisor for the University of Iowa’s ASHP Student Chapter. Dave is an active member of ASHP and recently completed his fourth term on ASHP’s Council of Pharmacy Management and served as this year’s committee Chair. He is currently serving his second term on ASHP’s Nominations Committee. Dave has served several years as a ASHP delegate from Iowa. Statement I am humbled to be nominated for a Board of Trustee’s seat with the Iowa Pharmacy Association (IPA). Strong leadership is required to guide any organization through the inevitable challenges it will face over time and the profession of pharmacy is no stranger to difficult challenges. Adequate reimbursement, product shortages, medication safety, internal practice model changes and external healthcare model changes are all examples of difficult challenges facing Iowa pharmacists today. Strong leadership was the key when dealing with the challenges of the past and will continue to be vital for the future. I have over 20 years of leadership experience from a health-system perspective that would help IPA address these challenges. Examples of my leadership include participation in ASHP’s Practice Model Initiative at UIHC. After completing the survey I worked to increase the number of clinical pharmacists on the patient care units and centralizing distribution services to help meet the goals of the initiative. I have also been a strong supporter for residency training opportunities and have participated with our residency program expansion. I re-established the College of Pharmacy’s student ASHP chapter, which now has over 120 student members who are learning about health-system pharmacy and how organizational involvement such as IPA membership is important to the profession globally as well as their own professional development. Strong leadership is the key to success. Through clearly defined goals and messaging from IPA to our membership, local communities and statewide stakeholders, IPA will help the pharmacists and technicians in Iowa successfully deal with these ever present challenges. It would be an honor to share my leadership experience and my passion for the profession of pharmacy with the pharmacists and technicians from across the state. I am confident that I can help make IPA a stronger and more influential organization and maintain IPA as a strong advocate for the profession of pharmacy for the upcoming years.

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Greg Young, PharmD, Des Moines

Greg is the Director of Pharmacy at Mercy Medical Center – Des Moines. In this role he is responsible for pharmacy operations located at Mercy facilities which serve patients across the care continuum. Included are referral medical centers, critical access hospitals, ambulatory pharmacies, and long-term and hospice care facilities. Greg received his bachelor (1980) and Doctor of Pharmacy (1987) degrees from the University of Iowa. In addition to his current role, during his career he has worked as a pharmacy technician, staff pharmacist, and hospital pharmacy clinical coordinator. He has been a long-time member of the IPA and ASHP, and is a former IPA board member. Statement The IPA continues to represent and serve the profession of pharmacy, Iowa pharmacists and pharmacy technicians extremely well, and in exemplary fashion. Under Tom Temple’s leadership, IPA became recognized as a premier pharmacy professional organization in America. We’re fortunate to now have Kate Gainer “carrying the torch” as CEO and performing as a strong leader for our organization. Unique practice opportunities continue to appear as a result of pharmacists being recognized by other health professionals and patients as the medication experts. New roles for pharmacists and pharmacy technicians exist in the areas of medication reconciliation, patient education, MTM, collaborative practice with providers, specialty pharmacy, and ACO and other managed care opportunities. We also face significant challenges. This includes the ongoing pursuit of provider status and seeking increases in reimbursement for both medication dispensing and consultative services. These opportunities and challenges come at a time in which the pharmacist supply is plentiful (some say too plentiful) and the availability of qualified pharmacy technicians may be too limited. I would greatly welcome the chance to serve as a member of the IPA board and work with Kate, IPA staff, other leaders, and members to help our profession meet our challenges and continue to thrive by taking advantage of expanding opportunities.

board of trustees election For trustee - at large Jason Hansel, PharmD, Bettendorf

Jason is the District Pharmacy Supervisor for Walgreens in the Quad Cities District which includes locations in Eastern Iowa and Western Illinois. Jason is a 2000 graduate of the University of Iowa. His first pharmacy experience was as an intern at Strawberry Point Drug in Strawberry Point, Iowa and has since held several positions within Walgreens over the past 16 years. In his current position his responsibilities are most certainly varied but his passions are in teaching and engaging team members to support clinical services and to be involved in their local community. Jason has served in IPA’s House of Delegates, Advisory Committee on Medicaid and Pharmacy Benefit Programs, Legislative Advisory Committee, the Iowa Patient Safety Taskforce, and is a past attendee of the Leadership Pharmacy Conference. Jason is also currently serving as the Chair of the Professional Advisory Committee for Midwest Technical Institute’s Pharmacy Technician Program in Moline, IL. He is a veteran of the Iowa Army National Guard and is active in the American Legion Post 154, Bettendorf, Iowa.

Statement Over the past few years many discussions within the Iowa pharmacy community have been centered on the environment of change and the need for change. The time has come to shift the conversations to those of implementation. The path for the future of pharmacy is clear and the time is now to shift to clinical services. The Affordable Care Act has created a stimulus for the medical community to explore new options to improve health and wellness. Pharmacy is in the perfect position to fill the adherence, awareness, and educational gaps. In order to succeed we need to change expectations, the expectations of the medical community and of our patients. We change expectations one interaction at a time with the support of strong professional associations like IPA. It is also critical that we uphold the IPA motto “One Profession, One Voice”. While our practice sites are different with unique challenges, at our core we have the same goals. We need each other’s support and IPA needs ours. I’d like to thank the nominating committee and I ask for your support for the Board of Trustees.

Laura Knockel, PharmD, North Liberty

Laura Knockel, PharmD, currently works as a pharmacist at Hy-Vee Pharmacy in Iowa City, Iowa. She received her Doctor of Pharmacy degree at the University of Iowa in 2005. Upon graduation she completed a 1-year community pharmacy residency with the University of Iowa and Hy-Vee Pharmacy in Cedar Rapids, Iowa. She is currently involved in implementing a diabetes self-management program at her pharmacy and is also certified to administer immunizations. Laura enjoys working with students and serves as a professional mentor to University of Iowa pharmacy students. She was selected to participate in the Pharmacy Leadership Conference in 2008. Laura is an active member of the Iowa Pharmacy Association and has served on IPA’s Medicaid and Pharmacy Benefit Management Advisory Committee.

Statement I decided I wanted to become a pharmacist when I was a junior in high school. Back then, I didn’t realize all of the additional responsibilities that pharmacists face, such as drug shortages, reimbursement issues, and the fight to be recognized as a health care provider by insurance companies. The Iowa Pharmacy Association is one of the leaders nationwide in those battles and will continue to push the profession forward. My first experience with IPA was during an elective rotation in my final year of pharmacy school and I have seen firsthand the impact that this organization can have on pharmacy. I am proud to say I am from the state of Iowa and I strongly believe we have one of the best state associations in the country. I am honored to be nominated for the Board of Trustees and look forward to fulfilling my obligations should I be elected.

Hear it from participant

june 13-14, 2014 • altoona, ia Iowa Pharmacy Association • 2014 Annual Meeting

THE FUTURE IS NOW

Jan.Feb.Mar 2014

board of trustees election For pharmacy technician G. Jean Gallogly , CPhT, Vincent

Jean is a certified pharmacy technician at Van Diest Medical Center in Webster City, IA. She has worked at this hospital for over six years and has been certified twice since the first test was implemented. She took and passed the first test available to technicians in 1991. After a move to Vincent in 2000 she pursued a different career path allowing her certification to expire. In 2008 she successfully took the test again to re-certify in order to work her present position at the hospital. During the 20 plus years Jean has worked as a technician, she has had experience in both capacities of pharmacy retail and hospital settings. She is a member of IPA, and has served on the Iowa Pharmacy Association Technician Advisory Committee for several years. She has helped critique the CEU Tech-CheckTech offered by the IPA for continued education. Outside of the pharmacy setting she is currently active in her community as a church council member and possesses a seat on the Vincent city council. Statement I was quite excited to learn about my nomination for a seat on the Board of Trustees within the Iowa Pharmacy Association. As an active certified pharmacy technician, I find my job to be a very rewarding experience. We have seen so many positive changes in the past few years. It has been a goal of mine to try to stay at the forefront of the pharmacy industry and the growing responsibilities of the technician role within our state. I believe the Iowa Pharmacy Board, State of Iowa legislature, and the IPA has well represented our current legislative changes and will for the ones to come in the future. Some of the issues at hand are of great interest to me and my colleagues. The Tech-Check-Tech program, new CEU requirements, and the upcoming proposed new national requirements on certified pharmacy technician education and testing would be all positive changes for our job and the profession. If elected I would be proud to represent the pharmacy technicians within the state of Iowa on the IPA Board of Trustees.

Judith L. Neville, CPhT, Elk Horn

Judy Neville is program chair for the Pharmacy Technician Department at Vatterott College in Omaha, Nebraska. She also serves as the externship coordinator as well as teaching numerous classes including aseptic technique, Pharmacy Practice and Law, Medical Terminology, Pharmacology, Pharmacy Dosage Calculations, and Review for the Certification Exam. Judy has also taught a number of Pharmacy Technician Certification Review classes in southwest Iowa at Iowa Western Community College. Judy is certification governing committee board member of the Institute for the Certification of Pharmacy Technicians (ICPT) assisting with exam-writing for the Exam for the Certification of Pharmacy Technicians (ExCPT). She is an active member of the Iowa Pharmacy Association (IPA) serving on the Pharmacy Technician Advisory Committee. Judy holds office as the Area Director for the American Association of Pharmacy Technicians (AAPT). She is also an active member of the Nebraska Pharmacy Association (NPA), Pharmacy Technician Educator’s Council (PTEC), and American Society of HealthSystem Pharmacists (ASHP). She is a certified technician (CPhT) through both certification bodies: ICPT and PTCB. Along with peer reviews for professional journals and book reviews, Judy has written articles for the Journal of Pharmacy Technology. She has authored three college-level pharmacy practice textbooks: Pharmacy Technician Exam Review Guide published by J&B Learning, and two books published by Mosby Elsevier: Pharmacy Technician Lab Manual and Pharmacy Management Software for the Pharmacy Technician.

Statement I’m committed to the pharmacy profession in my daily work as well as my personal life. I have two daughters engaged in the pharmacy profession with my oldest daughter a Pharm D candidate attending the UNMC College of Pharmacy and my other daughter a CPhT working parttime at Walgreens in Clinton, Iowa. I look forward to serving as an IPA Board of Trustees member; helping to reach organizational goals. A few goals I would like to see achieved are to maintain and increase membership and to provide value to that membership. I want to see IPA to continue to provide benefits such as professional development and support in our careers, updates and explanations on government affairs, as well as networking opportunities with other members. I’ve been an active member of IPA for a number of years serving on special committees. I am willing to serve and help meet these goals by attending meetings and participating in committee work. I want to be a leader in pharmacy and to have a positive impact on the future of pharmacy.

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Jan.Feb.Mar 2014

midwest pharmacy expo

FEBRUARY 7-9, 2014

The Meadows Events & Conference Center ALTOONA, IOWA

Friday, Feb. 7, 2014

8:30am – 4:45pm Together. Providing Quality Care to Patients in Pain A day in the life of a Pain Patient: Join your colleagues and

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peers as we work through the most difficult pain management issues, together. As identified by clinicians throughout the Midwest, we will be discussing the challenging scenarios you face every day, including: • Appropriate opioid prescribing, including adverse effect management • Use of non-opioids and adjunctive therapy to treat non-malignant pain • Patient engagement and the health care team’s responsibility in pain management

• Identifying and taking action when a patient is misusing pain medication • Pain management at the end-of-life This interactive, interprofessional conference will present evidencebased data, best practices, and innovative solutions to help you, as a primary care provider, safely and effectively manage your patients who live with acute or chronic pain.

5:30pm – 7:30pm

OPENING Reception and EXHIBITS! Welcome to the Midwest Pharmacy Expo! Network with

your colleagues, peruse the exhibit hall, and enjoy dinner and a beverage before a weekend filled with best practice examples, clinical pearls, and professional engagement. We’ll see you there!

june 13-14, 2014 • altoona, ia

Saturday, Feb. 8, 2014

7:00-8:15a Annual Pharmacy Political Leadership Breakfast

Join Susan Winckler, Senior Advisor at Leavitt Partners, as well as a member of the firm’s FuturePanel. Susan, an Iowa-native, has previously worked for APhA, served as Chief of Staff for the FDA, and is currently President and CEO of the Food and Drug Law Institute. Attendees will gain insight into the Affordable Care Act and policies impacting change in healthcare. She will discuss true opportunities as well as threats that exist in today’s evolving healthcare system for pharmacists. You won’t want to miss this informative annual favorite!

8:30-8:45a Welcome 8:45-9:30a 1st General Session: Personalized Medicine 9:30-10:30a 2nd General Session: The Lacks Family: An Onstage Interview

The Lacks Family has enthralled audiences across the country talking about their mother, grandmother and greatgrandmother, Henrietta Lacks and her important contribution to science. The international success of Rebecca Skloot’s New York Times bestseller, The Immortal Life of Henrietta Lacks, has left people keenly interested in the Lacks Family and Henrietta’s legacy. The family will share what it meant to find out— decades after the fact—that Henrietta’s cells were being used in laboratories around the world, bought and sold by the billions. They will provide us with a

sincere first-person perspective on the collision between ethics, race and the commercialization of human tissue, and how the experience changed the Lacks family from generation to generation. Their discussion serves to honor Henrietta’s unparalleled contributions to science, and above all—celebrates Henrietta’s life and legacy. Books are available for purchase on the registration form and the Family will be available for book signings during the morning break.

10:45-11:45a Breakout Sessions: • Update in Anticoagulation • Update in Autoimmune Diseases • Update in Psychiatry • Update in Cholesterol (Technician Activity) • In-no-va-tion (Student Activity)

4:30-5:30p Breakout Sessions:

• Managing Change in Turbulent Times • Managing The Patient Experience • Managing Death and Dying • The Art of Managing Up (Technician Activity) • Managing NAPLEX – How to Start and What to Expect (Student Activity)

6:30p Leadership Pharmacy Conference Reunion 6:30p Exhibit Theaters

Theater times and topics to be announced

11:45-12:45p Lunch 12:45-1:45p Breakout Sessions: • Difficult to Treat Diabetes • Difficult to Treat Asthma • Difficult to Treat Delirium • Management of Hypo and Hyperglycemia (Technician Activity) • State Pharmacy Law Exam: Plan to Pass! (Student Activity)

2:00-3:00p Breakout Sessions: • Drug-Induced Kidney Injury • Appropriate use of Medications in Pregnancy • Balancing the Risks & Benefits of Pharmacotheraphy for Insomnia • Medications in the Aged (Technician Activity) • Oh, The Places You’ll Go! (Student Activity)

3:15-4:15p Breakout Sessions: • The Case for Nutritional Supplements

• Electrolite Management in Adult Parenteral Nutrition • Integrating Natural Medicine in your Pharmacy Practice • Nutrition’s Impact on Medications (Technician Activity) • Ask Not What Pharmacy Can Do For You… (Student Activity)

This year we are excited to offer Presentation Theaters! Each Presentation Theater session provides attendees with an opportunity to ask product-specific questions of key experts and industry representatives, find out information on new pharmaceutical products and services, and learn the latest in data and research findings. Food & Beverage provided!

Sunday, Feb. 9, 2014

General Sessions: 8:00 – 9:00a Rooting out Errors in Your Pharmacy 9:00 – 10:30a New Drug Update 10:45a – 12:45p Gamechangers in Pharmacy 2013 12:45 – 1:00p Box Lunch Pick Up 1:00 – 2:00p State Law Outreach

Hear it from participants “I really appreciate how knowledgeable the presenters always are. The material is often complex and I always know more when I leave each year. Thank you for bringing these quality programs close to me!” “The Expo is very well organized and I have been impressed by the importance, scope, and practicality of the topics included. The presentations, as well as the hallway discussions, are a positive learning experience.”

“I’ve been attending Expo for almost 15 years. I can think of no other forum that offers as much timely, high-quality continuing education as Expo does and that includes many national pharmacy organization meetings.” “I highly enjoyed this session. It was technician based and I learned a lot from it. I felt like I could use the material in everyday cases and work.” - Technician participant Jan.Feb.Mar 2014

guest column

Battling Prescription Drug Abuse Through InterConnect Iowa Pharmacy Association – Guest Article featuring Dr. Benzoni

A Thomas E. Benzoni, DO Mercy Medical Center Sioux City, IA

IPA and the Iowa Medical Society have partnered to address prescription drug abuse. Writing guest columns for the other’s publications is one step in a multi-faceted strategy.

s an Emergency Medicine physician in Sioux City, Iowa, I can set eyes on both South Dakota and Nebraska from my office window. It is troubling to think that prescription drug diverters can travel between states, even into my own facility, seeking prescriptions from practitioners who have no ability to review their prescription history in these neighboring states. Iowa’s Prescription Drug Monitoring Program (PDMP) has proven to be a valuable asset to physicians and pharmacists alike; it only makes sense to continue to enhance this tool with the latest available benefits. The National Association of Boards of Pharmacy (NABP) has established an InterConnect system allowing authorized users of state-run PDMP to link to other participating state PDMPs. This interstate compact system allows for the sharing of patient prescription history and facilitates a more effective means to tackle drug abuse occurring across state lines. To date, 20 states are participating in the sharing of prescription data with the InterConnect system – these include border states Illinois, Minnesota, Kansas, Wisconsin, and South Dakota. With this system enhancement, physicians and pharmacists are able to better recognize when patients are traveling from state to state to misuse or divert prescription drugs. The institution of the InterConnect system for the PDMP in Iowa is a practical and logical step towards combating the prescription drug abuse problem in our state and across the nation. Connecting Iowa’s PDMP with those of surrounding states will provide access to real-time prescription information, allowing physicians to make more informed treatment decisions, and helping physicians and pharmacists to ensure that patients are only receiving the

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medications they actually need. Without the InterConnect benefit, Iowa physicians and pharmacists lack a comprehensive view of a patient’s medication regime. Iowa’s current PDMP capabilities shield interstate doctor-shoppers from detection. Prescription drug abuse has reached epidemic levels across our nation. More than 20,000 people die each year in the United States from a drug overdose. In Iowa alone, 62 people died from an overdose of prescription medication in 2011. Drug overdose deaths in our state have quadrupled just since 1999. Many solutions have been suggested to remedy this on-going problem; not all of which are practical resolutions to this very real problem. Fortunately, there is a policy measure which I and fellow members of the Iowa Medical Society believe to be a productive step toward combating prescription drug abuse and diversion. Skeptics of the InterConnect system have expressed concerns regarding patient confidentiality and the transfer of patient information across state lines. It is important to understand the InterConnect system is highly secure, with each state protecting its citizens’ information in the same way it is protected when accessed within the state between authorized PDMP users. Healthcare practitioners are accustomed to keeping patient information confidential; prescription drug history is no different. In my view, the benefits of participation in the NABP InterConnect system far outweigh any potential risk. During the 2014 legislation session, the Iowa Medical Society is very pleased to partner with the Iowa Pharmacy Association to jointly pursue legislation to link Iowa’s PDMP to the InterConnect system.

guest column

Prescription Drug Abuse: A Pharmacist’s Perspective

he widespread use of controlled substances raises caution flags to a community pharmacist. Pharmacists verify the valid use of every written prescription, yet also have a heightened sense of awareness for a controlled substance.

Lucky enough, the Iowa Board of Pharmacy has created a useful tool for healthcare providers to access and utilize to help better serve patients. Our pharmacy accesses the Prescription Drug Monitoring Program (PDMP) for every controlled substance prescription written. We see this as a part of our pharmacy’s workflow in order for the pharmacist to best take care of patients. We are very open and honest with our patients concerning the use of the PDMP and the regulations surrounding its use. Patients need to understand that all licensed Iowa pharmacies feed their data on controlled substances (Schedules II, III, and IV) into this system on a weekly basis. As a healthcare provider, it is also important to know that the information in the Iowa PDMP is specific to Iowa only. There is no information from other pharmacies licensed by other states entered into this database. Our efforts are strengthened when the PDMP is accessed by all pharmacies as well as all prescribers when a controlled substance prescription is written, ordered, or dispensed. Pharmacists are sometimes put in a difficult situation when they are the first healthcare provider to check the PDMP and discover patterns of abuse. At that point, the patient has already been seen by a physician or other provider and upon receiving a prescription has a high expectation that they will receive the controlled substance medication from their pharmacy. The PDMP is available to any healthcare provider with an NPI number, and up to three agents of the practitioner. Each user has to apply to the Iowa Board of Pharmacy for a specific username and password. All

healthcare providers that provide controlled substances to a patient should utilize this tool. Even though the PDMP is not updated real-time, practitioners can still identify patients may be overusing or abusing these dangerous medications through recognition of patterns or statewide alert notifications. Our pharmacy staff is trained to look for patients that use multiple prescribers (especially prompt care, urgent care or ER providers), multiple pharmacies, pay cash versus insurance, and discrepancies between number of tablets and days supply. Another useful tool in curbing substance abuse and misuse is the utilization of pain contracts between patients and prescribers. At this point, most pharmacies do not have access to this contract or information of its use. At our pharmacy, we have encouraged local providers to notify our pharmacy when a pain contract is in use for a patient. This type of communication with our local provider offices has really helped to create a team approach to ensuring patients with legitimate pain receive the medications they need.

Jerome Bukstein, PharmD

Ward Eastside Pharmacy, a GRX Holdings, LLC business Des Moines, Iowa

ONLINE ONLY FEATURE

While the PDMP allows our pharmacy to get a snapshot of a person’s prescription habits, the final decision to dispense a controlled substance medication is revealed upon appropriate counseling with that patient on the proper use of that medication. Once I have had a chance to review the PDMP and counsel the patient, our pharmacy can determine if a call to the provider’s office (or law enforcement) is necessary. No matter your practice site, please take the time to learn about the PDMP and sign up today. You will be able to help your patients and our communities decrease the amount of overused and misused controlled substances. A team approach to managing the misuse and abuse of controlled substances is critical. Jan.Feb.Mar 2014

health care hot topics The profession of pharmacy and health care continue to change and evolve with each day that passes. Here is a short summary of events that have had an effect on our profession. Senator Grassley proposes ‘Pharmacist Provider’ Amendment to SGR Bill

• Senator Charles Grassley and his staff proposed pharmacyrelated amendments to the Sustainable Growth Rate (SGR) bill of 2013. The Senate Finance Committee was to consider an amendment that sought to add pharmacists to the list of recognized providers in the accountable care organizations (ACOs) now emerging as major delivery models in our health care system. While the proposed amendment to the Sustainable Growth Rate (SGR) bill was not introduced or approved, we can officially say that efforts towards provider status are moving forward. Getting pharmacists as providers mentioned at the Congressional level, let alone introduced into the amendment record, is a significant accomplishment. Unfortunately, there were over 140 amendments to be considered. Most, including this amendment, were withdrawn or not introduced, when the sustainable growth rate (SGR – “doc fix”) bill went to vote. The mention of pharmacists in the amendment record gives us hope for future discussions as we continue an ongoing national debate around fixes to our health care system.

Woes With Insurance Marketplace Rollout

• Healthcare.gov, the website used to sign up for health insurance under the ACA’s marketplace exchange, experienced problems during its rollout starting on October 1, 2013. Technical glitches had prevented many people from using the website to sign up for insurance plans. It took two months of upgrades and improvements for the website to handle the capacity

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goals of 50,000 concurrent users and 800,000 visits per day.

the bill signing, the FDA promptly issued three draft guidances that would implement provisions of the law. FDA is taking an aggressive stance in regulating the industry and traditional pharmacies, including a surprising reliance on USP Chapters <795> and <797> in the pharmacy compounding guidance that has potentially farreaching impact on practice.

During his reelection campaign, President Obama assured the public that they would be able to keep their current health insurance plan under the ACA. Despite this promise, there had been many health insurance plan cancellations, which caused backlash and criticism of the ACA. In response, President Obama announced that health insurance companies could continue to provide coverage in 2014 for current policyholders that otherwise would have been cancelled under the new health law. The President’s plan would apply only to people who had their existing policies canceled because they didn’t meet minimum standards.

JNC 8 & New Cholesterol/ Obesity Guidelines • At long last,

Drug Quality and Security Act Signed into Law • The Drug

Quality and Security Act (DQSA), was signed into law by President Obama on November 27, 2013. This law was passed after the meningitis outbreak from contaminated steroid pain injections killed 64 people and sickened more than 750 across the country in 2012. The outbreak was traced back to the New England Compound Center in Massachusetts, which had been regulated under a hodgepodge of Federal and state laws. This law also outlines critical steps to build an electronic, interoperable system to identify and trace certain prescription drugs as they are distributed in the United States. After

the Eighth Joint National Committee (JNC 8) released its new guidelines in December 2013 on the management of adult hypertension, which contain two key departures from JNC 7 that the authors say will simplify care. The expert writing group recommends a relaxing of the more aggressive JNC 7 target blood pressures and treatment-initiation thresholds in elderly patients and in patients under age 60 with diabetes and kidney disease. JNC 8 also backs away from the recommendation that thiazidetype diuretics should be initial therapy in most patients, suggesting an ACE inhibitor, angiotensin-receptor blocker (ARB), calcium-channel blocker (CCB), or thiazide-type diuretic are reasonable choices. The American College of Cardiology and the American Heart Association also published four new guidelines. These reports contain new evidence-based recommendations for the management of cholesterol, obesity, lifestyle, and assessment of cardiovascular risk. Major changes include less focus on LDL targets, a new risk assessment calculator, and an even greater emphasis on statin use and lifestyle changes. These new guidelines take the place of the Adult Treatment Panel III (ATP 3) cholesterol guidelines, which came out in 2001 and were updated in

health care hot topics 2004, and the 1998 Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults.

Obama Administration Nominates Murthy as Surgeon General • The Obama administration

nominated Vivek Murthy, MD, to become the country’s 19th surgeon general and the first of Indian descent. Dr. Murthy is a hospitalist at Brigham and Women’s Hospital in Boston, Massachusetts. He is also the president and cofounder of Doctors for America and an advocate for the Affordable Care Act (ACA). If confirmed by the Senate, Dr. Murthy would succeed the Acting Surgeon General Boris Lushniak, MD, MPH, who has occupied the post since Regina Benjamin, MD, MBA, stepped down in July 2013. Dr. Benjamin publicly endorsed the U.S. Public Health Service report, “Improving Patient and Health System Outcomes through Advanced Pharmacy Practice: A Report to the Surgeon General 2011,” which championed the support of pharmacists delivering expanded patient care services. The report was led by pharmacist Scott Giberson, BSPharm, MPH, who currently serves as the Acting U.S. Deputy Surgeon General. Not much is currently known about Dr. Murthy’s view of pharmacy practice.

Drug Shortage Help Requested by the FDA • The FDA proposed

a double-faceted approach to prevent shortages of crucial medications that have disrupted care at hospitals and clinics nationwide. In their strategic plan, the FDA called for improved response to upcoming or existing shortages while implementing long term methods to deter underlying causes. In addition, the FDA plans to improve communication with the launch of a new mobile app, further clarify manufacturers’ roles and responsibilities to prevent shortages, and update internal processes for early response. The proposal would

require that manufacturers of medically important prescription medicines, including biologics, would have to notify FDA six months ahead of any changes that could disrupt the U.S. supply. This would include any plans to discontinue a product or manufacturing changes that could slow production. The agency cannot require companies to increase manufacturing capacity to guard against shortages, or to require a company to make a product if it is not profitable.

FDA Proposes Ban on Trans Fat

• The FDA publically announced its preliminary decision that partially hydrogenated oils (PHOs), the primary dietary source for artificial trans fat in foods, are not “generally recognized as safe” for use in food. Starting in November, the agency opened a 60-day public comment period in order to collect input and data on how long it would take for manufacturers to reformulate their products containing PHOs. The FDA cited that a reduction in dietary consumption of trans fat has the potential to further reduce 20,000 myocardial infarctions and 7,000 deaths from cardiac disease each year. The Institute of Medicine has also stated trans fat provides no health benefits with no safe level of consumption. This controversial recommendation has been met with resistance from some manufacturers, yet others already made progress with eliminating trans fat since the issue first rose 6 years ago. This ban would only apply to artificial trans fat, and will not affect foods like dairy and some meat that naturally contain this ingredient.

FDA Implementing Plan to Phase Out Antibiotic Use in Farm Animals • The FDA will be

implementing a voluntary plan to phase out the use of certain antimicrobials in animals for enhanced food production. The FDA cited the growing concern of antimicrobial-resistant bacteria and the importance of only using antimicrobials when medically necessary. The FDA’s efforts are focused on medically important antimicrobials that have use in treating human disease. The FDA called for animal pharmaceutical companies to voluntarily remove the FDA-approved growth enhancement and feed efficiency indications of these drugs and to revise their labels. The FDA requested that animal pharmaceutical companies notify the FDA of their intent to sign on to the plan within the next three months. There would then be a three-year transition process for the companies to make the proposed changes.

Jan.Feb.Mar 2014

iowa pharmacy news IPA Headquarters – New Website Coming – CEI Update

• The office space at 8515 Douglas Avenue has been home to the Iowa Pharmacy Association since 1980. At the 1985 Annual Meeting in Iowa City, a mortgage burning ceremony (in a mortar and pestle!) was hosted to signify the importance of having a permanent home for the profession of pharmacy in Iowa. IPA owns five condo units in this office, totaling 6,250 square feet. Over the past 33 years, IPA has changed the space as needed – for example acquiring additional space to accommodate large and small meetings in different conference rooms, and the ability to host board meetings, committee meetings, and even a reception from time to time. Over the next year, IPA will upgrade various technologies in order to meet the needs of our members, including Board room audio-visual equipment for virtual meetings, a more robust phone system, and a new website and membership database. Over the years, several business ventures have originated within the four walls of IPA’s headquarters including:

• IPSC (Iowa Pharmacy Service Corporation) • PNI (Pharmacy Network of Iowa) • pap’I (Pharmacists Aiding Pharmacists in Iowa – later to become IPRN) • PEI (Pharmacy Enterprises Inc)

• Pharmacists Financial Services (PFS, later changed name to PMG, Pharmacy Marketing Group) • QA, Inc • (CEI) Collaborative Education Institute

CEI, as a partnership between IPA, the University of Iowa College of Pharmacy, and Drake University College of Pharmacy and Health Sciences, was incorporated in 2008 as the sole accredited provider of continuing pharmacy education in Iowa . Since 2008, CEI’s team has maintained offices within IPA’s headquarters. Beginning in 2014, CEI will transition to a virtual office, providing the opportunity for expanded growth in national program offerings, while continuing service to its three founding and supporting organizations. They can continue to be reached through their website, www.gotocei.org, by phone 515-2708118, and through mail to PO Box 71306, Des Moines, Iowa 50325. Through this transition, a new opportunity is created for available office space within IPA’s headquarters. If any IPA member would like more information, please contact kgainer@iarx.org.

Pharmacy Practice Evolving So Close to Home! • Are you aware

of the new opportunities that exist for pharmacist-delivered care in Iowa?

Community Care Coordination Project Begin in Two Regions in Iowa As a result of funding from the Iowa Legislature in 2013, the Iowa Primary Care Association (IPCA) in its role in convening the Iowa Collaborative Safety Net Provider Network selected two regions of the state to receive funding to support community care coordination initiatives. Mercy Medical Center—North Iowa in Mason City and the Webster County Health Department in Fort Dodge were each the recipient of a $300,000 grant to improve quality, population health, decrease costs and engage practices in quality improvement initiative to meeting the Institute for Healthcare Improvement’s Triple Aim. In collaboration with the Iowa Prescription Drug Corporation, IPA has been working to deploy pharmacist-provided care coordination services to help support primary care practices and meet the unique needs of high risk populations. Community Transformation Grant Encourages MTM For Self-Insured Employers Since early 2012, IPA has been working with the Iowa Department of Public Health (IDPH) on the Community Transformation Grant (CTG), a program of the Center for Disease Control and

office SPACE FOR LEASE Immediate availability 8515 douglas avenue urbandale, ia 50322

For more information or visit the space: Contact Michael Wolnerman, rph, ccim

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• Competitive full service monthly rental rate • 1,250 -1,930 square feet available or individual office(s) • Short-term or long-term lease options available • Excellent location in Urbandale, IA with easy access • Plenty of free parking right up to the building • Chairs, desks, cubicle walls available at no charge for term of the lease • Appliances in breakroom included in rental rate

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iowa pharmacy news Prevention. The grant’s purpose is to reduce risk factors responsible for the leading causes of death and disability by creating healthier communities. One of IDPH’s goals is that by September 2016, there will be an increase in the number of selfemployers in the state who support a pharmacist-delivered MTM model for employees to address at minimum the control of high blood pressure, high cholesterol, and diabetes. One selfemployer near Dubuque has already received a seed-grant from the CTG program to implement a MTM program that reimburses pharmacists for MTM services in 2014. Watch for additional communication from IPA as more selfinsured employers take advantage of available CTG funds. New Practice Model Brings Tech-CheckTech to Community Practice In 2014 multiple community pharmacies will work to transform their care delivery model through IPA’s New Practice Model initiative. With the work of seven pilot sites, community pharmacies across Iowa will implement a tech-check-tech program as a means to realign pharmacy resources in order to free up pharmacist’s time to engage in clinical services. With assistance from Drake University and approval by the Iowa Board of Pharmacy, pharmacies will investigate the impact of tech-check-tech on specific patient safety measures and provision of patient care services. The Collaborative Education Institute will be providing technician and pharmacist education prior to the implementation of this initiative. In late 2014, additional pharmacy sites are planned enter into the New Practice Model initiative. Pharmacists Help Reduce Recidivism with Department of Corrections Program In April 2013, the Iowa Prescription Drug Corporation (IPDC) expanded its Iowa Medication Voucher Program to serve incarcerates with mental disorders transitioning out of the Iowa Department of Corrections system. Prior to the start of this program, offenders with chronic illnesses who left the prison system were given a 30-

day supply of medications. Thirty days is often not an adequate length of time for an offender to establish a source of continuous medication therapy. Discontinuing many types of psychiatric medications can lead to the underlying illness or illnesses no longer being under control, an outcome of which could lead to the individual reoffending. The expansion of the Iowa Medication Voucher Program provides up to 90 days of mental health prescription drug coverage for transitioning incarcerates. The additional time is essential to allow a released offender to locate a medical provider, be evaluated, and receive financial assistance - all of which is necessary to create a stable environment outside of the prison system. Preliminary results of this program are currently being collected and will soon be released. State Innovation Model Plans ACO For Iowa Medicaid In February 2013, the State of Iowa learned that they were provided a Model Design Award as part of a State Innovation Models (SIM) Cooperative Agreement with the Centers for Medicare and Medicaid Services (CMS). The goal of this CMS Innovation Center initiative is to test whether new payment and service delivery models will produce superior results when implemented in the context of a state-sponsored State Health Care Innovation Plan. The SIM initiative is meant to plan, design, test, and support evaluation of new payment and service delivery models in the context of larger health system transformation. IPA has been working closely with Iowa Medicaid and its SIM workshops in 2013 to integrate pharmacist-provided services in the development of a multi-payer ACO model focused on patients with mental health conditions or receiving care in long-term care settings. Trinity Pioneer ACO MTM Program Serves Patients Across North Central Iowa Pharmacy’s long struggle to win professional recognition and a full seat at the health provider table is finally finding some traction as health systems, individual healthcare providers, health plans and plan payers begin to

connect the dots and build a workable framework for a more patient-centric, evidence-based and cost-effective system of care in the United States. On November 8th, the Trinity Pioneer ACO, based out of Fort Dodge, began utilizing community pharmacists to deliver MTM services as part of a care transitions project. With key stakeholders of The University of Iowa and OutcomesMTM, IPA hopes this program will locally showcase the ability of community pharmacists to reduce hospital readmissions and overall hospitalization within a Medicare ACO population.

IPA is Going Local Again in 2014!

• Thank you to everyone that joined us for an IPA Goes Local event in 2013. IPA will once again be partnering with local associations in Iowa throughout the year. As part of this partnership IPA will provide one hour of continuing pharmacy education on patient safety to attendees, helping to fulfill the Board of Pharmacy requirement.

Stay tuned and look for more updates this spring as locations in your area are finalized. Hope to see you there! • Dubuque Area Pharmacy Association (Dubuque) – March 5, 2014 • CIPA (Des Moines) – April 10, 2014 • Quad Cities Area Pharmacy Association (Davenport) – April 24, 2014 • Black Hawk/Bremer Co Pharmacy Association (Waverly) – May 2014 • North Iowa Pharmacy Association (Mason City) – May 20, 2014 • Trinity Pioneer ACO Project (Fort Dodge) – Aug. 21, 2014 • SWIPA (Council Bluffs) – Aug. 2014 • JCPA (Mercy Hospital in Iowa City) – Sept. 16, 2014 • Northwest Iowa Pharmacy Association (Spencer/Spirit Lake) – Fall 2014 Jan.Feb.Mar 2014

iowa pharmacy news

NCPA Annual Meeting

• Over 40 Iowa pharmacists and student pharmacists traveled to Disney World in Orlando for the 2013 NCPA (National Community Pharmacists Association) Annual Convention on October 12-17. The NCPA Convention included sessions on ownership, succession planning, 340B workshops, MTM practices, and medical home/ACO integration. Plan to join other IPA members at the 2015 meeting on Oct. 18-22 in Austin.

ASHP Midyear - - Iowa Represents • Over 20,000

attendees took part in the ASHP Midyear Clinical Meeting, held in Orlando December 7-11, 2013. Nearly 300 pharmacists, residents, and student pharmacists from Iowa attended the convention. A reception was hosted by IPA, Drake University, and UI College of Pharmacy for all attendees. This year’s Midyear included a keynote address from former Secretary of State, General Colin Powell who addressed pharmacists as healthcare providers. Couldn’t make it this year?…mark your calendar for Midyear 2014 on Dec. 7-11 in Anaheim.

APhA 2014 – SAVE THE DATE Hosted in Orlando, APhA 2014 will take place March 28 – 31. Iowa pharmacist, Matt Osterhaus, will be installed as the 2014-2015 President of the American Pharmacists Association. The Iowa reception will take place on Sunday, March 30th at the Hyatt Regency Orlando from 5:30-7:30pm. Join members of the Iowa pharmacy family as APhA celebrates ‘The Power & Promise of Pharmacy.’

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residents and student pharmacists.

WHAT IS IT? 2/2/2 is a new IPA

program designed for you to stay engaged and stay informed on hot issues impacting the profession of pharmacy. These online webinars will be free of charge to all pharmacy professionals in Iowa. 2/2/2 webinars are not accredited for CE. Thank you to the 170 that have participated in the four 2/2/2 webinars held in the fall 2013. All previous 2/2/2 programs are recorded and available at no charge on IPA’s website.

WHEN IS IT? 2nd Tuesday of every month at 2:00 PM. CST

UPCOMING TOPICS YOU WON’T WANT TO MISS • February 11: Practice Advancement Across Iowa Hospitals • March 11: An Update on National Provider Status Efforts • April 8: Implications of Federal Compounding Legislation • May 13: Open Forum on Proposed IPA Policies Take advantage of these Virtual Engagement Opportunities by registering with 2/2/2 Quick Link at www.iarx.org.

Health-System Liaison Board Develops Plan for Practice Advancement • IPA was awarded

a grant by the ASHP Research and Education Foundation to host a workshop with key pharmacy leaders and stakeholders in Iowa to continue the mission to advance pharmacy practice throughout our State. The workshop was held on October 24th in conjunction with the meeting of the IPA Health-System Liaison Board (HSLB). Attendees included the HSLB members, IPA Board of Trustee members, select state hospital pharmacy leaders, and a host of

Tom Thielke, Professor Emeritus at The University of Wisconsin School of Pharmacy, and Stacy Livingston, PGY2 Pharmacy Administration Resident at The University of Wisconsin Hospital and Clinics, served as facilitators for this workshop. Tom and Stacy brought great experience from doing similar work through the Pharmacy Society of Wisconsin and The University of Wisconsin. They helped to set the stage for further discussion by outlining categories of focus of ASHP’s Pharmacy Practice Model Initiative (PPMI), national goals, and their previous experience in Wisconsin’s PPMI initiatives. As part of this four-hour workshop, information was presented and participants engaged in discussion regarding opportunities for pharmacist and pharmacy technician advancement within the State of Iowa. A list of ideas was compiled from a large group discussion followed by a small group breakout session where attendees chose specific advancement ideas to evaluate. This work resulted in the development of several priorities that IPA will focus on over the next three years. The group finalized two immediate initiatives to target to help achieve the additional priorities developed. * Development of a Strategic Leadership Team charged with implementation of priorities * At Least 80% Completion of the PPMI Hospital Self-Assessment Pharmacists continue to prove their worth and value by serving patients across all care settings. Yet, implementing these strategic ideas in the name of advancing care for our patients will not be successful without sharing your story beyond your own place of work. Look for upcoming opportunities to get involved in this exciting practice advancement movement across Iowa. More information will be provided

Jan.Feb.Mar 2014

iowa pharmacy news in communications from IPA. The Health-System Liaison Board truly believes the initiatives discussed at this workshop will serve as an important strategic plan in implementing PPMI objectives, ensuring Iowa health-system pharmacists are integral healthcare team members who provide the highest quality patient care.

LTC & Senior Care Advisory Committee Bridge Gap with Iowa Department of Aging

• On October 10, 2013, the IPA Long Term Care & Senior Care Advisory Committee held its regular meeting at the IPA headquarters to discuss current topics related to long-term care (LTC) pharmacy practice. The focus on health care remains on value-based care delivery, and LTC pharmacy practice is no exception to these discussions. For the first time ever, the Director of the Iowa Department of Aging, Donna Harvey, attended the Committee’s regular meeting. While in her current role, Harvey was chosen to serve as the Chair for the LTC Integration Workgroup within the Iowa Medicaid’s State Innovation Model (SIM) grant project. The Committee held thorough discussions on the potential opportunities of integration of pharmacist-provided medication therapy management and care transitions in the Medicaid ACO model. From the positive discussion that ensued, IPA will continue to collaborate with the Department of Aging to best serve LTC patients in Iowa. The Committee also held open discussion on the current and proposed Iowa Board of Pharmacy regulations that affect LTC practice settings. The Committee recommended that IPA support the Board of Pharmacy proposed amendments that clarify the definition of strip pack and unit dose medications, as well as clarify the rules on repackaging patient med packs. The Committee also recommended that IPA should follow-up with the Iowa Board

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of Pharmacy to evaluate the recent changes to IAC 657-22.7(5) regarding labeling requirements in LTC. Other guests joined the Committee for candid discussion for consideration by IPA. These guests included: Ronna Hauser and Carolyn Ha from NCPA’s LTC Division, and Rachel Digmann from Telligen. NCPA reviewed federal healthcare updates from the impact of short cycle dispensing to DME and compounding services. Digmann focused her comments on mechanisms for LTC pharmacy to decrease inappropriate antipsychotic use across LTC facilities in Iowa. 2013-2014 IPA Long-Term Care and Senior Care Advisory Committee: Kristen Meyer, Chair Mark McMullen, Vice Chair Natalie Benson Geena Brickson Katelin Campbell Lisa Doorenbos Anisa Fornoff Alex Hoopes Bryce Jackman Becky Kehoe Marcia McNulty

Richard Michael Robert Nichols Justin Rash Jeff Reist Joshua Rose Christine Shinstine Jessica Smith Ryan Thurm Amy Wadstrom Michael Williams Pamela Wong

Medicaid & Pharmacy Benefit Programs Advisory Committee Meets with Catamaran, Wellmark • The IPA Medicaid & Pharmacy Benefit Programs Advisory Committee met at the IPA headquarters on October 23, 2013. The Committee used this meeting as an opportunity to discuss the tough issues affecting community pharmacies across the state this past year. The Committee focused their attention on Medicaid expansion, PBM practices, and new pharmacy practice models.

Over the past year, IPA members have expressed strong concern over the practices of Catamaran, the primary PBM for Wellmark. The Committee invited Karen Peterson and Kerri Tanner of Catamaran to explain Catamaran’s audit program for prospective review

of claims. They provided insight into how Catamaran compensates their audit partners, and has plans to improve their audit practices in 2014. In addition, the Committee was able to meet with Matt Hosford, Director of Pharmacy at Wellmark. Hosford sought feedback for future pharmacist reimbursement models while providing insight into Wellmark’s decision to delay its participation in the health insurance exchange until 2015. Despite a last minute cancellation from representatives from Iowa Medicaid, the Committee focuses on understanding Medicaid’s expansion program, the Iowa Health and Wellness plan, which is scheduled to begin January 1, 2014. The Committee also expressed appreciation of IPA’s efforts to obtain a 1% increase in Medicaid’s dispensing fee and address discrepancies between AAC and FUL for product reimbursement. IPA Medicaid & Pharmacy Benefit Programs Advisory Committee Members: Ryan Frerichs, Chair Kim Spading, Vice Chair Marissa Ausman Charlie Comito Neal Daley John Daniel Abby Davis Josh Feldmann John Forbes Jessica Frank Dave Gavin

Michelle Garvin Jason Hansel Danielle Kennedy Blake Porter Mark Richards David Seiler Al Shepley Julia Strause Sarah Thune Ben Urick Jerod Work

IPRN Committee Convenes To Help Serve Recovering Professionals Across Iowa

• The Iowa Pharmacy Recovery Network (IPRN) serves as a confidential resource to assist impaired pharmacists, pharmacy students and pharmacy technicians obtain an evaluation, treatment, aftercare, support, and as a mechanism for reentry into the profession of pharmacy. IPRN works to verify the individual’s concerns and then takes steps to assist the professional in receiving an

iowa pharmacy news evaluation, subsequent treatment, and aftercare support needed to remain a viable member of the profession of pharmacy. The efforts of IPRN are no better realized than during a meeting of the IPRN Committee. The most recent meeting occurred on November 13th. While IPRN’s activities are completely confidential, the Committee holds semi-annual meetings to review updates from the Board of Pharmacy, the student chapters at Drake and The University of Iowa, IPA, and IPRN clients. In addition, Emily Dykstra, IPRN’s Monitor, reviewed similarities and differences between IPRN and the recovery network for physicians in Iowa and sought the Committee’s feedback for mechanisms to improve IPRN’s impact.

than 30 residents across 10 Iowa pharmacy residency programs to come together to network, learn from each other, and interact with IPA leadership and staff. The value meter needle was way past full in the room – residents valuing IPA, IPA valuing residents, IPA valuing residency programs, and the residents valuing their residency experience while still early in their residency training.

IPRN can only be successful if we all work together to recognize addiction as a disease and know that each intervention will positively affect a person’s life. The Committee recognizes that it is difficult to take an initiative and get help for someone you care about. But it is more difficult to watch a colleague’s personal and professional life fall apart. IPRN needs your help to make a difference to each and every pharmacy professional in Iowa. Become an IPRN advocate today by contacting IPA at ipa@iarx.org!

In an effort to recognize the location of residents in different parts of the state, the Annual Resident’s Meeting moved locations in 2013 to Coralville. The relocation of this event will alternate each year between Des Moines and Iowa City. In addition, the meeting was held in conjunction with the IPA College Night to allow residents to interact with over 100 student pharmacists interested in pursuing a residency. During the meeting, residents were treated to a lunch presentation on leadership and advocacy for the profession from Mike Brownlee, Chief Pharmacy Officer/Associate Hospital Director for University of Iowa Health Care. One of the most striking parts of the meeting every year is when each resident discusses their progress on their residency project. It was inspiring to learn of how each project aligns so closely with the mission and vision of IPA!

Iowa Pharmacy Residents Come Together With IPA

TakeAway Reaches 75,000 lbs. Milestone! • A riddle: When an

• These days the word “value” is used a lot. We hear about the value in healthcare, value added steps and the value experience. Value is the “new kid on the buzz-word block” replacing quality. Whether it is quality or value, it may be difficult to define, but you know it when you have it, see it and feel it. There is a lot of “value” that occurred at the Annual Resident’s Meeting on October 8, 2013 at the Marriott in Coralville. This year’s conference served as a platform for more

Iowan thinks of something that weighs 75,000 pounds, of what are they thinking? It could be 1,340 bushels of corn, 63 beef cows, or 5 combines…but now Iowans have a new 75,000 pound claim to fame and it has nothing to do with farming. In January 2014, the Iowa TakeAway medication disposal program surpassed the mark of 75,000 pounds of properly disposed prescription and over-the-counter drugs! TakeAway currently consists of more than 440 pharmacies from all of Iowa’s 99 counties and participating pharmacies

Erik, PharmD and Jenifer Maki, PharmD pose with Pill Dude.

have returned almost 2,800 twentygallon TakeAway systems with an average of 78 prescriptions that weigh 31 pounds per return. November 2013 marked the fourth year of existence of Iowa’s TakeAway medication disposal program, and the year of 2013 alone brought in over 23,000 pounds of properly disposed medications! The achievement of yet another milestone showcases that TakeAway: Iowa continues to be the leading statewide drug disposal programs in the nation. Keep up the great work TakeAway pharmacies, partners and Iowans, as each and every proper medication disposal makes Iowa a safer, healthier place to live, work and play! In 2014, watch for new developments within the TakeAway: Iowa program. In April 2014, research is planned for top collecting sites within the program. This research will survey patients to better understand the reasons for medication disposal at the local pharmacy while taking a quick inventory of the medications collected. With collaboration of advanced practice rotation students, the data collected will help to showcase the viability of the program and obtain additional funding from outside sources. In addition, 2014 will hopefully bring new regulations from the DEA to allow TakeAway: Iowaparticipating pharmacies to collect and dispose of controlled substances. Continue to watch for communication from IPA on these new developments! Jan.Feb.Mar 2014

ipa foundation

thank you for contributing to the ipa foundation in 2013! The Iowa Pharmacy Association Foundation sincerely thanks those members who make a contribution to the future of the profession by supporting the efforts of the Foundationâ€Śthese contributions truly make a difference. The following list of contributors is for January 1, 2013 â€“ December 31, 2013: Platinum Level ($1,000+)

Carol Anderson Tim Becker Kevin & Diane Cassatt Jordan Cohen Chris & Connie Connolly Jay Currie Wendy Duncan Josh Feldman Steve Firman John & Cindy Forbes Ryan Frerichs Kate Gainer Felix Gallagher Russ Johnson, Jr Gene & Susan Lutz Gary Maly Max Ireland Estate Jim Miller TJ Johnsrud Leman Olson Robert Osterhaus Matthew Osterhaus Chuck & Janalyn Phillips Lisa Ploehn Charlie Porter Anthony Pudlo Kevin & Sue Purcell Raylene & Scott Rospond Jim Scott Al Shepley John & Sarah Swegle Tom Temple Jenny Tuttle

Gold Level ($500-$999)

Gary Albers Rockford Anderson Bill Brazell (Jody Orth) Renae Chesnut Michele Evink

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Cory & Michelle Garvin Dennis Jorgensen Rick Knudson Don Letendre Katherine Linder Ed Maier Erik Maki Marcia McNulty Kyle Peters Morgan Sayler Bob Stessman

Silver Level ($250-$499)

Bill Baer Todd & Patricia Burkle Neal Daley Sandra Dirks Ashley Dohrn Allen Fann Tom Halterman Matt Hummel Jack Kampf Margaret Karbeling Julie Kuhle Nick Lehman Mary Mosher Anh Thu Nguyen Susan Shields Mindy Smith Denise Soltis CoraLynn Trewet

Bronze Level ($100-$249)

Cheryl Anderson Dave Brothersen Michael Brownlee Ginelle Bryant Ray Buser Paula Carlson Michele Cooper John Daniel

Nancy Davison Steve Deutsch Marty Dunn Carmen Dunphy Peter Fay Jessica Frank Betsie Frey Stanley Fullerton Theresa Ganzel Danette Gibbs Tom Greene John Hamiel Jason Hansel Brett Hansen Lucinda Harms James Hoehns Kim Hurlburt Ryan Jacobsen Terry Jacobsen Terry Johnson Jesse Kleinhesselink Robert LaGrange Tammy Lanphier Lesley Leuwerke Nick Lund Rex & Phyllis McKee Steven Martens Chasity Mease Karen Merrill Gary & Mary Milavetz Laura Miller Jennifer Moulton Johnna Neary Phyllis Olson Heather Ourth Brandon Patterson Anthony Puffett Mike Pursel Elissa Reed Gordon Reed Jeff & Diane Reist Heather Rickertsen Kathy Rinehart Doug Schara

Bernard Sorofman Angie Spannagel Joseph Thompson Christopher Tuetken Ben Urick Stevie Veach Patrick Verdun Robert Vonnahme Emily Vyverberg Jim Wallace Nancee Waterbury Matthew Witry

Business Partner Contributors

Amgen APhA Foundation APMS CEI Community Pharmacy Foundation Great River Medical Center PharmServ Johnson County Pharmacists Association McKesson Medicap-Urbandale Miller-Purcell Northwest Iowa Pharmacists Association NuCara Corporation Northwestern Mutual Osterhaus Pharmacy Main at Locust Pharmacy Teva Pharmaceuticals Quad City Area Pharmacy Association Tom Temple Consulting Towncrest Pharmacy Wasker, Dorr, Wimmer, Marcouiller

IPA FOUNDATION IPAF Board Meeting in Review

• Bernard Sorofman, Executive Associate Dean University of Iowa, was welcomed to the Board of Directors. Bernard fills the vacancy of Dean Letendre who had to resolve his seat due to his election to a three-year term on the ASHP Board of Directors. Welcome, Bernard! The IPAF Board reviewed and voted favorably for the 2014 budget proposal as well as reviewed the investment portfolio. Discussion was held on the following fundraising efforts: • The Thomas R Temple Leadership Endowment Fund • Legacy Society • Foundation Institute • Gift Acceptance Policy The Board also discussed the 2014 IPAF RAGBRAI team. This week long event is

a new avenue to promote the pharmacy profession, networking opportunities and raise funds for IPAF. A planning committee has been formed and began meeting in December. The Board reviewed reports on the programs and activities supported by IPAF, including: • Scholarships • Leadership Development • Grant Projects • CEI activities The Board thanked Tom Temple, Tom Temple Consulting, LLC, for his consultation over the past two years. Tom has dedicated his time to establishing new opportunities for IPAF to continue to grow and support the programs and initiatives for many years to come. Thank you, Tom!

Thomas R Temple Leadership Endowment • For the past 26 years, the Leadership Pharmacy Conference has provided leadership training to over

300 new pharmacy practitioners. To ensure that the conference continues on in perpetuity an endowment campaign goal of $750,000 has been established. This summer leaders from Iowa and Wisconsin divided this endowment goal in half and each state is working towards attaining their portion of $375,000. To date more than $372,548 in pledges and contributions from past Leadership Pharmacy Conference participants, McKesson and Teva have been secured in Iowa. Please help us reach our goal by joining the list of contributors to the Leadership Pharmacy Endowment.

DONATE TODAY:

http://www.iarx.org IowaPharmacy/Foundation/ IPF.aspx Donations to the Thomas R Temple Leadership Endowment are tax deductible.

Looking to Fulfill Your New Year’s Resolution?

Join the Inaugural IPAF RAGBRAI Team! The Register’s Annual Great Bicycle Ride Across Iowa (RAGBRAI) is scheduled for July 20-26, 2014. Join IPAF and pharmacy colleagues as we ride across Iowa to inspire generosity and fulfill the aspirations of the profession of pharmacy. You can sign up to ride one day, a few days, or the entire week. Not a cyclist? No problem. IPAF is looking for volunteers to help get the team from the Missouri River to the Mississippi River, as well as help with outreach efforts along the RAGBRAI route by providing screenings and other pharmacy promotions. WHAT DO YOU GET WHEN YOU RIDE THE IPAF TEAM? Week-Long Riders receive all benefits of the daily rider, plus: -IPAF Team Bike Jersey (free) -Transportation to the start and from the finish to a central Iowa meeting location -2 days of Laundry service Daily Riders (up to 3 days): -IPAF Team Bike Jersey (discounted rate) -Transportation of gear and supplies -Official registration through RAGBRAI -Official RAGBRAI wristband -Camping with Host families or the RAGBRAI campgrounds (if needed) -Snacks for each day -Water and coffee available each day -Personal Shower Tents (shower bag is rider’s responsibility) -SAG Service for tired riders if needed or half-day riders -Electrical Charge Station

IPAF Team Fees Week-Long Rider Pharmacist Member Technician/Student Member Non-IPA Members

(includes spouses & children)

Early (by Mar. 1)

Late (by Mar. 31)

$500 $400

$600 $500

$500

$600

$80/day

$100/day

Daily Rider Donation to Support Individual Riders are welcomed!

CLICK HERE TO REGISTER FOR THE IPAF RAGBRAI TEAM Jan.Feb.Mar 2014

ipa foundation

SAVE THE DATES:

2014 IPA Annual Meeting June 13-14*

Prairie Meadows Conference Center Altoona, IA

*new schedule – meeting concludes at noon on Saturday! Donate to the IPAF 2014 Silent Auction • Donate and bid on great treasures, artifacts, unique items, and amazing trips!

The Silent Auction will be held on Friday evening, June 13, 2014, following the IPA Annual Recognition & Awards Banquet held at Prairie Meadows Conference Center in Altoona, IA. All contributions are used to support student programming, leadership development, and research & development projects. Please contact Joan Stover at jstover@iarx.org, with a detailed description and estimated value of your contribution to contribute to the 2014 Silent Auction.

2014 IPAF Eggleston/ Granberg Golf Classic Friday, September 19 Brown Deer Golf Course, Coralville, IA

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foundation institute IPA Foundation Institute

A newly formed group of donor leaders in Iowa who are recognized collectively for their commitment to annual giving in support of the Foundation’s mission. Foundation Institute donors identify with the charitable purpose of the Foundation and the need to support the profession through education and practice based research. Since its formation in 1960, the IPA Foundation has been dedicated to serving the pharmacy profession through support of a variety of programs including:

• Student Scholarships • Professional Development Programs for Students • Leadership Development Initiatives • Cutting Edge CPE Programming • Innovative Practice Projects • Residency Training • Pharmacy Heritage Preservation

We are inviting you to join the IPA Foundation Institute...

because you are a leader in the profession and have been loyal to IPA and the IPA Foundation. Your gifts and your service show us your respect for support of student pharmacists, leadership development, continuing pharmacy education, professional practice innovation, and the preservation of pharmacy’s rich heritage. When you invest in the Foundation Institute you invest in new concepts in pharmacy practice. Thank you for your commitment to the Foundation Institute which ushers in a new level of pharmacy philanthropy. Membership in the Foundation Institute recognizes varying levels of on-going, annual financial support for the IPA Foundation.

Platinum Membership Gold Membership Silver Membership Bronze Membership Sustaining Membership

$1,000 or more $500-$999 $250 to $499 $100 to $249 Up to $99

All contributions to the IPA Foundation, a 501(c) 3 charitable organization, are fully tax deductible.

Jan.Feb.Mar 2014

public affairs

Board of Pharmacy Continues To Protect Patients Across Iowa Generic-to-Generic Substitutions

In response to controversial proposed regulations on drug product selection, the Board held an open hearing on December 17th to provide feedback to the Rules Committee on the next appropriate actions. At the hearing, the Board heard from pharmacy stakeholder groups including IPA and representatives from the Epilepsy Foundation of Iowa. Several pharmacy stakeholders presented on the issue, and IPA reviewed the efforts and recommendations of the stateappointed Epilepsy Task Force.

Pharmacist Intern Changes

The Board recently proposed amendments revising the requirements for pharmacist-intern registration, the number of intern hours required, and the reporting of completed internship training. The Board determined that the collegebased training included in the college curriculum provides adequate prelicensure training, and requiring a pharmacist-intern to obtain additional training and credit outside the school year is not necessary. The proposed amendments would eliminate the requirements for completion and submission of the Iowa internship booklet.

Telepharmacy Practice

The Board has approved four telepharmacy practice settings in collaboration with two managing community pharmacy locations. The Board held a summit of key stakeholders on December 16th to discuss the future of telepharmacy in Iowa. Discussion focused on an

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appropriate definition of telepharmacy that would address the use of technology in remote order verification, dispensing processes, and cognitive services.

Changes from PTCB

During the November Board meeting, a representative from the Pharmacy Technician Certification Board (PTCB) presented on the changes to their certification exam and recertification process. PTCB is recognized as one of the national certifications available to technicians in Iowa. The implications of the changes from PTCB will continue to be evaluated by the Board of Pharmacy as well as IPA. The most significant change would require that by the year 2020, any new candidate for PTCB certification must graduate from an ASHP-accredited pharmacy technician education program. See page xx for a complete review of these changes.

Outreach to Southwest Iowa

On November 6th, members and staff from the Board of Pharmacy met in Council Bluffs as part of recent Board Outreach meetings. The Board reviewed recent changes to pharmacy regulations and responded to concerns, including the current penalties to prescription drug abusers and pharmacy theft as well as the detrimental practices of PBMs.

New Compliance Officer

Pharmacist Andrew R. Funk accepted the position of Compliance Officer with the Board.

Beginning November 22nd, Andrew will assist with Board outreach efforts to pharmacies in the counties of Audubon, Carroll, Cherokee, Crawford, Dallas, Guthrie, Ida, Lyon, Oâ€™Brien, Osceola, Plymouth, and Sioux. Andrew is a 2004 graduate of Roseman University of Health Sciences in Henderson, Nevada. CLICK HERE for the IPA for full map of compliance officer county responsibilities.

2014 LEGISLATIVE DAY & CAPITOL SCREENINGS DAY

Thursday, February 20, 2014 Des Moines Downtown Embassy Suites Iowa State Capitol

public affairs

Medicaid Expansion for Iowa Summary of Changes to IowaCare December 31, 2013: IowaCare is replaced by the Iowa Health and Wellness Plan • Iowa Medicaid will automatically transition IowaCare patients whose income they can verify • All other IowaCare members will be directed to apply at www. healthcare.gov or 1-800-318-2596

January 1, 2014: Iowa Health and Wellness Plan Begins

• Contains two separate options: Marketplace Choice Plan & Iowa Wellness Plan • All individuals may apply at www. healthcare.gov or 1-800-318-2596 • Members will be eligible for 12 months of covered benefits at a time

• Eligibility will be effective the 1st day of the month following application • Members will not be dual eligible with Medicare

Marketplace Choice Plan

• For adults age 19-64 with income 101-133% of the Federal Poverty Level • Plan managed by commercial insurer (CoOportunity Health or Coventry Health Care) • Medicaid pays the premiums • Uses the commercial plan’s provider network • No co-pays on prescription medications

Iowa Wellness Plan

• For adults age 19-64 with income up to and including 100% of the Federal Poverty Level • Plan managed by Iowa Medicaid • No co-pays on prescription medications • Eligible for Pharmaceutical Case Management (PCM) through Iowa Medicaid

More information available at: http://www.dhs.state.ia.us/uploads/ IHAWP_FINAL_10212013.pdf

YOUR SUPPORT IS NEEDED! Does one person’s support matter? The answer is yes!

Every contribution, large and small, helps pharmacy maintain a visible presence and relationship with legislators.

Please help keep Iowa pharmacy a viable, strong, and active participant in the legislative process. IPA actively advocates on behalf of the profession- both during the legislative session and throughout the interim. We need your continued support in order to remain effective. Please consider making your contribution today by going online:

www.iarx.org/Resources/Legislation/IPPAC.aspx

Jan.Feb.Mar 2014

peer review

Recent Pediatric Infectious Disease and Acne Therapy Guidelines: Implications for the Pharmacist Joseph Brandenburg Doctor of Pharmacy Candidate, 2014 Drake University College of Pharmacy and Health Sciences Daniel Litzenberg Doctor of Pharmacy Candidate, 2014 Drake University College of Pharmacy and Health Sciences Corresponding Author: Edward A. Bell, PharmD, BCPS Professor of Pharmacy Practice Clinical Sciences Department Drake University College of Pharmacy and Health Sciences 2507 University Avenue Des Moines, Iowa 50311 ed.bell@drake.edu 515-271-1841 (office) 515-271-4569 (fax)

Introduction Several guidelines have recently been published on common conditions affecting infants, children, and adolescents. These conditions â€“ acute otitis media, rhinosinusitis, community-acquired pneumonia, and acne â€“ likely account for a large share of pharmacotherapeutic treatments recommended and prepared by pharmacists. As the pharmacotherapy regimens in these guidelines are evidence-based, peer-reviewed, and have been recommended by national experts, it is important for pharmacists to become familiar with them. Antibiotics are commonly used in the pediatric population, with acute otitis media, rhinosinusitis (often referred to more simply as

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The authors report no conflicts of interest.

Abstract

Therapy guidelines for four conditions commonly affecting infants, children, and adolescents have recently been published in the peer-reviewed medical literature. These guidelines, developed using evidence-based and peer-reviewed methods, assess the diagnosis and therapy of acute otitis media, rhinosinusitis, communityacquired pneumonia, and acne. As pharmacotherapy is a significant aspect of the management of these conditions, it is important for pharmacists to understand the therapeutic recommendations offered in these guidelines. These pharmacotherapeutic

sinusitis), and community-acquired pneumonia, accounting for a large proportion of antibiotic use. Due to altered epidemiologic patterns in the causative bacterial pathogens of these infectious illnesses in infants and children, and their changing antibiotic susceptibility profiles, the selection and use of specific antibiotics is important to maximize treatment efficacy.1 Pharmacists can play an important role by assessing and recommending antibiotic treatment regimens for their pediatric patients. Also important to the appropriate use of antibiotics is the similarity of clinical presentation between the infectious diseases discussed here and common pediatric respiratory tract infections, often resulting from infection with viruses. While diagnosis is beyond the

recommendations include prescription and non-prescription products, and are applicable to ambulatory and hospitalized pediatric patients. Specific antibiotics targeting the most likely bacterial pathogens, based upon antimicrobial sensitivity patterns, are recommended by the guideline authors and are discussed. Antibiotic dosing considerations, additionally important when treating infants and children, are also reviewed. The unique role of nonprescription products in the treatment of infants and children with these conditions is reviewed. Pharmacists who function in these settings and provide care to the pediatric population will benefit from knowledge of these recently published guidelines.

scope and practice of pharmacists, it is helpful for pharmacists to be knowledgeable on important diagnostic criteria for the conditions reviewed here and clinical situations where antibiotics are more likely to be beneficial and indicated. Pharmacists can use this information to educate patients and their families about when antibiotics can be useful, and when they are not indicated. As many effective agents indicated to treat acne in children and adolescents are non-prescription products, pharmacists can also play an important role by recommending patient-specific products that are most likely to be safe and effective. Pharmacists can also assist in the care of patients with acne by providing helpful counseling on the

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appropriate use of prescription and non-prescription acne products. This review discusses these newly published, evidence-based, pediatric guidelines and their recommended pharmacotherapeutic regimens, including important implications for pharmacists.

Acute Otitis Media

The recently updated guideline, The Diagnosis and Management of Acute Otitis Media, from the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP), includes modification of diagnostic criteria as well as secondary treatment options for patients.2 This guideline revises the original guideline on acute otitis media (AOM) published by these organizations in 2004.3 The scope of this guideline includes infants and children 6 months â€“ 12 years of age without concomitant conditions that may alter the natural course of AOM. First-line antibiotic therapy (high-dose amoxicillin, 8090 mg/kg/day) remains unchanged. The original guideline defined AOM as: (1) acute onset of symptoms, (2) presence of middle ear effusion (MEE), and (3) signs of acute middle ear inflammation. This definition lacked sufficient precision to exclude children with otitis media with effusion (OME, fluid in the middle ear space without concomitant signs or symptoms), and it allowed for the diagnosis of AOM with an onset of symptoms, such as severe otalgia, and middle ear effusion, without other otoscopic findings of inflammation. In contrast to the 2004 guideline, the current guideline indicates that children 6 months to 2 years of age with unilateral or bilateral AOM, and mild symptoms (mild otalgia for <48 hours, temperature <102.2 F) are candidates for initial observation. When observation is

used, it is important to ensure that close follow-up with caregivers is available, as antibiotic therapy may need to be instituted if observation fails. The purpose behind these diagnostic changes is to encourage the appropriate use of antibiotics and limit antimicrobial resistance. Surveillance studies indicate that the three most common bacterial pathogens in AOM include Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.4 Current data indicate that approximately 83% of isolates of S. pneumoniae from all age groups are susceptible to regulardose amoxicillin (40-45 mg/kg/day) and 87% are susceptible to high-dose amoxicillin (80-90 mg/kg/day).5-8 High-dose amoxicillin yields middle ear fluid levels that exceed the minimum inhibitory concentration (MIC) of all S. pneumoniae serotypes that are intermediately resistant to penicillin.9-11 This may be beneficial in patients who are likely to have non-susceptible pathogens (children who attend day care, have used antibiotics within the past 30 days, and children under the age of 2 years). High-dose therapy is considered first-line therapy as well in patients who have no risk factors for non-susceptible pathogens due to increasing resistance patterns of S. pneumoniae and the relative safety of amoxicillin. Weight-based antibiotic doses in children should not exceed adult doses; a maximum daily dose of amoxicillin should not exceed 4 grams. Consistent with the 2004 guidelines, high-dose amoxicillin-clavulanate (90 mg/kg/day) is recommended as firstline treatment when antibiotics are warranted and the child has received amoxicillin in the past 30 days, has concurrent purulent conjunctivitis, or has AOM unresponsive to amoxicillin. Amoxicillin-clavulanate provides increased coverage for H. influenzae and M. catarrhalis due to beta-lactamase production by these

organisms. Amoxicillin-clavulanate 600 mg/5 ml (e.g., Augmentin ES-600) is the product of choice when choosing high-dose amoxicillin-clavulanate due to the ratio of 14:1 of amoxicillin to clavulanate. This ratio allows for therapeutic levels of amoxicillin to be achieved in the middle ear space while minimizing the amount of clavulanate given. Use of an amoxicillin-clavulanate 600 mg/5 ml product, along with proper counseling to take with food, can reduce the likelihood/ severity of gastrointestinal distress (e.g., diarrhea). However, the overall probability of gastrointestinal adverse effects continues to limit the first-line use of amoxicillin-clavulanate when amoxicillin is deemed acceptable. The current guideline contains revisions regarding the use of antibiotic therapy in patients with a type I hypersensitivity (urticaria or anaphylaxis) to penicillin. Table 1 lists the cephalosporins that are recommended for the treatment of AOM. The likelihood of cross-reactivity is higher between penicillin antibiotics and cephalosporin antibiotics with similar structural side chains.12 Susceptibility studies have shown the four cephalosporins listed in Table 1 to have better activity against the three common bacteria responsible for AOM, particularly S. pneumoniae.5-7 Other cephalosporins have not been shown to be as effective when targeting these specific pathogens. Commonly prescribed antibiotics such as macrolides (erythromycin and azithromycin), have limited efficacy against H. influenzae and S. pneumoniae.6-8 For this reason, pharmacists may consider discussing alternative antibiotics with the physician if a macrolide antibiotic is prescribed for an infant or child AOM. It is important that prescribers and pharmacists be aware of their community institutionâ€™s antibiogram and the sensitivity patterns. With

Jan.Feb.Mar 2014

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increased levels of antibiotic resistance, it is helpful to educate patients and families on the role and benefit of antibiotic therapy, and when antibiotics may not be necessary (e.g., upper respiratory tract infections not diagnosed as AOM). Recurrent AOM was not addressed in the 2004 AOM guideline. The current guideline discusses antibiotic prophylaxis and tympanostomy tubes as potential treatment options for recurrent AOM. The decision to use tympanostomy tubes will be made by an otolaryngologist. Teele and colleagues analyzed 16 studies of long-term antibiotic use for AOM and found no differences in recurrent AOM between children who received prophylactic antibiotics compared with those who received placebo.13 The current guideline does not recommend the use of long-term, prophylactic antibiotics. The management of pain should be addressed regardless of the use of antibiotics (i.e., observation without initial antibiotic use). Consistent with the 2004 guidelines, orally administered acetaminophen, 10-15 mg/kg every 4-6 hours, or ibuprofen, 5-10 mg/kg every 6-8 hours, are the mainstay of pain management for children with AOM. Topical anesthetic products (e.g., benzocaine ear drops, 4-5 drops every 1-2 hours) can provide additional, although brief, benefit when used in children older than 5 years. As AOM very commonly occurs in the pediatric population, pharmacists can significantly impact the care of infants and children with this infectious illness. Certain antibiotics, in specific weight-based doses, are more likely to be effective for treatment, and pharmacists can assess patientspecific treatment regimens, and offer recommendations for change, when necessary. Pharmacists can counsel families and caregivers on the role of antibiotics for the treatment of AOM, and in what

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situations observation without initial antibiotic use may be appropriate. Pain and discomfort from AOM can be significant, and pharmacists can additionally offer patient-specific dosing recommendations to parents and caregivers for analgesic therapy. Pharmacists can additionally counsel families on the benefit of immunization with influenza and pneumococcal vaccines (i.e., Prevnar) to reduce AOM illness. As most episodes of AOM follow viral upper respiratory tract infection, including influenza virus, administration of influenza vaccine can substantially reduce AOM development. Prevnar is labeled to reduce infection and illness, including AOM, due to S. pneumoniae serotypes contained in this vaccine. (Table 1).

Rhinosinusitis

Guidelines for the diagnosis and treatment of acute bacterial rhinosinusitis (ABRS) in children and adults were newly published in 2012

(Infectious Disease Society of America Clinical Practice Guideline for Acute Bacterial Rhinosinusitis in Children and Adults).14 Clinical distinction between bacterial and viral infection remains a challenge and treatment is often based on severity of symptoms.15 Respiratory symptoms beyond 7-10 days and presence of a fever typically are indicative of a bacterial infection, while viral infections often present with a shorter duration of symptoms, clear nasal discharge, and no fever. Pharmacists can be helpful by recommending and counseling on the need for antibiotic therapy, appropriate antibiotic selection when indicated, and non-prescription product recommendation. Once a clinical diagnosis of ABRS is established, antimicrobial therapy is recommended. This allows for a shorter duration of illness, earlier symptom relief, and improved quality of life. Amoxicillin-clavulanate is

Table 1: Recommended Antibiotics for Initial and Delayed Treatment and Failure of Initial Antimicrobial Therapy for Acute Otitis Media2 Initial (Immediate or Delayed) Antibiotic Treatment Recommended FirstLine Treatment • Amoxicillin (80-90 mg/kg/day) in 2 divided oral doses • Amoxicillinclavulanate (90 mg/ kg/day of amoxicillin and 6.4 mg/kg/ day of clavulanate) in 2 divided oral doses, (amoxicillin to clavulanate ratio of 14:1)

Alternative Treatment (if Penicillin Allergy) • Cefdinir (14 mg/ kg/day) in 1 or 2 divided oral doses • Cefuroxime (30 mg/kg/day) in 2 divided oral doses • Cefpodoxime (10 mg/kg/day) in 2 divided oral doses • Ceftriaxone (50 mg/kg intramuscularly or intravenously) once daily for 1 to 3 days

Antibiotic Treatment After 48-72 hours of Initial Antibiotic Failure Recommended First-Line Treatment • Amoxicillinclavulanate (90 mg/kg/day of amoxicillin and 6.4 mg/kg/day of clavulanate) in 2 divided oral doses (amoxicillin to clavulanate ratio of 14:1) • Ceftriaxone (50 mg/kg intramuscularly or intravenously) once daily for 3 days

Alternative Treatment • Clindamycin (30-40 mg/kg/day) in 3 divided oral doses for 3 days, with or without a 3rd generation cephalosporin • Ceftriaxone (50 mg/ kg intramuscularly or intravenously) once daily x 3 days Failure of Second Antibiotic • Clindamycin (30-40 mg/kg/day) in 3 divided oral doses, plus a 3rd generation cephalosporin (cefdinir, ceftriaxone, or cefpodoxime) • Consult infectious disease specialist

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recommended over amoxicillin for initial therapy due to the increasing prevalence of H. influenzae and beta-lactamase production by this pathogen. Prior to 2000, S. pneumoniae was more associated as an infecting pathogen as compared to H. influenzae; however the prevalence of H. influenzae has increased and that of S. pneumoniae has decreased in the post-pneumococcal vaccine era.16 The addition of clavulanate to amoxicillin significantly improves the coverage for beta-lactamase producing respiratory pathogens (e.g., H. influenzae and M. catarrhalis).17 High dose (90 mg/kg/day) amoxicillin-clavulanate given twice daily is recommended for children with severe infection (evidence of systemic involvement with fever â‰Ľ39 C), attendance at day care, age < 2 years, recent hospitalization, antibiotic use within the past 30 days, and for children who are immunosuppressed. Lower doses of amoxicillin-clavulanate (e.g., 40-45 mg/kg/day) can be used for children without these risk factors. For patients with a type I hypersensitivity (urticaria or anaphylaxis) to penicillin, respiratory fluoroquinolones (levofloxacin and moxifloxacin) remain highly active against all common respiratory pathogens including S. pneumoniae and beta-lactamaseproducing H. influenzae and M. catarrhalis.18,19 It was previously thought that fluoroquinolones were not safe to use in children due to the increased manifestation of joint pain. However the safety and tolerability of levofloxacin in children was assessed prospectively among 2,523 children who participated in several randomized efficacy trials in the Pediatric Levaquin Program.20 The results indicated that levofloxacin was well tolerated during and for 12 months following therapy when compared to those who received non-fluoroquinolone antibiotics. Antibiotic resistance continues to be

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a concern with ABRS. The prevalence of macrolide-resistant S. pneumoniae in the United States has increased significantly since the 1990s.21 Studies reveal that macrolide resistance is even higher among isolates from children < 2 years of age (> 50% during 2000-2006).22 For this reason, macrolides are not recommended in the treatment of ABRS. Trimethoprim/ sulfamethoxazole (TMP/SMX) is also no longer recommended due to high rates of resistance among both S. pneumoniae and H. influenzae.23 Topical and oral decongestants, along with antihistamines, are commonly used as adjunct therapy in patients with ABRS. However, objective rhinometric findings do not support additional benefit from using these agents.24 Several randomized controlled trials have assessed the additive effect of topical and oral decongestants or antihistamines to antimicrobial therapy in children with ABRS. The results indicate no benefit of using these products, and more subjects reported adverse effects (i.e. rebound congestion from topical decongestants and drowsiness from antihistamines), which lead to discontinuation.25 Children in many cases can experience paradoxical effects with antihistamines and decongestants, causing them to experience an adverse effect opposite of what is expected (i.e. hyperactivity from antihistamines). Based on this evidence, topical and oral decongestants, and antihistamines, should be avoided in children with ABRS. Symptomatic management should focus on hydration, and fever and pain control. Saline (physiologic or hypertonic) irrigation (e.g., nasal saline rinse, spray, drops or neti pot use) has also been shown to be effective for treating symptoms associated with ABRS. Relatively minor adverse effects (irritation, nasal burning) and low cost also afford saline irrigation to be an appealing option for symptom management. The most optimal

concentration, frequency, volume, and administration technique have not been clearly determined, however.26 Pharmacists can have opportunities to improve the care of infants and children diagnosed with rhinosinusitis by assessing antibiotic choice, dosing, and by counseling on the appropriate use of prescribed antibiotic therapy. As families may seek out non-prescription products for the many symptoms that can occur with rhinosinusitis, pharmacists can play an important role in product selection. Pharmacists may also be helpful to families initially seeking therapy with non-prescription products, by educating on the role of antibiotics and the relationship with symptom duration.

Community-Acquired Pneumonia

Pneumonia is the leading cause of death in children worldwide, accounting for 20% of all deaths in children younger than 5 year.27 Guidelines for the treatment of pediatric communityacquired pneumonia (CAP) in the United States were published in 2011 (The Management of CommunityAcquired Pneumonia in Infants and Children Older Than 3 Months of Age: Clinical Practice Guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America).28 This guideline document represents a new publication on this subject for infants and children. Infants and children younger than 3 months, and infants and children with certain other conditions (immunosuppression, receipt of home mechanical ventilation, or various chronic conditions, such as cystic fibrosis) are not discussed in this new guideline. Infants and children presenting to a pharmacy for non-prescription treatment of a severe cough, respiratory distress, tachypnea, crackles, or decreased breath sounds may need to be referred to a physician. Absence of tachypnea has significant negative predictive value for pediatric

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CAP. Hospitalization is recommended for infants or children with moderate to severe CAP (defined by respiratory distress or hypoxemia), infants <3 to 6 months with suspected bacterial CAP, children and infants with suspected or documented CAP by a pathogen with high virulence (e.g., communityacquired methicillin-resistant Staphylococcus aureus, MRSA), and for children and infants who cannot be closely monitored at home. Although viruses are among the most common pathogens to cause CAP, bacteria also can play a significant role. Because infection with viruses can commonly result in CAP, antibacterial therapy is not always necessary. The most likely bacterial pathogen to produce CAP in the pediatric population is S. pneumoniae. Amoxicillin dosed at 90mg/kg/day divided three times daily is the preferred antibiotic and dose.29 Thrice-daily dosing for amoxicillin is recommended because of documented increased efficacy (90% vs. 65% cure) as compared to twice-daily dosing. For patients allergic to penicillin, or who cannot tolerate amoxicillin, a 2nd or 3rd generation cephalosporin (cefpodoxime, cefuroxime, cefprozil) or oral levofloxacin are recommended alternatives. These cephalosporins are recommended because of their excellent activity towards S. pneumonia. These antibiotics are preferred therapy for CAP, as other classes, such as macrolides (erythromycin, clarithromycin, azithromycin), do not provide adequate activity towards S. pneumonia. Macrolide resistance is prominent in some strains of S. pneumoniae.30 When antibiotics for CAP are prescribed, treatment duration of ten days is recommended. Communityacquired MRSA (CA-MRSA) may require longer than ten days of treatment, and provides an opportunity for pharmacists to counsel patients on the need for completion of therapy to promote efficacy and reduce

resistance.31 A patient with a positive MRSA culture is considered to have CAMRSA if the following criteria are met: ambulatory status or hospital stay for less than 48 hours, lack of implanted medical devices or indwelling catheters, negative medical history for previous MRSA infection, and no history of recent stay in a nursing home or long-term care facility. Pharmacists can be helpful by assisting the health care team with specific antibiotic recommendations and dosing. If an infant or child presents with symptoms suggestive of CAP during a period of widespread influenza activity in the community, the patient should be assessed for infection with influenza virus. Neuraminidase inhibitors (oseltamivir, zanamivir) are recommended for treatment of seasonal influenza, and are labeled by the Food and Drug Administration for infection with influenza A and B. Patients will likely benefit from influenza antiviral therapy if initiated as soon as symptoms are apparent, preferably within 48 hours of onset of symptoms. Antiviral therapy is also recommended for infants and children who have severe, complicated, or progressive disease, require hospitalization, or are at higher risk for complications. Risk factors for infants and children include age <5 years, morbid obesity, immunosuppression, asthma, long-term aspirin therapy, and various chronic conditions. Oseltamivir is labeled for treatment of children â‰Ľ12 months, and zanamivir is labeled for treatment of children â‰Ľ7 years. Families of infants and children without risk factors for more severe disease can be counseled on the benefit and risk (including cost) of these agents, which generally reduce symptom duration by less than 1 day.32 Pharmacists can additionally educate pediatric patients and their families on the potential benefit of immunization and the ability of several vaccine products to potentially reduce risk of

acquiring CAP. Three vaccines can effectively reduce risk of CAP, including conjugate pneumococcal vaccine (Prevnar), Haemophilus influenzae type B vaccine (Hib), and pertussis vaccine (DTaP, Tdap). These vaccines are included in the current routine pediatric immunization schedule. Discussion of the benefit of infants and children receiving these vaccines to reduce morbidity and mortality from CAP can additionally be a message to share with families about the importance of adhering to the pediatric immunization schedule overall. An additional pneumococcal vaccine, a polysaccharide vaccine (i.e., Pneumovax), can be given to some children with underlying medical conditions, such as deficient splenic function, sickle cell disease, or immunosuppression, as these conditions increase risk of systemic illness from S. pneumoniae infection.33 Influenza immunization is currently recommended for infants â‰Ľ6 months of age, children, and adolescents. Influenza immunization is also recommended for parents and caregivers of infants less than 6 months, including pregnant adolescents. Pharmacists can contribute to the care of infants and children with CAP through assessment of appropriate antibiotic regimens, appropriate use of antivirals for CAP resulting from infection with influenza virus, and education of families and caregivers on the role and benefit of pediatric vaccines.

Acne

The first evidence-based clinical guidelines on acne, developed by The American Acne and Rosacea Society and endorsed by the American Academy of Pediatrics, were published in 2013 (EvidenceBased Recommendations for the Diagnosis and Treatment of Pediatric Acne).34 Acne is a common condition that affects up to 87% of adolescents. There are numerous

Jan.Feb.Mar 2014

IOWA PHARMACY RECOVERY NETWORK

Assisting Impaired Pharmacists, Student Pharmacists, and Pharmacy Technicians

Where do you turn when you, a coworker or someone you care about needs help with an addiction, physical illness or psychiatric disorder?

Providing support . . . through caring volunteers

HOPE FOR RECOVERY 1-877-890-IPRN http://www.iowarecovery.org/ 44

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peer review

non-prescription products available for acne, and product selection can be confusing to patients, families, and providers. Pharmacists can be helpful to adolescents and their families by recommending appropriate patientspecific non-prescription products, and by providing counseling on product use. Acne is defined as a common inflammatory disorder of the sebaceous glands, and presents with either inflammatory lesions or comedones. Comedones, commonly called zits or pimples, can occur as closed (whitehead) or open (blackhead) lesions. The pathogenesis of acne can be described by four primary mechanisms: sebaceous gland hyperplasia, change in follicular growth, follicular colonization by Propionibacterium acnes (P.acnes), and immune response to P. acnes with inflammation. A precursor to a comedone formation is termed a microcomedone. Microcomedones may not be visually apparent, but are important in the formation of new comedones. Acne can be stratified into mild, moderate, and severe, with severity primarily defined by the extent of inflammatory lesion involvement. Although severity classifications are used in this guideline, the authors note that there is no agreed-upon standard, and assessment is subjective (Table 2). Two non-prescription acne products have been studied extensively, including benzoyl peroxide (BPO) and salicylic acid. In comparative studies performed, salicylic acid demonstrates inferior efficacy to BPO, and BPO is thus recommended as a primary treatment ingredient.35 The mechanism of BPO includes antibacterial activity towards P. acnes, and it additionally provides mild anti-inflammatory actions. There are many products available containing BPO as the active ingredient, with concentrations ranging from 2.5% to 10%. If an adolescent has sensitive skin, it may be beneficial to recommend a product with ≤5%

BPO, since it is a highly drying agent. As BPO can cause bleaching of the skin and clothes, photosensitivity, and dryness of the skin, this information is important to discuss when counseling. Many BPO products are inexpensive ($5-10), and are available in numerous dosage forms (e.g., cream, gel, foam, liquid wash, lotion). Adolescents with acne should be counseled to wash their face with a gentle soap-free, pHbalanced cleanser twice daily. Face washes containing BPO are available, and are appropriate for face washing. Other products indicated for acne are additionally available by prescription. These products include topical retinoids (tretinoin, adapalene, tazarotene), oral antibiotics (e.g., minocycline, doxycycline), topical antibiotics (clindamycin, erythromycin, dapsone), and oral isotretinoin. These medications are often used in combination, and it is not uncommon for an adolescent to be prescribed multiple products. Topical retinoids can cause burning, stinging, dryness, and scaling, all of which can likely be reduced by initiating therapy at the lowest dose, using three-timesweekly dosing, or by regular use of a moisturizer. A pea-sized amount of a topical retinoid product should be applied to cover the entire face, and should not generally be applied as spot therapy. Adverse effects associated oral doxycycline includes photosensitivity and “pill” esophagitis, and thus counseling should include sunscreen use, dose administration with a large glass of water, and maintaining an upright for at least 1 hour after dosing. Minocycline administration may result in vertigo and dizziness, which typically subside with discontinuation of therapy, and may be prevented by using weightbased dosing of the extended release formulation at 1 mg/kg once daily. Due to their slow onset and potential for bacterial resistance development, topical antibiotics are not recommended as monotherapy. BPO should be added to topical antibiotic

therapy if antibiotics are to be used for more than 3 weeks, to augment antimicrobial activity. Isotretinoin provides activity towards all of the physiologic causes of acne described above, and thus can be very effective. This enhanced efficacy, however, must be balanced with isotretinoin’s high propensity for significant and potentially severe, adverse effects. Common adverse effects of isotretinoin include dry, chapped skin and lips, often leading to nosebleeds, dry eyes, and myalgias. Isotretinoin is additionally highly teratogenic, and thus it must be used with appropriate safeguards in adolescents of childbearing potential. These safeguards, contained in the iPLEDGE program, include females using two forms of contraception simultaneously for one month before, during, and after therapy, two negative urine or blood pregnancy tests prior to therapy, and negative pregnancy tests monthly during therapy.36 Isotretinoin is recommended only for moderatesevere acne, and is considered to be very efficacious due to its mechanism involving all four pathophysiologic factors. Adherence is a major concern with the pediatric and adolescent population when treating acne, and is a major cause of treatment failure. Acne pharmacotherapy commonly requires 4-8 weeks to demonstrate visible efficacy, and adolescents may grow impatient about their therapy. Education, use of a simple drug product regimen, and use of combination medications are can improve adherence. Counseling points that may be helpful include technique of topical product application to microcomedones (e.g., avoid spot therapy application), relating acne mechanisms to practical use (e.g., slow onset relates to increased time to efficacy demonstration), and an expected time frame for improvement. Frequent education and counseling is crucial to promoting adherence, and is Jan.Feb.Mar 2014

peer review

best if given during each visit. It is helpful to assess patient product preference (e.g., route of administration, topical dosage form) for all adolescents treated for acne, as adherence is one of the strongest factors affecting therapy benefit.37 Treatments for mild, moderate, and severe acne are outlined in Table 2. Prior to instituting changes in a medication regimen, adherence should be assessed. Oral and topical treatments generally are similarly efficacious, although oral combination therapy should be reserved for patients with more extensive inflammatory acne. When possible, combination products should be used to promote patient adherence. As the majority of treatment regimens for acne involve use of nonprescription products, pharmacists can significantly impact the care of children and adolescents with this common disorder. With treatment adherence an important component for long-term therapy, benefits of frequent counseling on appropriate product use by pharmacists to families can be substantial.

Summary

References

The conditions discussed above, commonly affecting a significant portion of the pediatric population, are treated largely with antibiotics and non-prescription products. As the respiratory infections reviewed here may be caused by viral as well as bacterial pathogens, antibiotics have a specific role, and may not always be indicated for ill infants and children. Acne represents a medical condition affecting many children and adolescents, with non-prescription products comprising a significant portion of therapy. As pharmacists often may be the initial health care provider that caregivers seek out for treatment options for these conditions, they can play an important role in educating families and patients about the role of non-prescription products, antibiotics, and other prescription drug products, and can refer families to additional medical care when necessary. The appropriate and optimal use of non-prescription and prescription products in infants and children is unique, and pharmacists should be familiar with these uses for the common illnesses reviewed here.

Table 2: Treatment options for mild, moderate, and severe acne34 Clinical Presentation Initial Therapy

Inadequate Response

Mild Acne

Mild or extensive BPO or topical retinoid comedonal involvement and/or scattered inflammatory lesions

Assess adherence, then: • BPO + topical retinoid or • Change topical retinoid or • Increase BPO concentration

Moderate Acne

Mild or extensive comedonal involvement and/or marked number of inflammatory lesions

Assess adherence, then: • Change topical retinoid and/or • Add or change oral antibiotic or • Consider isotretinoin

Severe Acne

Extensive inflammatory Oral antibiotic + lesions and/or diffuse Topical retinoid + scarring BPO +/topical antibiotic

BPO: benzoyl peroxide

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Topical retinoid + BPO or Topical retinoid + BPO + topical antibiotic or oral antibiotic

Assess adherence, then: • Change oral antibiotic and • Consider isotretinoin

1. Klugman KP. Clinical impact of antibiotic resistance in respiratory tract infections. Int J Antimicrob Agents 2007;29(Suppl 1):S6-S10 2. Lieberthal AS, Carroll AE, Chonmaitree T, et al. The diagnosis and management of acute otitis media. Pediatrics 2013131:e964-e999 3. American Academy of Pediatrics Subcommittee on Management of Acute Otitis Media. Diagnosis and management of acute otitis media. Pediatrics 2004;113:1451-1465. 4. Coker TR, Chan LS, Newberry SJ, et al. Diaganosis, microbial epidemiology, and antibiotic treatment of acute otitis media in children: a systematic review. JAMA 2010;304:2161-2169 5. Tristram S, Jacobs MR, Appelbaum PC. Antimicrobial resistance in Haemophilus influenzae. Clin Microbiol Rev 2007;20:368-389. 6. Jacobs MR, Good CE, Windau AR. Activity of ceftaroline against emerging serotypes of Streptococcus pneumoniae. Antimicrob Agents Chemother 2010;54:2716-2719. 7. Jacobs MR. Antimicrobial-resistant Streptococcus pneumoniae: trends and management. Expert Rev Anti Infect Ther 2008;6:619-635. 8. Piglansky L, Leibovitz E, Raiz S. Bacteriologic and clinical efficacy of high dose amoxicillin for therapy of acute otitis media in children. Pediatr Infect Dis J 2003;22:405-413. 9. Dagan R, Johnson CE, McLinn S. Bacteriologic and clinical efficacy of amoxicillin/clavulanate vs. azithromycin in acute otitis media. Pediatr Infec Dis J 2000;19:95-104. 10. Dagan R, Hoberman A, Johnson C. Bacteriologic and clinical efficacy of high dose amoxicillin/clavulanate in children with acute otitis media. Pediatr Infect Dis J 2001;20:829-837. 11. Jacobs MR, Bajaksouzian S, Windau A, Good C. Continued emergence of non-vaccine serotypes of Streptococcus pneumoniae. Presented at: The 49th Interscience Conference on Antimicrobial Agents and Chemotherapy, Cleveland, May 30, 2009. 12. Pichichero ME. A review of evidence supporting the American Academy of Pediatrics recommendation for prescribing cephalosporin antibiotics for penicillin-allergic patients. Pediatrics 2005;115:1048-1057. 13. Teele DW, Klein JO, Word BM. Greater Boston Otitis Media Study Group. Antimicrobial prophylaxis for infants at risk for recurrent acute otitis media. Vaccine 2000;19(suppl 1):140S-143S. 14. Chow AW, Benninger MS, Brook I. IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clin Infect Dis 2012;54:e72-e112. 15. Gwaltney JM, Hendley JO, Simon G, Jordan WS. Rhinovirus infections in an industrial population, II - Characteristics of illness and antibody response. JAMA 1967;202:494-499. 16. Casey JR, Adlowitz DG, Pichichero ME. New patterns in the otopathogens causing acute otitis media six to eight years after introduction of pneumococcal conjugate vaccine. Pediatr Infect Dis J 2010;29:304-309. 17. Tristram S, Jacobs MR, Appelbaum PC. Antimicrobial resistance in Haemophilus influenzae. Clin Microbial Rev 2007;20:368-389. 18. Anon JB. Current management of acute

bacterial rhinosinusitis and the role of moxifloxacin. Clin Infect Dis 2005;41(suppl 2):167S-176S. 19. Patel SN, McGeer A, Melano R. Susceptibility of Streptococcus pneumoniae to fluoroquinolones in Canada. Antimicrob Agents Chemother 2011;55:3703-3708. 20. Arguedas A, Dagan R, Pichichero M. An open-label, double tympanocentesis study of levofloxacin therapy in children with, or at high risk for, recurrent or persistent acute otitis media. Pediatr Infect Dis J 2006;25:1102-1109. 21. Lynch JP 3rd, Zhanel GG. Streptococcus pneumoniae: does antimicrobial resistance matter? Semin Respir Crit Care Med 2009;30:210-238. 22. Jenkins SG, Farrell DJ. Increase in pneumococcus macrolide resistance, United States. Emerg Infect Dis 2009;15:1260-1264. 23. Harrison CJ, Woods C, Stout G, Martin B, Selvarangan R. Susceptibilities of Haemophilus influenzae, Streptococcus pneumoniae, including serotype 19A, and Moraxella catarrhalis pediatric isolates from 2005 to 2007 commonly used antibiotics. J Antimicrob Chemother 2009;63:511-519. 24. Sipila J, Suonpaa J, Silvoniemi P, Laippala P. Correlations between subjective sensation of nasal patency and rhinomanometry in both unilateral and total nasal assessment. J Otorhinolaryngol Relat Spec 1995;57:260-263. 25. McCormick DP, John SD, Swischuk LE, Uchida T. A double-blind, placebo controlled trial of decongestant-antihistamine for the treatment of sinusitis in children. Clin Pediatr 1996;35:457-460. 26. Wang YH, Yang CP, Ku MS, et al. Efficacy of nasal irrigation in the treatment of acute sinusitis in children. Int J Pediatr Otorhinolarygol 2009;73:1696-1701 27. Wardlaw T, Salama P, Johansson EW. Pneumonia: the leading killer of children Lancet 2006;368:1048-1050. 28. Bradley JS, Byington CL, Shah, SS. The management of communityacquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clin Infect Dis 2011 Oct;53:e25-e76 29. Bradley JS, Garonzik SM, Forrest A. Pharmacokinetics, pharmacodynamics, and Monte Carlo simulation: selecting the best antimicrobial dose to treat an infection. Pediatr Infect Dis J 2010;29:10431046. 30. Harrison CJ, Woods C, Stout G. Susceptibilities of Haemophilus influenzae, Streptococcus pneumoniae, including serotype 19A, and Moraxella catarrhalis pediatric isolates from 2005 to 2007 to commonly used antibiotics. J Antimicrob Chemother 2009;63:511-519. 31. Blaschke, AJ, Heyrend C, Byington C, et al. Molecular analysis improves pathogen identification and epidemiologic study of pediatric parapneumonic empyema. Pediatr Infect Dis J. 2011;30: 289â€“294. 32. Centers for Disease Control and Prevention. Influenza antiviral medications: summary for clinicians. http://www.cdc.gov/flu/professionals/ antivirals/summary-clinicians.htm (accessed 2013 July 30). 33. Muorti JP, Whitney CG. Prevention of pneumococcal disease among infants and children â€“ use of 13-valent pneumococcal conjugate and 23-valent pneumococcal polysaccharide vaccine. MMWR 2010;59:1-18 34. Eichenfield L. Krakowski AC, Piggott C. Evidence-based recommendations for the diagnosis and treatment of pediatric acne. Pediatrics 2013;131:163186. 35. Shalita AR. Comparison of a salicylic acid cleaner and a benzoyl peroxide wash in the treatment of acne vulgaris. Clin Ther 1989;11:264-267 36. The iPLEDGE Program. Patient introductory brochure. www. ipledgeprogram.com/Pateintinformation.aspx (accessed 2013 Dec 15). 37. Koo J. How do you foster medication adherence for better acne vulgaris management? Skinmed 2003;2:229-233

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Consider submitting your research manuscript to be peer-reviewed by the Journal of IPA. Please send articles to IPA@iarx.org.

Jan.Feb.Mar 2014

member section

IPA Member Spotlight on:

Candace Jordan, PharmD, BCPS By: Bret Francis 2014 PharmD Candidate University of Iowa College of Pharmacy The healthcare landscape is constantly changing and many more changes are on the horizon. With these changes, the profession of pharmacy needs innovative leaders like Candace Jordan who will help shape and develop best practices. As the Mercy West Lakes & Rural Pharmacy Manager, Candace wants to improve pharmacists’ ability to be involved in new ACO models through strategic, efficient, and cost-effective positions to improve healthcare delivery in Iowa.

Why Pharmacy?

Candace Jordan’s interest in pharmacy was founded on the ever growing issue of polypharmacy. During her undergraduate training she was working part-time at a community center for handicapped adults where she met and grew fond of a schizophrenic patient. Candace would take the patient swimming every week and the patient appeared to be doing great, interacting and progressing. However, Candace noticed shortly after a meeting consisting of the psychologist, psychiatrist, nurse, and the patient’s parents that something just was not right with the patient. The patient became somnolent and was not all there because of all of the new medications they had piled on. Candace was very upset with this, so she took the nurses medication book and went through every medication the patient was prescribed. She noted all of the side effects and interactions that were occurring. She explained this story to her boyfriend’s mother,

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who is a nurse, and she told Candace, “This is why you need to become a pharmacist.”

and learning the business side of health care.

Pharmacy School & Life After Graduation

Family and Fun Her family

Candace selected Creighton’s online PharmD program, allowing her some flexibility as she was raising two young children at the time, and graduated in 2009. Candace went on to pursue residency training at Mercy Des Moines. Upon completion of her residency, she moved into a position at the VA in Des Moines where she served as a clinical pharmacist and PGY-1 Residency Director. She also pursued additional training, receiving her BCPS in 2011. Candace worked at the VA until July 2013 and is now the Mercy West Lakes & Rural Pharmacy Manager in West Des Moines, IA.

Current Position

When asked about her current position, Candace stated “I love working for Mercy. I love the people at Mercy and especially at West Lakes. The pharmacist and pharmacy technicians at West Lakes have the same vision and attitude towards our patients that I do and they work tremendously hard to put forth great work with efficiency and accuracy.” Candace also loves working with the managers of Mercy and other healthcare professionals, who all bring knowledge to the table. “I started at Mercy as a resident and they had me at hello!” said Candace. She feels the most rewarding part of her position is that she is able to see a project come to completion and have those involved embrace it and see the positive change that occurred. The most difficult part of the position is that it requires Candace to wear many hats and juggle many positions at the same time. Other challenges that Candace has worked through have been the transition into management

consists of her husband and three children, ages 9, 5, and 15 months. She enjoys all types of sports, likes to run (she has completed three half marathons), and enjoys doing anything and everything with her children.

Leadership and Community Involvement

Within the profession, Candace has held positions on IPA’s Health-System Liaison Board, Public Affairs Policy Committee, and on the Continuing Professional Development Task Force. She was also the Central Iowa Pharmacy Associations President from 2010-2011. In her community, she is co-president for PTO at Karen Acres Elementary School, and she coaches the 4th and 5th grade boys’ basketball team. She also assists her husband in creating a detailed, animatronic haunted house every year. The admission is free, but they encourage a donation to Sentinels of Freedom, which provides life scholarships to veterans. This past Halloween, over 500 visitors stopped by the haunted house, where they raised almost $4,000 for the cause. Check out their website at www.thezombiehollow.com.

The Iowa Pharmacy Family Experience

During her transition with her kids and two dogs from Washington, D.C. to Des Moines for her residency, she met Lisa Donahue, a pharmacist at Mercy. Lisa had heard Candace’s story and how her husband had to stay in Washington, D.C. for work and decided to surprise her with paying for snow removal for her house. The gentleman

member section

doing the snow plowing then heard Candace’s story and said he would take no payment and would do it for free. Lisa then heard this and went a step farther and paid for a maid service to come and clean Candace’s kitchen and bathrooms for the year. Candace is extremely grateful to the kindness of Lisa and all of the staff at Mercy, for helping her through a very stressful year managing family, residency, and all of the other things we all know that come up in our lives.

The Future of Pharmacy

Candace believes the future of pharmacy is bright. She says, “With the new ACO model changes,

pharmacists in the hospital can make a big impact on many areas of transition of care. I also see great opportunities with hospital pharmacists being more on the front lines and seeing patients regarding their medication and home regimens prior to discharge and being a face to the patient instead of the quiet soldier behind the scenes.” Candace encourages pharmacists to embrace change and look forward to it. She envisions that if pharmacists just wait around for change, they will be forgotten and set aside. Instead, Candace believes pharmacists need to be aggressive and forward thinking in order to improve the profession and to ensure that pharmacists have a seat

at the table. Pharmacists are great at collaborating with nurses and doctors inside hospital walls, but Candace advises that pharmacists need to do a better job of collaborating with nurses and doctors outside of the walls and inside local, regional, and national associations. She states, “If we know where nurses and physicians are heading through their associations, we can see where we can help and fill in the puzzle pieces. By being on the outside of their associations we fall short of knowing what they are charged with and looking for in their future. We need to collaborate both inside the walls of our organization and outside.”

IPA Member Milestones • Congratulations to IPA Past-President, Bill Bear, RPh, of Chariton who retired from Lucas County Health Center.

• Jerod Work, PharmD, was elected for a four year term on the Sioux Center Community School District Board of Directors.

• Congratulations to Bruce Alexander, PharmD, BCPS, of Iowa City who retired from VA Medical Center - Iowa City.

• Congratulations to Iowa’s oldest pharmacy, Penn Drug Company in Sidney, on celebrating 150 years! Penn Drug opened in November 1863.

• Jamie Sinclair, MS, RPh, FASHP, is the new Director of Pharmacy at Mercy Medical Center in Cedar Rapids. • Susan Vos promoted to Director of the Professional Experience Program at The University of Iowa. • Emily Beckett joined the University of Iowa faculty as Assistant Clinical Professor with her practice site at Broadlawns Medical Center family medicine in Des Moines. She also recently became BPS-certified as a Pharmacotherapy specialist. • Tim Welty was recently elected as Chair-Elect of the Continuing Professional Education section of AACP (American Association of Colleges of Pharmacy).

• Pocahontas Pharmacy recently celebrated their 30th Anniversary on November 1, 2013. • Evelyn Kay Berkland was born on October 4, 2013 to proud parents Allison Berkland, PharmD, BCADM, BCACP (VA Medical Center – Central Iowa) and Matt. • Miles Jeffrey Nesler was born on December 18, 2013 to proud parents Amber Baybayan, PharmD (OutcomesMTM) and Jeff Nesler. Send your member milestones to Lynndi at lkoester@iarx.org for inclusion in the next IPA Journal.

Jan.Feb.Mar 2014

member section

Welcome

NEW IPA MEMBERS

Health care is changing.

Joining IPA is more important than ever. SUPPORT YOUR PROFESSION.

Thank you for supporting IPA! oct 1 - dec 31: Matthew Arnold, Davenport Adam Baird, Iowa City Emily Beckett, Johnston Andrea Bennett, North Liberty Michelle Bowdish, Argyle Nancy Brace, Indianola Jennifer Cardines, Des Moines Samantha Dow, Marble Rock Gerald Fleshner, Carroll Jennifer Goings, North Liberty Tonya Gross, Mason City Ashley Hildebrand, Manchester Alan Hoppe, Sibley Julie Kane, West Des Moines Holly Lawrence, Dubuque Wendy Lantaff, Iowa City Mark Nessen, Corydon Tim Peterson, North Liberty Rachel Poppen, Pocahontas Mattie Robertson, Keokuk Kyle Rotert, Ankeny Alex Schoenhard, West Des Moines Martha Severance, Grundy Center Christopher Simpson, Conrad Jamie Sinclair, North Liberty Jean Theobald, Mapleton Taryn Thompson, Exira

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To You. To Patients. To The Profession.

recent achievements

• Expanded pharmacist immunization authority • PBM regulations proposed • Pioneer ACO model incorporating MTM services • New Practice Model pilot project approved • IPA Goes Local hosted in 7 counties • FREE law and patient safety CPE offered to IPA pharmacist members • Increase in Medicaid dispensing fee • TEAM series developed for technician members • Host PPMI (Practice Advancement) Workshop

upcoming

• Passage of PBM regulations priorities • Position pharmacists in emerging healthcare models • Host inaugural Midwest Pharmacy Expo • Partner with Board of Pharmacy: Telepharmacy & Compounding • Pilot tech-check-tech as a New Practice Model

join/renew today!

JOIN ONLINE TODAY AT WWW.IARX.ORG (Membership Quick Link)

Support Iowa Companies that support IPA! Endorsed by the Iowa Pharmacy Association and based in Iowa

National Pharmaceutical Returns (NPR)

• Full Service Reverse Distributor headquartered in Urbandale, Iowa • Discounted rates for IPA members • Discounted rates for all Iowa Pharmacies • Financial support to IPA for usage of NPR services • Servicing pharmacies nationally since 1995 • VAWD accredited since 2009

800-470-7725 – www.npreturns.com

PharmWaste Technologies, Inc. (PTI)

• Pharmaceutical Waste Consultants headquartered in Urbandale, Iowa • Discounted rates for IPA members • Financial support to IPA for usage of PTI services • Serving Fortune 500 companies since 2007 • Pharmaceutical Waste Services include: Consultation, Training, Formulary Characterizations, Disposal

515-276-5302 – www.pwaste.com Jan.Feb.Mar 2014

technician’s corner

Technician Advisory Committee Collaborates for Future of all Pharmacy Professionals There is a need today for well-qualified, competent pharmacy technicians for the safe provision of medications across all pharmacy practice settings. On October 20, 2013, nine members of the IPA Technician Advisory Committee discussed current pharmacy technician topics and how the growing complexity in medication use needs the continued efforts of pharmacy technicians to forge a new future for the practice of pharmacy. The Committee took time to reflect on the IPA strategic plan and focused their discussion on technician membership as well as the importance of active technician involvement within IPA and the profession. It was noted that there is a need to educate the role of a pharmacy technician as a healthcare professional and the advantages of being a part of a professional organization. The Committee provided feedback on IPA’s current technician member benefits including the monthly Tech Tidbit e-newsletter and Tech

Corner within the Journal of the IPA. The Committee provided direction to IPA staff on the format and structure for the 2014 Technician Forum, and encouraged additional opportunity for technician-specific networking sessions at IPA events. The Committee extensively reviewed the changes by PTCB to their examination and recertification process. The Committee recognized that requiring technicians to complete an ASHP-accredited technician education course before sitting for the PTCB certification exam would bring new challenges to pharmacies in Iowa. However, the Committee acknowledged standardization in education and examinations for technicians would be positive for advancing the pharmacist patient care role, promote safe medication systems, and improve patient care. The Committee also reviewed emerging opportunities for pharmacy technicians

across Iowa. Members discussed the importance of technicians to be part of the solution as evidenced by Tech-Check-Tech (TCT) programs and the medication reconciliation process. Pharmacy technicians, just as much as pharmacists need to always ask how can a pharmacy technician can make the profession of pharmacy better.

2013-2014 IPA Technician Advisory Committee Members: Lori Foster, Chair Judy Neville, Vice-Chair Michelle Garvin, Past Chair Connie Bentrott Jean Gallogly Sonya Jones Kelly Komen Elise Leonard Judy Mentzer Tammy Sharp-Becker Jessica Sinning Alyce Steig Julie Strause Robert Taylor

ARE YOU AWARE OF THE NEW PTCB PROGRAM CHANGES? The Pharmacy Technician Certification Board (PTCB) announced future changes to the PTCB Certification Program. The new changes will advance pharmacy technician qualifications by elevating PTCB’s standards for national certification and recertification. During the next seven years, PTCB will phase in the changes, including mandatory background checks, accredited education requirements, and changes in acceptable continuing education (CE) programs for recertification. These program changes are the result of a PTCB initiative which began with a 2011 summit focused on five areas

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related to pharmacy technicians: Consumer Awareness, Resources, Education, State Policy and Testing (C.R.E.S.T.). Summit attendees included pharmacists, certified pharmacy technicians (CPhTs), educators, major employers, state boards of pharmacy, and others. Summit findings, combined with results from two profession-wide surveys, called for PTCB and the pharmacy profession to make decisive changes in certification standards. New PTCB requirements to become recertified: • 2014: PTCB will require one of the 20 required CE hours to be in

medication safety, in addition to one already required in law • 2015: PTCB will only accept pharmacytechnician-targeted CE hours • 2016: The number of CE courses allowed from college courses will be decreased • 2018: The number of in-service hours allowed for CE will be phased out New PTCB requirements to become initially certified: • 2014: Criminal background checks • 2020: PTCE candidates will be required to complete an ASHPaccredited education program

technicianâ€™s corner

newly ptcb certified iowa technicians July 1, 2013 through September 30, 2013 Please join IPA in congratulating the following pharmacy technicians on becoming PTCB-certified! Kristen Atherton Brandi Babilya Katie Bagby Connie Baysingar Taylor Berntsen Nicole Bieret Andrea Binger Heather Birkeland Jessica Blackledge Jenna Blunt Amy Brown Sarina Bruschi Andrea Canady Daniel Carlsen LeAnn Carter Misty Carder Rachael Castle Chloe Chabal Marissa Chambers Cody Clancy Kara Clark Rolette Coleman Barbara Cordero Allison Crossett Taylor Davis Sarah DeVries Michael Diede Sadie Donahue Nicole Dudley Ashley Duncan Erin Eilders Chasity Ellis Lisa Elmore Manuel Espinoza Kristen Feller-Trenkamp Laura Feuchtwanger Maria Fluit Joe Frasher Amber Garthwaite Megan Gardner Kyle Graham Victoria Grau Chad Gubbels Cecily Gutierrez Tiffany Halvorson Michelle Hansen Kurtis Hartsock Isabelle Hayes Denise Heagy Vanessa Helt Cassie Henderson

Erika Hilleman Laura Hintz Kathryn Hinshaw Jane Hoyman Lorri Hutchcroft Ruth Jarrell Brittany Jeffries Nicholas Jellison Janet Jergens Shelby Johnson Caymen Jones Edyta Judge Asmir Jukic Sarah Kadura Brittany Katska Anastasia Kem Chelsea Khaw Kourtney Krause Kenna Lambertsen Barbara Landon Jeanne Langhurst Alexis Lee David Liao Jeremy Long Kimberly Long Valerie Lowe Dawn Maassen Andrew Martin Nichole Martinez Alexander McConnell Gayle McDowell Ingrid McHugh Stacie McKay Laura Meadow Martha Meiners Kellie Montour Ryan Mulkey Erin Narby Elizabeth Northway Katherine North Lori Nosbisch Linda Obbink Donielle Oâ€™Brien Kyle Overmire Kimberly Parrish Pamela Parker Kasey Patterson Melanie Peterson Kaeley Peterson Soulynn Phrathany Lindsey Pogge

Hannah Popp Sarah Prescott Brooke Pruitt Mary Ramos Julien Rashid Chloe Ratekin Madison Rector Julia Rippe Lindsey Rogers Hannah Rohling Tiffany Roth Courtney Sadler Whitney Sadler Toni Sage Amber Schippers Niccole Schulte Jordan Selover Abby Shimp Shannon Sisco Dina Smith Sherry Smith Janette Smith Thane Soderstrom Phillip Staver Alyssa Stoehr Ellen Sullivan

Nathan Swanson Dalton Swift Kendra Teeling Lindsi Tillo Jennifer Tuttle Cassandra Upshaw Travis Landhuis Valentine Nathan Van Veldhuizen Rebecca VanLengen Tara Van Surksum Holly Vogt Erika Voss Rebecca Walker Eric Webberson Courtney Weidner Kaylee Weiland Jerad Welter Julie Wiebke Amanda Wiedemeier Maddison Wignall Amanda Williams Kimberly Williams Leslie Wille Sam Williams Annette Yoder

Jan.Feb.Mar 2014

college of pharmacy news

P4 student attends World Youth Forum for Ethics in Business

• Encouraging responsible global citizenship and understanding is an important aspect of the Drake education. Mitch Webster, a P4 student in Drake’s College of Pharmacy and Health Sciences, had the opportunity to advance his understanding of global responsibility as the United States’ representative at the World Youth for Ethics in Business Forum in Brussels, Belgium, this November. Drake University President David Maxwell nominated Webster for the conference, and he became one of 60 students from around the world chosen to participate. The weeklong conference from November 9–16 brought young professionals ages 18 to 35 together to learn about ethical business practices. Additionally, participants spent time at the European Union and engaged in workshops with EU leaders.

“Mitchell has been a great asset for this year’s forum, always doing more than what was comfortable for him,” says Camille Abgrall, executive director of the World Youth Forum for Ethics in Business. “He really stretched beyond reasonable limits for the group’s goals’ achievement and supporting his peers. The excellence of his participation and dedication to foster ethics in the world is outstanding.” In 2013, Webster was awarded the Lon Larsen Engaged Practitioner Award, given to a third-year doctor of pharmacy student who demonstrates high ethical standards, reflective practice, innovation, and community service. Webster says the Forum offers a unique opportunity to engage with other young leaders from around the world.

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Scholarships create opportunity in independent pharmacy • Drake University’s College of Pharmacy and Health Sciences (CPHS) was one of four schools to receive a $125,000 gift from Cardinal Health to fund scholarships for pharmacy students interested in careers with independent pharmacies. Thomas Walters, a PharmD and M.B.A. candidate at Drake, is the first student to benefit from Cardinal Health’s generous gift. “The selection committee was impressed with Tom’s balance of experience in independent pharmacy, along with his commitment to professional organizations and campus involvement,” says Renae Chesnut, professor of pharmacy practice and associate dean for academic and student affairs. “He was selected for his understanding of the importance of independent pharmacists, possessing both outstanding clinical and entrepreneurial leadership skills, and his demonstrated commitment to advocacy efforts.” Walters is currently on rotation at Eli Lilly, a pharmaceutical manufacturer in Indianapolis, where he is working with insurance companies to expand access to certain medications. His work helps patients get the medications they need at a lower cost.

Community and global engagement continues to rise in the CPHS • Community and

global engagement have long been priorities for the College of Pharmacy and Health Sciences (CPHS) at Drake University. But, with a new dean and strategic planning in full force, the college’s commitment to community and global responsibility is on track to reach new heights.

As assistant dean of clinical affairs, Denise Soltis, has helped student pharmacy organizations with community outreach as well as connected students with global advance pharmacy practice experiences and senior experience opportunities. The College has identified more than 50 students who are interested in a global experience in 2014. In the past, the CPHS has sent students to India, Belize, South Africa, Australia, Dominica, and Tanzania, among others. Soltis says her goal is to find a placement for every student who is interested. Experiences in Ethiopia and Uganda are currently in development.

Drake pharmacy graduate gives back to DELTA Rx Institute • Samantha (Wykle) Zoske, PH’03, and her husband Sam Zoske were one of three finalists in Cardinal Health’s Best Practices Text-to-Vote competition at the annual Retail Business Conference (RBC) for independent pharmacies. The Zoske’s best practice was a prescription auto fill program that eliminates patients’ wait time for prescriptions and helps increase the likelihood that they are compliant with their medications. In honor of the Zoske’s, Cardinal Health gave a $1,000 award to Drake University’s College of Pharmacy and Health Sciences. The Zoskes have chosen to donate the money to Drake’s DELTA Rx Institute. The DELTA Rx Institute promotes entrepreneurial leadership in the pharmacy profession.

college of pharmacy news

•Susan Vos, associate professor (clinical) •Nancee Waterbury, adjunct associate professor

Gov. Terry Branstad and Lt. Gov. Kim Reynolds Toured College of Pharmacy • On October 24,

Gov. Branstad and Lt. Gov. Reynolds visited with Dean Letendre, faculty, staff, and students, and learned about the important programs provided to students and the state. Student leaders hosted the tour.

Jordan Cohen, Emeritus Dean of the College of Pharmacy, was appointed July 1, 2013 as the interim executive director of The National Institute for Pharmaceutical Technology and Education, Inc. (NIPTE).

Dr. Aliasger Salem awarded the Lyle and Sharon Bighley Professorship • Dr. Salem,

associate professor and head of the Division of Pharmaceutics and Translational Therapeutics was awarded the Lyle and Sharon Bighley Professorship in Pharmaceutical Sciences on October 3. Dr. Lyle Bighley graduated from the UI College of Pharmacy with an MS in 1963 and a PhD in 1966. He was also an assistant professor and later promoted to an associate professor in the college from 1969-1977. The College of Pharmacy recently welcomed Stephanie Malenfant, assistant professor (clinical), and Emily Beckett, assistant professor (clinical), to its faculty. Recent faculty earn promotions: •Matthew Cantrell, associate professor (clinical)

Michelle Fravel, PharmD, BCPS, was recognized as the UI College of Pharmacy Collegiate Teacher of the Year. Other teachers recognized include: •Jill Fowler, PharmD, MSPhr, BCPP, was awarded P3 Teacher of the Year •Jeffrey Reist, BS, PharmD, BCPS, was awarded P2 Teacher of the Year •Jennifer Fiegel, PhD, who was awarded P1 Teacher of the Year The 2012-2013 winners of the Preceptor Excellence Award were: • Heather Bream-Rouwenhorst (Faculty category), UIHC Cardiology/ Pulmonary Care • Brett Faine (APPE category), UIHC Emergency Treatment Center • Luke Bartlett (IPPE category), Walgreens #05077 Pharmacy

New set of instructional tools added to Pharmacy Library in July • APhA and The University

of Iowa College of Pharmacy have collaborated to develop 270 exercises for integration in the professional curriculum. Covering 11 different areas of practice required by the Accreditation Council for Pharmacy Education, these materials give faculty members exercises and evaluation tools necessary to teach today’s student application-oriented practice skills in areas ranging from therapeutics to drug information and from patient counseling to lifelong learning.

Stevie Veach, PharmD, assistant professor, Division of Applied Clinical Sciences, will join seven faculty members from across the country as the second class of the National Association of Chain Drug Stores (NACDS) Foundation Faculty Scholars Program. Launched in 2012, the program educates assistant

professors from U.S. schools and colleges of pharmacy about designing, implementing and publishing community pharmacy-based patient care research. The scholars will engage in peer-to-peer review, receiving support from an experienced network of researchers nationwide. They will also be eligible to receive a research grant to launch a community pharmacybased patient-centered care project. Jeanine Abrons, Pharmacy Practice and Science assistant professor (clinical), was appointed as an Associate Editor for the Journal of the American Pharmacists Association (JAPhA). Her term will run from January 1, 2014 - January 31, 2016. Karen Lai, a P4 student, has been appointed to the American College of Clinical Pharmacy (ACCP) Student Network Advisory Committee as member-at-large. Members of the committee have an integral role in the development of new programs and services for the student members of ACCP. Kayla Lalor recently joined the college as an alumni relations coordinator. Kayla will be developing, implementing, and executing strategies for engaging College of Pharmacy alumni. Nicole Brogden was selected as a finalist for the 2013 Principal Financial Group Iowa Women of Innovation Award. Nineteen PTT graduate students presented 22 posters at the 2013 American Association of Pharmaceutical Scientists (AAPS) Annual Meeting and Exposition, held in San Antonio. Sheetal D’mello won the graduate student symposium in biotechnology, and Hoa Nguyen the graduate student symposium in pharmacokinetics, pharmacodynamics, and drug metabolism. Additionally, Professor Lee Kirsch was appointed a fellow of AAPS. Jan.Feb.Mar 2014

STUDENT SECTION

Congratulations student pharmacists class of 2017 Drake University White Coat Ceremony | Sunday, Aug. 25th, 2013

Benson Abraham Jaclyn Alexander Krista Allbee Austin Arnold Spencer Baer Elizabeth Bald Katie Beachner Trisha Benjamin Kendra Borchers Krystin Bradshaw Christina Bravos Linh Cao Michael Cardamone Emily Cook Dalton Fabian Anna Fischer Amy Frew Carolyn G’Sell Angela Giannetto Andrea Gomez Andrew Greeley Rebecca Gross Tori Groves

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Katelin Hardisty Michelle Hartman Nicole Hartsock Lindsay Hawkins Emma Hegemann Nathan Hemsley Alyse Herman Hanna Hollingsworth Bonnie Hoots Dylan Horton Emily Householter Emma Huepfel Samuel Huntington Tyler Ishman Kelsey Japs Aubrey Johnson Kayla Jonason Steven Jordan Jessin Joseph Samantha Julsen Kelsey Klein Jamie Knie Madison Koppin

Shane Kozlowski Molly Krook Jessica Leong Ted Lindgren Laura Litwin Jenna Luitjohan Sara Magill Krista Maguire Shannon Mahony Molly Malone Nathaniel Martin Jessica Marx Samantha Maryan Maren McGurran Kyle McNett Morgan McPherson Kalie Miller Taylor Monson Celia Morton Patrick Murphy Megan Nelson Kya Norby Mary O’Brien Sarah O’Rourke Brady Oates Molly Obermark James Orris Eunice Park Manali Patel Shreeraj Patel Alex Pettit Marica Potkonjak

Bergen Quaerna Suzanne Rettey Carolyn Riedl Melissa Rieger Hayley Runde Andrew Ruplin Pamela Sanford Hannah Sauer Marissa Schaefer Diana Schreier Anna Showalter Alex Smith Derek Sprang Emily Spring Grant Stimes Amanda Supercynski Adati Tarfa Krystle Thai Brittany Thelemann Keller Toral Keisha Troendle Erica Truong Matthew Van Rahul Verma Jacqueline Vonderhaar Andrew Wagner Danielle Walla Cariann Walsh Dylan Webster Zachary Wright Laura Zahr Nathan Zimmermann

STUDENT SECTION

Congratulations student pharmacists class of 2017 University of Iowa White Coat Ceremony | Saturday, Aug. 24th, 2013

Mousa Aboissa Meagan Adamsick Eddy Airiohuodion Rebecca Anderson Alyssa Bailey Allison Barker Ashley Beckman Alison Bieber Mark Binder Jenna Blunt Jessica Bonthuis Christine Butler Jacqueline Camacho Ashley Campbell Daniel Carlsen Luke Carlson Vilasatry Chanthinouvong Erin Chaplin Courtney Converse Meghan Delaney Kristin Dlouhy Douglas Dual Rachel Fetters Allison Fick Chase Fifield Brianne Forgie Estefany Garcia Katherine Garczek Rachel Gean Reese Geis Brandon Gerleman Amanda Gillispie Rachel Grolmus

Alex Hagg Sylvie Hall Alyssa Haught Ashley Hickey Kayla Hoogendoorn Mark Hopper Emily House Courtney Howe Eric Hundley Alanah Johnson Marshall Johnson Renu Johnson Dana Jones Ben Jorgensen James Kay Natalie Kelly Melissa Kessler Chelsea Khaw Andrea Klepper Jordann Kunkel Danielle Larson Joshua Lemm Anneka Levra Carrie Linn Alexandra Lovell Angela Lutwitze Andrew Martin Emily Matthews Laura Meadow Chenise Meyer Paige Milbach Kyla Miles Jesse Monthei

Amanda Gillispie is coated by her professional mentor, Carolyn Boerner.

Logan Murry Jaclyn Myers Nahal Nassabeh Laura Nesheim Hoang Nguyen Minh Nguyen Robert Nichols Michael Oâ€™Brien Kristen Peterson Valerie Pisowicz Jacob Polson Heather Purscell David Quach Mary Tatjana Ramos Katherine Reynolds Addy Rickels Julia Rippe Danielle Ritchie Amanda Rixen Zachary Rose Jennifer Ross

Robert Nichols

Ashley Sabus Christopher Sanchez Thomas J. Sayre Amanda Schares Monica Schmidt Tricia Schneider Erin Schreiber Brett Spiek Katharyn Stange Taylor Steckler Panagiota Terzis Jenna Tingleff Phi Q. Tran Michael Trisler Susan Voong Devin Welke Rachel Wenman Brittney Westermeyer Daniel Widman Hayley Wittnebel Shavea Zapata Juan Jan.Feb.Mar 2014

STUDENT SECTION

Leadership, Legislation, and Your Role at IPA

Matt Farley

2015 PharmD Candidate The University of Iowa 2013-2014 IPA Board of Trustee

ATTEND A MEETING. My story with IPA first started when I attended the annual IPA College night at The University of Iowa as a first year pharmacy student. Like many P1’s at the time, I was enticed by the idea of a free meal and a night filled with meeting pharmacists and students alike. The meal was good, but my lasting impression of IPA was better. One of the most memorable parts of the evening for me was a student panel, in which each panelist described their experience with IPA and different ways students could get involved. One particular person really stuck out to me. Jake Shell, the current president of the student council and student member of the IPA Board of Trustees. Jake encouraged students to dive into IPA and get involved wherever we could—advisory committees, policy committees, attend Expo or Annual Meeting, participate in the Golf Classic. I was inspired by his challenge to us, he said “Put yourself in uncomfortable situations.” It was these situations that we could grow our skills and expertise in the areas of leadership and advocacy for our profession. It was at that time that I decided to pursue a similar path to Jake, and subsequently was voted into the position of student council president, and ultimately the IPA Board of Trustee member representing students at The University of Iowa. BE A VOICE. Serving as a student member on the Board of Trustees has brought to light the many opportunities for our profession to be heard. The profession continues to change, and will always evolve. With the active leadership of our Association, we can forge new pharmacy practice models and continue to practice in a state that has always been known to be progressive. The time for student advocacy has never been greater though. There is a plethora of ways student pharmacists can get involved in advocacy efforts. One of the greatest ways is to talk directly with legislators about issues important to our profession. Attend the IPA Legislative Day to become familiar with the process of visiting the State Capitol and talking

| JAN.FEB.MAR jan.feb.mar 2014

with legislators. Students can also be an advocate for pharmacy profession to other health professions. With the focus on interdisciplinary learning in our college curriculum, showcase what you know and how you can add value to the healthcare team while you’re learning alongside other health professionals. These are great ways to get started in your personal advocacy efforts for our profession. GET INVOLVED. My knowledge of the Affordable Care Act and pharmacy reimbursement issues has drastically improved over this past year. I have come to appreciate the work of IPA to protect our profession while improving our scope of practice and ability to be compensated for our services. It seems there are constant obstacles that IPA overcomes in order to ensure the best healthcare for our patients. Many obstacles also mean many opportunities to further our profession. Being able to present a viewpoint to the appropriate stakeholders that frame policies and procedures is important and a needed role for pharmacists. An example of how students can provide that viewpoint is active participation on an IPA advisory committee, such as the Medicaid & Pharmacy Benefit Programs Advisory Committee. This committee is one of several where students have the ability to participate in meetings that decide recommendations to the rest of the association and can be pivotal in shaping how we proceed as a profession. ADVANCE OUR PROFESSION. IPA gives students a chance to learn more about current issues and help shape the future of pharmacy. It is my challenge to you to take the same advice I took, and put yourself in situations that stretch your abilities and understanding. There are hundreds of ways you can get involved at IPA, and it is truly the need of our profession to cultivate future leaders to continue to advance the practice of pharmacy and improve patient health.

STUDENT SECTION

Continued Success at the 4th Annual IPA College Nights

• IPA and the Colleges of Pharmacy hosted “College Nights” to introduce student pharmacists to the role of the Association and benefits of involvement. Hosted in West Des Moines and Coralville, student and faculty attendees heard from a panel of student pharmacists and one new practitioner that sought leadership roles in IPA over the past year. After a welcome from IPA President Michele Evink, words of wisdom were shared on the impact that professional involvement within IPA made on the lives of these individuals. With over 400 individuals combined attending College Nights in 2013, IPA would like to thank all student pharmacists and faculty members for their attendance and participation at this year’s College Nights!

Jan.Feb.Mar 2014

STUDENT SECTION

Advocacy as a StudentPharmacist in Iowa: Why We Are Important? Nathan Peterson

2014 PharmD Candidate The University of Iowa

As students, being passionate about an issue facing pharmacy can be difficult. We are not practicing yet, and reading about what may be affecting pharmacy is not the same as experiencing it. Nonetheless, we often find ourselves in scenarios where legislators, patients, and the general public want to know our opinions on difficult subjects. In 2013, it was compounding, PBMs, provider status, Medicaid reimbursement, immunization authority, and various other issues. Which concerns took priority depended on the pharmacy organization. It can be difficult to keep track of how we are supposed to feel about such complex topics in the profession. My goal is not to tell you what is most important, nor am I going to tell you to write your legislator for something you need to learn about. My goal is tell you what made me passionate about advocating for pharmacy, with the hope it does something similar for you. We became advocates for the profession the moment we got our white coats, and whether itâ€™s in a community pharmacy back home or the Capitol in Des Moines, understanding why Iowa is a special place for pharmacy will make you a stronger pharmacist and stronger advocate. We certainly are told from day one we are unique for being in Iowa. From our Deans at our white coat ceremony to the faculty and clinicians, we repeatedly learn this mantra at every chance given. We are told how exceptional we are simply for being in the state of Iowa. How it is our responsibility to lead the profession through the challenges of tomorrow. Understanding why we are inherently unique requires a little more explanation,

| JAN.FEB.MAR jan.feb.mar 2014

and a lot more history. The following is a brief but important story that establishes the relevance of Iowa pharmacy at the national level. It is one of many. They all start with an opinion.

1985

Between 1960 and 1980, the pharmacy profession saw a huge increase in the clinical presence of pharmacists. Clinical education, in the form of a Doctor of Pharmacy degree and residency programs, allowed pharmacists to be a part of patient care and started what would be a long transformation for the profession. Instead of distributors of a product, pharmacists became a valued member of the health care team. In 1985, the American Society of Health-System Pharmacists (ASHP) held a conference at Hilton Head Island, South Carolina, to determine the definition, goals, and direction for clinical pharmacy.1 The keynote speaker for what would be known as a turning point for the profession completed his M.S./Residency and Ph.D. at the University of Iowa. Charles D. Hepler, former director of the M.S./Residency program at University of Iowa Hospitals and Clinics, spoke of the role for pharmacy in society as a whole. The attendees of the conference agreed on several points for the future of clinical practice and began discussing what would become known as pharmaceutical care.1

1989

Dr. Hepler and Linda Strand, a PharmD/PhD from the University of Minnesota, wrote a landmark paper on pharmaceutical care that would shape the pharmacy profession for decades. Opportunities and responsibilities in

STUDENT SECTION pharmaceutical care is one of the most influential documents in our profession. It outlined pharmacy’s societal role and emphasized our increased responsibility beyond dispensing.2 Debate would linger long after its publication about finer points within definitions, but the premise of the paper would become the foundation for pharmacy and pharmacy education across the U.S for years to come.1

1998

Many textbooks and publications would cite Hepler and Strand in efforts to tailor the fundamentals of pharmaceutical care to specific environments.3,4 In 1998, the Iowa Center for Pharmaceutical Care program for redesigning practice published a guide for implementing pharmaceutical care practice, called A practical guide to pharmaceutical care.4 The authors were from Drake University, The University of Iowa, and the Iowa Pharmacy Association. The book showed pharmacists how to practice patient care that improved patient outcomes.

2007

Two more editions of A practical guide to pharmaceutical care would be published by the American Pharmacists Association, each addressing the evolving needs of the profession with regards to patient care.4,5,6 The third edition is the primary learning aid used by the American Pharmacists Association for faculty resources in teaching pharmaceutical care.7

faculty received two other prestigious national honors for improving practice and enhancing medication safety. This is one example of why we are indeed unique for being student pharmacists in Iowa, and how a simple opinion on an issue can have monumental impact. By being at Drake or The University of Iowa, we are one degree of separation from some of the biggest names in our profession. I would also recommend learning about the evolution of Medication Therapy Management (MTM) and its relationship with the Iowa Center for Pharmaceutical Care. I can now tell you as a P4, soon to graduate; those Deans, practitioners, and faculty know what they are talking about. We really will shape what is to come for pharmacy - they already have. Being trained as a pharmacist in Iowa does set us apart in our ever-growing, constantly changing profession. We really are in a unique position simply for being in Iowa, and if you are not drinking the Kool-Aid yet, you should be. You have power you may be unaware of, and its our turn to shake things up. The next time a legislator or a patient asks you about a particular topic, remember that how you feel on the issue has the potential to shape our profession for decades down the road. Your opinions are valued. Educate yourself and tell them what you know. “I’ll get back to you” is an appropriate student pharmacist response. If you need proof of that power, just look at the history.

References

1. Kelly, W.N. Pharmacy; What It Is and How It Works. 3rd Edition. Boca Raton, Florida, 33431. CRC Press, 2006. P. 139142. Google Books. 1 Nov 2013 2. Hepler, C.D., Strand, L.M. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990; 47:533-43. 3. Cipolle, R.J., Strand, L., Morley, P. Pharmaceutical Care Practice: The Patient-Centered Approach to Medication Management. 3rd Edition. New York. McGraw-Hill, 2012. 4. Rovers, J.P., Currie, J.D., Hagel, H.P., McDonough, R.P., Sobotka, J.L. A Practical Guide to Pharmaceutical Care. 1st Edition. Washington, D.C. American Pharmaceutical Association, 1998. 5. Rovers, J.P., Currie, J.D., Hagel, H.P., McDonough, R.P., Sobotka, J.L. A Practical Guide to Pharmaceutical Care. 2nd Edition. Washington, D.C. American Pharmaceutical Association, 2003. 6. Rovers, J.P., Currie, J.D. A Practical Guide to Pharmaceutical Care. 3rd Edition. Washington, D.C. American Pharmaceutical Association, 2007. 7. http://www.pharmacist.com/facultyresources

ONLINE ONLY FEATURE

Today

The works of Hepler, Strand, and the ICPC faculty permeate pharmacy practice literature. It is impossible to read about pharmaceutical care, the foundation of our pharmacy education, without finding reference to the names previously mentioned. Drs. Hepler and Strand received the Remington Medal, and the ICPC

Jan.Feb.Mar 2014

STUDENT SECTION

GET INVOLVED in ipa 2013 Capitol Screening Day O

NA ,

Plan to Attend the Midwest Pharmacy Expo! February 7-9, 2014 Prairie Meadows Conference Center, Altoona Join student pharmacists from 8 states for the Midwest Pharmacy Expo (previously called the Educational Expo). IPA is excited to offer opportunities for student pharmacists to stay engaged and informed about pharmacy practice issues while helping to further develop your professional and leadership skills. The newly expanded regional meeting is packed with high quality education, sought-after keynote speakers, exhibit hall & opening reception, exhibit theaters and much, much more! As a student pharmacist, this is an annual event you don’t want to miss!

Student Programming Will Help Address These Questions:

, 7-9 F E BRUARY

4 201

•

T AL

Students Can Attend:

• General Sessions on Personalized Medicine from Julie Johnson, Dean at the University of Florida College of Pharmacy and The Lacks Family: An Onstage Interview • Interprofessional Education on Pain Management • Over 18 hours of continuing pharmacy education sessions • Opening Reception & Exhibits • Exhibit Dinner Theaters

• How do I develop & implement an innovative program? • How do I prepare for the NAPLEX & MPJE? • How do I set myself apart from my classmates? • How can I make an impact on the profession?

student registration at www.gotocei.org Participate in Other Expo Highlights that

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Thursday, February 20th, 2014 10 AM – 1 PM Des Moines Capitol Pharmacists and student pharmacists will be providing various clinical screenings to showcase the advancing role of the pharmacist in today’s healthcare system. Held in conjunction with the IPA Legislative Day, screenings planned to be provided include: blood pressure, blood glucose, cholesterol, and bone density.

*If you’re interested in participating or supporting this event, please contact Anthony at apudlo@iarx.org.

STUDENT SECTION

Max W. Eggleston Executive Internship

The Eggleston Executive Internship in Association Management is a 12week program held each year during the summer months in the IPA offices in Des Moines. During the internship experience, the intern will receive education instruction in each of the Association’s division as follows: • Public Affairs and Business Development • Professional and Educational Affairs • Organizational and Administrative Affairs The ideal candidate is an IPA student pharmacist member currently in their second year of pharmacy school. Applicants should submit their online application along with a current resume and writing sample to Anthony at apudlo@iarx.org by March 1st. For more information, please review the IPA website or contact IPA at 515.270.0713.

Deadline – march 1

TakeAway Intern Position

Bill Burke Student Pharmacist Leadership Conference

TakeAway, Iowa’s medication disposal program available through community pharmacies, has served the state since November 2009. IPA is seeking a passionate and motivated student pharmacist to serve as the part-time TakeAway intern. The intern will assist in the administration of this statewide program, including:

September 19-20, 2014

• Communications to participating pharmacies • Assist in research and marketing of the program • Coordination of events for Pill Dude, TakeAway’s mascot The ideal candidate is an IPA student pharmacist member currently in their first year of pharmacy school. Applicants should submit their online application along with a current resume and writing sample to Anthony at apudlo@iarx.org by March 1st. For more information, please review the IPA website or contact IPA at 515.270.0713.

Deadline – march 1

The 19th Annual Bill Burke Student Pharmacist Leadership Conference is scheduled for September 19-20, 2014, at the Marriott Hotel in Coralville. In 2014, the conference will be held in conjunction with the IPA Foundation’s Annual Eggleston-Granberg Golf Classic to provide additional opportunities for networking and learning. There are planned events scheduled on September 19th to be held at the Brown Deer Golf Course in Coralville after the Golf Classic. Online applications are now being accepted for current P1 through P3 student pharmacists from Drake University and The University of Iowa.

Deadline – April 1 The Bill Burke Student Leadership Conference aims to: • Instill quality organizational leadership skills • Increase awareness of issues impacting the profession of pharmacy • Encourage development of leadership skills and involvement in professional and community activities • Recognize pharmacy students who have displayed leadership potential • Improve communication and teamwork skills

Jan.Feb.Mar 2014

last laugh

need a relief pharmacist? contact

“Joseph in Relief” Joseph Thompson, RPh 9616 Quail Ridge Urbandale, IA 50322

CALL 1.888.278.0846 515.278.0846

Advertise in our publications

Place your ad/classified ad with us. All ads, contracts, payments, reproduction material and all other related communication should be addressed to Lynndi at lkoester@iarx.org or call the IPA office at 515.270.0713 for more information.

2014 Calendar of Events february 2014 Immunization Administration Training - Altoona 7 7 Together. Providing Quality Care to Patients in Pain - Altoona, IA 7-9 Midwest Pharmacy Educational Expo - Prairie Meadows Events and Conference Center - Altoona 11 2/2/2 Virtual Engagement Series 12 Log-in To Learn e-journal Club IPA Board of Trustees Meeting, IPA Headquarters 19 20 Legislative Day and Capitol Screenings March 2014 3-4 ASHP Ambulatory Care Conference & Summit - Dallas, TX 11 2/2/2 Virtual Engagement Series 12 Log-in To Learn e-journal Club 28-29 NASPA Spring Meeting - Orlando, FL 28-31 APhA Annual Meeting & Exposition - Orlando, FL

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April 2014 AMCP 26th Annual Meeting & Expo - Tampa, FL 2-4 8 2-2-2 Virtual Engagement Series Log-in To Learn e-journal Club 9 10 IPA Goes Local - Central Iowa Pharmacy Association Des Moines IPA Board of Trustees Meeting, IPA Headquarters 23 24 IPA Goes Local- Quad Cities Area 26-29 NACDS Annual Meeting - Scottsdale, AZ May 2014 7-8 NCPA Legislative Conference - Washington, D.C. 13 2-2-2 Virtual Engagement Series 15 IPA Goes Local - Black Hawk/Bremer Co Pharmacy Association - Waterloo 20 IPA Goes Local - North Iowa Pharmacy Association Mason City 31 ASHP Summer Meeting - Las Vegas, NV

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PBM is MedImpact

Our founders and team members have extensive experience in health insurance, and through collaborations with known high-quality providers and best-practice business partners, we’re giving our members — and you! — the best possible experience. Pharmacy Help Line 24/7 access to check member eligibility, claim processing, prior authorizations or other prescription processing questions. 1.800.492.7259 We look forward to providing outstanding, no-hassle service for our members and their providers of care — including Iowa’s pharmacists.

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