The Journal of the Iowa Pharmacy Association | A Peer-Reviewed Journal
JUL.AUG.SEPT 2014 2014 Annual Meeting Million Hearts Campaign
JUL.AUG.SEPT 2014 | Vol. LXVIV, No. 3
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 Kate Gainer, Managing Editor kgainer@iarx.org Lynndi Koester, Layout & Design Anthony Pudlo, PharmD, MBA, BCACP apudlo@iarx.org Laura Miller lmiller@iarx.org
OFFICERS
Chairman Michele Evink, MS, PharmD, CGP, FASCP, Osceola 641.342.5322, mevink@clarkehosp.org PRESIDENT John Swegle, PharmD, BCPS, Mason City 641.428.7182, john-swegle@uiowa.edu PRESIDENT-ELECT Bob Greenwood, RPh, Waterloo 319.234.1589, bob@greenwoodpharmacy.com TREASURER Steve Firman, RPh, Cedar Falls 319.277.7540, steve@pmgrx.com SPEAKER OF THE HOUSE Connie Connolly, RPh, BCACP, DeWitt 563.652.5611, conniejconnolly@hotmail.com VICE SPEAKER OF THE HOUSE CoraLynn Trewet, MS, PharmD, BCPS, CDE, Ankeny 515.360.0065, coralynn.trewet@sanofi.com
TRUSTEES REGION 1 Kristin Meyer, PharmD, CGP, CACP, FASCP, Marshalltown 641.753.4580, kristin.meyer@drake.edu REGION 2 John Daniel, PharmD, Fort Dodge 515.573.3431, jfdaniel@frontiernet.net REGION 3 Erik Maki, PharmD, BCPS, Johnston 515.326.0171, erik.maki@drake.edu REGION 4 Ashley Dohrn, PharmD, Le Claire 563.324.5004, ashley.dohrn@me.com AT LARGE Justin Rash, PharmD, CGP, Ankeny 515.331.2594, rash.justin@gmail.com Felix Gallagher, PharmD, Des Moines 515.334.4293, fgallagher@pharmservstaffing.com David Weetman, RPh, Iowa City 319.356.2577, david-weetman@uiowa.edu Laura Knockel, PharmD, North Liberty 319.354.7121, lauraknockel@gmail.com HONORARY PRESIDENT Bruce Alexander, PharmD, BCPP, Iowa City bruce.alexander@va.gov PHARMACY TECHNICIAN G. Jean Gallogly, CPhT, Vincent crittersandstuff@yahoo.com STUDENT PHARMACISTS Grant Houselog, University of Iowa grant-houselog@uiowa.edu Carson Klug, Drake University carson.klug@drake.edu
COVER IPA’s 135th President - John Swegle, PharmD, BCPS
FEATURES President’s Page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 2014 Annual Meeting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Million Hearts Campaign . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Online Features:
• Check out IPA’s 2014 Annual Report and IPA Foundation’s Annual Report • Find a complete list of IPA’s 2013-2014 Committee, Task Force, and statewide volunteers
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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 Koester Design, LLC.
President’s Page
John Swegle PharmD, BCPS IPA President
Inaugural Address Delivered at IPA’s 2014 Annual Meeting on June 13th in Altoona
THE FUTURE IS NOW.
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hank you for this opportunity to be the next President of IPA. It is truly an honor and a privilege for me to be in this position. My hope over this upcoming year is to continue the work of this Association and represent IPA to the best of my abilities.
There is a long list of people who have inspired me throughout my career. I am always fearful of missing names however I need to give thanks to Sarah and our kids Ben, Sam, and Analeah for putting up with me and allowing me to pursue opportunities within pharmacy. I also wish to thank my parents for all they have done for me and their support throughout my career. Many years ago, I was a junior in high school not knowing what I wanted to
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do after graduation. My mother was one who never asked the question of “if” I was going to college but “where” was I going. Having that direction, I first needed to figure out what I wanted to do with my life. I liked the health sciences and I liked patient contact but had no desire to be in school long enough to pursue medicine as a career. So I looked at other options in the healthcare field. We had a local pharmacy in Conrad, Iowa and TJ Johnsrud was my pharmacist growing up. He invited me to job shadow and exposed me to the profession of pharmacy. At the time, I was like the general public in assuming pharmacists took things from big bottles and put them into little bottles. I didn’t know all of the “other” things that pharmacists do when preparing medications for patients or the opportunities that existed outside the walls of a pharmacy. These experiences intrigued me to the point of declaring pharmacy as my major. I have to tell you that I am a proud alumni of both Drake University and the University of Iowa. Yes, the boy who did not want to be in school forever decides to get two pharmacy degrees. Although I did have a two year stint as a community pharmacist before heading to graduate school at Iowa. Even though I currently work for Iowa, I wouldn’t be here if it wasn’t for the education I received at Drake. We are fortunate in this state to have two exceptional Colleges of Pharmacy. My current practice setting has sheltered me from a number of things that directly affect pharmacy. As a solo pharmacist working in a Family Medicine residency program, my focus is on education and my audience is physicians and students. I knew more about education of primary care physicians and issues facing that profession than I did about my own. This past year as President-Elect for
IPA has enlightened me to issues and concerns that affect pharmacy. And not just one aspect of pharmacy but all areas of pharmacy. I always knew pharmacy in Iowa was strong and we have great leaders in this state and this profession. But I somehow didn’t fully comprehend what that meant. Now I know. And I found this wealth of knowledge from past and current leaders within the Association. Many people have asked me what my goals are for the upcoming year. The first thing I want to do is continue advancing the IPA strategic plan. These areas include 1) Patient care, Safety, and Health Outcomes, 2) Membership, and 3) Advocacy for the Profession. We’ve certainly made progress in these areas but I realize there is always more we can do. I plan to work with the Executive Committee, the Board of Trustees, and IPA staff to continue advancing our strategic plan.
“ I always knew pharmacy in Iowa was strong and we have great leaders in this state and this profession. But I somehow didn’t fully comprehend what that meant. Now I know.” Pharmacy is in an interesting position. I like to think of it as a period of transition. We talk about being tied to product but really we are tied to patient care. Our goal is to help people utilize medications in a safe and effective manner to achieve the best possible outcome. The challenge for us has little to do with the product as much as it does reimbursement for that product. So we look for other sources of revenue. And whatever that source of revenue is, it has to be
president’s page sustainable. This is not new…..I’ve been hearing this for over 20 years as a pharmacist. I’m supportive of provider status but I believe we need to look for other areas of recognition. One area our profession should target pertains to cost savings through appropriate use of medications. Healthcare is targeting preventative medicine, healthy living, adherence to treatment plans, and many other things. And the overall goal is providing quality care while at the same time reducing healthcare costs. Other disciplines understand the value pharmacy brings as part of the healthcare team. Now is the time for our profession to decide how we want to be involved. I want pharmacy to decide what is best for pharmacy. If we as a profession do not define our role, we will potentially have it decided by other entities. When opportunities present, we need to be prepared and ready to jump right in. This requires us to be actively engaged. I know all of you are involved in patient care to varying capacities but I want us to expand what we currently do. I want us to be creative. Think outside the box. We are “one voice, one profession” however we do not have the same practice sites or areas of expertise. I can manage quite a number of disease states because that is what I do in Family Medicine. But don’t ask me to manage an ICU patient, or an infusion pharmacy, or even reconcile a claim. And please don’t ask me to compound anything…..my point is all of us have different skills. I want us
to exploit those skills and coordinate our efforts. Utilize technology to help us connect with experts. Again, the bottom line for all of us is patient care. Let’s work together to optimize our efforts.
brings. There is something to offer all pharmacists and pharmacy technicians in this Association. And if you don’t think this is true, let me know and I will make every effort to change that.
One area in particular I want to pursue over the upcoming year is increasing our membership. I’m not looking for just members, I want engaged members. We need to promote the benefits of being a member of IPA. All of you in attendance tonight already understand the benefits of belonging to IPA. The people I want to target are those who are not here. I ask all of you to help us promote our Association because it is just that….. OUR Association. We all have a responsibility to our profession…..a sense of ownership. Pharmacy is not just a job, it is a career as a healthcare professional. I want all of you to go out, find someone who is not a member, and actively recruit them. We will help you but the best advocacy for IPA is from its members…..that’s you. And once we have new members, we need to keep them. We need to show the value our
I am looking forward to this coming year. Kate and her staff work hard to keep this Association moving forward. There are challenges we face but if we continue to work together, we will find a way to prevail. I’m very appreciative of the efforts of the entire staff. IPA is in a great position to represent all of us regardless of practice site. Together we can and will make a difference. But it will take all of us. Again, this is your Association and all of us are working for you!
Below: IPA’s presidential office transitions as Michele Evink installs John Swegle during the 2014 Annual Banquet.
Association
“ I want us to be creative. Think outside the box. We are “one voice, one profession” however we do not have the same practice sites or areas of expertise. ” This Journal highlights the Annual Meeting’s main events, including: • Inaugural address by IPA President, John Swegle • Speaker’s address by Randy McDonough • Policy statements adopted by the House of Delgates • Professional award presentations • Sponsors and contributors • IPA-F fundraising events
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2014 Annual Meeting
june 13-14, 2014 • altoona, ia Iowa Pharmacy Association • 2014 Annual Meeting
THE FUTURE IS NOW
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2014 annual meeting Unable to attend IPA’s Annual Meeting in June?
HEAR WHAT NATIONAL LEADERS HAD TO SAY! Keynote Speaker: Dennis Helling, CEO Emeritus, Kaiser Permanente: “Pharmacy leaders from around the country often ask,
“What is it about Iowa Pharmacists?” While at this year’s IPA meeting, I attended the Leadership Dinner, the HOD, the Poster Session, the Exhibits, and the Awards Banquet. The “Aha” moment for me was putting it all together. The reason Iowa produces more national pharmacy leaders is that IPA has for many, many years provided the forum for pharmacists to be a part of the HOD, no matter their area of focus or their geographic location. I witnessed pharmacist after pharmacist go to the microphone and speak their opinion about a whole host of topics important to Iowa pharmacists. They were articulate and confident. All the while, the bright and engaged students from the University of Iowa and Drake University were observing and, at times, going to the microphones. I have never witnessed a more engaged state association membership. Well done, Iowa Pharmacy Association!” Matt Osterhaus, RPh, APhA President: “The IPA Annual meeting reinforced why the Iowa Pharmacy Family continues to lead our profession: innovative, engaged professionals who want to make a difference for their patients and the world we live in.” Doug Hoey, RPh, CEO, National Community Pharmacists Association: “I have the opportunity to meet pharmacists from all over the country and Iowa seems to have a disproportionate share of pharmacy leaders! The meeting past presidents, current Board members, and partners including the Board of Pharmacy and the two Colleges of Pharmacy demonstrated Iowa’s innovation and collaboration. It was a pleasure attending the IPA meeting again this year and having the chance to interact with some of the top pharmacists in the country.”
FEEDBACK FROM ATTENDEES “Thank you for the keynote presentation from Joan Becker – it was an extremely powerful presentation! I hope IPA will follow up with more education on how pharmacists can collaborate to find a solution to our broken mental health system.” “The new IPA Foundation events – Red Envelope – Heads or Tails – Slipper Sale – Ring Toss – infused excitement at the end of the evening and were a creative way to include everyone and provide all price points to donate to IPAF.” “My primary reason for attending the IPA Annual Meeting was networking. All events were great for this!” “During the ‘Trending Topics’ roundtable discussions, I gained much needed insight about how to communicate better with my hospital colleagues!” jul.aug.sept 2014
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2014 Annual Meeting even if it was, they never let their fear stop them from achieving their destiny. These individuals inspired me, gave me guidance and direction, and taught me to embrace life’s challenges. It is during some of these most challenging moments in our lives when, if we persevere, an opportunity arises that we never would have anticipated or even had experienced had we not continued on with our quest.
Randy McDonough
PharmD, MS, CGP, BCPS IPA Speaker of the House Speaker of the House Address delivered at IPA’s 2014 Annual Meeting on June 13th in Altoona
create your destiny
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rom my earliest memories I have been in awe with those individuals who have endured life’s seemingly unbearable challenges, diversities, and tribulations. What most impressed me about these individuals were their great resolve, courage, and strength to overcome an impossible opponent or situation. What I learned from these individuals was their belief in themselves and their unwillingness to waiver during times when others doubted or questioned their decisions or beliefs. I often thought that fear must have been a constant companion to their daily lives. But,
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The first 6 months of 2013 were some of the bleakest months of my professional career. In early January, I had stumbled upon an unexpected occurrence that eventually challenged the viability and sustainability of my practice. What I stumbled upon was a significant reduction in reimbursement from the Pharmacy Benefits Manager (PBM) for our largest insurer in the state. As my business partner and I monitored the effects of the PBM’s reimbursement reductions, we began to fully realize the extent of the cuts. We estimated that our reimbursement from this PBM had been reduced by 50% from the previous year—a significant reduction, an unsustainable reduction. The reality of the situation became apparent when we received our first quarter statements from our accountant—our practice’s viability and sustainability was being threatened. To say that I was scared is an understatement. I was concerned about my livelihood, financial ruin, my responsibility to my employees, and my ability to care for my patients. I had come face-to-face with an unbearable and seemingly unbeatable foe. My days were spent fighting for my practice and profession—whether it was working with national and state leaders, contacting legislators, working with my wholesaler, directly contacting the PBM or meeting with lawyers. Come June, my resolve was weakening and I was prepared to give up the fight—the future of my practice was no longer
bright and I had lost control of my destiny. It was time for me to accept what was happening and move on. Throughout our lives there are defining moments that alter our decisions or motivations. For me, my defining moment came when I sat down with my wife and kids and informed them that I was selling my practice—that I did not have the strength nor resolve to fight the PBM industry. Their initial reaction was silence and the words that followed altered my course—altered my destiny—“Don’t give up”. They knew the emotional and mental anguish I was experiencing, but they also knew that I would regret not fighting for what I believed in.
“. . .my defining moment came when I sat down with my wife and kids and informed them that I was selling my practice— that I did not have the strength nor resolve to fight the PBM industry.” After receiving the encouragement and confidence from my family, my attitude changed. I realized that I had a choice in the matter. I could just sit back passively and watch the PBM industry destroy our profession or I could become an active advocate for pharmacy and fight for what I believed and not accept the destiny they were giving me. I chose the latter and it made all the difference. I wanted to be in control of my future and create my own destiny. Even if I didn’t achieve my ultimate goal, knowing that I was gave my all, gave my heart and soul to create a better future for our profession provided me with the strength and resolve to
2014 annual meeting continue my quest for a better future. The past six months have proven to me that standing up for your beliefs can impact your life and destiny. I experienced the strength and power of a profession that became one voice in the state of Iowa that led to legislation and regulation to better govern PBMs in the state of Iowa. Recognizing the changes occurring in health care, my business partner and I renewed our commitment to create the kind of practice that we had always aspired to. We revamped our documentation system, remodeled our pharmacy, and hired new staff to ensure our practice was ready for future opportunities. And these opportunities did come and we were ready. Our practice became one of the initial sites to implement the new
practice model enhancing the role of our technicians so that pharmacists can focus on patient care services. We integrated pharmacy performance measures into our daily practice as we provide prospective drug utilization reviews for all patients. And we initiated discussions with key stakeholders about payment for our professional services, which were accepted, and are currently being implemented. Our theme this weekend is “The Future is Now”. We can no longer wait for someone else to fix our profession, be passive about our future, or accept what is unacceptable. There are many opportunities and threats that are looming in our pharmacy future— and it is what we do today that will
see what we’ve achieved!
determine our tomorrow. Being passive or apathetic will most assuredly allow the threats to take root and jeopardize our future. But if each pharmacist stands up and fights for the profession and gives their heart and soul to creating a better future, a better tomorrow then the opportunities are boundless. We can create or own destiny! I look forward to a productive meeting. I am proud to be a pharmacist and I am most proud to be an Iowa Pharmacist!! I will end my talk with a quote from Abraham Lincoln: “The best thing about the future is that it comes only one day at a time.”
check out the annual reports online
IPA’s Annual Report highlights the achievements and advancements your association has made during the previous administrative year. At a quick glance, IPA members and other individuals quickly learn the impact pharmacists have on improving the health of Iowans through education, communication, and innovation. Important sections include: Advocacy; Education; Practice Development; Professionalism; 2013 Award Recipients; Volunteer Thank-Yous; and Adopted Policy.
Mark Your Calendar! The IPA Foundation has a new and improved look to its Annual Report! Instead of a traditional report, the Foundation’s progress, achievements, and funding updates are presented in a 12 month calendar full of photos and excerpts from the previous year. It is our hope these calendars will be hung proudly on the walls of pharmacies, business offices, and IPA members’ homes to display the important efforts of the IPA Foundation visible each month. Hang yours up today! (to request additional copies, please contact ipa@iarx.org) APR.MAY.JUN 2014 | JUL.AUG.SEPT jul.aug.sept
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2014 Annual Meeting
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he Iowa Pharmacy Association’s 2014 House of Delegates welcomed over 100 delegates consisting of pharmacists, pharmacy technicians, and student pharmacists to Altoona on June 13-14, 2014. The chairs of the Policy Committees on Public and Professional Affairs presented their thoughtful recommendations to the House for debate. The direction of the Iowa Pharmacy Association will be led by the following policy statements that were adopted by our members:
14-U1: Biosimilar Medications (“Follow-on Biologics”) & Interchangeability • IPA supports the development of safe and effective biosimilar medications in order to provide more affordable and accessible treatment options for patients. • IPA supports the FDA’s role to develop a scientificallybased process to determine interchangeable versions of biologic medications. • IPA opposes the implementation of state regulations regarding biosimilar medication interchangeability that do not align with FDA guidance.
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• IPA supports appropriate postmarketing surveillance to ensure the safety and efficacy of biosimilar medications. • IPA supports education of pharmacists and other health care professionals concerning the appropriate use of biosimilar medications.
14-U2: Non-Resident Pharmacies
• IPA supports collaboration with the Board of Pharmacy and other stakeholders to determine appropriate licensure of nonresident pharmacies that promotes patient safety without restricting access to care. • IPA recommends non-resident pharmacies comply with the same Iowa Board of Pharmacy regulations required of resident Iowa pharmacies. • IPA supports the pharmacist-incharge of a non-resident pharmacy must be licensed to practice in Iowa. • IPA recommends the use of a systematic process to approve or deny licensure of a non-resident pharmacy with assistance of a standardized inspection service, other Boards of Pharmacy, and the National Association of Boards of Pharmacy (NABP).
14-U3: Distribution of Medications in Emergency Situations
• IPA supports the professional judgment of pharmacists acting in the best interest of the patient during an emergency or lifethreatening situation. Such actions should be given protection from civil and criminal prosecution. • IPA supports collaboration with necessary stakeholders to implement community-based public health programs where pharmacists provide medications to be used in emergency or life-threatening situations. • IPA encourages the education of health care professionals, patients, and caregivers about the use of medications during an emergency or life-threatening situation.
14-R1: Role of Pharmacy in Meaningful Use
• Reaffirm IPA policies 09-R1 and 06-U2. • IPA supports appropriate and equitable compensation for pharmacists’ contribution to achieving meaningful use standards.
14-R2: Reimbursement and Safety of Specialty Medications • IPA recommends public and private payers, pharmaceutical manufacturers, and health care
2014 annual meeting providers collaborate to create standardized, outcomes-based, and safe processes for distribution and administration of specialty medications to ensure appropriate care coordination. • IPA supports timely payment authorization and coverage verification processes that facilitate communication among patients, pharmacists, other health care providers, and payers prior to therapy administration. • IPA recommends education of payers, healthcare professionals, and pharmaceutical manufacturers on the issues associated with reimbursement and integrity of specialty medications that are managed through limited (or restricted) distribution channels.
14-R3: Accreditation of Pharmacy Technician Education Programs
• IPA supports the accreditation of
pharmacy technician education programs. • IPA supports the availability of accredited pharmacy technician education programs that are affordable, prepare individuals for practice in a variety of settings, and assist in the creation of expanded roles for pharmacy technicians. • IPA recommends evaluation of the impact accredited technician education has on pharmacy technician effectiveness and patient safety. IPA recommends the utilization of the results by the Board of Pharmacy, employers, and other stakeholders to develop standardized policy and procedures for technician education.
14-NBI-01: Regulation of Pharmacy Benefit Managers (PBMs)
and made in good faith. • IPA encourages Pharmacy Service Administrative Organizations (PSAOs) to represent their pharmacy customers fairly and responsibly when signing PBM contracts on the pharmacy’s behalf and to do all work to ensure fair and reasonable payment is received by the pharmacy. • IPA supports PBMs’ MAC pricing methodologies that are transparent (obvious, clear, and unambiguous), up-to-date, and based on rates available to multiple Iowa pharmacies. • IPA supports that PBMs respond and update pricing in a timely (within 72 hours) and fair manner to requests and concerns about MAC prices. • IPA supports retroactive payment from PBMs to pharmacies when price updates are delayed.
• IPA supports that contracts between PBMs and Pharmacy providers are fair to both parties
Leadership Academy Invited to Annual Leadership Dinner
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ach year prior to the IPA Annual Meeting, the Iowa Pharmacy Association hosts a special dinner for leaders in our state. This year’s Leadership Dinner was hosted on the outdoor terrace of the State Historical Building, overlooking the capitol. Current and incoming board members from IPA and IPAF are invited as well as Committee Chairs, to represent current leadership. All past presidents and past honorary presidents are invited to attend, in addition to important IPA partners, including the Deans from Drake and Iowa, the Board of Pharmacy, CEI, and McKesson.
New in 2014, the participants of the Leadership Academy were invited to be recognized for completing leadership training, which began at the Leadership Conference last August in Galena. Their attendance expanded the guest list to represent not only past and current leaders, but future leaders in the profession of pharmacy. (The 2013-2014 Leadership Academy was supported by the Thomas R. Temple Leadership Endowment Fund and a grant from Teva Pharmaceuticals.)
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2013 Leadership Academy:
Amber Baybayan, West Des Moines Amanda Bushman, Urbandale Ashley Dohrn, Le Claire Carmen Dunphy, Humboldt Nicholas Lehman, Urbandale Mary Mosher, Cedar Rapids Sara Newton, Argyle Shannon Peter, Omaha Morgan Sayler, Indianola Kathryn Starbuck, Waukee jul.aug.sept 2014
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ipa annual meeting ipa annual meeting The Iowa Pharmacy Association takes great pride in recognizing individuals for their contributions of leadership, patient care, professional involvement and public service. The following awards, presented by IPA’s Chairman of the Board, Michele Evink, and IPA’s Executive Vice President & CEO, Kate Gainer, during the association’s 2014 Annual Meeting, serve to capture Iowa pharmacy’s spirit of service and its culture of professionalism.
Bowl of Hygeia Award Craig Clark, RPh, of Cedar Rapids
Robert G. Gibbs Distinguished Pharmacist Award Al Shepley, RPh, of Mount Vernon
Excellence in Innovation Award Thane Kading, RPh, CDE, of Iowa City
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Honorary President Award Mark Jones, PharmD, of Davenport
Distinguished Young Pharmacist Award Stevie Veach, PharmD, BCACP, of Tiffin Presented by Kim Dornbier & Karla Krogman-Sauer of Pharmacists Mutual
2014 annual meeting
Patient Care Partner Award Dr. Richard Dobyns, MD, MSPM, of Iowa City Pictured with Nominators Mike Kelly and Jeff Reist
Health-System Pharmacist of the Year Award John Hamiel, PharmD, of Evansdale
Individual Appreciation Award Bill Doucette, PhD, RPh, of Iowa City
Corporate Appreciation Award Iowa Prescription Drug Corporation (IPDC)
pharmacy technician of the year Award Alissa Young, CPhT, of Ames
GenerationRx Award Brett Barker, PharmD, of Nevada Presented by Ginger Hibbert of Cardinal
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ipa annual meeting
jerry karbeling leadership Award Student Pharmacists: Laura Vollmer of Drake and Matt Farley of Iowa Presented by Tim Becker, IPA Foundation President
poster presentation Award Rachel Smith, PharmD, of Dubuque “Evaluation of Community Pharmacist-Managed Transitions of Care on Hospital Readmission Rates”
50- year Pharmacist Award (L to R) Dennis Dobesh of Newton, John Susich of Las Vegas, NV, Dennis Killion of Red Oak, Thomas Lehman of Carroll, and John Capper of Parnell. (Not Pictured: Donald Avise of W. Des Moines, Jean Abrahamson of Edmond, OK, Bernard Cremers of Iowa City, Harvey Eernisse of Fort Dodge, Louis Gaffney of Sioux Falls, SD, Jack Gile of North Fort Meyers, FL, Alan Henricks of Dubuque, Russell Imboden of Corona, CA, Gary Jones of Ottumwa, Paul Miler of Chico, CA, Charles Nigut of Des Moines, William Reimer of Elkader and Jerome Schweitzer of Bedford).
Contributors & Sponsors:
Amgen Cardinal Health CarePro Health Services Advance Health CarePro Compounding Pharmacy CarePro Home Infusion Pharmacy Liberty Pharmacy Tipton Pharmacy Shepley Pharmacy A Avenue Pharmacy CarePro at the Pavilion
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CoverMyMeds Drake University College of Pharmacy & Health Sciences Iowa Pharmacy Association Foundation Iowa Pharmacy Recovery Network IPDC - Iowa Prescription Drug Corporation Lundbeck Pharmaceuticals McCord Holdings McKesson Nucara Pharmacies Otuska Pharmaceuticals
Pfizer Vaccine Pharmacists Mutual Companies PharmServ Staffing Sharps Silent Auction Contributors Swisslog Healthcare Solutions University of Iowa College of Pharmacy QS1
SUPPORT FOR STUDENT ATTENDANCE
Gary Albers Jane Allen Tim Becker Carl Chalstrom Jay Currie Steve Firman Kate Gainer Sarah Grady
Bob Greenwood June Johnson TJ Johnsrud Jack Kampf Kristin Meyer Lisa Ploehn Andy Ploehn Morgan Sayler Doug Schara
IPAF SUPPORT
Thank you to all silent auction contributors and bidders, ring toss donors and players, and red envelope takers ... The Foundation raised over $15,000 at the Annual Meeting to support student scholarships and practice advancement.
2014 annual meeting
Thank you ipa board members 2014-2015 IPA Board of Trustees:
IPA welcomes the incoming 2014-2015 Board of Trustee members. The Board met for a strategic planning retreat July 9-10 in Carroll, Iowa, where they reviewed the Strategic Plan and updated IPA’s priority projects for the upcoming year. Guest presentations were delivered by Linda Wendt, Director of Quality/PCMH for UnityPoint Clinics and Mike Brownlee, Chief Pharmacy Officer, from UIHC on the direction and philosophy of large health systems in the state.
2013-2014 Board of Trustees Members pose for a picture at IPA’s Annual Meeting. (L to R) Front Row: Marilyn Aldrich, Cheryl Clarke, Michele Evink, Julie Kuhle, Connie Connolly and Ashley Dohrn. Back row: Kate Gainer, Randy McDonough, Justin Rash, Felix Gallagher, Steve Firman, Steven Martens, Mark Jones, Pat Thies, Kelsey Lawfer, John Daniel and John Swegle. Not pictured: Michelle Garvin and Matt Farley.
Thank you outgoing 2013-2014 IPA Board of Trustee Members for your time, dedication and service to the profession of pharmacy:
IPA would like to sincerely thank the members listed below for their dedication and service to the profession of pharmacy in Iowa. The outgoing Board of Trustee members have served the association during an important time of transition. The time and effort that these members gave to direct IPA and ensure a smooth transition of leadership has been invaluable.
Julie Kuhle, RPh, Indianola – Chairman of the Board Randy McDonough, PharmD, MS, CGP, BCPS, Iowa City – Speaker of the House Mark Jones, RPh, Davenport – Honorary President Steven Martens, PharmD, Grundy Center – Trustee, Region 1 Pat Thies, RPh, MS, FACHE, Cedar Rapids – Trustee, Region 5 Cheryl Clarke, RPh, CHC, Waukee – Trustee At Large Marilyn Aldrich, RPh, Des Moines – Trustee At Large Michelle Garvin, CPhT, Wilton – Pharmacy Technician Kelsey Lawfer, Student Pharmacist – Drake University Matt Farley, Student Pharmacist – University of Iowa
Pharmacy Leadership is Important Join your colleagues in addressing the diverse opportunities for pharmacy. Please consider serving on the Board of Trustees or IPA Committee. Contact Anthony Pudlo at apudlo@iarx.org
Michele Evink, MS, PharmD, CGP, FASCP, Osceola Chairman of the Board John Swegle, PharmD, BCPS, Mason City - President Bob Greenwood, RPh, Waterloo - President-Elect Connie Connolly, RPh, DeWitt - Speaker of the House Steve Firman, RPh, Cedar Falls - Treasurer CoraLynn Trewet, MS, PharmD, BCPS, CDE, Ankeny - Vice Speaker of the House Bruce Alexander, PharmD, BCPP, Iowa City - Honorary President Kristin Meyer, PharmD, CGP, CACP, FASCP, Marshalltown Region 1 Trustee John Daniel, PharmD, Fort Dodge - Region 2 Trustee Erik Maki, PharmD, BCPS, Johnston - Region 3 Trustee Ashley Dohrn, PharmD, Le Claire - Region 4 Trustee Felix Gallagher, PharmD, Des Moines - Trustee At-Large Laura Knockel, PharmD, North Liberty - Trustee At-Large Justin Rash, PharmD, CGP, Ankeny - Trustee At-Large Dave Weetman, RPh, Iowa City - Trustee At-Large Jean Gallogly, CPhT, Vincent - Pharmacy Technician Grant Houselog, 2016 PharmD Candidate, University of Iowa Carson Klug, 2016 PharmD Candidate, Drake University
Newly elected Board of Trustees Members being sworn in at IPA’s Annual Meeting. (L to R) Carson Klug, Jean Gallogly, Kristin Meyer, Erik Maki, Bob Greenwood, Connie Connolly, Dave Weetman and Laura Knockel
IPA 2015 Annual Meeting June 12-13; Coralville, Ia 15 jul.aug.sept 2014
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million hearts campaign
The Million Hearts® Campaign: Make Your Impact!
M
illion Hearts® is a national initiative with the goal to prevent 1,000,000 heart attacks and strokes by 2017. During this 5-year project, Million Hearts® is coordinating with the CDC, CMS, and other federal, state, and local stakeholders including the American Heart Association, American Pharmacists Association, YMCA, Walgreens, and United Health Care to increase awareness and care for cardiovascular health. Specifically, they work to improve care by encouraging providers to focus on the ABC’S (aspirin, blood pressure, cholesterol management, and smoking cessation) of cardiovascular risk and empowering Americans to make healthy lifestyle choices. Their benchmarks can be found in the chart to the right1:
Individual patients can help reach this goal by signing a pledge online and committing to prevent heart disease and stroke. This can be done by understanding the risks,
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exercising for 30 minutes several days a week, knowing the ABC’S, eating a heart healthy diet, and being adherent to prescribed treatment and recommendations. In April 2014, pharmacists, public health workers and other stakeholders in Iowa attended a workshop hosted by Million Hearts® leaders in West Des Moines. This workshop was the first of 5 state conferences hosted by Million Hearts®. Its goal was to teach participants about the Million Hearts® initiative, how their organization can align with the campaign, and what they can do to get involved in Iowa. Regional speakers detailed the project at a national level, and Iowa speakers such Dr. William Doucette (Iowa City) demonstrated how pharmacists are getting involved in hypertension management. Participants also discussed TeamBased Care/Care Coordination and Working with Pharmacists to Address Hypertension Management. Pharmacist involvement in hypertension management was strongly emphasized at this workshop, and participants from a variety of backgrounds discussed ways to increase pharmacist involvement. During the workshop, Dr. William Doucette showcased the role pharmacists play as part of the healthcare team and the Indicator
Pharmacy attendees at April 2014 Workshop (from left to right: Elizabeth Patterson, Brian Wall, Danielle Kennedy, Bill Doucette, Stephanie Thrall)
positive impacts they can have on cardiovascular health.2 In his recent study through the University of Iowa College of Pharmacy, community pharmacists partnered with primary care physicians to make interventions to decrease hypertension. This study focused on creating providerpharmacist teams and lists factors that contribute to a successful working relationship. The Collaboration Among Pharmacists and Physicians To Improve Outcomes Now (CAPTION) study3 is another example of ongoing research to quantify the results of pharmacist intervention on blood pressure control. This study, led by Dr. Barry Carter, is being conducted at 32 family practice offices across the country. These studies, along with many more, are proving the positive impacts pharmacists can have on Baseline
2017 Goal
Aspirin use for people at high risk
47%
65%
Blood pressure control
46%
65%
Effective treatment of high cholesterol (LDL-C)
33%
65%
Smoking prevalence
19%
17%
Sodium intake (average) Artificial trans-fat consumption (average)
3.5 g/day
20% reduction
1% of calories/day
50% reduction
million hearts campaign
a patient’s blood pressure control and cardiovascular risk reduction. Pharmacists across the state can make an impact by focusing on the ABCS listed above, participating in team based care with physicians, and starting adherence programs at their practice sites. Stakeholders from a variety of organizations are recognizing the value of hypertension management. Through the Million Hearts® initiative, they are also beginning to understand the importance of involving pharmacists. Pharmacists and pharmacies are an integral part to the success of blood pressure management and prevention of cardiovascular events such as heart attack or stroke. With the increased push for pharmacist partnership, how can you “Be One in a Million Hearts”? Pledging your support for the program at millionhearts.hhs.gov is the first step to getting involved. Multiple resources are available to advance your current pharmacy practice. For example, you may access example protocols, links to evidence, and toolkits to advance your practice. All of this material is free of charge and is meant to expand the outreach by pharmacists to help prevent 1,000,000 heart attacks and strokes. The time for pharmacists to become part of the healthcare team is now. Other healthcare professionals are recognizing how a pharmacist can improve patient outcomes. The Million Hearts® program is a perfect way to capitalize on this moment. The profession needs to embrace this recognition and further prove that pharmacists have what it takes to be part of the healthcare team! If you have any further questions on how you can get involved with Million Hearts® contact Anthony Pudlo at apudlo@iarx.org.
Look here for more information
Resources tab on millionhearts.hhs.gov
Other helpful initiatives for blood pressure management
Publications & articles • Studies verifying the involved methods for blood pressure control Protocols • Sample collaborative protocols for you to adapt to your pharmacy setting Action guides • Guides to help initiate blood pressure management services Script your future • http://www.scriptyourfuture.org/ Team Up. Pressure Down • http://millionhearts.hhs.gov/resources/ teamuppressuredown.html#Pharmacists
References 1. Million Hearts® Fact Sheet. Accessed online on 4/28/14 at http://millionhearts.hhs.gov/ aboutmh/overview.html. 2. Doucette W, Lickteig C, Veach S, et al. Fostering Provider-Pharmacist Team Management of Hypertension in the Community, Final Report to IDPH, July 2012 Accessed on 4/28/14 at http://www.astho.org/Programs/Prevention/Chronic-Disease/Million-Hearts/Iowa/FinalReport/ 3. University of Iowa. Collaboration Among Pharmacists & Physicians To Improve Outcomes Now (CAPTION). 2009. Accessed online on 5/5/14 at http://www.ctsdmc.org/projects/ caption/index.html.
be one in a million hearts® Preventing 1 million heart attacks and strokes by 2017 will require the work and and commitment to change from all of us. There are steps that each of us can take to reach this goal as a nation. Be one in a Million Hearts® and see how your actions can make a positive difference. A Million Hearts® begins with YOU.
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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. List of Cosponsors Grows on Pharmacist Provider Status Bill H.R. 4190 is bipartisan legislation aimed at amending the Social Security Act to recognize pharmacists as providers under Medicare Part B. This bill will recognize licensed pharmacists working within their state pharmacy practice acts to deliver care for patients in federally defined medically underserved communities. As of June 19, 2014, the bill has 54 cosponsors and has been referred to the Subcommittee on Health.
Clabaugh Appointed Director Of Iowa DPH
On May 19, 2014, Governor Terry E. Branstad appointed Gerd Clabaugh of Johnston as the new Director of the Iowa Department of Public Health (IDPH). Clabaugh has served Iowa’s communities for the last 25 years, most recently as Director of Operations for the Iowa Healthcare Collaborative (’07-’11) and then Deputy Director of the Iowa
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Department of Public Health (’11’14). He became interim director of IDPH after the previous director, Dr. Mariannette Miller-Meeks, stepped down in January to concentrate on campaigning for the U.S. House of Representatives.
Sebelius Resigns, Burnwell Confirmed As New HHS Secretary
On April 10, 2014, Kathleen Sebelius resigned her position as HHS Secretary, just one week following the close of the Affordable Care Act’s (ACA) OpenEnrollment period. Sylvia Mathews Burwell was named as Sebelius’ replacement. Burwell served as the director of the Office of Management and Budget prior to this appointment, and has also served as the President of the Walmart Foundation and President of the Global Development Program with the Bill and Melinda Gates Foundation. Her first task will be the continued implementation of the ACA.
Broadlawns To Join ACO Movement
Beginning on July 1, 2014, Broadlawns Medical Center in Des Moines will be recognized as an Accountable Care Organization (ACO), working with the Iowa Wellness Plan. This plan, available for patients between 100-133% of the federal poverty level, encourages patients to complete two “healthy behaviors” each year, as defined by the plan. One of these healthy behaviors includes a wellness visit, which Broadlawns’ new ACO model will encourage patients to complete.
Federation of State Medical Boards Adopt New Model Policy on Telemedicine With the growth of telemedicine, delegates of the Federation of
State Medical Boards adopted new policies on telemedicine on April 26, 2014. The goal of these policies is to “provide flexibility in the use of technology by physicians—ranging from telephone and email interactions to videoconferencing—as long as they adhere to widely recognized standards of patient care.” These standards included items such as confirming physician-patient relationship and ensuring the same standard of care for “direct-to-consumer telehealth” as traditional in-person care.
Affordable Care Act Enrollment Reaches 8 Million After the March 31st sign-up deadline was extended by two weeks, over 8 million individuals are now covered under the Affordable Care Act (ACA). 35 percent of those signed up are under the age of 35. Much of this is due to the ACA allowing more young adults to stay covered under their parent’s insurance plan leading to 3 million more being covered. This younger demographic is essential to the success of the ACA.
VA System Names New National Director
As stories circulated surrounding waittimes for patients at various VA Hospitals and Clinics, Eric Shinseki, Director of Veterans Affairs, was asked to step down from his position. After approval, Judith JohnsonMekota, FACHE, was appointed the new Director of Veterans Affairs. Johnson-Mekota has served in various leadership positions within the VA for more than 20 years, including as Deputy Network Director for the Veterans Integrated Service Network (VISN) immediately prior to her appointment.
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iowa pharmacy news PBM Legislation to Take Effect HF 2297, passed the Iowa legislature in 2014, and was signed by Governor Branstad on March 14. The legislation is scheduled to go into effect on July 1, 2014. Pursuant to this legislation, PBM’s will follow different rules on generic drug MAC pricing, including disclosure requirements of MAC methodology, demonstrating MAC prices determined by drugs available to Iowa pharmacies for purchase, and limiting MAC pricing to multiplesource generic drugs following the generic exclusivity period and A-rated generics only. Simultaneously, the Iowa Insurance Division has adopted updated rules to Iowa Administrative Code 191 – Chapter 59 (Pharmacy Benefits Managers), originally passed in 2008. These updated amendments go into effect July 2nd, and address PBM audit practices and 3rd party audit review; contract termination or suspension; price changes and timely updates; complaints; and Iowa Insurance Commissioner examinations and authority to fully enforce state laws and regulations pertaining to PBM practices.
Congratulations to the following IPA members on being appointed to the Hospital Leadership Team! Brian Benson UnityPoint Health, Des Moines
Mike Brownlee
University of Iowa Hospitals & Clinics, Iowa City
Kevin Cassatt Genesis Medical Center, Davenport
Mary Beth Gross
Veterans Affairs Medical Center, Des Moines
John Hamiel
Wheaton Franciscan—Covenant, Waterloo
Scott Leigh Gayle Mayer Spencer Hospital, Spencer
DeeAnn Wedemeyer Oleson Guthrie County Hospital, Guthrie Center
IPA Creates Hospital Leadership Team
Broadlawns Medical Center, Des Moines
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forward. With support from the National Association of Chain Drug Stores (NACDS) and the Community Pharmacy Foundation, pharmacists across the state are working together to implement a new workflow and business model for community pharmacy practice. Seven pharmacies are currently participating (Phase 1) in this Board of Pharmacy-approved project to pilot Tech-Check-Tech for refill prescriptions. Pharmacists at these sites are pursuing different opportunities to increase direct patient care including collaboration with hospitals and local physicians in their communities to become more involved in the evolving healthcare system. The New Practice Model Task Force, consisting of several community pharmacy representatives, met on May 29th to discuss expansion of the NPM pilot (Phase 2) to eight additional sites starting in the fall of 2014. Expansion of this pilot will demonstrate the reproducibility of the new workflow and business model in a variety of community pharmacy settings.
UnityPoint Health—Trinity Regional, Fort Dodge
At the time of print, IPA lacked details on the impact of changes following the July 1st and July 2nd effective dates.
To advance the Pharmacy Practice Model Initiative (PPMI), a nationwide campaign launched by ASHP and the ASHP Foundation to advance pharmacy practice in hospitals and health systems, IPA has appointed a Hospital Leadership Team to concentrate practice advancement efforts in Iowa. The decision to pursue development stemmed from the efforts of the Practice Advancement Workshop held in conjunction with the IPA Health-System Liaison Board meeting in October 2013. The Hospital Leadership Team will
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convene in August with a focus on analyzing the aggregate report of the PPMI Hospital Self-Assessment (HSA) for Iowa hospitals. The HSA is a 100-question survey that examines the adoption of the PPMI recommendations in individual hospitals. Upon completion of the survey pharmacy directors are able to create a customized action plan for practice advancement for their hospital. The aggregate report will guide the Hospital Leadership Team into prioritizing specific initiatives for hospital pharmacy.
Craig Osland
Mercy Medical Center—North, Mason City
David Seiler
Jamie Sinclair Mercy Medical Center, Cedar Rapids
Pat Thies UnityPoint Health—St. Luke’s, Cedar Rapids
Travis Tubbs
Veterans Affairs Medical Center, Iowa City
Doug Wetrich
Mary Greeley Medical Center, Ames
Greg Young Mercy Medical Center, Des Moines
New Practice Model Initiative Begins June 2nd The New Practice Model (NPM) Initiative continues to steadily move
Trinity Pioneer ACO MTM Program Hits Critical Point
After 8 months of community pharmacists providing MTM services in the 8-county service area of the Trinity Pioneer ACO, over 295 Medicare ACO patients have been served. Pharmacies continue to showcase the impact of MTM within the ACO. All stakeholders including IPA, OutcomesMTM, and The University of Iowa hope to display reduction in overall hospitalizations and 30-day hospital readmissions through utilization of community pharmacists as part of the ACO team. As of the end of May 2014, an OutcomesMTM assessment of these MTM services projects estimated cost avoidance (ECA) over $400,000. A complete analysis of the Medicare ACO data is currently being evaluated by researchers at The University of Iowa.
iowa pharmacy news Top Participating Pharmacies in ACO Project 1) Hy-Vee Pharmacy in Fort Dodge 262 MTM Claims 2) Wal-Mart Pharmacy in Fort Dodge 124 MTM Claims 3) Hy-Vee Drugstore in Fort Dodge 90 MTM Claims 4) Daniel Pharmacy in Fort Dodge 58 MTM Claims 5) Walgreen’s Pharmacy in Fort Dodge 45 MTM Claims 6) Wal-Mart Pharmacy in Storm Lake 38 MTM Claims
Community Care Coordination Projects Expand Across Iowa
As a result of funding from the Iowa Legislature in 2013, the Iowa Primary Care Association (IPCA) and its Iowa Collaborative Safety Net Provider Network selected two regions of the state to receive funding for community care coordination initiatives. Mercy Medical Center—North Iowa in Mason City and the Webster County Health Department in Fort Dodge have been working to improve quality, population health, decrease costs and engage practices in quality improvement to meet the Institute for Healthcare Improvement’s Triple Aim. In 2014, additional funding from the Iowa Legislature will expand the Community Care Coordination effort with
Development or Implementation grants ranging from $50,000 to $200,000 for the period of September 1, 2014 through June 30, 2015. Newly funded regions are expected to participate in a Learning Collaborative based on the needs of local providers. Learning Collaboratives will bring together teams of health professionals to focus on healthcare redesign efforts around efficient patient care delivery. You and your pharmacy team may be asked to participate if you are located in a selected region.
Informatics Institute, Medication Safety Collaborative, or Pharmacy Practice Policy meetings. IPA members, Jack Kampf, Lisa Mascardo, and Dave Weetman, represented Iowa during the ASHP House of Delegates for thoughtful debate. During this meeting, ASHP introduced a new logo to its membership to help reflect the evolving future of health-system practice.
In collaboration with the Iowa Prescription Drug Corporation, IPA continues to advocate for and deploy pharmacistprovided care coordination services to help support primary care practices and meet the unique needs of high risk populations.
The Iowa Pharmacy Recovery Network (IPRN) serves as a confidential resource to assist impaired pharmacists, pharmacy students, and pharmacy technicians looking to return into the profession of pharmacy. IPRN works with participants on an individual level and assists them in receiving an evaluation, treatment, and aftercare support needed to remain in their profession.
The Next Generation of Learning at the 2014 ASHP Summer Meetings
Over 15 Iowa pharmacists were in Las Vegas, Nevada on May 31-June 4 to attend the 2014 ASHP Summer Meetings & Exhibition. Through combining three meetings into one event, ASHP allowed attendees to learn and network at the
IPRN Achieves Successful Year for Education and Recovery
IPRN hosts semi-annual meetings to coordinate activities between members of the committee. These meetings are confidential, but involve representatives from IPA, Board of Pharmacy, IPRN clients, and student representatives from Drake University and the University of Iowa. Both colleges have reached outside
Katy the Kangaroo teaches medicine safety! The Iowa Pharmacy Association (IPA) developed Katy’s Kids as a program to teach children about medicines and medicine safety. Katy’s Kids was developed by the IPA in 1988 and was recently updated. All presenter materials and program information can be found at www. katyskids.com. Katy’s Kids strives to instill a sense of proper medication use in children. Katy’s Kids was developed for kindergarten through second grade students. Presentations are given to classrooms by pharmacists and student pharmacists of the community.
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iowa pharmacy news of the pharmacy profession and Iowa’s border to expand important addiction education. Each college hosted events on prescription medication abuse targeting all members of the healthcare team. A nationally recognized speaker from the University of Utah School on Alcoholism and Other Drug Dependencies presented to both colleges on the science behind addiction.
since 2008, but has the opportunity to increase through the exclusive McKesson/PACE relationship when Iowa pharmacies utilize this program.
PNI Board of Directors Meeting
2/2/2
PNI, Inc, IPA’s for-profit subsidiary, met on Thursday, June 5, 2014 at IPA Headquarters. The PNI Board is comprised of six past presidents and meets once annually. Bob Stessman, Manning, serves as the President. Currently, the primary and only activity of PNI, Inc, is ownership of the IPA headquarters and ownership of PACE Alliance (buying group) shares. The Board discussed lease options for IPA office space with a corporate real estate agent, as nearly 50% of IPA’s current floor plan is unoccupied. Revenue from PACE has been stable
What is it? 2/2/2 is an IPA program designed for you to stay engaged and stay informed on hot issues impacting the profession of pharmacy. These online webinars are free of charge to all pharmacy technicians. 2/2/2 are not accredited for CE. All previous 2/2/2 programs are recorded and available at no charge on IPA’s website.
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Monthly client meetings continue to provide direct support to recovering professionals. The Committee highlighted these meetings as a strong resource for clients during their recovery and those in charge of the meetings were commended for their efforts. The accomplishments of IPRN and all its stakeholders are only possible through the efforts of many dedicated professionals. Recognizing addiction as a disease is no small task, but every bit of effort put into
IPRN translates to positive outcomes for a person’s life. Become an IPRN advocate today by contacting IPA at ipa@iarx.org!
5 201 , 5 -1 F e bruary 13
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s de
m
Get up to 17 hours of Continuing Pharmacy Education!
When is it? 2nd Tuesday of every month at 2:00 pm CST
Upcoming Topics You Won’t Want to Miss:
• August 12th: EQuIPP for Quality Medication Use • September 9th: Community Pharmacy Practice Accreditation • October 14: IPA’s Pre-Election Briefing Take advantage of these Virtual Engagement Opportunities by registering with the 2/2/2 Quick Link at www.iarx.org. Have a hot topic that you think would be of interest to pharmacists and pharmacy technicians? Contact Laura at lmiller@iarx.org to make it a part of this series.
ipa goes local 2014 visits: Already Visited Upcoming Visits Scheduled
IPA Goes Local stops in Greenwood Drug, Waterloo, IA
ipa continues to go local
IPA has partnered with local pharmacy associations across Iowa throughout 2014. This partnership allows IPA to provide one hour of continuing education on patient safety to attendees. Rachel Digmann, PharmD, BCPS, and Kate LaFollette, RN, of Telligen have spoken on ‘The Missing Link: Medication Manager’. IPA Goes Local events also create opportunities for IPA staff and leadership to visit pharmacy practices and local communities across the state. IPA has already ‘gone local’ to Dubuque Area Pharmacy Association (March 4th), Central Iowa Pharmacy Association (April 10th), Quad Cities Area Pharmacy Association (April 17th), Black Hawk Bremer Co Pharmacy Association (May 15th), and North Iowa Pharmacy Inc (May 20th). Over 195 pharmacists and pharmacy technicians attended these events. IPA Executive Vice President and CEO, Kate Gainer, and Laura Miller, IPA Membership & Development Director, stopped into pharmacies and hospitals along the way to meet with fellow Iowans. Below is a map representing the places IPA has gone and plans to go this year. In orange are the counties IPA has already visited and dark blue represents the areas IPA plans to visit by end of 2014. Contact Laura at lmiller@iarx. org to set up a visit to your practice. Mark your calendars for these remaining 2014 IPA Goes Local events: • Southwest Iowa Pharmacists Association – August 14th in Omaha, NE • Trinity Pioneer ACO Service Area – August 21st in Fort Dodge, IA • Johnson Co Pharmacy Association – September 18th in Iowa City, IA • Northwest Iowa Pharmacy Association – October 16th in Spencer, IA
watch for ipa to visit your 2014 area!| 23 jul.aug.sept
ipa foundation In addition, the IPA Foundation continues to advance our strategic plan and work to accomplish its mission of “Inspiring generosity and fulfilling the aspirations of the pharmacy profession through support of education, practice-based research and practice development” through: • Student Pharmacist Support: Providing scholarships and facilitating professional development programs for student pharmacists in Iowa.
Tim Becker
RPh, FASCP IPA Foundation President
thank you iowa pharmacists
Y
our giving in action through 2013-2014 resulted in the IPA Foundation receiving grants for practice development exceeding $90,000; raising more than $35,000 for the Thomas R Temple Leadership Endowment Fund through a successful friendly rivalry with the Pharmacy Society of Wisconsin (PSW); establishing the inaugural IPAF RAGBRAI team to participate in The Register’s Great Annual Bicycle Ride Across Iowa; launching new programs to assist with providing sustainable funding into the Foundation; and hosting a another successful golf tournament which resulted in three additional student scholarships.
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• Leadership Development: Facilitating programs of leadership skill development for student pharmacists and new pharmacistpractitioners. • Continuing Professional Education: Supporting the development, in cooperation with Iowa’s two colleges of pharmacy, of CPE programs for pharmacists and pharmacy technicians.
The generosity of Iowa pharmacists is something we all greatly cherish. One group I would like to thank for their time and efforts to support the activities of the IPA Foundation are my fellow on the IPAF Board of Directors: Bill Baer, RPh, CGP, Vice President, Chariton Kate Gainer, PharmD, Secretary/ Treasurer, Des Moines Carl Charlstrom, RPh, Anamosa Renae Chesnut, RPh, EdD, MBA, Des Moines Jay Currie, PharmD, FCCP, FAPhA, Iowa City Wendy Duncan, PhD, Des Moines Sue Purcell, RPh, Dubuque Bernard Sorofman, PhD, Iowa City Bob Stessman, RPh, Manning Julie Kuhle, RPh, Indianola Cheri Rockhold Schmit, RPh, Ames
• Pharmacy Heritage: Preserving pharmacy’s rich heritage and promoting its culture to the profession and the general public. • Professional Recognition: Spotlighting excellence in leadership and practice innovation through award programs. • Resource Development: Obtaining resources from pharmacy-related organizations and professionals via annual fundraising programs, estate gifting, memorials, and endowed programs of scholarship, recognition, and professional development. We ask you to consider how you might best help our profession by making a tax-deductible contribution in support of our great profession.
1. Create and Strengthen Brand Identity Among the Pharmacy Community 2. Complete the Leadership Pharmacy Endowment Campaign - $375,000 Goal 3. Develop and Implement a Comprehensive Plan for General IPA-F Fundraising
IPA FOUNDATION IPA-F Board of Directors: May Meeting Recap
The IPA-F Board of Directors spring meeting was held on May 22nd, 2014. The board meets quarterly to discuss support of education, research, and practice development while inspiring generosity and fulfilling the aspirations of the profession. Discussion at the May meeting included: RAGBRAI –The inaugural IPA-F RAGBRAI team will kick off their ride on July 20th in Rock Valley and end on July 26th in Guttenburg. 13 members and non-members will be participating on this year’s team. The board discussed plans to work with local pharmacies to promote the profession of pharmacy through the week-long event. Eggleston/Granberg Golf Classic –This year’s event will be held on September 19th at Brown Deer Golf Course in Coralville. New this year the Golf Classic will be coupled with the Bill Burke Student Pharmacist Leadership Conference. Thomas R Temple Leadership Endowment – The endowment was established three years ago with most commitments being paid off in 2013. The board discussed opportunities to fulfill the remaining endowment goal with additional pledges and encouragement of 100% participation from past conference participants. Iowa’s portion of the Endowment is $375,000. It was shared that to date, just over $303,000 has been raised. Legacy Society/Foundation Institute – The Board was notified that promotional materials for the Legacy Society/Foundation Institute are now available. It was discussed that these methods of giving are to provide sustainable funding to the Foundation and these levels of giving will be recognized accordingly. The board also heard updates from IPA and CEI staff on current professional and educational programs. The next
board meeting is for September 19th in conjunction with the EgglestonGranberg Golf Classic. Board of Directors 2014-2015 – Tim Becker was nominated and successfully elected to serve as President for 2014-2015 and Bill Baer was nominated and successfully elected to serve at Vice President for 2014-2015. The Board also recognized Leman Olson and Steve Mullenix for the completion of their terms on the board. They were thanked for their service and time to the Board. We would like to welcome the 2014-2015 Board of Directors members, Julie Kuhle and Cheri Rockhold Schmit.
Successful IPA Foundation Silent Auction
This year proved to be another successful IPA Foundation Silent Auction and Dessert Reception held during the 2014 IPA Annual Meeting. More than 95 items were donated and auctioned throughout the evening. More than a dozen people contributed bottles of wine and spirits to the 2nd Annual Ring Toss. Those who attended the reception enjoyed a variety of desserts as they bid on items. A new lively game of heads and tails was introduced. Attendees enjoyed the game and the opportunity to win $1,000. Over $15,000 was raised to help support the mission and activities of the IPA Foundation. In conjunction with the Annual Meeting activities the IPA Foundation introduced the Red Envelope challenge. Attendees had the opportunity to purchase envelopes that were labeled from 1-100. Donations were then given in correspondence to the dollar amount on the outside of the envelope. Through this new interactive game we were able to raise an additional $4,197 for the IPA Foundation.
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ipa foundation Ragbrai
Best of luck to the IPAF team!
jerseys available!
Male & Female Available – Medium & Large – Includes FREE Socks
We appreciate your efforts to inspire generosity and fulfill the aspirations of the profession of pharmacy across the state! • Don Letendre, Iowa City, IA • Matthew Letendre, Providence, RI • Ben Urick, Iowa City, IA • Anthony Pudlo, Des Moines, IA • Theresa Legg, Atlantic, IA • Melanie Furman, Cedar Rapids, IA • Wendy Duncan, Des Moines, IA • Sean Mount, Des Moines, IA • Kate Oltrogge, Coralville, IA • Angie Spannagel, Dubuque, IA • Brian Spannagel, Dubuque, IA • Sharon Cashman, Waverly, IA • Sarah Cashman, Waverly, IA • Natalie Roy, Des Moines, IA • Pam Stierman, Dubuque, IA • Emily Vvyerberg, Dubuque, IA
Thanks to our sponsors and contributors
• Teva Pharmaceuticals, Presenting Sponsor • Nucara Pharmacies, One Day Sponsor • Meyer Pharmacy, Student Sponsor • John Daniel, Rider Sponsor
Thanks to our fellow pharmacists
that have agreed to host our team along the route • Rock Valley – Del Knobloch • Okoboji (Iowa Great Lakes) – Gayle Mayer • Emmetsburg – Mark & Barb Anliker • Forest City – Matt Farndale and Mary Ellis • Mason City – Tim Becker • Waverly – Sharon Cashman and Colleen Losey • Independence – Mitch Barnett • Guttenburg (post ride) – Dick Hartig
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Thomas R Temple Leadership Endowment With an Iowa goal of $375,000, the Thomas R. Temple Leadership Endowment was organized to endow the Leadership Pharmacy Conference. The endowment campaign was created three years ago in recognition of the founder of Leadership Pharmacy, Tom Temple, CEO Emeritus of the Iowa Pharmacy Association. To date, over $303,000 in pledges and payments have been secured for the Endowment Fund. We need your help to tackle the rest of the goal. This Fall, the Iowa Pharmacy Association and Pharmacy Society of Wisconsin will be bringing back the friendly competition to see which state can raise more money for their Leadership Pharmacy Endowment Fund leading up to the upcoming Big Ten Rivalry Football Game on November 22nd between The University of Iowa and University of Wisconsin-Madison. Contact the IPA office at 515-270-0713 to make a contribution or set up an annual pledge schedule to help IPA win the challenge over PSW and ensure the future of the Leadership Pharmacy Conference!
100%
$375,000
90%
$333,000
80%
$300,000
70%
$262,500
60%
$225,000
50%
$187,500
40%
$150,000
30%
$112,500
20%
$75,000
10%
$37,500
IPA FOUNDATION Foundation Student Scholarship Awardees
Congratulations to the 20142015 IPA-F Student Pharmacist Scholarship Awardees! Your commitment to your professional education and outstanding contributions to the profession of pharmacy do not go unnoticed! Keep up the great work! The University of Iowa: 2014-2015 Academic Year IPA-F Eggleston-Granberg Scholarships Aaron Peck Jeremy Price IPA-F General Scholarships Courtney Converse Savana Novak Alison Bieber
Drake University: 2014-2015 Academic Year IPA-F Eggleston-Granberg Scholarships Doug Dlouhy Carson Klug IPA-F Mike & Terry Pursel Scholarship Eric Liu IPA-F Russell E. Johnson Jr. & Lucille Johnson Scholarship Stacy Reid IPA-F General Scholarships Natalie Roy Travis Carlson Kirsten Elwood Anne Feldman Natalie Gadbois
Be part of the FOUNDATion Institute This group of donor leaders in Iowa make a commitment to annual giving in support of the Foundation’s mission. Contact the Foundation to set up your 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-$499 $100-$249 Up to $99
REGISTER tODAY! Eggleston-Granberg Student Scholarship Golf Classic is a fun amateur golf event, sponsored by IPA-F, to support pharmacy student scholarships at Iowa’s colleges of pharmacy.
friday, september 19th 1:00pm Shotgun Start 6:30pm BBQ & Awards Dinner Brown Deer Golf Course | Coralville, IA
Register at www.iarx.org Participant Registration Includes: 18 Holes of Golf, Cart, Prizes and BBQ Dinner
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ipa foundation
Future is Now:
Pharmacists Selected to Leadership Pharmacy
T
he Leadership Pharmacy Conference & Academy is set to begin on August 7-10 at the Eagle Ridge Inn and Resort near Galena, Illinois, on August 7-10, 2014. This Conference serves as the primary event and kick-off to a 10 month Leadership Academy. The Leadership Academy provides an unequalled opportunity for pharmacists in their first fifteen years of practice to develop organizational skills which enable both personal and professional growth. This year’s participants will be recognized for completion of the Leadership Academy at IPA’s 2015 Annual Meeting.
Congratulations 2014-2015 Leadership Pharmacy participants! Gary Christensen, PharmD Katie Cinnamon, PharmD, BCPS Kyra Corbett, PharmD John Daniel, PharmD Alisha Eggers, PharmD Candace Jordan, PharmD Danielle Kennedy, PharmD Emily Muehling, PharmD Kate Oltrogge, PharmD Wes Pilkington, PharmD
Hy-Vee Pharmacy – Iowa Falls Genesis Medical Center – Davenport CarePro Liberty Pharmacy Daniel Pharmacy – Fort Dodge NuCara Pharmacy – Waterloo Mercy Medical Center – West Lakes Towncrest Pharmacy – Iowa City UnityPoint Health – Des Moines University of Iowa Hospitals and Clinics Greenwood Drug – Waterloo
Congratulations!
Greenwood Pharmacy congratulates Wes Pilkington, PharmD on being selected to attend the 2014 TRT Leadership Pharmacy
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IPA FOUNDATION
congrats, candy JOHN DANIEL, PharmD on his selection by the Iowa Pharmacy Association as a participant in the 2014 Leadership Pharmacy Conference.
Congratulations to
Candace Jordan, PharmD, RPh Pharmacy Manager at Mercy West Lakes – West Des Moines on being selected to attend the IPA Leadership Conference.
Daniel Pharmacy
Committed to serving our community’s healthcare needs
on being selected to participate in the 2014 TRT Leadership Pharmacy Conference
leadership pharmacy sponsors:
Emily Muehling, PharmD
Your support is appreciated! jul.aug.sept 2014 JUL.AUG.SEPT
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public affairs
Bill Wimmer, JD IPA’s Legislative Counsel
Angela Davis, JD IPA’s Legislative Counsel
Legislative Session Recap Submitted by Bill Wimmer & Angela Davis, IPA’s Legislative Counsel
T
he 2014 Iowa Legislative Session was an interesting series of election year positioning and limited bipartisan cooperation. Recurring news headlines painted graphic attacks on the operation of state government by highlighting a multitude of issues involving the Governor, the Department of Administrative Services, and the Secretary of State’s office. The
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Senate Oversight Committee hearings on alleged “secret settlement agreements” monopolized a great deal of legislator time which extended the session longer than originally predicted. While legislators attempted to focus on legislative priorities for the most part, on the back-burner were re-election concerns and campaign strategies that have recently emerged more publicly through newspaper articles and television commercials. Open seats in the U.S. Senate, as well as the First and Third Congressional districts have engaged legislators on the state level to run for higher office. Losing some state legislators to national campaigns has resulted in targeted recruitment for new House and Senate candidates. Federal and state primary results were out in early June, and campaign efforts to further introduce state candidates are underway. With a slim margin in both the House and Senate—Democratic majority in the Senate, Republican majority in the House—leadership in both chambers is strategically working to increase margins that will allow for a change in dynamics next legislative session. In the area of pharmacy it was an impactful year with the passage of House File 2297, which gives more authority to the Iowa Insurance Division to regulate PBMs operating within the state. This legislation is a first step in trying to bring fairness back into a process that has damaged pharmacies in Iowa, resulting in 41 pharmacies closing their doors last year. IPA’s grassroots network was instrumental in supporting our legislative efforts at the Capitol with both legislators as well as the Governor’s office. The voices and stories from around the state each played a part in helping develop awareness of how damaging PBM practices have become. Administrative rules introduced by the Insurance Division were also passed this session. Other bills of interest include the cannabis bill, Senate File 2360, which
passed the House in the final week of session. In a surprisingly swift move, an amendment was approved that limits the original bill to allow epileptic patients and their caregivers to possess cannabidiol with a neurologist’s recommendation and a state-issued ID card. The doctor must practice in Iowa and caregivers must be designated by the recommending doctor. House File 2463, the Health and Human Services bill contained language that attempts to resolve issues on Prior Authorization, Healthiest Children Initiative, and appropriation amounts to Medicaid programs. The Board of Pharmacy was also successful in passing two pieces of legislation that were signed by the Governor in early April—Senate File 2080 to expand PMP connectivity to neighboring states and Kansas and Senate File 2121 dealing with substance abuse schedules. Overall, it was a strong year for pharmacy issues. We continue to look ahead hopeful that the steps taken in 2014 will support the long-term goals of the pharmacy profession and our valued pharmacists across the state.
2015 LEGISLATIVE DAY:
thurs, Jan. 29
CAPITOL SCREENINGS DAY
thurs, Apr. 7
Des Moines Downtown Embassy Suites & Iowa State Capitol
Karbeling Award Honorees Attend NCPA Legislative Conference
By: Matthew Farley 2015 PharmD Candidate Laura Vollmer 2015 PharmD Candidate The National Community Pharmacists Association (NCPA) Legislative Conference was an incredible learning experience full of passion and excitement for the profession of pharmacy. The conference incorporated speakers from various areas of healthcare and provided in-depth information at each general session. We were thrilled to be able to be among individuals that are pushing the profession forward in a positive manner. Each session comprised of a speaker(s) that talked about hot topics within the profession such as issues with PBM’s, new regulations from the FDA and much more. The Legislative discussion provided a great culture of encouragement and understanding about how pharmacy leaders could implement change. We were overwhelmed by all the knowledge and wisdom presented to us throughout the trip! Futhermore, we were grateful to learn about Iowa’s pharmacy leaders and their encompassing goals for the profession. We were amazed by the presence of Iowa leaders on the national level and impressed by their ideas. We visited Iowa’s Congressmen and presented information about current issues impacting both pharmacists and patients alike. We feel truly grateful to have been a part of the Karbeling Leadership trip to Washington D.C. It was an inspiration for our future practice. Patient and pharmacy advocacy is an essential part of the pharmacy profession. We were not only honored, but also inspired to continue Jerry Karbeling’s legacy of passion and excitement for the political process.
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. 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 at www.iarx.org.
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public affairs Board of Pharmacy Collaborates for Patient Safety Telepharmacy Task Force Develops Recommendations The Telepharmacy Task Force met three times in the spring of 2014. The Task Force was charged to develop recommendations for the profession of pharmacy to address legislative and regulatory requirements, as well as education and best practices related to telepharmacy in community settings, acute and institutional applications, as well as specialty opportunities.
process for telepharmacy practice sites to be approved by the Board of Pharmacy for each applicant. 5. To recommend continuing education and training for pharmacists and pharmacy technicians providing patient care services through telepharmacy. 6. To maintain rules relating to hospital pharmacy remote order verification in board rules regarding hospital pharmacy practice (657 IAC Chapter 7). 7. To further explore opportunities for telepharmacy applications in other pharmacy practice settings.
Task Force Members: Brett Barker Randy 2014 Recommendations Mike Brownlee McDonough 1. To pursue legislative changes in Renae Chesnut Jim Miller 2015 to IC chapters 147 and 155A, Michele Evink John Swegle amending the current requirement for Ryan Frerichs Todd Thompson AMDS in telepharmacy practices. Susan Frey Judy Trumpy 2. To revise telepharmacy rules in 657 Felix Gallagher Sam Zoske IAC, re-defining telepharmacy services and establishing necessary criteria. Compounding Task Force Reconvenes 3. To state the purpose and intent Fifteen IPA members have been active of telepharmacy rules, providing that on a BOP/IPA joint task force on telepharmacy is intended to increase compounding pharmacy practice. This access to pharmacist and pharmacy task force was set up to evaluate the services, and enhance the care and current definitions of compounding communication between patients and in Iowa and provide guidance to the pharmacists. stakeholders regarding provisions of 4. To create an application form and the Drug Quality and Security Act. The Board of Pharmacy was presented information on the NABP Verified Pharmacy Program (VPP), Professional Licensure & Ethics an online Counsel and Representation network for pharmacy • Licensing Board Inquiries • Ethics inspection • Professional Discipline • Errors and Omissions reports. This • Proactive Negotiation with Insurance VPP program Federal and State Agencies • Coverage was a point of and Administrative Boards • Conflicts of Interest discussion during the compounding Contact: David L. Brown, Chester C. Woodburn, III task force or Alexander E. Wonio meeting as a possible 5th Floor, U.S. Bank Building mechanism
HANSEN, MCCLINTOCK & RILEY
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520 Walnut Street Des Moines, IA 50309 515-244-2141
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www.HMRLAWFIRM.com
to confirm inspections of non-resident pharmacies licensed in Iowa. This task force will continue to meet in 2014 to prepare its recommendations to the BOP and IPA. PIC Responsibility Task Force Meets for First Time Key members of the Iowa Patient Safety Task Force, which convened throughout 2012 and 2013, have come together with members of the Board of Pharmacy’s Rules Committee to review and recommend revisions to Iowa Board of Pharmacy rules and statute related to Pharmacist-in-Charge responsibilities. At the initial May 13th meeting, the group reviewed the IPA Policy on the Patient Safety Task Force recommendations and other ethical and legal responsibilities of the PIC seen in other states. At this time, the task force is looking for areas that need legislative changes moving forward into the 2015 legislative year due to limitations in current Iowa Code. Therapeutic Shoe Fitting Confusion In recent months, pharmacies were notified by their accrediting organization of an Iowa law that would preclude pharmacies from fitting or dispensing therapeutic shoes as of July 1, 2014. Over the past 3 months, IPA has worked to seek clarity on this issue through numerous meetings with the Board of Pharmacy, Attorney General’s office, accrediting organizations, shoe insert manufacturers, and its members. The Boards of Pharmacy and Podiatry have written letters to the eight (8) different accrediting organizations and CMS stating that the fitting and dispensing of therapeutic shoes are within the scope of pharmacy practice in the state of Iowa. This supports the ability of Iowa pharmacies to continue to provide therapeutic shoes and inserts to patients in their communities as of June 30th.
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peer review
Overcoming Barriers:
A survey of Iowa’s Perinatal HIV Transmission Prevention Readiness Authors: Sarah J Johnson, PharmD, BCPS Clinical Pharmacy Specialist/Clinical Assistant Professor Department of Pharmaceutical Care University of Iowa Hospitals and Clinics University of Iowa College of Pharmacy Rawand Khasawneh, PharmD Clinical Pharmacist Fellow University of Iowa Hospitals and Clinics Kristi L Dimke, MS, PharmD, MPH Clinical Pharmacist, Veterans Affairs Hospital (Iowa City, IA) Erika J Ernst, Pharm.D.,BCPS,FACCP Associate Professor University of Iowa College of Pharmacy Corresponding author: Sarah J Johnson, Pharm.D., BCPS Clinical Pharmacy Specialist/Clinical Assistant Professor Department of Pharmaceutical Care University of Iowa Hospitals and Clinics University of Iowa College of Pharmacy 200 Hawkins Drive, CC101GH Iowa City, IA, 52242-1009 sarah-j-johnson@uiowa.edu 319-356-7328 (office) 319-353-8443 (fax) Conflict of interest statement: The authors have no conflicts of interests to disclose. ABSTRACT: Background: Each year more than ten HIV positive mothers give birth in Iowa hospitals, and this number is increasing. Of note, between 2000 and 2010, there were 7 confirmed cases
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of perinatal HIV transmission in Iowa. Development of institutional perinatal HIV prevention protocols in Iowa hospitals is supported by and consistent with CDC recommendations; without treatment, an HIV positive mother has a 25% chance (1 in 4) of passing the virus to her baby. Goal of the study: To assess the readiness of Iowa’s birthing hospitals to provide care to HIV positive mothers to prevent the transmission of the virus to newborns. Methods: To assess the readiness of Iowa birthing hospitals in prevention of perinatal HIV transmission, a survey, based on a previously conducted Illinois survey, was sent to all 83 Iowa birthing hospitals. The survey included both healthcare providers in labor and delivery units as well as hospital pharmacists. Our team contacted the pharmacy providers to administer the survey over the telephone. The labor and delivery units were sent the survey electronically, but were telephoned with reminders to complete the survey. Results: Of the 37 labor and delivery unit representative in Iowa that completed the study, only 50% reported the availability of a documented HIV test results for >90% of mothers who present to labor and delivery. The pharmacy survey indicated that zidovudine (AZT) was not readily available in most Iowa hospitals. Conclusion: The cases of perinatal HIV transmission in Iowa, despite the known effectiveness of preventive strategies, highlight a real problem. Consistent with Iowa law, all pregnant mothers should receive information about HIV and HIV testing, and should be tested unless they “opt-out.” Pharmacies in birthing hospitals should maintain a stock of IV AZT as well a bottle of oral AZT liquid in their inventories. Pharmacists must be knowledgeable on the appropriate HIV prevention drug administration protocols.
I
ntroduction: HIV in Iowa The Center for Disease Control and Prevention (CDC) estimates that as of the end of 2010, there were 872,990 persons in the United States living with human immunodeficiency virus (HIV) and approximately 487,692 persons in the United States living with
acquired immune deficiency syndrome (AIDS).1 In its 2012 HIV Surveillance Report, the Iowa Department of Public Health (IDPH) accounted for 2,023 persons living with HIV or AIDS who were Iowa residents at time of diagnosis, but there are likely more persons living with HIV when adjusted for underreporting, lack of diagnosis and those diagnosed in other areas before moving to Iowa.2 In Iowa, over the past 10 years an average of 111 persons per year were diagnosed with HIV; in 2012, 120 persons were diagnosed. The prevalence of HIV in Iowa continues to increase. As of the end of 2012, there were 64 persons living with HIV or AIDS per 100,000 persons; this is an increase from 10.7 persons per 100,000 persons since 2008. Each year more than ten HIV positive mothers give birth in Iowa hospitals, and this number is increasing. Between 2000 and 2005, 46 infants were born to HIV positive mothers in Iowa, and 3 (7%) became infected with HIV. Four additional confirmed cases of perinatal transmission of HIV occurred in Iowa between 2006 and 2010; for a total of seven cases of HIV transmission between 2000 and 2010.3 HIV transmission from mother to baby is considered by the CDC to be a sentinel event, and the birth of each HIV infected infant represents a missed preventive opportunity.4,5,6 Intrapartum treatment of the mother and postpartum treatment of the infant can reduce transmission rates to less than 10%, while both antepartum and intrapartum treatment of the mother and post-partum treatment of the infant can reduce transmission to less than 2%4; without treatment one in four HIV positive mothers will transmit the virus to her newborn.1 The efficacy and safety of both antepartum and intrapartum treatment of the mother and post-partum treatment of the infant with zidovudine (AZT) have been demonstrated in a number of clinical trials.7,8,9 In the Pediatric AIDS Clinical Trials Group 076 (PACTG 076 trial),
Table 1: HIV Testing During Pregnancy10 Who should be tested? • All pregnant women should be screened for HIV infection. • Health care providers should test women for HIV as early as possible in the pregnancy.
Connor et al, found that maternalinfant HIV transmission was reduced by two thirds with the use of such an approach.7 The results from PACTG 076 trial were congruent with those reported when HIVNET 012 trial was conducted to compare the safety and efficacy of short-course oral nevirapine (NVP) and AZT for preventing motherto-child transmission of HIV-1.8,9 Given the available evidence assuring both the safety and efficacy of AZT in the prevention in perinatal HIV transmission, we elected to assess the readiness of Iowa’s birthing hospitals to provide care to HIV positive mothers to prevent the transmission of the virus to newborns through the availability of intravenous and oral solutions of AZT at the time of delivery.
Iowa Law
In 1998 Iowa law mandated that healthcare providers offer HIV testing to pregnant mothers who meet certain high risk criteria. Since then, Iowa Code has been updated to reflect current CDC and American College of Obstetrics and Gynecology (ACOG) recommendations that all pregnant mothers should be tested for HIV infection unless they “optout”, or decline the test (Iowa Code Chapter 141A.4). Although it is not codified in law, the Iowa Department of Public Health (IDPH), CDC, and ACOG recommend that a second HIV test be performed during the third trimester, preferably at less than 36 weeks gestation in those mothers with risk factors for HIV infection (Table 1).5,10,11 CDC, IDPH and ACOG guidelines also recommend rapid antibody testing (point of care testing) for all mothers whose HIV status is unknown at the time of labor and delivery, and testing of newborns immediately after birth if the HIV status of the mother is unknown.5,10,11 The latter recommendation for testing newborns is not consistent with Iowa Code 141A.6, which requires the consent of the parent or guardian. This inconsistency may lead to lack of testing in infants.
A Survey of Iowa’s Perinatal HIV Transmission Prevention Readiness
What are risk factors for additional follow-up testing? • Women who use injection drugs and their sex partners • Women who exchange sex for money or drugs. • Women who are sex partners of HIV-infected persons. • Women who have had a new or more than one sex partner during pregnancy. • Women who have signs or symptoms consistent with acute HIV infection.
Cases of perinatal transmission in Iowa are sobering and highlight a very real problem; despite widespread knowledge of how to prevent motherto-child transmission of HIV, barriers to detection of the virus and how to prevent its transmission still exist. Barriers can be further divided into those related to the lack of HIV test results upon presentation of an HIV infected mother to her local hospital for delivery, and others related to lack of a hospital specific protocol for administration of prophylactic AZT therapy to HIV positive mothers during labor and delivery.8
Purpose of the study
The purpose of this study was to ascertain the knowledge and practices of all Iowa birthing hospitals with regard to HIV testing of intrapartum women in labor and delivery and hospital ability to provide timely IV AZT prophylaxis to prevent vertical HIV transmission in HIV positive mothers. The survey results are intended to aid in efforts to increase patient access to rapid HIV testing and antiretroviral prophylaxis. A survey of all 83 Iowa birthing hospitals was conducted during spring of 2010. To assess the readiness of both pharmacy and labor and delivery practices, two surveys were conducted; one for the pharmacy and one for the nurse manager of the labor and delivery units (appendix A). The survey included 83 labor and delivery units at institutions where labor and delivery services were offered or planned to be offered in the near future and 80 Iowa hospital pharmacies. Only 80 pharmacies were surveyed because some pharmacies were providing services to more than one labor and delivery unit.
The survey questions were based in part on an Illinois study, which also sought to assess the perinatal HIV transmission safety net.12 The nurse managers’ survey contained 40 questions and was distributed electronically. An email letter of introduction was sent to all nurse managers of labor and delivery units in Iowa. A follow up email with a word document containing the survey along with a link for the electronic survey was sent within one week of the introductory email. Survey respondents could elect to complete the printed survey and return the results by mail. A reminder email was sent that contained another link for the survey (Appendix A). Pharmacies were surveyed by telephone because they were easier to identify and contact and the survey was shorter, containing only 8 items (Appendix B), and the contact for the pharmacy was more easily identifiable.
HIV Screening
Surveyed labor and delivery unit representatives responded with a rate of 45% (n=37). Of the labor and delivery units in Iowa that completed the survey, accounting for approximately one-half of the births in the state of Iowa, only 49% reported the availability of a documented HIV test result for more than 90% of mothers who present to labor and delivery, and only 51% of hospitals have the ability to rapidly test for HIV. Survey respondents noted that the most commonly encountered barriers to having an available HIV test result related to insufficient prenatal records transfer (40%) and lack of prenatal testing (27%). Results from the perinatal HIV needs assessment survey indicate that when it comes jul.aug.sept 2014
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peer review to HIV testing at the time of labor and delivery, only 27% of hospitals automatically order a rapid HIV test for mothers whose HIV status is unknown. In Iowa, 54% of reporting hospitals indicate that HIV testing is never done in labor and delivery, and rapid testing is only available in about half of labor and delivery units.13 Lack of HIV testing means that the available data reported on transmission and rates of HIV positive mothers giving birth in Iowa may be underreported.
Zidovudine (AZT) Availability
Sixty three percent (n=50) of hospital pharmacies responded to the phone survey. The pharmacy survey indicated that AZT, the antiretroviral agent commonly used for prophylaxis in the prevention of perinatal HIV transmission, was not readily available in most Iowa hospitals. See Table 2 for the results of the pharmacy survey. Lack of pharmacy protocol for AZT administration is the most prominent barrier in local hospitals, approximately 20% of surveyed hospital pharmacies has either parenteral AZT or syrup AZT available for use within 30 minutes should the need arise. Pharmacy personnel were aware of the purpose of AZT prophylaxis at most responder sites. The DHHS recommends that intrapartum intravenous (IV) AZT be administered to all HIV positive mothers, regardless of the antepartum regimen, from the onset of labor until delivery to reduce perinatal transmission.4 An exception to this rule, are HIV-infected mothers receiving combination ARV regimens who have a viral load < 1000 near delivery in which the case the administration of IV AZT is no longer required.4 Based on pharmacokinetic data, in women with HIV RNA ≼ 1000 copies/mL near delivery for whom AZT is recommended, IV would be preferred to oral administration in the United States; in situations where IV administration is not possible, oral administration can be considered.4 Of the pharmacists responding to
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Table 2: Pharmacist Telephone Survey Responses Telephone survey questions (n=50 ; 63% response rate)
n
%
Labor & delivery has 24-hour access to medications
42
84.0
Routinely stocks IV AZT
9
18.0
Routinely stocks syrup AZT
10
20.0
Ability to provide IV AZT within 30min of order anytime
10
20.0
Ability to provide syrup AZT within 30min of order anytime
11
22.0
Pharmacy personnel are aware of purpose of AZT prophylaxis
33
66.0
Prioritization of dispensing AZT to labor & delivery as a STAT medication
9
18.0
Table 3: Response to HIV Testing Survey- Web survey (n=37 ; 45% response rate) Number of women who present with a documented HIV result
%
Almost everyone (> 90%)
50.0
More than half but less than 90%
13.0
Less than half but more than 10%
17.0
Less than 10%
17.0
Of the women who present without a documented HIV status; what percentage receives testing?
%
Less than 10%
50.0
More than 90%
27.0
A test would be automatically ordered if a previous result was not available
23.0
A protocol is in place which states that all pregnant women without a documented HIV status at time of labor must be counseled and offered rapid HIV testing
10.0
Rapid HIV testing is available
50.0
Point of care HIV testing is available
the survey, a least 62% did not have AZT on hand or even stocked at the hospital to treat HIV infected mothers or for the prophylaxis of infants, and those that did not have AZT indicated that if the drug was needed it would take greater than two hours to obtain. Further, 84% of pharmacists indicated that they had no protocol in place for the administration of prophylactic antiretroviral therapy to HIV positive mothers during labor and delivery.
Implication of the study
Ensuring that AZT, now generically available, is stocked in Iowa’s birthing hospitals is a relatively simple and inexpensive barrier to overcome. The average wholesale price (AWP) of 10 vials of IV AZT (the recommended amount of drug to keep on hand, and which remains stable for approximately three years), is roughly $350. This stands in stark contrast to the cost of antiretroviral therapy which is estimated to be greater than $1,800 per month up to nearly $3000 per day.14,15 Taking into consideration the average life expectancy
0
of a child with HIV, the lifetime cost of treatment would conservatively exceed 1.4 million dollars.16,17 Our study demonstratedthe importance of issuing recommendations regarding rapid HIV testing and offer protocols and support to all hospitals. It might be useful to identify regional hospitals which can champion the cause in their area and be a resource for other hospitals with regard to teaching and drug availability.
Role of the Pharmacist in Perinatal HIV Management
The use of effective highly active antiretroviral treatment (HAART) during pregnancy and labor and delivery, reduces the risk of passing HIV to infants.7 Effective HAART is a triad of early initiation of at least three HAART agents during pregnancy, IV administration of AZT at onset of labor, and administration of oral AZT to the infant immediately after birth and for six weeks thereafter (Table 3).18 In collaboration with other team
public affairs
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peer review members, the pharmacist must ensure the aforementioned strategies are implemented whenever an HIV infected mother presents in active labor. Lack of knowledge of current HIV status due to the absence of prenatal care, low socioeconomic class, and suboptimal adherence to HAART throughout pregnancy, represents an actual obstacle to care in such cases.18 Clinical pharmacists at the hospital play an instrumental role in the prevention of perinatal HIV transmission. Pharmacists can be an HIV counselor for both inpatients and outpatients; by proactively attending the STDs, OB/ GYN clinics and spread the knowledge through informative leaflets and posters. The pharmacist can fulfill a clinical role by being an important member of the team of physicians and consultants responsible for HIV drug therapy and must be knowledgeable regarding the appropriate AZT drug administration protocols. Pharmacists in the community have a unique relationship with their patients and should recommend prenatal HIV testing to their patients, provide educational resources regarding testing, or offer testing services.19 Pharmacists can encourage pregnant HIV positive mothers to seek prenatal care and to maintain close follow-up with their HIV specialist throughout their pregnancy. Pharmacists can also play a key role in enhancing adherence, educating their patients on the importance of continuing HAART in order to suppress HIV viral load, reduce pregnancy complications, and prevent perinatal HIV transmission. Improving patient’s awareness of possible adverse events and how to deal with such events represent a crucial component in increasing tolerability of medications. Pharmacists in the community can contact the local hospital where the patient is planning to deliver to ensure AZT supplies are on hand. In situations where an HIV positive mother may have to travel some distance to a labor and
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delivery unit, it may be advisable to contact other, more local surrounding hospitals to ensure that IV and oral AZT is immediately available should the patient need to utilize an unplanned labor and delivery unit, and the pharmacist can play an important role in this aspect.
Future direction and recommendations
Efforts must be condensed to improve adherence with perinatal mother to infant HIV transmission prevention guidelines. Firstly, continuing education must be provided to nurses regarding the opportunities for HIV testing and intervention, when feasible. Secondly, Drafting and sending a “Dear Provider” letter to OB and family practice physicians outlining the current best practices for HIV testing and treatment and ask them to support hospital based testing for those who haven’t had testing. Moreover, providing detailed information and cost information to inpatient pharmacies and stress the importance of continuously stock the medication. Increasing awareness of NIH guidelines and effective testing/ treatment protocols, and working with hospitals to increase capacity for rapid testing and to implement protocols for rapid testing is another effective way to enhance compliance with current guidelines. Finally, working with pharmacies to increase their awareness and capability to provide timely AZT prophylaxis (i.e. AZT is generic, long shelf life, relatively inexpensive) is another potential solution to the current problem.
Summary
The knowledge of how to prevent perinatal transmission is available, labor and delivery units in Iowa’s birthing hospitals should have the resources and protocols in place to ensure that no further perinatal HIV infections occur. Consistent with Iowa law, all pregnant mothers should receive information about HIV and HIV testing, and should be tested unless they “opt-out.”
Physicians and their representatives should ensure test results and prenatal records are available to labor and delivery units when patients present, and that a means of obtaining these records during nights and weekends exists. All birthing hospitals should have the capability to rapidly test for HIV in the event that a mother presents with no prenatal care, or if the results of previous HIV testing are not available in the maternal chart. Pharmacies in birthing hospitals should maintain a stock of IV AZT as well a bottle of AZT oral liquid in their inventories. Pharmacists should be knowledgeable regarding the appropriate AZT drug administration protocol. Transmission of HIV from mother to child is almost entirely preventable, while the consequences of not being prepared for such a situation include a lifetime of antiretroviral therapy for the infected infant. References 1. Centers for Disease Control and Prevention. HIV in the United States: An Overview. http:// www.cdc.gov/hiv/statistics/basics/ataglance. html (accessed 2014 February). 2. Iowa Department of Public Health. State of Iowa End-of-Year Surveillance Report (2012). http://www.idph.state.ia.us/HivStdHep/HIVAIDS.aspx?prog=Hiv&pg=HivSurv (accessed 2014 February). 3. 2011 Epidemiological Profile of Iowa . http:// www.idph.state.ia.us/HivStdHep/HIV-AIDS. aspx?prog=Hiv&pg=HivSurv (accessed 2014 July). 4. Panel on Treatment of HIV-Infected Pregnant Mothers and Prevention of Perinatal Transmission. Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1 Infected Mothers for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States. Updated March, 28, 2014; pp 1-225. http://aidsinfo.nih.gov/guidelines/html/3/ perinatal-guidelines/0 (accessed 2014 July). 5. Whitmore S, Taylor A, Espinoza L, et al. Correlates of Mother-to-Child Transmission of HIV in the United States and Puerto Rico. Pediatrics 2012:129; 1: e74-81. DOI: 10.1542/ peds.2010-3691. 6. Joint commission sentinel event policy and procedures. June, 10, 2013. http://www. jointcommission.org/Sentinel_Event_Policy_ and_Procedures/ (accessed 2014 February). 7. Connor EM, Sperling RS, Gelbert R, et al. Reduction of maternal-infant transmission of HIV type 1 with zidovudine treatment. NEJM 1994;33:1173-1180. 8. Guay L A, Musoke P, Fleming T, et al.
Table 4: Recommended Intrapartum Maternal and Neonatal Zidovudine Dosing for Prevention of Mother to Child Transmission of HIV4 MATERNAL INTRAPARTUM Zidovudine (AZT) Intrapartum and neonatal single-dose nevirapine compared with zidovudine for prevention of mother-to-child transmission of HIV-1 in Kampala, Uganda: HIVNET 012 randomized trial. Lancet 1999;354(9181):795– 802. DOI: 10.1016/S0140-6736(99)80008-7. 9. Jackson J B, Musoke P, Guay L A, et al. Intrapartum and neonatal single-dose nevirapine compared with zidovudine for prevention of mother-to-child transmission of HIV-1 in Kampala, Uganda: 18-month follow-up of the HIVNET 012 randomized trial. Lancet 2003;362(9387):859–868. DOI:10.1016/ S0140-6736(03)14341-3. 10. HIV/AIDS/Hepatitis Program. Iowa’s Perinatal Guidelines for HIV. Iowa Department of Public Health. Updated March 10, 2008. Available at: http://www.idph.state. ia.us/adper/common/pdf/disease_prevention_ immunization/perinatal_guidelines_HIV_2007.pdf 11. American College of Obstetricians and Gynecologists. Reducing HIV/AIDS Infection in Babies and Improving the Health of Pregnant Mothers with HIV/AIDS .http:// mothersandhiv.org/sites/default/files/pdf/ State%20Leg%20HIV%20Toolkit_2012.pdf (accessed 2014 February). 12. Eary, RL, Bryant Borders AE, Handler A, et al. AZT availability in Illinois birthing hospitals: is the perinatal HIV prevention safety net in place? Matern Child Health J 2007; 11:313-8. DOI: 10.1007/s10995-006-0175-y. 13. Johnson S, Dimke K, and Ernst E Assessment of hospital readiness in prevention of HIV transmission. Presented at: ASHP midyear meeting, New Orleans, LA, December 2011. 14. Cost of antiretroviral therapy. Available at: http://aidsinfo.nih.gov/guidelines/html/1/ adult-and-adolescent-treatment-guidelines/0 (accessed 2014 July). 15. Wilson LS, Basu R, Christenson M, et al. Pediatric HIV costs across three treatment eras from 1986 to 2007. Pediatrics 2010: 126; 3:e541-9. DOI: i: 10.1542/peds.2009-3485. 16. Child trends data bank: life expectancy for newborns. http://www.childtrends. org/?indicators=life-expectancy (accessed 2014 February). 17. Life expectancy for children born with HIV. http://positivelyorphaned.org/2011/03/28/lifeexpectancy/ (accessed 2014 February). 18. Foisy M, Hughes C. Role of the pharmacist in perinatal management of HIV disease. Am J Health-Syst Pharm 2011; 68: 2116-22. 19. What you should know about HIV testing during pregnancy. http://healthymaryland. org/wp-content/uploads/2013/03/12HIV-Testing-During-Pregnancy-Brochure.pdf (accessed 2014 February).
Looking to get Published? Consider submitting your research manuscript to be peer-reviewed by the Journal of IPA. Please send articles to IPA@iarx.org.
Dosing
Duration
2mg/kg body weight intravenously over 1 hour, followed by continuous infusion of 1mg/kg body weight per hour
Onset of labor until delivery of infant
AZT
≥35 weeks gestation: 4mg/kg body weight per dose given orally twice daily, started as soon after birth as possible, and preferably within 6-12 hours after delivery. (If unable to tolerate oral agents, 3 mg/kg body weight per dose given intravenously 6-12 hours after birth, then every 12 hours.)
Birth through 4 to 6 weeks
AZT
<35 to ≥30 weeks gestation: 2 mg/kg body weight per dose given orally (or 1.5 mg/kg body weight per dose intravenously), started as soon after birth as possible and preferably within 6-12 hours of delivery, then every 12 hours, advanced to 3 mg/kg/ dose PO (or 2.3 mg/kg/dose IV) every 12 hours at age 15 days.
Birth through 6 weeks
AZT
<30 weeks gestation: 2 mg/kg body weight per dose given orally (or 1.5 mg/kg/dose intravenously) started as soon after birth as possible and preferably within 6-12 hours of delivery, then every 12 hours, advanced to 3 mg/kg/dose PO (or 2.3 mg/kg/dose IV) every 12 hours after age 4 weeks.
Birth through 6 weeks
AZT NEONATAL
Additional Antiretroviral Prophylaxis Agents for HIV-Exposed Infants of Women who Received No Antepartum Antiretroviral Prophylaxis (initiated as soon after delivery as possible) In addition to ZDV as shown above, administer nevirapine
3 doses in the first week of life • 1st dose within 48 hrs of birth (birth–48 hrs) • 2nd dose 48 hrs after 1st • 3rd dose 96 hrs after 2nd
Birth weight 1.5–2 kg: 8 mg/dose PO Birth weight >2 kg: 12 mg/dose PO
HIV and Pregnancy; Myths and Facts2,4 MYTH: HIV only affects IV drug users and other high risk groups. FACT: Not all women are aware they are infected with HIV, hence HIV screening is strongly recommended as part of prenatal care for all women. MYTH: Antiretrovirals are unsafe to use during pregnancy. FACT: Most antiretrovirals are safe during pregnancy; however, some are not considered so. Nevirapine is not usually started in women with CD4 count >250 because of the risk of hepatic toxicity. Efavirenz should not be started in the first few weeks of pregnancy, however, women who become pregnant while taking this medication can continue it. Antiretroviral therapy is recommended to decrease the likelihood of mother to child transmission. MYTH: Antiretrovirals can be held until labor and delivery. FACT: A combination of at least three antiretrovirals is recommended in all pregnant women. In addition, IV AZT should be administered during labor and delivery. Combination ARV regimens should include a dual nucleoside reverse transcriptase inhibitor (NRTI) backbone that includes one or more NRTIs with high levels of transplacental passage (AZT, lamivudine, emtricitabine, tenofovir, or abacavir). MYTH: In Iowa transmission of HIV from mother to baby is unlikely; and carrying supplies of IV AZT is an added expense. FACT: It is true that in Iowa HIV is uncommon; however, there have been 7 transmissions in the past decade. Perinatal transmission of HIV is considered a sentinel event and is highly preventable. Stocking IV AZT is of minimal price when compared to the possible consequences of not having the drug on hand should the need arise, and compared to the cost of a lifetime of HIV/AID anti-retroviral therapy.
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peer review Appendix A State of Iowa Perinatal HIV Needs Assessment Survey Please answer the following questions to the best of your ability. If you believe that you are not the most qualified person to answer these questions please forward this survey to the appropriate person. If you have questions regarding the survey please call or email Kristi Dimke at kristi-dimke@ uiowa.edu 716-307-5038. Contact information for person filling out this survey: Name Title Hospital Hospital Level Address Phone number Email General Information 1) Approximate number of nurses in labor and delivery work pool, including who float to L&D? 2) Number of obstetricians, family practitioners and midwives who have privileges to deliver at your hospital? 3) Number of total deliveries per year at your facility? 4) Estimated percentage of deliveries per year with no prenatal care? 5) Estimate the number of women who present to labor and delivery with a documented HIV result available at the time of presentation. < 10% (almost no one)/ ( 11 – 50%) (fewsome) / (51 – 90%) (many-most)/ /> 90% (almost everyone) 6) Of the women who present without a documented HIV status, what percentage receive HIV testing prior to delivery? < 10% (almost no one)/ ( 11 – 50%) (fewsome) / (51 – 90%) (many-most)/ /> 90% (almost everyone) Prenatal Records 7) How are prenatal records currently transferred from prenatal clinics to your labor and delivery or care unit? Faxed/Mailed/Computer records always available/Hand delivered by patient/Other/ Multiple Ways 8) Prenatal records are transferred or available at the labor and delivery unit at what gestational age? always available/20-31 weeks/32-35 weeks/> 36 weeks/ not specified/other 9) If a woman presents in preterm labor before records are usually transferred, how are prenatal records obtained? Computer/ Call office or clinic for records during office hours/Patient carries prenatal
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records on a card with them/ Clinic is attached to hospital, prenatal records always available/ Prenatal Records are not available off hours before ____ weeks /other 10) Currently, what are the barriers to having the HIV test results immediately available when a patient presents in labor? Check all that apply. (Please add comments if applicable.) Prenatal HIV tests are not done/ HIV test results are not documented/ Prenatal records are not efficiently transferred from prenatal clinics/ Prenatal records are transferred but difficult to access on L&D/ Prenatal records are not always available on nights or weekends/Laboratory does not release HIV test results to L&D staff/ No computer availability/Confidentiality issues prevent access to HIV results/No barriers identified/Other issues 11) Currently, are HIV results from prenatal testing documented in the maternal patient’s labor and delivery chart? Yes/ No/Sometimes 12) Are the prenatal maternal HIV results documented on the newborn pediatric chart? Yes/ No/Sometimes 13) Who is responsible for documenting the prenatal HIV results in the labor and delivery and newborn pediatric chart? Check all that apply. Nurse/Clerk or unit secretary/Physician/Mid-wife/ House staff/ Not documented/Other HIV Testing 14) Are HIV tests ever conducted on mothers or infants in your L&D unit? Yes /No 15) If a woman currently presents to L&D with no documented HIV test result, is an HIV test automatically ordered? Yes /No 16) Where does your hospital currently send its HIV tests to be run? Your hospital lab/an outside lab/conducted by L&D staff/do not know /Other (please specify) 17) How long does it take for the test results to come back? < 1 hour/< 6 hours/6-12 hours/12-24 hours /24-48 hours /48-72 hours/3-7 days/1-2 weeks/> 2 weeks 18) How are HIV test results (tests that are sent from L&D) reported back to L&D staff? Phone call to L&D charge nurse/ Phone call to ordering health care provider/ Fax/Computer/ Paper report for chart/Results are not reported/ Other (please specify)/ Not sure 19) Who has access to these results? Check all that apply. Nurse/ Physician/ Mid-wife/House officer /Unit Secretary/ Primary attending physician only/Other (please specify) Rapid HIV Testing 20) Is your hospital currently using Rapid HIV Testing in your labor and delivery unit? Yes/No
21) What test are you using? Clearview Complete HIV ½/Clarview HIV ½ Stat Pak/ Multispot HIV-1/HIV-2/Oraquick Advance/Reveal G3/Uni-Gold Recombigen/I don’t know/ Other (please specify)/We do not use rapid testing 22) How long have you been using rapid testing? up to 2 years/2-5 years/greater than 5 years/N/A 23) Is the rapid test run by lab personnel or at the point of care (i.e., by nurse, physician, or other health care professional)? Lab/ Point of care/N/A 24) Approximately how long does it take for the rapid test result to come back? <15 minutes/ (15-30) minutes/(30-60) minutes/( 1-2 )hours/( > 2) hours/ N/A 25) Do you have a protocol/policy in place that all pregnant women without documented HIV status at time of labor must be counseled and offered rapid HIV testing? Yes/No 26) Do you have a protocol/policy in place that all newborns without documented maternal HIV status at the time of delivery must be recommended to have a rapid HIV test performed? Yes/No Infant Testing 27) Do you ever test an infant for HIV? Yes/No 28) Under what conditions would you test an infant for HIV? (Check all that apply). Mother’s HIV status is unknown/ unavailable/Mother refuses an HIV test/ Mother has symptoms suggestive of HIV/ Infant has symptoms suggestive of HIV/ Mother has risk history/We do not test infants for HIV/Other (please specify) Consent 29) When you test for HIV, how do you obtain consent from pregnant women? (Choose the ONE answer that best describes your approach). We have a form specific to HIV that must be signed/We have a general consent for medical care that is signed upon admission and is sufficient to cover consent for HIV/ We obtain oral consent/We do not obtain consent/We inform the patient that HIV testing is conducted on all women unless they decline (i.e., we use an opt-out method)/ Other (please specify). 30) Who is responsible for obtaining consent for HIV testing from pregnant women in L&D? Nurse/Physician/Mid-wife/House officer/Unit Secretary/Primary attending physician only/ Other (please specify) 31) If it is determined that testing of an infant is desired, from whom is consent obtained? (Check all that apply). Mother/guardian/Physician/health care provider/ Other (please specify) /Do not test
peer review 32) Currently, who seeks informed consent from the mother to test the infant for HIV? Check all that apply. Nurse/Nurse Educator/ Obstetrician / Mid-wife/ Pediatrician/ House officer /Other/Consent is not Obtained Confirmatory Testing 33) Is there a protocol on Labor and Delivery for ordering confirmatory testing when a rapid test is positive? Yes/ No 34) Who is responsible for ordering confirmatory testing following a positive rapid HIV test result? Nurse/ Nurse Educator/ Obstetrician /Other/ Mid-wife/Pediatrician/House officer 35) Who is responsible for counseling the patient about the results of HIV testing? Nurse/ Nurse Educator/ Obstetrician /Other/ Mid-wife/Pediatrician/House officer HIV Prophylaxis 36) Is there a protocol on L&D for administration of prophylactic antiretroviral therapy to HIV positive mothers during delivery? Yes/ No 37) Is there a protocol for administration of prophylactic antiretroviral therapy to infants born to HIV positive mothers? Yes/ No 38) Is zidovudine (AZT) (intravenous and syrup) available in your hospital pharmacy for the treatment of HIV-infected mothers and
for the prophylaxis of infants exposed to HIV? Yes, 24 hours a day/ Yes, but only certain hours/Yes, but it must be ordered in advance/No/I don’t know 39) If intravenous AZT was ordered stat on labor and delivery at 2AM on a weekend, how many minutes (on average) would it take to have the AZT available for administration (hanging)? Less than 15 minutes/Between 15 to 30 minutes/Between 30 to 60 minutes/ Between 1 to 2 hours/Greater than 2 hours 40) If intravenous AZT was ordered stat on labor and delivery at 11AM on a weekday, how many minutes (on average) would it take to have the AZT available for administration (hanging)? Less than 15 minutes/Between 15 to 30 minutes/Between 30 to 60 minutes/ Between 1 to 2 hours/Greater than 2 hours Appendix B Pharmacy Telephone Survey Questions 1) Does the hospital have a 24 hour pharmacy? a. Are Labor and Delivery personnel able to access IV AZT (Zidovudine) when the pharmacy is closed? 2) Does the hospital pharmacy have IV AZT in stock now? a. Does the pharmacy always stock IV
AZT (i.e. is it on a critical stock list or does it never run out)? 3) Does the pharmacy have syrup AZT in stock now? a. Does the pharmacy always stock syrup AZT (i.e. is it on a critical stock list or does it never run out)? 4) Could the hospital pharmacy provide a one week supply of AZT to a patient upon discharge(including weekends and holidays) for newborn prophylaxis? 5) Could the hospital pharmacy provide IV AZT to labor and delivery within 30 minutes of receiving an order at 2 am on a weekend? 6) Could the hospital pharmacy provide syrup AZT to labor and delivery within 30 minutes of receiving an order at 2 am on a weekend? 7) Are pharmacy personnel aware that perinatal transmission of HIV can be significantly reduced by administration of antiretroviral therapy during labor and delivery? a. Do pharmacy personnel prioritize the preparation and dispensing of AZT to labor and delivery as a stat medication? 8) Does the hospital pharmacy have a protocol for giving AZT to women on labor and delivery? Name of pharmacist answering survey: Number of years at current position Phone number and E mail address
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member section
IPA Member Spotlight on:
Justin Rash, PharmD, CGP
By: Amanda Siegle, PharmD 2014 Graduate, Drake University College of Pharmacy and Health Sciences Pharmacy practice in Iowa has deep roots in tradition and core values, yet continues to flourish as innovation drives the profession in new and exciting directions. As the profession continues to strive toward attaining provider status, IPA members need to not only listen, but more importantly, make our voices heard. As a current IPA Board of Trustees member, Justin Rash knows just how important informed advocacy is for the profession. Like many of us, Justin Rash didn’t start his college career with an immediate goal of attaining a PharmD. When Justin started his college education at Drake University in Des Moines, he knew he was headed in the direction of health care but had not considered pharmacy until he met some charismatic pharmacy students that put it firmly on his radar. After much research and deliberation, the vast array of professional choice in many fields ultimately convinced Justin that pharmacy was the right choice for him. Justin worked in community pharmacy throughout his college career, but developed a passion for the geriatric population and long-term care pharmacy after an enlightening rotation experience at the Iowa Veterans Home. After graduation in 2005, Justin accepted a position as consultant pharmacist at HyVee and eventually moved on to his current position at
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Martin Health Services long-term care pharmacy. Justin received his certification on geriatric pharmacy and is preparing to become certified in psychiatric pharmacy as well. At Martin Health Services, Justin has a direct impact on the quality of life and outcomes for geriatric patients as well as those needing skilled care services. By reviewing patient medical records and coordinating with the physicians and nursing staff of the various nursing facilities, Justin helps to tailor patient medication regimens to specific patients and their needs. The most rewarding part of his work as a consultant pharmacist is to find that a patient is experiencing better quality of life as a result of his efforts in tailoring their regimen. Although Justin provides excellent care to his patients, he believes that pharmacists gaining provider status would help him to be able to provide even better patient care with a mechanism for individual patient interaction. Professional involvement has been a focus for Justin, and IPA has served as a primary springboard for his advocacy efforts. Justin participated in the Leadership Pharmacy Conference in 2006. He also spent two years serving as Chair of IPA’s Long-Term Care/Senior Care Advisory Committee before becoming a member of the IPA Board of Trustees. When Justin isn’t busy with work and professional involvement, he enjoys spending time outdoors, hiking and playing sports with his family. Justin and his wife, Emily, have two sons, Caden and Maddox, and a puppy named Rooney. As Justin reflects on preparation for the future for himself and other pharmacy professionals, he recommends staying informed to prepare for change. IPA provides updates on the issues impacting
pharmacy in our state, so reviewing IPA publications (e.g.TOP5, the Journal of IPA) would be a great way to accomplish this task. Justin also suggests directing change when possible. He believes that one of the best things to do for the profession to direct the changes in motion is to be an advocate. He explains, “If being a committee member isn’t something you have interest in, I think that’s okay. I think you can be just as much of an advocate with the colleagues you work with on a daily basis.” If your colleagues are not members of IPA, Justin encourages members to ask why and to explain what membership means to you. The larger the pharmacist population IPA represents, the better our voice is heard to stakeholders. To prove we can rise to the challenge, the people we need to convince are great in number, from our government officials to other health professionals, but perhaps most importantly, our patients. Just knowing about medication isn’t enough to bolster our position in changing the health care system. Patient success stories can get us where we need to go. Justin summarizes, “I would like to see pharmacists get back to more of a model of the past where we were the neighborhood pharmacist […] The future of our profession depends solely on how well we can take care of patients.”
member section
IPA Member Milestones
WELCOME NEW IPA MEMBERS Thank you for supporting IPA! marCH 1 - june 1: Adam Danielson, Des Moines Kelly Simon, Parkersburg Timothy Sullivan, Des Moines Erin Anderson, Dubuque Natalie Boelens, Kewanee Amber Kelley, North Liberty Lisa Crossett, Knoxville Michael Schweitzer, Bedford Lane Toring, Saint Michael Timothy Wright, Le Claire Max Nedved, Webster City William Shipley, Council Bluffs Ron Hartman, Ottumwa Emily Muehling, Urbandale Marilyn Turner, Sioux City Michael Berg, Iowa City Frank Caligiuri, Des Moines Shane Madsen, North Liberty Michelle George, Marion Joan Easton, Cedar Falls Megan Johannesen, Mason City
• Marilyn Aldrich, RPh, is retiring as Pharmacy Director, Dahl’s, after 38 years with the company. • Sarah Morrow was promoted to the new Director of Pharmacy at Dahl’s. • Katie Starbuck, PharmD (Medicap Pharmacy), and her husband Michael welcomed daughter Aislynn Elizabeth on April 30. • Gary Christensen, PharmD (HyVee), welcomed son Harrison Levi on May 16. Harrison joins big sister Chloe and big brother Eli. • Holly Randleman, PharmD (UnityPoint), welcomed her second son Grant Kenneth Randleman to the world May 20th. • Natalie Benson, Drake Student, PharmD Candidate 2016, current IPA Executive Intern married Michael Roy on June 20, 2014 in Indianola. • Allie Marr (Des Moines) ran a Boston Marathon qualifying time of 3 hr 34 min 19 sec at the 2014 Chevron Houston Marathon in January. • Owl Pharmacy, Centerville, Iowa, celebrated 50 years in July under ownership of the Reznicek family (Rollie and his son, Frank). Send your member milestones to ipa@iarx.org for inclusion in the next IPA Journal.
office SPACE FOR LEASE Immediate availability 8515 douglas avenue urbandale, ia 50322
For more information or visit the space: Contact Michael Wolnerman, rph, ccim
515-778-3867
• 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
flexible leasing options
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member section
get involved today! ipa wants to hear from you! It is never too early or too late in your pharmacy career to become actively involved in IPA. If you are interested in volunteering or would like to nominate a colleague to serve on an IPA committee In 2014-2015, please contact Mindy Pertzborn at mpertzborn@iarx.org. Opportunities to serve on a committee include:
• Policy Committee on Professional Affairs • Policy Committee on Public Affairs • Legislative Advisory Committee • Iowa Pharmacy PAC Advisory Committee • Health-System Liaison Board • Long Term Care and Senior Care Advisory Committee
• Advisory Committee on Medicaid and Pharmacy Benefit Programs • Pharmacy Technician Advisory Committee • IPA Foundation Golf Classic Planning Committee • RAGBRAI Planning Committee • Iowa Pharmacy Recovery Network
IPA would like to sincerely thank the members of the Advisory Committees, Policy Committees, Planning
Committees, and Task Forces for their dedicated service to the profession of pharmacy in Iowa! As a membership-driven organization, IPA achieves success through the pharmacists, pharmacy technicians, and student pharmacists who volunteer their time and expertise. IPA appreciates the work of all 2013-2014 committee members!
Find a complete list of your colleagues that served the profession in Iowa during 2013-2014 online.
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Online Feature
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technician’s corner
newly ptcb certified iowa technicians January 1, 2014 through March 31, 2014 Please join IPA in congratulating the following pharmacy technicians on becoming PTCB-certified! Abbey Ahlrichs
Martinana Corral
Ashley Kruse
Malaytong Naovarath
Jennifer Scoggins
Lauren Anderson
KaLana Crawford
Kathryn Larsen
Sarah Neuroth
Angie Siedelmann
Emily Baker
Shannon Curtis
Tamara Lee
Lan Chi Nguyen
Amanda Solomon
Amanda Bertjens
Jennifer Dara
Dawn Liekweg
Kelly Nieland
Belinda Swenson
Jamie Berwick
Nicholas Elgersma
Madeline Marra
Herve Nzombo
Samantha Teachout
Rebecca Berry
Jade Feller
Ashley McBride
Molly O’Brien
Tricia Tenley
Raquael Bond
Caitlin Forrester
Aaron McDonough
Jena Peters
Shelby Tilkes
Erin Brannick
Katherine Frerichs
Chelsea Meade
David Post
Barbara Trafton
David Brecount
Grace Garrett
Mekdes Megeressa
Alison Prada
Patricia Trimble
Stephanie Brown
Cynthmanee Heeren
Katie Meldrem-
Amber Riihinen
Jessica Vanfossen
Shawna Butler
Lynn Helgerson
Ferneau
Chelsea Rivers
Mary Weidman
Marilyn Carter
Betsy Henningsen
Riva Midgyett
Avery Robbins
Emily Welsh
Kelcey Cassady
Anthony Hunt
Seyedeh Moosavi
Michelle Runde
Melissa Wiersma
Erin Clark
Nicole Jimmerson
Nicole Morrow
Ethan Sabers
Lauren Wilde
Angela Cohrs
Crystal Kendrick
Jill Mostaert
Vikki Schmidt
Sherry Zieser
ipa n i o j y toda
Certified technicians -
Looking for Quality Education?
IPA Technician Membership Includes 10 FREE Hours of CPE If you, or the technicians who work with you, are looking for quality CPE (Continuing Pharmacy Education) – the search is over! IPA Technician Membership now includes 10 hours of FREE Continuing Education each year. The CPE included with membership will help technicians maintain their certification. Continuing education topics will follow the PTCB blueprint domains. The New Topics for 2014 can be found on the CEI website at www.gotocei.org (under Technician tab)
Pharmacy Technician Education for Association Members
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TEchnician’s corner
Michelle L. Garvin MA, CRC, CPhT Wester Drug, Inc.
The Future is Now for Technicians
A
s I take a few moments to reflect on my tenure as the Technician Member on the IPA Board of Trustees, one thing keeps coming to mind….THE FUTURE IS NOW! Other than being the theme for the recent Annual Meeting, my time on the Board of Trustees provided the opportunity to learn how the profession of pharmacy has evolved to the point that the time is now to show our value to the health care system. The role of the pharmacist and technician have evolved and accelerated rapidly to the point that pharmacists can and will be recognized as healthcare providers! All pharmacy technicians need to get on board now as a collective unit and show the profession how we can and do improve patient
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care outcomes by empowering our pharmacists. From wellness programs to medication synchronization and other adherence programs to medication therapy management to specialized compounded medications, our roles are changing. Many pharmacies in our state now have access to quality measures through the EQuiPP platform. You can see how adherent your patients are their prescribed regimens in order to begin developing targeted services to improve their quality measures. These measures will be the grade that our pharmacies display to other health care providers and more importantly payers. As I’ve mentioned before as the role of the pharmacist evolves, so will the role of the technician. As a technician and pharmacy owner, it’s my duty to create an environment where our pharmacists are consistently able to provide the above mentioned clinical services in the community pharmacy setting. To help make this happen, technicians can and do take on the duties and responsibilities necessary to allow the pharmacist to provide quality clinical services thus helping to improve patients’ over-all health and well-being. I’m excited to be part of an evolving industry where there is potential for such impact on a patients overall health. By saying “The Future is Now,” we must unite and step into the role of healthcare professional NOW! Our patients NEED us to act on their behalf!
TECHNICIAN PHARMACY L FORUM NA EDUCATIO
Don’t Forget!
The Pharmacy Technician Educational Forum has moved to the Fall!
at the Stoney Creek Hotel & Conference Center 5291 Stoney Creek Ct. Johnston, IA 50131
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college of pharmacy news
National Alumni Association announces new board members
The Drake University National Alumni Association recently appointed seven new members to its board of directors. The new members directly support the mission of the Drake University National Alumni Association, which works to provide both Drake and its alumni with a channel for meaningful participation in University matters. The National Alumni Association Board of Directors is dedicated to facilitating alumni understanding of University goals and provides a vehicle for consulting alumni on significant issues. The seven new board of directors members are: •Tim Coonan, AS’96, LW’02, director of government relations for the Iowa Association of Electric Cooperatives • Sally Holmberg, ED’63, GR’69, GR’83, GR’94, retired • Laura Myers, AS’95, dermatologist for McFarland Clinic • Crystal Nance, JO’10, AS’10, manager of community development for the northern region of the Girl Scouts of NE Kansas and NW Missouri • Zach Nunn, AS’02, senior intelligence officer for the U.S. Air Force (Major), and owner/ cyber security entrepreneur for Nunn Enterprises, L.L.C. • Brian Reisetter, PH’85, GR’87, founding partner for Medical Marketing Economics, L.L.C. • Nikki Syverson, JO’03, event director for the Des Moines Wine Festival Foundation
Brian Gentry’s NASA Base Program grant selected for funding
Brian Gentry, assistant professor of pharmacology, was recently selected as base program manager by the Iowa Space Grant Consortium for his proposal titled “Infection Mitigation during Space Flight: Combination Pharmacotherapy to Combat Herpes Viral Infections, Curtail Drug Resistance, and Decrease Incidence Rates of Adverse
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Effects.” The project incorporates ideas and techniques across a variety of disciplines and departments and will provide interdisciplinary research opportunities and scholarships for students in the College of Pharmacy and Health Sciences as well as students studying biology. As base program manager, Gentry will serve on the selection committee for the ISGC Fellowship and Scholarship Program at Drake. The program helps to meet Outcome 1 of the Space Grant program, which is to contribute to the development of the STEM workforce in disciplines needed to achieve NASA’s strategic goals. The base program also helps to meet Outcome 2, which is to attract and retain students in STEM disciplines through a progression of educational opportunities for students, teachers, and faculty.
Drake College of Pharmacy and Health Sciences celebrates annual pinning and hooding ceremonies
Drake University’s College of Pharmacy and Health Sciences (CPHS) held its annual Pinning Ceremony on Thursday, May 8, and its Pharm.D. Hooding Ceremony on Saturday, May 17. The Pinning Ceremony, a longstanding tradition for CPHS, serves as a memorable event for third year pharmacy students and health sciences majors as it marks their entry into their capstone experiences. Additionally, four prestigious awards are presented to the following students at the 2014 Pinning Ceremony: • Kevin Betthauser, Larson Engaged Practitioner Award • Rachel Herr, Cardinal Health Student Scholarship Award • Melissa Parks, Outstanding Health Sciences Student Award • Ngoc (Jade) Cao, Outstanding Health Sciences Student Leadership Award At the hooding ceremony on May 17, students received their doctoral hoods and heard from Abebe Mengesha, assistant professor of pharmaceutics. Mengesha served as the keynote
speaker after being awarded Teacher of the Year in 2014.
Bell publishes article on drug treatments for ear infections
Edward Bell, professor of pharmacy practice at Drake University, recently published an article concerning the proper use of medicines that are applied into the ear. Bell’s article: “Ototopical Antibiotics: When Should They Be Used?” was published in the April 2014 issue of Infectious Diseases in Children, a monthly print publication with a circulation of more than 55,600. The publication is one of many produced by Healio.com, a provider of health care news and information, and published by SLACK Incorporated. Bell’s article, which also appears online, contrasts the use of otic antibiotics against the use of oral alternatives (those antibiotics applied by mouth) in the treatment of children. The article summarizes effectiveness, proper administration, cost, clinical practice guidelines, and other variables related to the application of these products.
The 15th Annual Leaders and Luminaries Awards
The Leaders and Luminaries ceremony honors student leadership and achievement. Students receive awards for outstanding leadership, community service, student employment and extracurricular involvement. The top students in each class are honored as well as the prestigious Oreon E. Scott Award winner, whose recipient is considered to be the outstanding senior at Drake. Congratulations to the following CPHS students: • Kelsey Japs – Drake Service Award – Individual • Lisa Feldman – Top Sophomore • Layton Mikkalson – Top sophomore • Fawad Baig – Top sophomore • Emily Botten – Top sophomore • Tyler Moorehead – Top Senior (p4) • Sarah Mooney – Top Senior
college of pharmacy news
The College of Pharmacy APhA-ASP chapter attended an Iowa Foster and Adoptive Parents Association meeting on April 17th to teach parents about medication safety. The students, led by Associate Professor (Clinical) Dr. Susan Vos, PharmD, BCPS, gave a presentation about steps for safe medication administration, including how to properly use syringes and measuring tools and how to recognize dangerous side effects. After the presentation, the students worked one-on-one with parents to review the medications their children were taking and offer suggestions about how to manage side effects. After the presentation, the students worked one-on-one with parents to review the medications their children were taking and offer suggestions about how to manage side effects.
On Feb. 19, College of Pharmacy representatives participated in the University of Iowa’s Health Sciences Day at the Iowa State Capitol. The annual event featured representatives from the University of Iowa’s health sciences programs – including the colleges of pharmacy, medicine, dentistry, nursing, and public health, UI Hospitals and Clinics, and the State Hygienic Laboratory. The UI representatives provided the legislators and guests with information about training future health professionals, patient care, and research, highlighting how the UI health sciences programs work together to help communities all over Iowa.
Yiran Zhang and Jayoung Han received honorable mentions for the Postgraduate Best Paper Award in the Economic, Social & Administrative Sciences at the 2014 APhA meeting in Orlando, Fla. Yiran Zhang’s paper was titled “A Longitudinal Analysis of High Risk Medication Use among Beneficiaries in Two
Medicare Drug Plans” and was co-authored by William Doucette, Grant Brown, Jane Pendergast, and Jessica Frank. Jayoung Han’s paper was titled “Why Medicare Part D Beneficiaries Do Not Switch Plans: Testing a Model of Part D Plan Information Processing” and was coauthored by Julie Urmie.
Caitlin Lickteig, PharmD, received a Presentation Merit Award at the 2014 APhA meeting in Orlando, Fla. Her presentation, “Multi-case study of fostering providerpharmacist team management of hypertension in communities,” was co-authored by William Doucette, Stevie Veach, Barry Carter, and Barcey Levy. Barry Carter has been selected by the students of the Alpha Chi Chapter of the Rho Chi Society at Wayne State University Eugene Applebaum College of Pharmacy and Health Sciences as the recipient of the 2014 Roland T. Lakey Lecture Award. The award is conferred each year on an individual who has made a significant impact on the profession of pharmacy through practice, education, or research. Presented since 1963, the award honors the memory of Roland
Lakey, the college’s first dean, who served from 1928-1952.
Eight students from the College of Pharmacy – Sean Anderson, Ali Goodson, Meghan Halverson, Zainab Khan, Kathryn Klinefelter, Allison Martin, Kathleen McNamara, and Matthew Waters – participated in an
international service-learning course in Mexico over spring
break. The students administered oral deworming medications to over 3500 children in Xicotepec, Mexico. For their contributions and impact on this interdisciplinary course, which is a collaboration with Rotary International, Hazel Seaba and Chris Catney were recognized as Paul Harris Fellows. This award is given to Rotarians who have made an outstanding contribution to the community, both within and outside Rotary.
Shiny Parsai has been selected for the 2014 Paul Ambrose Scholars Program. As a PASP Scholar, she is invited to attend the Student Leadership Symposium in Washington, D.CA In March,
Bernard Sorofman
spoke at the DUPHAT 2014 – Dubai International Pharmaceuticals and Technology conference, Dubai, UAE. He met with H.H. Sheikh Hamdan Bin Rashid Al Maktoum, Deputy Ruler of Dubai, Minister of Finance for UAE, and President of the Dubai Health Authority at his palace as a part of a party representing the conference.
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STUDENT SECTION
Drake University College of Pharmacy Class of 2014 Sherstin Anderson Alexandria Arends Kimberly Askren Alicia Atwell Erin August Erin Beardsley Jenna Bender Alyssa Bendickson Blair Bentzinger Theodore Berei John Beyer Donald Bladt Shawn Blakeman Brittany Boldt Joseph Brandenburg Ellen Briscoe Kathryn Browning Elizabeth Ann Cady Zachary Carson Jennifer Clarke Rachel Clemens Daniel Clement Allyson Conn Michael Crown Emily Den Beste Danielle Evers Kelsey Gander David Gardner Meron Gartner Allison Gibble Korrie Gould Kristina Griffin Emily Hansen Emily Hanson Katelyn Harman
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Michelle Harris Laura Herzog Adrea Holler Andrea Homan Theodore Houston Megan Hutchinson Elizabeth Isleb Daniel Janke Heather Johnson Kimberly Kaufman Casey Kaup Erin Kelley Kristin Koch Logan Koch Benjamin Koenig Nicholas Kruger Kristin Kubota Marc Landes Jane Lee Daniel Litzenberg Matthew Lucht Emily Luecht Nickolas Lund Nichele Marquis Leah Marschall Eric Marsh Phillip Martel Kaitlin McArdle Courtney McCarthy Nicole McCombs Emily Meyer Erika Milas Samuel Miller Sarah Moldenhauer Lindsey Montross
Tyler Moorehead Elizabeth Moravec Tyler Morrell Kristin Morrison Victoria-Lee Moy Mohammad Mozaffar Jillian Murphy Kristen Neumeister Murphye Olsen Brianne Pape Brittany Parmentier Anokhi Patel Dipale Patel Nisha Patel Puja Patel Tina Patel Erica Pfeifer Andrea Piela Jordan Porter Ellen Prichard Nicole Quandt Hanna Raber Rani Raju David Reeb Carolyn Reich Brett Retzlaff Jennifer Rinehart Jessica Rubin Peter Ryan Lauren Schmidt Natalie Schmitz Michael Schnackenberg Emily See Holly Seubert Adrienne Sherman
Pinal Sheth Jordan Shlensky Amanda Siegle Allison Sielicki Sara Sladky Brittney Smith Toral Soni Kristin Stein Melvin Thomas Sarah Thune Tiffany Trumbo Valerie Uthoff Hayley Vance Dyson Wake Brian Wall Thomas Walters Mitchell Webster David Witkiewicz Megan Wood Taylor Wypiszynski Brittany Yang Samantha Zieminski
STUDENT SECTION
University of Iowa College of Pharmacy Class of 2014 Doctor of Pharmacy Reed Achenbach Anil Alimohd Phillip Anciaux Selamawit Asrat Dana Bakhit Abigail Banks Kelsey Bayliss Alexandra Begemann Jill Bonsall Mallory Breuker Jessica Brown Brittany Bruch Andrew Burkle Anita Cheruvillil Kennon Christian Katherine Chung Jason Cleppe Tana Colt Lisa Cook Kristin Cox Page Crew Kirk Davis Alejandro DeAnda Lisa Deiter Kristin Dwyer Shannon Eddy Sara Farrell Matthew Fleshner Bret Francis Samantha Garretson Michael Gassmann Elizabeth Geison Brittany Green
Heather Greenwood Amara Gudger Amanda Hagan Alyssa Haight Connor Halpin Kimberly Hannam Elizabeth Hansen Danielle Harris Katie Hassebroek Kristen Heidewald Kathryn Hensley Tyler Herrmann Brooke Hofmeyer Alexis Ireland Joseph Jackan Megan Jacobson Manda Johnson Tominique Johnson Amanda Kingery Alexander Kopelyan Ioannis Kourafas Karen Lai Yat-yee Lam Jada Le Sarah Leonard Zachary Less I-Chau Liang Theresa Mac Daniel Magistrelli Ann McCarty Lindsey McDevitt Colin McKee Ashley Meton Chad Michael
Grant Middendorff Danielle Miller Whitney Mills Kelsey Mohs Kevin Niehoff Sodiq Ogunnaike Silas Osiohwo Aaron Overstreet Nathan Peterson Lance Platt Emily Prosser Jessica Rank Elysia Rashid Kathryn Rolfes Colby Rueschenberg Cory Schlobohm Megan Schwartz Annie Shelton Giles Slocum Michelle Stammet Oakley Stamps Matthew Stefl Sarah Stolz Kelci Swenson Angela Sze Caitlin Taffe Tah Tangyie Michelle Terwilliger Stephanie Thrall Krystal Titus Derek Townsend Thomas Truong Renata Vaschevici Chris Wang
Lucas Watson Alison Webster Caitlin Wessels Tara Wessels Madison Williams Stephanie Wong Master of Science Wisam Al Bakri, MS in Pharmaceutics, Adviser: Maureen Donovan Yiran Zhang, MS Pharmaceutical Socioeconomics, Adviser: Bill Doucette Doctor of Philosophy Manar Al-Ghabeish, PhD in Pharmaceutics, Adviser: Maureen Donovan Tatian Kirresh, PhD in Clinical Pharmaceutical Sciences, Adviser: DJ Murry Puttarin Kulchaitanaroaj, PhD in Pharmaceutical Socioeconomics, Adviser: John Brooks Edwin Squirewell, PhD in Medicinal and Natural Products Chemistry, Adviser: Mike Duffel
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2014 Calendar of Events August 2014 7-10 Leadership Pharmacy Conference - Galena, IL 13 Log-in To Learn e-journal Club 14 IPA Goes Local - Southwest Iowa Pharmacists Association - Council Bluffs 20 Immunization Update 21 Webster City/Trinity Pioneer ACO - IPA Goes Local - Fort Dodge 23-26 NACDS Total Store Expo - Boston, MA 26 Immunization Administration Training - Des Moines September 2014 4 Drake Back to School Series 10 Log-in To Learn e-journal Club 11 Drake Back to School Series 18 IPA Goes Local - Johnson County - Iowa City 18 Drake Back to School Series 19 Eggleston/Granberg Golf Classic - Brown Deer Golf Course, Coralville, IA
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19-20 Bill Burke Student Leadership Conference - Coralville 25 Drake Back to School Series 30 IPA College Night - Iowa - Coralville Marriott October 2014 7 IPA College Night - Drake - West Des Moines Sheraton 7-10 AMCP Nexus - Boston, MA 8 Log-in To Learn e-journal Club 9-10 UI COP & UI COM Multidisciplinary Conference & Cardiovascular Update - Iowa City 12-15 ACCP Annual Meeting - Austin, TX 16 IPA Goes Local - NW Iowa Pharmacists Association - Spencer 17-19 NASPA Fall Meeting 18-22 NCPA Annual Convention - Austin, TX 25 Pharmacy Technician Educational Forum - Des Moines
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