Official Newsjournal of the Illinois Council of Health-System Pharmacists

ICHP KeePosted

December 2017

Volume 43 Issue 10

Print Entire Issue

2016 Best Practice Call for Entries

KeePosted Info

Feature

Call for Entries: 2016 Best Practice Award

Columns

President's Message

Directly Speaking

Leadership Profile

Board of Pharmacy Update

Government Affairs Report

Professional Affairs

Educational Affairs

ICHPeople

College Connections

Midwestern University Chicago College of Pharmacy

Roosevelt University College of Pharmacy

More

Welcome New Members!

Officers and Board of Directors

ICHP Pharmacy Action Fund (PAC) Contributors

Upcoming Events

KeePosted Info



Illinois Council of Health-System Pharmacists
4055 North Perryville Road
Loves Park, IL 61111-8653
Phone: (815) 227-9292
Fax: (815) 227-9294
www.ichpnet.org

KeePosted
Official Newsjournal of the Illinois Council of Health-System Pharmacists

EDITOR
Jacob Gettig

ASSISTANT EDITOR
Jennifer Phillips

MANAGING EDITOR
Scott Meyers

ASSISTANT MANAGING EDITOR
Trish Wegner

DESIGN EDITOR
Amanda Wolff

ICHP Staff
EXECUTIVE VICE PRESIDENT

Scott Meyers

VICE PRESIDENT - PROFESSIONAL SERVICES
Trish Wegner

DIRECTOR OF OPERATIONS
Maggie Allen

INFORMATION SPECIALIST
Heidi Sunday

CUSTOMER SERVICE AND
PHARMACY TECH TOPICS™ SPECIALIST

Jo Ann Haley

ACCOUNTANTS
Jan Mark and Trisha Blassage

COMMUNICATIONS MANAGER
Amanda Wolff

LEGISLATIVE CONSULTANT
Jim Owen

ICHP Mission Statement
Advancing Excellence in Pharmacy

ICHP Vision Statement
ICHP dedicates itself to achieving a vision of pharmacy practice where:
  • Pharmacists are universally recognized as health care professionals and essential providers of health care services.
  • Patients are aware of the training, skills, and abilities of a pharmacist and the fundamental role that pharmacists play in optimizing medication therapy.
  • Formally educated, appropriately trained, and PTCB certified pharmacy technicians manage the medication distribution process with appropriate pharmacist oversight.
  • Pharmacists improve patient care and medication safety through the development of effective public policies by interacting and collaborating with patients, other health care professionals and their respective professional societies, government agencies, employers and other concerned parties.
  • Evidence-based practices are used to achieve safe and effective medication therapies.
  • There are an adequate number of qualified pharmacy leaders within the pharmacy profession.
  • Pharmacists take primary responsibility for educating pharmacy technicians, pharmacy students, pharmacist peers, other health professionals, and patients about appropriate medication use.

KeePosted Vision
As an integral publication of the Illinois Council of Health-System Pharmacists, the KeePosted newsjournal will reflect its mission and goals. In conjunction with those goals, KeePosted will provide timely information that meets the changing professional and personal needs of Illinois pharmacists and technicians, and maintain high publication standards.

KeePosted is an official publication of, and is copyrighted by, the Illinois Council of Health-System Pharmacists (ICHP). KeePosted is published 10 times a year. ICHP members received KeePosted as a member benefit. All articles published herein represent the opinions of the authors and do not reflect the policy of the ICHP or the authors’ institutions unless specified. Advertising inquiries can be directed to ICHP office at the address listed above. Image disclaimer: The image used in the Pharmacy Tech Topics™ advertisement is the property of © 2016 Thinkstock, a division of Getty Images.

Copyright © 2016, Illinois Council of Health-System Pharmacists. All rights reserved.

Feature

Call for Entries: 2016 Best Practice Award


The objective of the Best Practice Award program is to encourage the development of innovative or creative pharmacy practice programs or innovative approaches to existing pharmacy practice challenges in health systems within the state of Illinois.

Applicants will be judged on their descriptions of programs and practices employed in their health system based on the following criteria:

  • Innovativeness / originality
  • Contribution to improving patient care
  • Contribution to institution and pharmacy practice
  • Scope of project
  • Quality of submission

If you have any questions related to the program please contact Trish Wegner at trishw@ichpnet.org.

Previous Winners

2015
Kuntal Patel, Pharm.D., Pavel Prusakov, and Heather Vaule
“Osteopenia of Prematurity (aka Better Bones for Babies)”

2014

Arti Phatak, Pharm.D.; Brooke Ward, Pharm.D., BCPS; Rachael Prusi, Pharm.D.; Elizabeth Vetter, Pharm.D.; Michael Postelnick, BS Pharm, BCPS (AQ Infectious Diseases); and Noelle Chapman, Pharm.D., BCPS

“Impact of Pharmacist Involvement in the Transitional Care of High-Risk Patients through Medication Reconciliation, Medication Education, and Post-Discharge Callbacks”

2013
Nicole Rabs, Pharm.D., Sarah M. Wieczorkiewicz, Pharm.D., BCPS, Michael Costello, PhD, and Ina Zamfirova, BA

“Development of a Urinary-Specific Antibiogram for Gram Negative Isolates: Impact of Patient Risk Factors on Susceptibility”

2012
Kathryn Schiavo, Pharm.D.; George Carro RPh, MS, BCO; Abigail Harper, PharmD, BCOP; Betty Fang, PharmD; Palak Nanavati, PharmD
“Outpatient Oncology Treatment Center Approach to Enhancing Continuity of Care Related to Dispensing Oral Chemotherapeutic Agents”

Online entry formhttp://ichpnet.org/pharmacy_practice/professional_practice/
best_practices/application_form/
 
Submission deadline: July 1, 2016

Eligibility
Applicants must be a member of ICHP practicing in a health system setting. More than one program can be submitted by a health system for consideration. Past submissions may be re-submitted if not previously given the award. Any new data should be included.

Instructions for preparing manuscript
Each entry for the Best Practice Award must include a manuscript prepared as a Word document, double-spaced using Times New Roman 12-pitch type. A header with the paper title and page number should appear on each page. The manuscript should not exceed 2000 words in length (not counting references), plus no more than a total of 6 supplemental graphics (tables, graphs, pictures, etc.) that are relevant to the program. Each picture, graph, figure, and table should be mentioned in the text and prepared as a separate document clearly labeled.

The manuscript should be organized as a descriptive report using the following headings:

  • Introduction, Purpose, and Goals of the program
  • Description of the program
  • Experience with and outcomes of the program
  • Discussion of innovative aspects of programs and achievement of goals
  • Conclusion

Format
Submissions will only be accepted via online submission form. The manuscript will be forwarded to a pre-defined set of reviewers. Please do not include the names of the authors or affiliations in the manuscript to preserve anonymity.

All applicants will be notified of their status within three weeks of the submission deadline. Should your program be chosen as the winner:

  • The program will be featured at the ICHP Annual Meeting. You will need to prepare a poster to present your program and/or give a verbal presentation. Guidelines will be sent to the winner.
  • You will be asked to electronically submit your manuscript to the ICHP KeePosted for publishing. This program will be accredited for CPE and will require that you complete material for ACPE accreditation.
  • You will receive a complimentary registration to the ICHP Annual Meeting, recognition at the meeting and a monetary award distributed to your institution.

Non-winning submissions may also be considered for publication in the ICHP KeePosted, but your permission will be obtained beforehand.


Thank you to PharMEDium for providing a grant for the 2016 Best Practice Award!







Columns

President's Message
Strengthen Your Chances of Success with Soft Skills

by Jen Phillips, PharmD, BCPS, ICHP President; co-written with Sheron Chen, PharmD, Assistant Professor of Clinical Sciences, Roosevelt University College of Pharmacy

During pharmacy school, students tend to spend more time and emphasis increasing their knowledge about a myriad of pharmacy-related topics. However, what most new practitioners discover soon after starting to practice is that having knowledge is only half the battle. Learning how to be successful in the workplace requires many different types of skills – communication, teamwork, adaptability, emotional management, to name a few. Knowledge is useless unless it can be shared – with a patient, with another healthcare provider, or with a colleague, and having the optimal tools to do this in an effective manner is critical to being an effective pharmacist. While the corporate world seems to have embraced the importance of these “soft skills” and their relationship to success, it has only recently worked its way into healthcare education and practice.  

In recent years, increased emphasis has been placed on developing pharmacy students who have the professional and personal skills necessary for the optimal practice of pharmacy. These skills, sometimes referred to as “soft skills”, are necessary for pharmacists to form optimal relationships with patients and other healthcare providers. The 2013 Center for the Advancement of Pharmacy Education (CAPE) outcomes and the 2016 Accreditation Council for Pharmacy Education (ACPE) Standards identified the following characteristics as being essential for every entry-level PharmD graduate to possess: self-awareness, leadership, innovation/entrepreneurship, and professionalism.1,2

Practicing pharmacists and technicians, who may not have benefited from these recent curricular changes, may be looking for ways to refine their skills in these areas and/or to help rotation students begin to develop these essential practice skills. The purpose of this article is to highlight methods and resources that practitioners may find helpful when strengthening their own “soft skills” or when helping to develop the skills of pharmacy students or residents they are precepting.

Emotional intelligence. The concept of emotional intelligence has been around for many years and has been defined several different ways. In essence, it involves the ability of an individual to appropriately sense, comprehend, and respond in an effective manner to emotional signals sent internally and by others.3,4 It has been suggested that individuals with higher amounts of emotional intelligence are more successful than those with lower emotional intelligence, even if their technical abilities are the same or less developed.5,6 The constructs of emotional intelligence vary slightly from source to source, but essentially involve the following components: self-awareness, self-regulation, social awareness, and relationship management.6

Self-awareness involves the ability to accurately identify emotions while they are happening. In other words, to discover what makes you “tick”. Knowing what triggers your buttons and why can help you develop more effective strategies to manage your emotions. Take time to observe yourself in a variety of emotional situations and think through what you are feeling and why. Try to avoid passing judgment on the emotion itself; get out of the habit of “labeling” every emotion as “good” or “bad”. Journaling may help as well – writing down what went well, what did not go well, and things to think about the next time you are in a similar situation will allow you to turn a perceived negative situation into a learning experience.

Learning how to regulate emotions is another key facet to emotional intelligence. Resisting the urge to “fly off the handle” during emotionally charged conversations is more difficult for some than others. However, maintaining self-control in these scenarios ultimately leads to less regret and improved chances for long-term success. Conversely, others may struggle with finding the courage to speak up in an unfamiliar environment. However, conquering fear in these situations can help improve self-efficacy and also lead to increased chances of long-term success. There are many strategies you can use to help regulate immediate physiological responses to stress, including deep breathing, visualization, and rationalization. New practitioners may also consider finding an individual who is very good at emotional management to serve as a role model when they are developing their own skills. Visualizing how that individual would handle a stressful situation may help you perpetually fine tune your own approach.  

Mastering one’s own emotions is just one step of the process, however. Working effectively in a group requires a keen sense of social awareness and relationship management as well. When you are in a group, pay attention to others’ body language, be present in the moment to listen to what people are saying, and then verify that you have heard and understood correctly. Learn how to give and take feedback well. Remember that every conflict involves two individuals and that, very rarely is one person entirely at fault. Concentrating on what you can do to mend the conflict will be a much more productive use of your time and will lead to a greater chance of mending a strained relationship.  

Emotional management may take a while to master, but is well worth the effort. Emotional intelligence has been associated with increased job satisfaction, better stress management as well as academic and professional success.3,7,8 Educators are increasingly recognizing the importance of this crucial skill, especially for healthcare practitioners.3 New practitioners working as junior faculty within a college of pharmacy may consider recommending that didactic coursework in this area be implemented. One study found that incorporating tenets of emotional intelligence into a required communications course within a college of pharmacy was well received by students.9 Many resources exist to help new practitioners develop their skills in the area of emotional intelligence, including many books, articles, and TED talks.  

Entrepreneurship and Innovation/Adaptability
Most people hear the word “entrepreneur” and think of an independent, capable, and business-savvy individual. However, an entrepreneur can be defined as a leader and forerunner in their field; someone who creates innovative opportunities within their profession.10 The history of pharmacy is characterized by the entrepreneurial and innovative pioneering of many pharmacists. Those who owned and operated independent pharmacies, created opportunities for patient care in clinical settings, and essentially forged paths where no pharmacist had gone before. It is thanks to these innovators that pharmacists today can enjoy the multitude of possible pharmacy roles available to a new practitioner.

While current pharmacy practice places a large emphasis on producing pharmacists adept in clinical knowledge and skills, we must still strive to maintain an entrepreneurial spirit like those who came before us.10,11,12 In our current environmental landscape, it is crucial that pharmacists practice with an entrepreneurial and creative mindset. With the shifting US healthcare model and an ever-increasing need for efficient and effective healthcare, pharmacists must take advantage of and create opportunities to expand or solidify their role as medication experts.

Pharmacists and technicians have been armed with the clinical knowledge and skills necessary to engage with healthcare workers and patients to optimize medication use in numerous settings. However, you might wonder how someone like yourself can practice with an entrepreneurial mindset. Necessity is a powerful incentive. Look around and analyze the pharmacy environment that you currently practice in. Ask yourself if there is any way that medication management or patient care can be improved by something you, as the pharmacist, can do. Perhaps you notice that the other healthcare providers you work with would benefit from an in-service about updated guidelines or newly approved medications. Maybe you see the need for offering diabetic counseling or smoking cessation sessions to the patients that regularly pick up their prescriptions from your pharmacy. Sometimes it may be as simple as providing dyslipidemia patients with a list of common foods that contain heart-healthy fats or teaching hypertensive patients where to find sodium content on a food label. If you are able to provide a new or improved service that can ultimately impact patient health using your skills and training, you are practicing as an innovative pharmacist. 

Once you have recognized the need, you will then need to plan out the basic logistics of how you can provide the service. Think about how you will operate the service and how to obtain any additional supplies you may need. Many times the most difficult resource to supply is manpower or time. This is where resourcefulness and determination is vital. If your practice serves as a rotation site, this may be an ideal area for students to help. A discussion with your supervisor may also help you brainstorm possibilities.

Many pharmacists may already feel they have enough on their plate without adding any additional work onto their load. However, an entrepreneurial spirit works with the end vision in mind, and is not deterred by the work and change that will be required to implement it. Although all change is difficult at first, you must believe that your efforts will produce a positive effect on your patients, co-workers, and ultimately—yourself! Imagine the sense of accomplishment and satisfaction that will come when you begin to witness the positive impact that your work has produced on those around you.
 
Professionalism. Professionalism is an integral component for the success of any pharmacist’s career. Professionalism can be defined as the general demeanor of a pharmacist towards their patients, peers, and other health care professionals, determined by their courteous, respectful, appropriate, and empathetic attitudes and behaviors.13 The definition of professionalism can also be seen as the compliance of an individual to all of the responsibilities inherent within his/her profession. For a pharmacist, this includes patient advocacy, ethical behavior, continual self-improvement, and respectful collaboration with other care providers.14

In your daily practice, do everything with the best interests of the patient in mind. Whether you work directly or indirectly with patients, your actions as a pharmacist can either positively or negatively affect patients. Use your knowledge of drug therapy and the health system to advocate for the patients within your care. As you work with others, whether they are physicians, nurses, patients, clerical staff, or the cleaning crew, your reputation of professionalism (or a lack thereof) will precede you. Treating others with respect and integrity nurtures positive and trusting relationships. It is essential that all pharmacists serve as role models for students, residents, and fellow practitioners. When precepting students and residents on rotation, remember to instill these values and expectations in them as well; ask them to treat every person at the rotation site with the same respect with which they treat their preceptor.
 
Conclusion. Although the name may sound deceiving, “soft skills” can provide a very solid foundation for professional development and their importance to your success as a professional should not be underestimated. As you begin your career, spend time developing an action plan for “soft skill” development; this combined with professional skill development will help to ensure that you practice at the top of your abilities.


References
1. Accreditation Council for Pharmacy Education. Accreditation Standards. https://www.acpe-accredit.org/pdf/Standards2016FINAL.pdf  Accessed October 28, 2015.
2. American Association of Colleges of Pharmacy, Center for the Advancement of Pharmaceutical Education. http://www.aacp.org/resources/education/cape/Pages/default.aspx Accessed October 28, 2015.
3. Romanelli F, Cain J, Smith KM. Emotional intelligence as a predictor of academic and/or professional success. Am J Pharm Educ. 2006;70(3):Article 69.
4. Mayer JD, Salovey P. The intelligence of emotional intelligence. Intelligence. 1993;17:432-42.
5. Goleman D. What makes a leader? Harv Bus Rev. 1998;76:93-102.
6. Bradberry, Greaves. Emotional Intelligence 2.0. San Diego, CA: TalentSmart; 2009.
7. Jaeger A. Job competencies and the curriculum: an inquiry into emotional intelligence in graduate professional education. Res High Educ. 2003;44(6):615-39
8. Sy T, Tram S, O’Hara LA. Relation of employee and manager emotional intelligence to job satisfaction and performance. J Vocat Behav. 2006;68(3):461-73.
9. Lust E, Moore FC. Emotional intelligence instruction in a pharmacy communications course. Am J Pharm Educ. 2006;70(1): Article 06.
10. Brazeau G. Entrepreneurial spirit in pharmacy. Am J Pharm Educ. 2013; 77(5) Article 88.
11. Svensson CK, Ascione FJ, Bauman JL, et al. Are we producing innovators and leaders or change resisters and followers? Am J Pharm Educ. 2012; 76(7) Article 124.
12. Gubbins PO, Micek ST, Badowski M, et al. Innovation in clinical pharmacy practice and opportunities for academic-practice partnership. Pharmacotherapy. 2014; 34(5): e45-e54.
13. Soric, MM. Maximize Your Rotations: ASHP’s Student Guide to IPPEs, APPEs, and Beyond. Bethesda, MD: American Society of Health-System Pharmacists; 2013.
14. American Society of Health-System Pharmacists. ASHP statement on professionalism. Am J Health Syst Pharm. 2008; 65: 172–4.



Directly Speaking
Letters I Hate and Love to Sign!

by Scott A. Meyers, Executive Vice President

Every month, I have chosen to personally sign letters that go to members whose memberships have expired. The letter is polite and aimed at coaxing these members back into the fold. And fortunately, that often happens! The letter is a gentle reminder that I’ve noticed that their membership has lapsed. This hits home especially well when that member is a member of the Board of Directors, a student chapter President or faculty advisor, or a Past President of ICHP. In those cases, 999 times out of 1000, it is a case of a misplaced renewal notice or a forgotten trip to the ICHP webpage to renew. Hopefully it touches everyone with a little guilt or reconsideration.

I hate signing these letters because it is saying good-bye to many members that I’ve not yet gotten to know well, and that makes me sad. I love signing the letters when I get to add a little note at the bottom for folks I do know personally, hoping that they will renew to stay in the fold. The evil side of me knows that this little note will often generate a red face and a quick trip to the internet as mentioned earlier for those members I know really well! Shame on me!

And of the members I didn’t get to know, I see a broad diversity that makes me wish we could have engaged them in some of the activities of the Council, ensuring that their membership would mean more to them so that they stayed involved and knowing that their perspectives would make our output more diverse and far-reaching. I’m always curious as to which of these exiting members ICHP could have tapped for significant contributions and why we missed that opportunity during the past year? I also hope that someday, they will come back to ICHP and share those skills and abilities for the profession.

I know that the personal invitation is the most powerful way to get people involved in any organization or cause. I also know that all of ICHP’s leaders, whether they are Board Members, Past Presidents, or division or committee members, want to include more members in all of our activities. Sometimes we forget to ask and often we don’t have the time to reach out to everyone personally. But we do reach out! What that means is that we do have time to answer anyone and everyone when they ask us, “Is there anything I can do?”

I hate to sign these letters because the monthly pile of letters has grown over the past few years. It’s primarily a reflection of the number of students in Illinois and the number of those who join ICHP at some point in their education. While turnover is normally not a good thing, this tells me is that today’s pharmacy student is willing to explore all career options but also that he or she is very busy. In my conversations with students and recent graduates, I also know that there is an intimidating obstacle to renewing their membership after graduation called the “student loan balance”! And as for the more seasoned practitioners who have let their membership lapse, it seems to be the “What have you done for me lately?” response. Yes, $125 seems like a lot to both groups when you’re writing the check or completing the online renewal, but in the broader picture of being a pharmacy professional, your representation with State government and its agencies makes that $125 worth much more than merely skipping one trip to Starbucks every other week.

I love knowing that most members “get it”! That they faithfully renew, even though the local “Supper Club” CE programs of now 15 years ago have disappeared. They understand that ICHP is working hard to find ways to bring them useful and timely products, services and CPE programming that helps them in their practice settings. And I love that many of us have become great friends merely by attending the Spring and/or Annual Meetings with a willingness to meet and greet new faces and share new accomplishments at practice sites all over Illinois.

I hate that the piles of these letters grow, but I love that the number who don’t get these letters is growing, too! I invite each of you to stay a little longer, ask what you can do to help or say “Yes” when someone asks you to help, and see that ICHP has a place for you. Do what you can to keep me from sending you a letter that I hate and love to sign!

P.S. If you do receive one of these letters for whatever reason, please pardon my penmanship! The more time I spend on the computer, the worse my handwriting gets. But it is still cursive (for the most part)!



Leadership Profile
Barb Limburg-Mancini, BS Pharm, PharmD

What is your current leadership position for ICHP?
I represent ICHP on the PTCB Certification Council, and this year I am President of the Council. Since the future of pharmacy relies on highly-qualified pharmacy technicians, we need to better educate technicians and assure competency through the national exam. By attending the PTCB meetings, it is interesting to realize all the individuals who work so hard behind the scenes to meet the goals and develop an excellent product.


What benefits do you see in being active in a professional association such as ICHP?
Besides the obvious benefit of networking with colleagues of similar interests and issues, ICHP provides the opportunity for professional growth, to give presentations and share current practice as a good stepping stone for interaction on local, state and national levels.


What initially motivated you to get involved with ICHP?
Other than being an ICHP member, my first active leadership position was as Chair of the Home Care Committee in the mid-1990s.


Where did you go to pharmacy school? 
The University of Illinois at Chicago (UIC) for both the Bachelor's degree in Pharmacy and the PharmD degree


Where have you trained or worked? 
I spent the majority of my career in home care infusion therapy, but I have also worked in the acute care setting, have surveyed for the Joint Commission and have consulted for long term care facilities. 


Describe your current area of practice and practice setting. 
I am currently involved in the education and training of the college of pharmacy students at Chicago State University and pharmacy technicians at South Suburban College.


Is there an individual you admire or look up to, or a mentor that has influenced your career?
Tom Rout was the first pharmacist who hired me to work in home infusion for 1 to 2 days per week. I loved it so much, I gave up the acute care setting to focus on the nutritional support of home care patients. Tom Rout got me into home care, and Mary Ann Kliethermes is the single best clinician I have ever worked with.


What advice would you give to student pharmacists?
Become life-long learners because the pharmacy profession has changed greatly in my career, and it will do the same during your career. 


Do you have any special interests or hobbies outside of work?
Downhill skiing is my first love. If I wasn't working, I would downhill ski every day. In the winter, I relax by doing crossword, Sudoku, and jigsaw puzzles, but I also love to read books (e.g., biographies, mysteries and good novels). In the summer, I love to work with the flowers.


Do you have a favorite restaurant or food? 
My favorite restaurant is Acqua Al Due in Florence, Italy with all their amazing Italian food. They now have restaurants in San Diego and Washington DC. You must go there the next time you are in town. Try their pasta sampler (if you go with at least 3 others) and steak with the blueberry sauce; it sounds awful, but you will never forget it.


What is your favorite place to vacation?
I have enjoyed my many trips to Europe, but I would especially recommend Norway for its spectacular beauty. I loved the cruise and discovered my cell phone worked better 350 miles north of the Arctic Circle than it did at home! One of the most relaxing places I have enjoyed is the Shakespeare festival in Stratford, Ontario. The theater is the best in North America, and you can also sit there and watch the swans go by. I also like Steamboat Springs, Colorado. More Olympic athletes come from there than any other city in the world. That city has biking, kayaking, downhill skiing, cross country skiing, and golf – just to name a few. I have been to all 50 states and have visited 43 state capitals.


What are some of your most memorable pharmacy experiences?
I think essentially all my memorable moments were related directly to patient safety. The most rewarding experience was saving a baby’s life when I was a Joint Commission home care surveyor. The technician compounded a tenfold overdose which I saw, but the pharmacist didn’t catch. I have often wondered how that child is doing today. My first visit to a patient’s house as a home care pharmacist was to teach the patient’s mom how to compound an IVIG product (back in the days when all IVIG was powdered). I got there, and the whole dining room table was covered with dog hair. I took a deep breath and prayed that their tent at Yellowstone National Park was cleaner! I assisted many hospitals and home infusion companies with USP <797> compliance and clean room design. This has the potential for safer care for thousands of patients. Lastly, a student told me recently, “I learned more from you, Dr. Limburg, than any other teacher in my life.”



Board of Pharmacy Update
Highlights from the March 2016 Meeting

by Scott A. Meyers, Executive Vice President

The March 8th Board of Pharmacy Meeting was held at the Department of Financial and Professional Regulations offices on Washington Street, Springfield, IL. These are the highlights of that meeting.

NABP District IV Meeting 2016 – The Illinois Board of Pharmacy and the UIC College of Pharmacy will be co-hosting the NABP District IV meeting on November 2-4, 2016 at the Crowne Plaza on Halstead in Greek Town, Chicago. Phil Burgess, Board of Pharmacy and Dr. Nick Popovich, UIC are co-chairs of the planning committee. The program will offer CPE and networking and will be open to any pharmacist who would like to attend. Registration will open in early fall.

2016 NABP Annual Meeting – The NABP Annual Meeting will be held in San Diego, CA on May 14-16. Several Board Members will be attending at their own or their company’s expense, as the State does not have funds for travel. Phil Burgess is the District IV representative to the NABP Executive Committee.

March MPJE Item Writing – Three Board of Pharmacy members will be writing test questions for the Illinois portion of the Multistate Pharmacy Jurisprudence Examination later in March. The questions will then be reviewed and are expected to appear on the test this fall. Of note: The length of the MPJE will expand in April with more test questions and the test is expected to become more difficult. Students graduating this spring are urged to study diligently with the anticipation of an even lower passing rate than occurs currently. The passing rate for the MPJE is currently lower than that of the NAPLEX and is expected to fall more after the test is expanded.

Termination of the PIC and Final Inventory – The Board and Department staff discussed what to do when a Pharmacist-In-Charge (PIC) is terminated and is not available to complete a final inventory with the in-coming PIC. The Department and Board agreed that the in-coming PIC and pharmacy administration (either owners or hospital administration) carefully document the inventory following the termination and document the reasons the former PIC did not participate. That information should be retained for the full 5 years.

Paperless Licensing – The Department staff reported that license renewal is progressing well with the relicensure rate on par with previous renewal periods even though no mailed notices will be sent to pharmacists, pharmacy technicians, student pharmacists or pharmacy owners or PICs. All correspondence is being sent via e-mail and eventually the Department will be e-mailing pdf copies of licenses to all registrants. In addition, all registrants will be able to log in to the IDFPR system and print their own copies of the licenses once that process has been finalized. All regulated professions will be transitioned to the paperless process with pharmacy being one of the first. So consequently, there has been a few bugs. The Department will not discipline pharmacies for failure to display licenses until the entire process has been finalized and ample time has elapsed for receipt of the pdf licenses. In the meantime, registrants are encouraged to printout the renewal notice that can be found on the “License Look-up” function of the IDFPR website and post it with the current licenses. As long as licenses appear as renewed online, the Department will not prosecute. Pharmacy technicians who are transitioning to certified pharmacy technicians will still need to mail in their applications with proof of certification.

Pharmacy License Number Notification – The Department has established a process for providing a new pharmacy with the license number in advance of opening for the purpose of setting up accounts with vendors, insurers, and other required parties. The license itself is not provided until the final inspection prior to opening has been completed. This process will help new pharmacies to undertake all the appropriate start-up activities necessary so that they can open within 24 hours of the final inspection.

Pharmacy Ticketing – As described in the January, 2016 highlights, the Department has now begun using a ticketing process for minor violations. The pharmacist-in-charge may accept and sign the ticket for up to three minor violations while the pharmacy pays the appropriate fine and no further discipline or hearing is required. Acceptance of a ticket will not create a disciplinary record on the pharmacy or PIC’s record. Repeated minor violations or more than three minor violations will result in an informal hearing and potential discipline. The fines assessed in the ticketing system are as follows:
1 minor violation during the same visit $100 fine
2 minor violations during the same visit $250 fine
3 minor violations during the same visit $500 fine

Below is a reference list of potential pharmacy violations cited on the ticket:

  • All required current licenses are posted in a conspicuous location in the pharmacy (pocket license or photocopy may be used when registrants are employed at multiple sites). 
  • Registrant wear proper clean attire and have proper name tags and designations.
  • The schedule during which the pharmacy services are provided is conspicuously displayed.
  • Security provisions are provided for all drugs and devices within the pharmacy when pharmacist is on staff and during the absence of a pharmacist.
  • Refrigerators for the exclusive use of medications are clean, defrosted and in working order maintaining proper temperature.
  • Pharmacy is clean and sanitary including but not limited to shelves, workflow area, sink and compounding area.
  • Pharmacy must have a sink with hot and cold running water.
  • Food and/or beverages are kept in designated areas away from dispensing activities and stored in refrigerators not used for medications.
  • Expired medications are stored separately from active medication stock.
  • All CII controlled substances are stored securely within the pharmacy.
  • Every prescription dispensed shall be documented with the name, initials or other unique identifiers of the pharmacist and pharmacy technician if one is used.
  • An offer to counsel shall be made on all prescriptions (new and refill prescriptions).
  • Controlled drug prescriptions and records must be properly filed and maintained.
  • Annual inventory of controlled substances are properly recorded, dated and signed.
  • Controlled substance purchase invoices are signed and kept in a separate file.
  • DEA 222 Form properly documented.
  • Any prepackaged drug must have a label affixed-name and strength of the drug, name of the manufacturer or distributor, beyond use date, lot number on each container.
  • Every licensed pharmacy shall conduct an annual self-inspection using forms provided by the Department.

Legislative Update – The March legislative update was provided by Scott Meyers, ICHP Executive Vice President. The bills relayed to the Board are described in the Government Affairs Report in this issue of KeePosted.

Next Board of Pharmacy Meeting – The next meeting of the Illinois Board of Pharmacy will be held at 10:30 AM on Tuesday, May 10th at the James R. Thompson Center, 100 W. Randolph St., Chicago.  Announcements and agendas are posted at least 14 days in advance on the IDFPR pharmacy website. The profession is welcome to attend the open portion of this meeting.



Government Affairs Report
The Fun Has Begun

by Jim Owen and Scott A. Meyers

The bill introduction deadline has passed, so we hope this is it. Although we have seen the General Assembly break almost every one of their rules over the past 9-10 months, so it’s anyone’s guess if there will be more to come. In general, this year has some very favorable bills for pharmacy and a couple of ones that we aren’t crazy about. Below you will find a list of all the bills ICHP is monitoring, but there are a few for which we would like you to pay close attention.

These bills are what we consider good ones starting at the top:
SB2515 PBM Regulation
HR0944 Study e-prescribing discontinuation/stop orders
HR1018 Urge Congress to ban Direct-to-Consumer Advertising
HB3627 Immunization expansion for pharmacists
HB5540 Dispensing naloxone without a prescription
HB5591 PBM Regulation
HB5809 Pharmacist prescribed hormonal contraceptives

These bills could be problems for pharmacy:
SB2498 Technical change to pharmacy practice act
SB3336 Establishes a pharmacy quality assurance program for error reporting
HB4936 Technical change to pharmacy practice act
HB6180 Establishes a pharmacy quality assurance program for error reporting

Here is the entire list of bills the ICHP Division of Government Affairs is currently monitoring:

Bill No. Sponsor Summary Status Position
SB2177 Noland, D-Elgin Creates the Illinois Universal Health Care Act. Provides that all individuals residing in the State are covered under the Illinois Health Services Program for health insurance. Sets forth the health coverage benefits that participants are entitled to under the Program. Sets forth the qualification requirements for participating health providers. Sets forth standards for provider reimbursement. Provides that it is unlawful for private health insurers to sell health insurance coverage that duplicates the coverage of the Program. Provides that investor-ownership of health delivery facilities is unlawful. Provides that the State shall establish the Illinois Health Services Trust to provide financing for the Program. Sets forth the requirements for claims billing under the Program. Provides that the Program shall include funding for long-term care services and mental health services. Provides that the Program shall establish a single prescription drug formulary and list of approved durable medical goods and supplies. Creates the Pharmaceutical and Durable Medical Goods Committee to negotiate the prices of pharmaceuticals and durable medical goods with suppliers or manufacturers on an open bid competitive basis. Sets forth provisions concerning patients' rights. Provides that the employees of the Program shall be compensated in accordance with the current pay scale for State employees and as deemed professionally appropriate by the General Assembly. Executive Comm. Neutral
SB2269 Bennett, D-Champaign Makes appropriations to Colleges of Pharmacy at UIC, CSU and SIUe from the General Professions Disciplinary Fund. Assignments Comm. Neutral
SB2349 Righter, R-Mattoon Makes appropriations to Colleges of Pharmacy at UIC, CSU and SIUe from the General Professions Disciplinary Fund. Assignments Comm. Neutral
SB2403 Rose, R-Champaign Hospitals shall ensure that professional staff with direct and indirect patient care responsibilities including pharmacy staff, are periodically trained to implement sepsis protocols. Public Health Comm Neutral
SB2408 Rose, R-Champaign Makes appropriations to Colleges of Pharmacy at UIC, CSU and SIUe from the General Professions Disciplinary Fund. Assignments Comm. Neutral
SB2461

Same as HB4970
Barickman, R-Bloomington Amends the Pharmacy Practice Act. Removes provisions concerning the position of deputy pharmacy coordinator. Removes limitations on the number of pharmacy investigators that must be employed by the Department of Financial and Professional Regulation (previously no less than 4 pharmacy investigators needed to be employed by the Department). Amends the Private Detective, Private Alarm, Private Security, Fingerprint Vendor, and Locksmith Act of 2004. Provides that the requirement for licensure that an applicant must submit certification issued by the Department of State Police that the applicant's fingerprinting equipment and software meets all specifications required by the Department of State Police applies to fingerprint vendor agencies (rather than fingerprint vendors), and that the requirement is a continuing requirement for licensure. Effective immediately. Licensed Activities and Pension Comm. Neutral
SB2498 Bush, D-Grayslake Amends the Pharmacy Practice Act. Makes a technical change in a Section concerning licensure without examination. Assignments Comm. Neutral
SB2515

Same as HB5591
Munoz, D-Chicago Amends the Illinois Insurance Code. Provides a process to register with the Department of Insurance as a pharmacy benefits manager and what information must be included. Provides that the Director of Insurance may revoke, suspend, deny, or restrict a certificate of registration for violation of the Code or on other grounds as determined necessary or appropriate by the Director. Provides that the Department shall regulate the drug pricing process used by pharmacy benefits managers, and specifies the appeals process for such pricing. Provides that pharmacy benefits managers shall not mandate that a covered individual use a specific pharmacy or provide incentives to encourage the use of a specific pharmacy under specified circumstances. Provides criteria for entities to use in performing on-site audits of pharmacy records. Provides that health plans must permit their enrollees to receive benefits, which may include a 90-day supply of covered prescription drugs, at any of its network community pharmacies. Contains provisions concerning medication synchronization. Provides that dispensing fees shall be determined exclusively on the total number of prescriptions dispensed. Regulates how pharmacy benefits managers may utilize personally identifiable data. Provides that the Department can regulate other specified activities of pharmacy benefits managers. Makes other changes. Effective January 1, 2017. Insurance Comm. Support
SB2901

Same as HB5949
Martinez, D-Chicago Amends the Pharmacy Practice Act. Extends the repeal of the medicine locking closure package pilot program from January 1, 2017 to January 1, 2018. Effective immediately. Assignments Comm. Neutral
SB3158 McCann, R-Jacksonville Amends the Home Health and Hospice Drug Dispensation and Administration Act. Provides that the Department of Public Health may by rule provide for the possession and transportation of greater quantities of specified drugs by a home health agency, hospice, or authorized nursing employee. Assignments Comm. Neutral
SB3326 Luechtefeld, R-Okawville Amends the Personnel Code to provide for partial jurisdiction B exemption for certain positions within the Department of Human Services. Assignments Comm. Neutral
SB3336

Same as HB6180
Righter, R-Mattoon Amends the Pharmacy Practice Act. Requires pharmacies to establish and maintain a quality assurance program designed to prevent dispensing errors as well as a process designed to detect and identify dispensing errors. Requires pharmacies to commence an investigation into any detected dispensing errors within 2 days after the date the dispensing error is discovered. Requires that if an investigation into a dispensing error indicates that the dispensing error is attributable, in whole or in part, to the pharmacy or its personnel, that a quality assurance review be performed. Provides requirements for the quality assurance review and its records. Provides that the records of the quality assurance review shall not be subject to discovery in any arbitration, civil, or other proceeding, except in certain circumstances. Effective 12 months after becoming law. Assignments Comm. Oppose
HR0944 Zalewski, D-Riverside Urges the Department of Financial and Professional Regulation to undertake a study to determine the appropriateness of mandating a mechanism for electronically-prescribed prescription orders to electronically transmit "discontinuation", "cancel", or "stop" orders from health care providers to pharmacies and to examine the effects of auto-refill programs on the unnecessary filling of discontinued medications no longer endorsed by the prescriber. Health Care Licenses  Comm. Support
HR1018 Mitchell, R-Decatur Urges Congress to adopt legislation banning direct-to-consumer advertising of prescription drugs. Urges the United States Food and Drug Administration to adopt appropriate rules and regulations banning direct-to-consumer advertising of prescription drugs. Rules Comm. Support
HB3627 Evans, D-Chicago Amends the Pharmacy Practice Act. Makes changes to the definition of "practice of pharmacy", including (ii) allowing for the vaccination of patients ages 10 through 13 pursuant to a valid prescription or standing order (was, limited to Influenza (inactivated influenza vaccine and live attenuated influenza intranasal vaccine) and Tdap (defined as tetanus, diphtheria, acellular pertussis) vaccines). Effective January 1, 2016. Rules Comm. Support
HB4408 G. Harris, D-Chicago Amends the Illinois Public Aid Code. Makes a technical change in a Section regarding Medicaid co-payments. Rules Comm. Neutral
HB4429 Nekritz, D-Buffalo Grove Amends the State Prompt Payment Act. Provides that after the effective date of the amendatory Act, any bill approved for payment under the Act and pursuant to a health benefit plan under the State Employees Group Insurance Act of 1971 or submitted under Article V of the Illinois Public Aid Code, except a bill for pharmacy or nursing facility services or goods, if payment is not issued to the payee in a timely manner under the Section, the following interest penalty shall apply to any amount approved and unpaid until final payment is made: the sum of the prime commercial rate plus 4.0% per year, applied pro rata for the amount of time the bill remains unpaid. Defines "prime commercial rate". Amends the Illinois Insurance Code. In provisions concerning timely payment for health care services, provides that the interest to be charged on late payments of periodic payments, payments by independent practice associations and physician-hospital organizations, and payments by health insurers, health maintenance organizations, managed care plans, health care plans, preferred provider organizations, and third party administrators shall be the sum of the prime commercial rate plus 4.0% per year. Defines "prime commercial rate". Amends the State Employees Group Insurance Act of 1971. Provides that the program of health benefits offered under the Act is subject to certain provisions of the Illinois Insurance Code concerning late payments and assignability except as otherwise provided. Finance Subcomm. Of Revenue and Finance Comm. Neutral
HB4539 Brady, R-Normal Makes appropriations to Colleges of Pharmacy at UIC, CSU and SIUe from the General Professions Disciplinary Fund. Rules Comm. Neutral
HB4554 Flowers, D-Chicago Amends the Illinois Insurance Code. Provides that individual or group policies of accident and health insurance amended, delivered, issued, or renewed in this State after the effective date of the amendatory Act shall provide coverage for all drugs that are approved for marketing by the federal Food and Drug Administration and that are recommended by the federal Public Health Service or the United States Centers for Disease Control and Prevention for pre-exposure prophylaxis and related pre-exposure prophylaxis services, including, but not limited to, HIV and sexually transmitted infection screening, treatment for sexually transmitted infections, medical monitoring, assorted labs, and counseling to reduce the likelihood of HIV infection among individuals who are not infected with HIV but who are at high risk of HIV infection. Provides that the provision does not require a policy of accident and health insurance to provide coverage for clinical trials relating to any drug for pre-exposure prophylaxis for HIV. Amends the Illinois Public Aid Code. Provides that upon federal approval, the Department of Healthcare and Family Services shall provide similar coverage. Effective January 1, 2017. Insurance Comm. Neutral
HB4936 Durkin, R- Amends the Pharmacy Practice Act. Makes a technical change in a Section concerning licensure without examination. Executive Comm. Neutral
HB4957 Tryon, R-Crystal Lake Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to provide medical assistance coverage for diabetes education provided by a certified diabetes education provider for children with Type 1 diabetes who are under the age of 18. Defines "certified diabetes education provider" to mean a professional who has undergone training and certification under conditions approved by the American Association of Diabetes Educators or a successor association of professionals. Defines "Type 1 diabetes" to have the same meaning ascribed to it by the American Diabetes Association or any successor association. Effective immediately. Rules Comm. Support
HB4970

Same as SB2461
Stewart, R-Freeport Amends the Pharmacy Practice Act. Removes provisions concerning the position of deputy pharmacy coordinator. Removes limitations on the number of pharmacy investigators that must be employed by the Department of Financial and Professional Regulation (previously no less than 4 pharmacy investigators needed to be employed by the Department). Amends the Private Detective, Private Alarm, Private Security, Fingerprint Vendor, and Locksmith Act of 2004. Provides that the requirement for licensure that an applicant must submit certification issued by the Department of State Police that the applicant's fingerprinting equipment and software meets all specifications required by the Department of State Police applies to fingerprint vendor agencies (rather than fingerprint vendors), and that the requirement is a continuing requirement for licensure. Effective immediately. Rules Comm. Neutral
HB4981 D. Harris, R-Mt. Prospect Amends the State Prompt Payment Act. Provides that, for bills paid on or after the effective date, the interest penalty shall be 0.75% per month (currently, 1% per month). Effective immediately. Rules Comm. Oppose
HB5534 Feigenholtz, D-Chicago Amends the Compassionate Use of Medical Cannabis Pilot Program Act. Makes changes to the definition of "designated caregiver". Allows pharmacists to oversee through MTM the use of medical cannabis.  Effective immediately. Rules Comm. Neutral
HB5540 Flynn-Currie, D-Chicago Creates Section 225 ILCS 85/19.1 Naloxone dispensing without a prescription.  Consistent with the Heroin Crisis Act of 2015. Rules Comm. Neutral
HB5591

Same as SB2515
Lang, D-Chicago Amends the Illinois Insurance Code. Provides a process to register with the Department of Insurance as a pharmacy benefits manager and what information must be included. Provides that the Director of Insurance may revoke, suspend, deny, or restrict a certificate of registration for violation of the Code or on other grounds as determined necessary or appropriate by the Director. Provides that the Department shall regulate the drug pricing process used by pharmacy benefits managers, and specifies the appeals process for such pricing. Provides that pharmacy benefits managers shall not mandate that a covered individual use a specific pharmacy or provide incentives to encourage the use of a specific pharmacy under specified circumstances. Provides criteria for entities to use in performing on-site audits of pharmacy records. Provides that health plans must permit their enrollees to receive benefits, which may include a 90-day supply of covered prescription drugs, at any of its network community pharmacies. Contains provisions concerning medication synchronization. Provides that dispensing fees shall be determined exclusively on the total number of prescriptions dispensed. Regulates how pharmacy benefits managers may utilize personally identifiable data. Provides that the Department can regulate other specified activities of pharmacy benefits managers. Makes other changes. Effective January 1, 2017. Insurance Comm. Support
HB5641 Bellock, R-Westmont Amends the Illinois Public Aid Code. In a provision concerning orthotic and prosthetic devices and durable medical equipment, provides that the Department of Healthcare and Family Services shall adjust the useful life expectancy of eligible orthotic and prosthetic devices and durable medical equipment to 5 years. Requires the Department to require by rule all vendors of durable medical equipment to be accredited by an accreditation organization approved by the federal Centers for Medicare and Medicaid Services and recognized by the Department. Provides that no later than 90 days after the effective date of the amendatory Act, the Department shall file proposed rules in accordance with the Illinois Administrative Procedure Act to implement this requirement. Provides that no later than 15 months after the effective date of the rule, all vendors must meet the accreditation requirement. Provides that the Department may contract with a third-party vendor to audit eligible durable medical equipment suppliers. Appropriations-Human Services Comm. Neutral
HB5750 Harris, D-Chicago Creates the Health Insurance Claims Assessment Act. Imposes an assessment of 1% on claims paid by a health insurance carrier or third-party administrator. Provides that the moneys received and collected under the Act shall be deposited into the Healthcare Provider Relief Fund and used solely for the purpose of funding Medicaid services provided under the medical assistance programs administered by the Department of Healthcare and Family Services. Appropriations-Human Services Comm. Neutral
HB5751 Ives, R-Wheaton Amends the Workers' Compensation Act. Provides that no medical provider shall be reimbursed for a supply of prescriptions filled outside of a licensed pharmacy except when there exists no licensed pharmacy within 5 miles of the prescribing physician's practice. Provides that, if there exists no licensed pharmacy within 5 miles of the prescribing physician's practice, no medical provider shall be reimbursed for a prescription, the supply of which lasts for longer than 72 hours from the date of injury or 24 hours from the date of first referral to the medical service provider, whichever is greater, filled and dispensed outside of a licensed pharmacy. Provides that the limitations on filling and dispensing prescriptions do not apply if there exists a pre-arranged agreement between the medical provider and a preferred provider program regarding the filling of prescriptions outside a licensed pharmacy. Rules Comm. Neutral
HB5809 Mussman, D-Schaumburg Amends the Pharmacy Practice Act. Provides that "practice of pharmacy" includes the prescribing and dispensing of hormonal contraceptive patches and self-administered oral hormonal contraceptives. Defines "hormonal contraceptive patch" as a transdermal patch applied to the skin of a patient, by the patient or by a practitioner, that releases a drug composed of a combination of hormones that is approved by the United States Food and Drug Administration to prevent pregnancy and "self-administered oral hormonal contraceptive" as a drug composed of a combination of hormones that is approved by the United States Food and Drug Administration to prevent pregnancy and that the patient to whom the drug is prescribed may take orally. Allows pharmacists to prescribe and dispense contraceptives to a person over 18 years of age and a person under 18 years of age only if the person has evidence of a previous prescription from a primary care or a women's health care practitioner. Requires the Department of Financial and Professional Regulation to adopt rules to establish standard procedures for pharmacists to prescribe contraceptives. Provides requirements for the rules to be adopted by the Department. Provides that all State and federal laws governing insurance coverage of contraceptive drugs and products shall apply to this Section. Rules Comm. Support
HB5949

Same as SB2901
Zalewski, D-Riverside Amends the Pharmacy Practice Act. Extends the repeal of the medicine locking closure package pilot program from January 1, 2017 to January 1, 2018. Effective immediately. Rules Comm. Neutral
HB6158 Willis, D-Northlake Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that on or after July 1, 2016, drugs which are prescribed to residents of a nursing home shall not be subject to prior approval as a result of the 4-prescription limit. Effective July 1, 2016. Rules Comm. Neutral
HB6180

Sam
e as SB3336
McAuliffe, R-Chicago Amends the Pharmacy Practice Act. Requires pharmacies to establish and maintain a quality assurance program designed to prevent dispensing errors as well as a process designed to detect and identify dispensing errors. Requires pharmacies to commence an investigation into any detected dispensing errors within 2 days after the date the dispensing error is discovered. Requires that if an investigation into a dispensing error indicates that the dispensing error is attributable, in whole or in part, to the pharmacy or its personnel, that a quality assurance review be performed. Provides requirements for the quality assurance review and its records. Provides that the records of the quality assurance review shall not be subject to discovery in any arbitration, civil, or other proceeding, except in certain circumstances. Effective 12 months after becoming law. Rules Comm. Oppose

As you can see, there are a lot of bills that could impact pharmacy in both good and bad ways. It is important for all members to make sure their email server does not block emails from @ichpnet.org, so that any call to action we post gets through to you. If you currently use a work email for ICHP communications, please contact your IT staff to make sure ICHP emails make it through your company’s filter, or send us your personal email address so that you don’t miss anything this legislative session or all year. We want to keep you informed, but we can’t if we’re caught in a spam filter!

Keep your eyes peeled for email updates or the next issue of KeePosted and its Government Affairs Report!




Professional Affairs
Strategy for dealing with fomepizole shortage: revisiting the use of alcohol as an antidote

by Katherine V. Zych, PharmD, BCPS, PGY2 Drug Information Resident, UIC College of Pharmacy; Anthony M. Burda, BS.Pharm, DABAT, Illinois Poison Center; Carol DesLauriers, PharmD, DABAT, Illinois Poison Center

Background
In 2014, the American Association of Poison Control Centers reported approximately 26,000 cases of toxic alcohol exposure.1 Since FDA approval in 1997, fomepizole (Antizol®) has remained the preferred antidote for toxic alcohol ingestion due to improved affinity for alcohol dehydrogenase (ADH), ease of dosing, and better safety profile as compared with ethanol.2,3 In light of recent drug shortages of fomepizole, ethanol is once again emerging as an alternative to the standard of care for cases of toxic alcohol ingestion.

ADH Inhibition 
Methanol (ME) and ethylene glycol (EG), the most frequently ingested toxic alcohols, are found in common automotive de-icers and antifreezes.2,3 Although relatively harmless as parent compounds, ME and EG are converted to toxic metabolites via endogenous ADH and aldehyde dehydrogenase (ALDH).3 Delayed complications of ingestion include wide anion gap metabolic acidosis, nephrotoxicity (in EG poisoning), blindness (in ME poisoning), cerebral edema and death. 

Several proposed criteria for administration of an antidote for ME or EG poisoning are provided in Table 1.2,3,5,6 Fomepizole (4-methylpyrazole [4MP]) and ethanol are currently the only available antidotes for toxic alcohol ingestion.2,3 Both agents act to competitively decrease the breakdown of toxic alcohols into their respective toxic metabolites by ADH.2 Table 2 provides a brief comparison of fomepizole and ethanol as antidotes.2,3 

Table 1. Criteria for administration of an ADH inhibitor2,3,5,6 
Documented ethylene glycol or methanol serum concentration >20 mg/dL (>200 mg/L)
OR
Documented/suspected recent history of ingestion with an osmolal gap > 10 mOsm/kg H2Oa
OR
Documented/suspected history of ingestion plus two or more of the following criteria: 
  • Arterial pH < 7.3 
  • Serum bicarbonate < 20 mmol/L (<20meq/L)
  • Osmolal gap > 10 mOsm/kg H2Oa
  • Presence of urinary oxalate crystals (ethylene glycol only) or visual disturbances (methanol only)
aOsmolal gap calculated after the ethanol contribution is subtracted. Absence of a wide osmolal gap does not exclude toxic alcohol poisoning. 



Table 2. Comparison of ADH Inhibitors2,3

Fomepizole Ethanol
ADH inhibition/ affinity Highly competitive Lower affinity and transient inhibition due to self-metabolism
Therapeutic drug monitoring Not necessary Frequent (every 1 to 2 hours)
Availability Limited due to shortages Good (especially oral formulation)
Cost Higher acquisition cost; possibly lower cost of monitoring Inexpensive acquisition cost; possibly higher cost of monitoring


Ethanol Dosing and Administration 
Several considerations should be taken into account when dosing ethanol for toxic alcohol ingestion, including history of alcohol intake, and whether the patient will be undergoing hemodialysis while receiving ethanol.3 Table 3 provides dosing for oral and intravenous ethanol. Since ethanol is dialyzable, higher maintenance doses are required for patients undergoing hemodialysis. Higher doses are also required for those who have a history of chronic alcohol use. Intravenous administration of ethanol will require compounding in dextrose 5% in water under sterile conditions due to lack of commercial availability. Table 4 provides a comparison of oral and intravenous administration of ethanol.2,3 


Table 3. Suggested ethanol dosing3
Loading Dose All patients
  10% IV solution  
10 mL/kg over 1 hour as tolerated
      40% oral solution      
2 mL/kg over 1 hour as tolerated
Maintenance dosing

Alcohol naïve
__________________
Alcohol experienced


1 to 1.6 mL/kg/hr

1.9 mL/kg/hr


0.3 mL/kg/hr to 0.4 mL/kg/hr
______________________
0.5 mL/kg/hr

Maintenance dosing
During hemodialysis
(Alcohol naïve and alcohol experienced)
3 mL/kg/hr to 4.3mL/kg/hr 0.8 mL/kg/hr to 1.1 mL/kg/hr



Table 4. Comparison of ethanol formulations2,3
Intravenous Oral
Advantages
  • 100% bioavailable 
  • Low risk of gastrointestinal symptoms
  • Useful for unconscious patients
Disadvantages 
  • Not commercially available

Advantages
  • Minimal preparation
  • Easy to administer
  • Can be given via naso-gastric tube

Disadvantages 
  • Variable absorption
  • Practicality of administration (i.e., placing orders, obtaining agent, conflicts with hospital policies/procedures)


Higher concentrations of ethanol (i.e. 40%) are appropriate for oral administration due to variability in oral absorption, whereas lower concentrations of 5% to 10% are recommended for intravenous use.3 It is important to note that the “proof” number on the oral ethanol products represent double the concentration; therefore “80 proof” ethanol is 40% ethanol by volume (40 mL/100 mL). To improve palatability and reduce incidence of gastritis, common commercially available 40% ethanol by volume products can be diluted with juice or water prior to administration.

To ensure adequate ADH inhibition, serum ethanol concentrations should be kept in the range of 100 mg/dL to 150 mg/dL.2,3 Due to large interpatient variations in metabolism, frequent monitoring (every 1 to 2 hours) is recommended. Fluid and electrolyte status, in addition to blood glucose should also be closely monitored throughout therapy. Antidotal therapy should be continued until toxic alcohol levels are < 20 mg/dL with resolution of acidosis and improvement in patient symptoms.3,7 

Ethanol Safety 
Adverse drug events related to ethanol administration include central nervous system depression, behavioral disturbances, hepatitis, pancreatitis, hypoglycemia, and dehydration.2 Pending other drugs the patient may have ingested prior to receiving ethanol therapy, disulfiram-like reactions may occur as a result of drug-drug interactions.3 Additional adverse effects specifically related to intravenous ethanol administration include local venous irritation, hyponatremia, and osmotic dehydration. 

Adjunct therapy 
It is important to remember that ethanol and other ADH inhibitors will only prevent the formation of toxic metabolites.3 In cases of severe poisoning, enhanced elimination with hemodialysis, in conjunction with continual ADH inhibition, may be necessary to remove the parent compound and toxic metabolites.5,6 Indications for hemodialysis in the setting of toxic alcohol ingestion are as follows: severe metabolic acidosis (pH <7.3) or electrolyte abnormalities unresponsive to conventional therapies, deteriorating vital signs in the setting of intensive supportive care, renal failure, vision abnormalities (ME only), or EG or ME concentrations > 50 mg/dL (unless fomepizole is being administered and the patient is asymptomatic with normal arterial pH). 

In summary, toxic alcohol ingestion is a serious clinical condition for which prompt recognition and aggressive treatment may help prevent permanent organ toxicity and death. In order to facilitate appropriate treatment, hospital pharmacies should have up to date treatment guidelines in place for treating these patients. Guidance for use of oral or IV ethanol should be in place for situations where fomepizole is not available. Policies and procedures related to obtaining and dispensing ethanol should also be clearly outlined.  

The Illinois Poison Center is available 24 hours a day 7 days a week for questions related to managing patients post toxic alcohol ingestion. Call 1-800-222-1222 to speak with a poison center specialist. 


References 
  1. Mowry JB, Spyker DA, Brooks DE, McMillan N, Schauben JL. 2014 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 32nd Annual Report. Clinical Toxicology. 2015;53(10):962-1147.
  2. McMartin K, Jacobsen D, Hovda KE. Antidotes for poisoning by alcohols that form toxic metabolites. [published online ahead of print November 9, 2015]. Br J Clin Pharmacol. doi:10.1111/bcp.12824.
  3. Hoffman RS, Howland MA, Lewin NA, Nelson L, Goldfrank LR, Flomenbaum N. Goldfrank's toxicologic emergencies. 10th ed. New York:McGraw-Hill Education; 2015.
  4. Drug Shortages (Fomepizole Injection). American Society of Heath-System Pharmacists website. http://www.ashp.org/. Updated November 19, 2015. Accessed December 2, 2015.
  5. Barceloux D. G BGR, Krenzelok E. P, Cooper H, Vale J. A. American Academy of Clinical Toxicology Ad Hoc Committee on the Treatment Guidelines for Methanol Poisoning. American Academy of Clinical Toxicology practice guidelines on the treatment of methanol poisoning. J Toxicol Clin Toxicol. 2002;40(4):415-446.
  6. Barceloux DG, Krenzelok EP, Olson K, Watson W. American Academy of Clinical Toxicology Practice Guidelines on the Treatment of Ethylene Glycol Poisoning. Ad Hoc Committee. J Toxicol Clin Toxicol. 1999;37(5):537-560.
  7. Antizole [package insert]. San Diego, CA: Amylin Pharmaceuticals Inc; 2007.



Educational Affairs
2016 Spring Meeting Poster Abstracts

EDITOR’S NOTE: For a detailed list of all posters as presented at the 2016 Spring Meeting, please refer to the Spring Meeting Syllabus, pages 14-16. Poster numbers as presented at the meeting are in parenthesis below. For Platform Presentations, please refer to the Spring Meeting Syllabus, page 10. All research was to have results and conclusions by the time of presentation. This may not be reflected in the posted abstracts below.


PLATFORM PRESENTATIONS

  1. Reducing adverse drug event risks for geriatric patients by optimizing prescribing for selected medication records
  2. Economic impact of major adverse drug events using hospital chargemaster data in 2014-2015

ORIGINAL

  1. Sacubitril; Losartan the next treatment for heart failure?
  2. The role of tenofovir in preexposure prophylaxis of herpes simplex virus type 2: a systematic review
  3. Calcium and Vitamin D co-supplementation in Gestational Diabetes Mellitus
  4. Oral lorazepam for seizure prophylaxis in adult patients treated with high dose intravenous busulfan before hematopoietic stem cell transplantation: A retrospective study
  5. Evaluation of a Protocol used to Screen and Control Glycemic Levels Following Total Orthopedic Knee and Hip Surgeries
  6. Analysis of Risk Factors and Antipsychotic Usage Patterns Associated with Terminal Delirium in a Veteran Inpatient Hospice Population
  7. Redesigning PGY1 Pharmacy Residency Interview Structure
  8. Impact of pharmacists within a multidisciplinary team on chronic obstructive pulmonary disease (COPD) readmission rates
  9. Efficacy, nephrotoxicity, and incidence of Clostridium difficile infection with broad spectrum antibiotic regimens in patients with nosocomial pneumonia
  10. Evaluation of fall risk in dementia patients on an atypical antipsychotic in the VA population
  11. Digoxin and Time to Cardiac-Related Hospitalizations: A Retrospective Cohort Study
  12. A Performance Improvement Approach to Implementing a Pharmacist-led Medication Education Program in a Community Hospital
  13. Evaluation of a Pilot Benzodiazepine Taper Clinic in Veterans with Concurrent Opioid Use

ENCORE

  1. Implementation of decentralized pharmacy technicians to improve medication delivery and nursing satisfaction
  2. Global Initiatives to Streamline Pharmacy Education and Workforce Development
  3. Antifungal prophylaxis consideration in patients being treated with blinatumomab for Philadelphia chromosome-negative relapsed or refractory b-cell acute lymphoblastic leukemia: a case report
  4. Differences in Clostridium difficile infection outcomes between guideline concordant and discordant therapy

STUDENT

  1. Assessment of healthcare needs of elderly patients in rural communities of central Illinois
  2. Effectiveness of Pharmacy Practice Model Initiative Competency
  3. Desmopressin (DDAVP) Dose Changes Post Discharge in Pediatric Patients with Diabetes Insipidus Receiving Oral DDAVP Compounded from Nasal Spray Inpatient
  4. Retrospective analysis of osteoporosis risk factors among the Chinese population
  5. Comparison of oral morphine equivalent doses vs. PHQ9 scores in a family practice setting
  6. Phytopharmacological evaluation of chamomile (Matricaria recutita L.) for indirect modulation of the endocannabinoid system
  7. Comparison of Pharmacist and Physician Attitudes and Knowledge of Pain Management


ICHP Poster Presentations – Platform Presentation #1

Category: Original - Research Complete

Title: Reducing adverse drug event risks for geriatric patients by optimizing prescribing for selected medication records

Purpose:  To improve the age-appropriate prescribing for selected medications in patients over 65 years old, to decrease the potential for adverse drug reactions (ADRs). 

Methods: This trial was conducted at a 600+ bed level 1 trauma center in Peoria, IL, which utilizes an electronic health record (EHR) with pre-selected or default medication doses and frequencies. To reduce potential ADRs associated with medication prescribing, seven medications (amitriptyline, cyclobenzaprine, diphenhydramine (oral and intravenous), glimepiride, glipizide, and glyburide were identified. These medications were selected because, their default doses and/or frequencies in the EHR did not adhere to age-appropriate guidelines as described by BEERs. The BEERs list, published in 1991, described the development of a consensus list of medicines considered to be inappropriate for geriatric patients and is endorsed by The American Geriatrics Society. It includes medications that should be avoided, and medications that should be used with extra caution, either in all elderly or in certain populations.1 Changes in doses and or frequencies were made based on recommendations from the BEERs criteria and the geriatric dosing provided in Lexi-Comp.2 EHR reports were obtained for two six month periods, baseline and follow up. The follow up period began two months after changes were implemented to ensure full integration. The percentage of medication orders within the geriatric appropriate dose and/or frequency targets were measured for both the baseline and follow up periods.  

Results: Positive changes in physician prescribing habits were seen in four out of seven medications, including cyclobenzaprine, diphenhydramine (both oral and intravenous), glimepiride and glipizide. The baseline percentage of orders within the target dose range compared to the follow up period were cyclobenzaprine (39.1% vs 61.1%), diphenhydramine oral (39.2% vs 49.4%), diphenhydramine intravenous (55.2% vs 57.4%), glimepiride (19.6%  vs 21.9%), and glipizide orders (14.1% vs 21.5%).  

References
1. American Geriatrics Society 2015 Beers Criteria Update Expert Panel. American Geriatrics Society 2015 updated Beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc 2015 Oct 8. doi: 10.1111/jgs.13702. [Epub ahead of print].
2. Lexi-Comp. Accessed August 2014.

Conclusion:  Improved compliance was achieved with physician ordering of medications (cyclobenzaprine, oral and intravenous diphenhydramine, glimepiride and glipizide) for patients over 65 years old by adjusting the default dose and or frequency, using evidence based criteria.  Although not specifically measured in this initiative, it is concluded that the risk of ADEs were reduced by adjusting the EHR default doses and frequencies for these selected medications.

Submitting Author: Amy B. Maxfield, BS Pharm

Submitting Organization: OSF SFMC

Authors: Amy B. Maxfield, BS Pharm; Heather M. Harper, PharmD, BCPS


ICHP Poster Presentations – Platform Presentation #2
Winner: Best Platform Presentation 2016

Category: Original - Research Complete

Title: Economic impact of major adverse drug events using hospital chargemaster data in 2014-2015

Purpose: Patient-specific adverse drug events (ADEs) have been previously associated with respective increases in hospitalization costs and length of stay. Literature determining the economic impact of ADEs is relatively outdated, driving health system administrators to apply an inflation factor to previously published figures in the processes to evaluate current cost avoidance of ADE prevention. The purpose of this study is to determine the economic impact of major ADEs on patient hospitalization costs and length of stay (LOS), in present time.

Methods: This study has been approved by the University of Chicago Institutional Review Board. ADEs were identified using both voluntary event reporting data and ICD-9 codes for patients admitted to the University of Chicago Medicine during the time period of April 2014 and May 2015. Case patients experienced a major ADE (as classified as “E” or higher on The National Coordination Council for Medication Errors Reporting and Prevention [NCC-MERP] Index for Categorizing Medication Errors).   Controls matched by admission during study time period, classification by diagnosis related group, age (±2 years), and sex of each case were included. Using eSimon (Algonquin, IL), a hospital cost accounting system, total cost of hospitalization and length of stay were determined for both cases and controls. All analyses were performed using a two-sample Wilcoxon rank-sum (Mann-Whitney) test in STATA (College Station, TX).

Results: Of a total of 416 patients who experienced major ADEs evaluated for inclusion in the study, 242 were matched with controls for analysis. The drug classes primarily accounting for studied major ADEs include chemotherapy (38%), corticosteroids (14%) and opioids (11%). Mean cost of hospitalization between patients who experienced a major ADE and those who did not differed significantly ($38,239.31 vs. $47,138.04, p=0.0440), as well as in mean LOS (8.03 vs. 9.92 days, p=0.005).

Conclusion: This study determined total cost of hospitalization and LOS remains significantly higher for patients experiencing major ADEs than those who did not.

Submitting Author: Bryan C. McCarthy Jr., PharmD, MS, BCPS

Submitting Organization: University of Chicago Medicine

Authors: Bryan C. McCarthy Jr., PharmD, MS, BCPS; Tara P. Driscoll, PharmD; Kristin A. Tuiskula, PharmD; Andrew M. Davis, MD, MPH


ICHP Poster Presentations – Original #1
(presented as Poster #14)

Category: Original - Research Complete

Title: Sacubitril; Losartan the next treatment for heart failure?

Purpose: Congestive heart failure (CHF) is a leading cause of morbidity and mortality for which there are few recent improvements in treatment. Over one million US patients on optimized drug therapy are hospitalized each year. Identification of neurohormonal mechanisms that do not overlap with existing therapies are needed. The enzyme Neprilysin impairs endogenous vasoactive compounds, including natriuretic peptide leading to diuresis, natriuresis, and vasodilation. Sacubitril, a neprilysin inhibitor in combination with valsartan is the first of these treatments to show morbidity and mortality benefit compared to enalapril, as reported in the PARADIGM-HF trial. The purpose of this study is to analyze the safety and efficacy data available on sacubitril; valsartan (SV) and to determine if there is a role for the drug in the clinical treatment of CHF.

Methods: A systematic review of the databases PubMed, MedLine, and EMBASE was performed up to December of 2015. The following keywords were used: heart failure, neprilysin, ACE inhibitors, ARB, sacubitril, vasopeptidise inhibitor, PARADIGM-HF. Inclusion criteria included: 1) adult patients with NYHA class II-IV HF with ejection fraction <40% 2) treatment with SV 3) direct comparison to recommended treatment with an ACE-I 4) inclusion of morbidity, mortality, and safety outcomes 5) CEBM level of evidence 2b or greater. Only one randomized control trial met all specified inclusion criteria. It was therefore decided to include retrospective analyses of this trial due to the novelty of this subject. Two secondary analyses were identified as relevant and included in safety and efficacy analysis.

Results: The use of SV compared to enalapril in the treatment of HF was found to significantly reduce the risk of death (17% vs. 19.8% NNT 36) from any cause and (13.3% vs. 16.5% NNT 31) from cardiovascular causes, and time to first hospitalization for CHF (12.8% vs. 15.6% NNT 36). Safety data for SV found patients experiencing significantly less angioedema, renal impairment, or adverse events leading to discontinuation compared to enalapril. However a significant (18% vs. 12%; NNH 17) increase in hypotension was found for patients on SV compared to enalapril. Secondary analysis revealed that the mortality benefit for SV is primarily related to a modification in the risk for sudden death or to worsening heart failure. This benefit was comparable amongst patients of all ages, except for the very oldest in the outcome of CV death and the composite outcome of CV death and heart failure hospitalizations.

Conclusion: More research is needed before clinicians should use SV for the treatment of heart failure, despite the positive outcomes of the PARADIGM-HF trial. The morbidity and mortality benefits found may not generalize to the population at large in the setting of the trial’s limitations. The most concerning of these being that there is only a single RCT comprised majorly of clinically stable white males to support the use of SV over ACE-I. The authors also chose to compare the maximum recommended dose of the ARB component of SV to a low-dose of enalapirl, making it possible that the clinical benefits found were due to greater RAAS inhibition. Additionally, 12% of patients dropped out of the active run-in period due to side effects making it likely that the rates of adverse reactions reported, including angioedema, are lower than would be expected in practice. Moreover, the authors chose to omit findings from pre-clinical trials that demonstrated an increase in CSF beta-amyloid protein for patients receiving SV. For these reasons it is difficult to justify the significant cost associated with SV, which is approximately 100x that of enalapril, until further safety and efficacy analysis can be completed.

Submitting AuthorMichael Fotis, RPh

Submitting Organization: Northwestern University Feinberg School of Medicine

Authors: Tara Marcus PA-S2, Master of Medical Sciences Candidate; Michael Fotis, RPh


ICHP Poster Presentations – Original #2
(presented as Poster #1)

Category: Original - Research Complete

Title: The role of tenofovir in preexposure prophylaxis of herpes simplex virus type 2: a systematic review

Purpose: Herpes simplex virus type 2 (HSV-2) is among the most common sexually transmitted infections, affecting approximately 417 million sexually active adults worldwide [1]. HSV-2 is the leading cause of genital ulcers, and is associated with pain, itching, negative social stigma and increased risk for HIV-1 [2]. Preventative measures include barrier methods, abstinence, and chronic antiviral suppressive therapy for HSV-2 positive patients. There is not a vaccination or medication for preexposure prophylaxis (PrEP) for HSV-2. The purpose of this study is to assess the efficacy of the nucleotide reverse-transcriptase inhibitor, tenofovir, in the preexposure prophylaxis of HSV-2.

Methods: Data sources included PubMed, Cochrane Library and Embase between 1966-2015. Search terms included, “ tenofovir prevention herpes simplex virus type 2”. A total of 222 articles resulted. Inclusion criteria were set as randomized controlled trials with human participants conducted over the last 5 years, which yielded 2 studies. The dominant reason for exclusion was non-human participants. The main outcome measured is HSV-2 seroconversion.

Results: In one study, the incidence rate of HSV-2 was 10.2 cases per 100 person years with pericoital application of tenofovir gel, compared to incidence rate of HSV-2 of 21.0 cases per 100 person-years with placebo gel, NNP = 9.8 [3]. A second study resulted in an incidence rate of HSV-2 of 5.6 cases per 100 person years with oral tenofovir-based PrEP, compared to 7.7 cases per 100 person years with placebo, NNP = 37.1 [4].

References
1. Looker, K.J., et al., Global and Regional Estimates of Prevalent and Incident Herpes Simplex Virus Type 1 Infections in 2012. PLoS One, 2015. 10(10): p. e0140765.
2. Tan, D., Potential role of tenofovir vaginal gel for reduction of risk of herpes simplex virus in females. Int J Womens Health, 2012. 4: p. 341-50.
3. Abdool Karim, S.S., et al., Tenofovir Gel for the Prevention of Herpes Simplex Virus Type 2 Infection. N Engl J Med, 2015. 373(6): p. 530-9.
4. Celum, C., et al., Daily oral tenofovir and emtricitabine-tenofovir preexposure prophylaxis reduces herpes simplex virus type 2 acquisition among heterosexual HIV-1-uninfected men and women: a subgroup analysis of a randomized trial. Ann Intern Med, 2014. 161(1): p. 11-9.

Conclusion: Tenofovir-based therapy significantly reduced HSV-2 seroconversion in two double-blinded, randomized controlled trials. Periocoital tenofovir gel resulted in a 51% absolute decrease in HSV-2 seroconversion, while oral tenofovir-based therapy resulted in a 30% absolute decrease in HSV-2 seroconversion, suggesting that topical therapy is more effective in preventing HSV-2 seroconversion compared to oral therapy, although future studies comparing topical and oral tenofovir therapy for PrEP of HSV-2 are needed. Limitations of the studies are: neither study was originally designed to assess the effect of tenofovir on HSV-2 acquisition thus randomization at study enrollment was not stratified by HSV-2 status; the studies do not use the same formulation of tenofovir and neither study assesses the timing of HSV-2 acquisition in relation to plasma tenofovir levels; given the current cost of oral tenofovir, this may be a very costly option; widespread and long-term use of tenofovir may lead to increased viral resistance. This systematic review suggests that there is a potential role of tenofovir to prevent HSV-2 acquisition, which could reduce genital ulcers, pain, social stigma and HIV risk associated with HSV-2.

Submitting AuthorMichael Fotis, RPh

Submitting Organization: Northwestern University Feinberg School of Medicine

Authors: Julia Silver PA-S2, Master of Medical Sciences Candidate; Michael Fotis, RPh


ICHP Poster Presentations – Original #3
(presented as Poster #13)

Category: Original - Research Complete

Title: Calcium and Vitamin D co-supplementation in Gestational Diabetes Mellitus

Explain the strengths and the limitations of the clinical data supporting the use of supplementation of calcium and vitamin D during pregnancy to improve maternal outcomes in patients with gestational diabetes.

Purpose: The purpose of this poster is to examine if vitamin D and calcium co-supplementation is an effective intervention during pregnancy to improve maternal outcomes in patients with gestational diabetes (GDM). Diabetes is a significant cause of morbidity and mortality in the US, and an important economic burden. The CDC estimates up to 9.2% of pregnancies are affected by GDM. Available studies examining the relationship between Vitamin D deficiency and insufficiency in patients with GDM and associated maternal outcomes are inconsistent in their findings. Although the mechanism of effect is unclear there a few studies of Vitamin D and calcium co-supplementation reporting promising results.  

Methods: A systematic review was conducted using EMBASE, PubMed, and MedLine databases between October and December 2015. Search terms included: Calcium, Vitamin D, and Gestational Diabetes. Studies written in English were included in this review. Studies that did not examine gestational diabetes or did not examine co-supplementation of calcium and vitamin D were excluded. Under these inclusion and exclusion criteria a total of 2 eligible studies were identified. The studies were CEBM level of evidence 1b.

Results: Karamali in a randomized placebo controlled trial of 60 patients found that Vitamin D and calcium co-supplementation in women with GDM decreased the rates of many maternal and neonatal outcomes. There was a significant reduction in cesarean rates from 63% to 23% the number needed to treat (NNT) estimated as 2.5, and for maternal hospitalization from 13% to 0 (NNT=7). For neonatal hyperbilirubinemia the NNT=2.7, neonatal hospitalization was reduced from 57% to 20% (NNT = 2.7), and macrosomia NNT = 3. 

Asemi in a randomized placebo controlled trial of 56 patients found statistically significant improvement in laboratory values for fasting plasma glucose, serum insulin, HOMA-R, LDL cholesterol, total cholesterol: HDL cholesterol, HDL cholesterol, GSH, and MDA. Clinical outcomes were not measured in this trial. 

Both studies had the same intervention length of 6 weeks with 1,000mg of calcium carbonate daily over 6 weeks, and 50,000U of Vitamin D3 two times during the intervention, once at baseline and once on day 21 of the intervention.

Conclusion: The two RCTs examined in this systematic review found co-supplementation with calcium and vitamin D improved maternal laboratory results and improved maternal outcomes. There are limitations to note: studies are small, both were conducted in Iran and may lack external validity, only a single small trial measured clinical outcomes where maternal outcomes were secondary outcomes and may not have been appropriately powered to detect differences. Further well-designed, high powered, randomized controlled trials investigating the impact on maternal and fetal outcomes are necessary to determine a clinical effect. If a positive effect is established, future studies can focus on the optimal amount of supplementation and the timing during pregnancy. While the studies did not report adverse events, one separate study has determined that a 300,000 intramuscular dose of Vitamin D is safe and efficacious in pregnant women, and the National Institute of Health recommends 1,000mg of calcium carbonate daily for pregnant and lactating women. Furthermore, with possible similarities in the pathophysiology of GDM and diabetes, and the risk of progression from GDM to Type 2 DM, the effects of co-supplementation in diabetes mellitus could also be explored.

Submitting AuthorMichael Fotis, RPh

Submitting Organization: Northwestern University Feinberg School of Medicine

Authors: Christina Hill PA-S2, Master of Medical Sciences Candidate; Michael Fotis, RPh


ICHP Poster Presentations – Original #4
(presented as Poster #17)

Category: Original - Research in Progress

Title: Oral lorazepam for seizure prophylaxis in adult patients treated with high dose intravenous busulfan before hematopoietic stem cell transplantation: A retrospective study

Purpose: To determine the efficacy of oral lorazepam in preventing seizures in adult patients receiving high dose intravenous busulfan prior to allogeneic hematopoietic stem cell transplant (HSCT). 

Methods: This is a single center study conducted at Rush University Medical Center (RUMC) located in Chicago, Illinois.
• This retrospective study was approved by the Institutional Review Board prior to data collection.
• A stem cell transplant database was used to identify patients who have received allogeneic HSCTs from January 1, 2009 to March 31, 2015.
• Patients were included if they were ≥ 18 years old, received intravenous high dose busulfan, received oral lorazepam for seizure prophylaxis.

· Patients were excluded only if they received concomitant phenytoin.

• RUMC's electronic medical record system and the stem cell transplant database will be used to collect the following: age, sex, race, underlying malignancy, type of transplant, conditioning regimen, dates of busulfan administration,  fever during busulfan administration.
• Medication charts were reviewed for past medical history of seizures, illegal drug use, AIDS, and CNS malignant disease involvement at or during diagnosis.
• The primary endpoint is the occurrence of seizures from the start of busulfan until 72 hours following the completion of busulfan.
• Per RUMC policy, patients receive oral lorazepam 0.5 mg every 6 hours starting 24 hours prior to busulfan administration and continuing for 48 hours after the completion of busulfan.
• Categorical variables will be analyzed using Chi square or Fischer's Exact test. 

Results: Research in progress 

Conclusions:  Research in progress

Submitting Author: Monica Timmerman, PharmD candidate

Submitting Organization
: Midwestern University Chicago College of Pharmacy and Rush University Medical Center

Authors: Monica Timmerman, PharmD candidate; Lisa M. DiGrazia, PharmD, BCPS, BCOP; Amanda N. Seddon, PharmD, BCPS, BCOP; Annette Gilchrist, PhD


ICHP Poster Presentations – Original #5
(presented as Poster #4)

Category: Original - Research in Progress

Title: Evaluation of a Protocol used to Screen and Control Glycemic Levels Following Total Orthopedic Knee and Hip Surgeries

Purpose: Perioperative hyperglycemia can affect a patient’s recovery following orthopedic surgery by increasing the risk of complications including infection and by increasing patient length of stay.  Currently, our institution does not have a standardized glucose management protocol for this patient population. The objective of this study is to implement a protocol that can effectively manage patient’s glucose levels post-operatively and decrease the rate of post-op infections in patients who have undergone a total orthopedic knee or hip surgery. 

Methods: Patients undergoing elective orthopedic knee or hip surgery will first have Hemoglobin A1c labs drawn during preadmission testing. Patients with an A1c <8 will undergo surgery as planned while patient with an A1c >8 will be referred to their primary care physician to help manage their glucose levels. Their surgery will be postponed until the patient can provide documented glucose logs demonstrating glucose control and management over a 4 week period.  Once patients undergo surgery their glucose level will be managed by a P&T approved protocol using a sliding scale or basal plus correction method of insulin administration. Both non-diabetic and diabetic patient’s glucose will be managed by this protocol. This study will compare the management of patient glucose levels prior to and after the initiation of the protocol. The primary outcome of the study is the rate of post-operative infection. Secondary outcomes include the average glucose on post-operative days 0, 1, 2, and 3. Other outcomes include nursing satisfaction and number of patients who are found to have new onset diabetes.  

Results: Research in Progress 

Conclusions: Research in Progress

Submitting Author: Patrick D. Hammond, PharmD

Submitting Organization: Presence St. Joseph Medical Center

Authors: Patrick D. Hammond, PharmD; Rishita Shah, PharmD


ICHP Poster Presentations – Original #6
(presented as Poster #2)

Category: Original - Research in Progress

Title: Analysis of Risk Factors and Antipsychotic Usage Patterns Associated with Terminal Delirium in a Veteran Inpatient Hospice Population

Purpose:  The purpose of this study is to (1) Identify risk factors for terminal delirium in a VA inpatient hospice population (2) Assess usage patterns of antipsychotics in terminal delirium (3) Describe nursing assessment, non-pharmacological and pharmacological interventions, and documentation of terminal delirium 

Methods:  This is a retrospective case-control study of patients who expired in the Edward Hines, Jr. VA Hospital Community Living Center (CLC) under the treating specialty “NH hospice” during the period of October 1, 2013 to September 30, 2015. Cases are defined as patients who were treated with antipsychotics for terminal delirium within the last two weeks of life. Controls are defined as patients who were not treated with antipsychotics for terminal delirium within the last two weeks of life.  All patients enrolled under the treating specialty “NH Hospice” will be evaluated with the exclusion of living hospice patients and patients discharged to receive home hospice care prior to death. Patients’ medical records will be reviewed from two weeks prior to death until the recorded death date during which the following will be assessed from the medical record as available: age, terminal diagnosis, time interval cancer diagnosis and death, war era, comorbid conditions, prescribed antipsychotic medications, other medications potentially contributing to delirium, documentation for antipsychotic use, non-pharmacological interventions, and date of death.  

Results: Research in progress 

Conclusions: Research in progress

Submitting Author: Emily Ellsworth, PharmD

Submitting Organization: Edward Hines, Jr. VA Hospital

Authors: Emily Ellsworth, PharmD; Kevin Bacigalupo, PharmD, BCPS; Kavita Palla, PharmD, BCPS; Seema Limaye, MD; Margaret Walkosz, ACHPN, GNP-BC; Sandra Szczecinski, BSN; Katie Suda, PharmD, MS


ICHP Poster Presentations – Original #7
(presented as Poster #8)

Category: Original - Research in Progress

Title: Redesigning PGY1 Pharmacy Residency Interview Structure

Purpose: The structure of our PGY1 residency interview day was redesigned to increase objectivity in candidate evaluations and exposure of candidates to the activities in our department while decreasing the preceptor time commitment.  

Methods: In 2015 the PGY1 recruitment team incorporated multiple mini interviews (MMI), interdisciplinary rounds and a departmental activity in the interview days for PGY1 residency candidates for the 2015 recruitment season. Each multiple mini interview assessed specific qualities deemed to be essential in pharmacy residency training and utilized standardized evaluation tools. In 2016, the interview day was again restructured to adjust the time candidates spend rounding, eliminated one of the MMIs and implemented a one-on-one discussion session with the candidates and a current resident. Following the interviews, candidates were sent an electronic survey to evaluate their satisfaction with the interview day and the new structure. Descriptive statistics were used to describe the survey results from 2015 and survey results from 2016 are pending. Preceptor time for interview days in 2015 and 2016 will be compared with the amount of time required of preceptors in previous years.  

Results: In 2015 a total of 72 candidates were interviewed and 49 completed the post-interview survey. The activities that left the highest positive impression during the interview day were the introduction section, departmental activity and traditional interview sessions. The majority of candidates (84%) stated that the interview day increased their desire to pursue residency training at University of Chicago and felt that time was adequately appropriated between activities. Preceptor time for candidate interviews decreased by 72% (600 hours vs 168 hours) and from 7.1 hours per candidate to 2.3 hours per candidate. With the new structure, the number of candidates per day was increased allowing us to decrease the number of interview days by 36%. Results from 2016 are in progress.  

Conclusion: The restructuring of the interview day in 2015 provided resident a positive impression of our residency program while requiring fewer preceptor hours dedicated to interviewing. These results will be compared and new conclusions drawn off of the research conducted on the 2016 interview cycle.

Submitting Author: Hailey P. Soni PharmD

Submitting Organization: University of Chicago

Authors: Hailey P. Soni PharmD; Shannon Rotolo, PharmD; Mary Kate Miller, PharmD; Jennifer Austin Szwak, PharmD


ICHP Poster Presentations – Original #8
(presented as Poster #6)

Category: Original - Research in Progress

Title: Impact of pharmacists within a multidisciplinary team on chronic obstructive pulmonary disease (COPD) readmission rates

Purpose: In FY2015, the Centers for Medicare and Medicaid Services (CMS) expanded the existing algorithm accounting for readmission of patients to include those admitted for an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The Medicare Hospital Readmissions Reduction Program (HRRP) penalizes hospitals for excess early readmissions of patients with AECOPD. Currently, the penalty is in place for all-cause 30 day readmissions. The purpose of this study is to evaluate the impact of pharmacists within a multidisciplinary team on chronic obstructive pulmonary disease (COPD) readmission rates. 

Methods: Patients were identified at admission to University of Chicago Medicine using an algorithm that identified documented COPD.  On admission, a medication history was performed by a pharmacist or student pharmacist during which five COPD-focused questions were asked to each patient. The patients were then seen by the pulmonary advanced practice nurse (APN).  After being seen by the APN, the pharmacy department provided inhaler education utilizing the teach-to-goal (TTG) method. Once the patient was discharged, a follow up appointment was scheduled within approximately seven to ten days with the pulmonary APN.  During this follow up appointment, the pharmacy department provided further inhaler education using TTG. The primary endpoint of this study was COPD readmission in 30 days. The secondary endpoints were to show an increase in completed medication histories and an improvement in patients’ inhaler techniques using the TTG method. COPD readmission rates were determined by reporting from the hospital’s quality department. Improvement in patients’ inhaler techniques was evaluated through a systematic scoring system which allowed for the comparison of initial and final inpatient technique scores. 

Results: Research in progress. Preliminary data collection comparing scores before TTG session and after TTG session in the inpatient setting shows the average increase in TTG score was 4.9 points for the MDI inhaler (percentage change 20.3%). For the tiotropium inhaler, the average increase in the TTG score was 6 (percentage change of 20%). 

Conclusions: Research in progress

Submitting Author: Leigh A. Moffett, PharmD, BCPS

Submitting Organization: University of Chicago Medicine

Authors: Leigh A. Moffett, PharmD, BCPS; Jennifer Szwak, PharmD, BCPS


ICHP Poster Presentations – Original #9
(presented as Poster #3)

Category: Original - Research in Progress

Title: Efficacy, nephrotoxicity, and incidence of Clostridium difficile infection with broad spectrum antibiotic regimens in patients with nosocomial pneumonia

Purpose: Identify the difference in efficacy, nephrotoxicity, and incidence of Clostridium difficile infection between vancomycin plus piperacillin-tazobactam and vancomycin plus cefepime (with or without metronidazole) in patients with nosocomial pneumonia. Vancomycin plus piperacillin-tazobactam is a broad-spectrum antibiotic regimen chosen as empiric therapy for a multitude of infections. Recent data suggest that this combination may increase the risk of nephrotoxicity when compared to vancomycin alone, or when compared to vancomycin plus an alternative beta-lactam antibiotic, such as cefepime. Recently, as a result of these studies and due to recommendations by pharmacy, prescribing at Edward Hines, Jr. VA Hospital has begun to shift from using vancomycin plus piperacillin-tazobactam to a regimen of vancomycin plus cefepime with or without metronidazole for anaerobic coverage. This regimen has been chosen for many infections, but most commonly for the nosocomial pneumonias: hospital-acquired pneumonia (HAP), healthcare-associated pneumonia (HCAP), and ventilator-associated pneumonia (VAP). This change in prescribing practices raises many important questions. First, in terms of aspiration pneumonia and VAP, what is the difference in efficacy between vancomycin plus piperacillin-tazobactam and vancomycin plus cefepime plus metronidazole? Additionally, in terms of nosocomial pneumonia without mention of aspiration, what is the difference in efficacy between vancomycin plus piperacillin-tazobactam and vancomycin plus cefepime? Finally, what is the difference in the rates of nephrotoxicity and Clostridium difficile infection associated with these regimens?

Methods: This study has been approved by the Institutional Review Board (IRB). This study is a retrospective, electronic chart review of patients with nosocomial pneumonia. Eligible patients for screening will be identified with active orders of piperacillin-tazobactam plus vancomycin, cefepime plus vancomycin, or cefepime plus vancomycin plus metronidazole. Inclusion criteria for the study include male and female patients ≥ 18 years of age with a clinical diagnosis of nosocomial pneumonia, who had a baseline serum creatinine obtained within 24 hours of admission, and who received one of these broad-spectrum antibiotic regimens for at least 48 hours. Patients will be excluded if they are receiving chronic dialysis or have a diagnosis of end stage renal disease. The primary outcome being evaluated is clinical efficacy of antibiotic regimens, which is reflected as improvement in two of the following three clinical symptoms (fever, leukocytosis/leukopenia, purulent secretions) at 48 hours. A secondary endpoint will be the incidence of Clostridium difficile infection, which is reflected as a positive Clostridium difficile toxin B PCR test with diarrhea (three or more unformed stools passed in 24 hours) or histopathological findings of pseudomembranous colitis within 14 days of starting antibiotics. An additional secondary endpoint of acute kidney injury, defined as an increase in serum creatinine ≥50% from baseline, an increase in serum creatinine of ≥0.5 mg/dL, or a urine output <0.5mL/kg per hour for >6 hours, will also be evaluated. Data collection will include demographics, classification/etiology of pneumonia, temperature, WBC count, blood pressure, pulse, sputum production, clinical improvement, use of broad-spectrum antibiotic regimens, number of days on oral or IV antibiotics in the previous 14 days, concomitant use of nephrotoxic drugs, and documented adverse drug reactions to antibiotics.

Results: Research in progress. 

Conclusions: Research in progress.

Submitting Author: Kaitlyn B. Kalata, PharmD

Submitting Organization: Edward Hines, Jr. VA Hospital

Authors: Kaitlyn B. Kalata, PharmD; Sue Kim, PharmD, BCPS; Ursula C. Patel, PharmD, BCPS, AQ-ID; Raymond Byrne, PharmD, BCPS


ICHP Poster Presentations – Original #10
Winner: Best Original Poster Presentation 2016
(presented as Poster #16)

Category: Original - Research in Progress

Title: Evaluation of fall risk in dementia patients on an atypical antipsychotic in the VA population

Purpose: Antipsychotics are widely used as off-label treatment for behavioral symptoms in dementia patients. It is recognized that antipsychotics can increase the risk for falls in the elderly population. When used in dementia patients, this risk is further increased, since dementia itself is an independent risk factor for falls. A study on the use of antipsychotics in the Veterans Affairs (VA) Community Living Centers (CLC) found that veterans residing in the dementia special care units were more likely to receive an antipsychotic, more commonly atypical antipsychotics. The purpose of this study is to determine whether atypical antipsychotics increase fall risk in dementia patients.

Methods: This study was approved by the Institutional Review Board. This study will be a retrospective cohort study comparing two groups in the VA population: dementia patients receiving atypical antipsychotics versus dementia patients not receiving atypical antipsychotics. The primary endpoint is the difference in the incidence of falls between the two cohort groups. The secondary endpoints are the differences in the incidence of falls between subtypes of dementia, different atypical antipsychotics, and different fall risk as defined by the Morse Scale. Primary endpoint will be analyzed using unpaired t-test, while secondary endpoints will be analyzed through descriptive analysis. The following data will be collected: age, gender, number of other Fall Risk Increasing Drugs (FRIDs), comorbid conditions that can also increase fall risk, subtype of Dementia, type of atypical antipsychotics, fall risk as defined by Morse Scale, and the documented fall. Each patient’s chart will be reviewed from admission and up to 6 months, or patient’s discharge, or patient's death whichever is the earliest to determine if a documented fall has occurred during that time. Determining fall risk in the dementia population receiving atypical antipsychotics can help prevent inappropriate prescribing of these agents for treatment of behavioral symptoms, leading to decreased fall risk. 

Results: Research in Progress

Conclusions: Research in Progress

Submitting Author: Lianna Serbas, PharmD, PGY1 Pharmacy Resident

Submitting Organization: Captain James A. Lovell FHCC

Authors: Lianna Serbas, PharmD; Yinka Alaka, PharmD


ICHP Poster Presentations – Original #11
(presented as Poster #15)

Category: Original - Research in Progress

Title: Digoxin and Time to Cardiac-Related Hospitalizations: A Retrospective Cohort Study

Purpose: The purpose of this study is to evaluate the safety of digoxin therapy in patients with atrial fibrillation with and without heart failure. The time to first cardiac-related hospitalization will be documented comparing patients with atrial fibrillation with and without digoxin therapy. Additionally, the safety of digoxin will be further analyzed by evaluating the length of digoxin therapy prior to first cardiac-related hospitalization and digoxin serum concentrations. Finally, a sub-group analysis of patients with and without heart failure will be conducted to determine if concomitant heart failure has any impact. 

Methods: This study is a retrospective cohort study with two groups of patients: patients with atrial fibrillation receiving digoxin therapy and patients with atrial fibrillation not receiving digoxin therapy. Cardiac event is defined as any of the following: cardiac arrhythmia, acute myocardial infarction, unstable angina, cardiac arrest, hypertensive urgency/emergency, and cardioembolic stroke. Patients included in the study are those who are 18 years of age and older, with one or more inpatient admission with a primary discharge diagnosis of atrial fibrillation or two or more outpatient, nonemergency department encounters for atrial fibrillation. Patients must also have at least one primary care or cardiology clinic visit. The following data will be collected for each patient: initial diagnosis of atrial fibrillation, patient age and gender, past medical history, start date of digoxin therapy, concurrent medications, date of initial hospitalization with a cardiac primary admission diagnosis, primary admission diagnosis, length of hospitalization, admission to ICU or general acute medicine floor, serum digoxin level, admission renal function, troponin, potassium, magnesium, and most recent height and weight. The data collected will be used to assess the time to first hospitalization in patients with atrial fibrillation with or without digoxin therapy. The time to initial hospitalization will be reported in number of days since atrial fibrillation diagnosis, and will be analyzed using a Cox proportional hazards regression. The secondary endpoints for continuous variables will be reported as percentages, means, and standard deviations, and assessed using a student t-test. 

Results: Research in Progress 

Conclusions: Research in Progress

Submitting Author: Stephanie Dwyer, PharmD, PGY1 Pharmacy Resident

Submitting Organization: Captain James A. Lovell Federal Health Care Center

Authors: Stephanie Dwyer, PharmD; Sherri Stoecklein, PharmD, BCPS


ICHP Poster Presentations – Original #12
(presented as Poster #7)

Category: Original - Research in Progress

Title: A Performance Improvement Approach to Implementing a Pharmacist-led Medication Education Program in a Community Hospital

Purpose:  The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is a standardized questionnaire that has become an important indicator of the patient’s view of perceived care. The study site was underperforming in the medication-related survey questions: “How often did hospital staff tell you what the medication was for?” and “How often did hospital staff describe possible side effects in a way you could understand?”.  The Pharmacy Department wanted to implement an intervention to improve patient satisfaction in this domain.  The purpose of the study was to determine the impact of a pharmacist-led medication education program on the medication-related HCAHPS scores. 

Methods:  The study was conducted at a small community hospital from July to December 2015.  All pharmacists and student pharmacists received competency and training to ensure uniformity in the medication education sessions. Patients from two medical-surgical units were targeted to receive medication counseling by a pharmacist or student pharmacist with priority given to those with heart failure, on an oral anticoagulant or receiving 6 or more medications. Nursing home patients and patients with altered mental status were excluded from receiving the intervention.  At the end of the month, data was reviewed and changes were made to the process to improve to the target goal of five counseling sessions per day. The primary outcome was change from baseline on medication-related HCAHPS scores.  A secondary outcome was number of documented counseling sessions performed, tracked on a daily basis on a department quality improvement board and trended monthly.   

Results: The 2015 HCAHPS results regarding the question about explaining medication indications improved by 8% and the scores regarding the question about side effects improved by 36% when comparing the pre and post implementation of the medication education service.  392 patients were counseled as part of the pharmacist-led medication education program with an average of 65 sessions performed per month.   

Conclusion: As shown in the study, pharmacist medication counseling can make an impact on the medication-related HCAHPS scores.  Medication education is an important aspect of patient communication in the inpatient setting and the launching of this service enhanced patient understanding of the indications and side effects of their medications as measured by these scores.

Submitting Author: Stacy Thomas Scaria, PharmD

Submitting Organization: Tenet Healthcare - Westlake Hospital

Authors: Stacy Thomas Scaria, PharmD; Deanna McMahon Horner, PharmD, BCPS; Dusica Jovic Szczybura, PharmD; Charlene Hope, PharmD, MS, BCPS


ICHP Poster Presentations – Original #13
(presented as Poster #5)

Category: Original - Research in Progress

Title: Evaluation of a Pilot Benzodiazepine Taper Clinic in Veterans with Concurrent Opioid Use

Purpose: Opioid pain relievers are implicated in nearly 17,000 overdose deaths in the United States. This is over a 100% increase in rates over the first decade of this century. Thirty-one percent of these deaths involved the concurrent use of benzodiazepine sedatives.  In late 2013, the Department of Veterans Affairs (VA) launched the Opioid Safety Initiative to reduce the use of opioids among veterans. While the initiative drew attention to clinical considerations regarding the risk of co-administration, a recent medication use evaluation concluded that over 700 Veterans had active outpatient prescriptions for both a benzodiazepine and an opioid at a single VA facility. As a result, a pilot benzodiazepine taper clinic will be implemented at Edward Hines, Jr. VA Hospital in January 2016 in collaboration with the Hines Primary Care and Mental Health Providers to reduce the number of veterans on high dose benzodiazepines and concurrent opioid therapy.  An order set for the treatment of insomnia will also be created and integrated into the electronic medical record system in February 2016 at Edward Hines, Jr. VA Hospital to promote and facilitate the use of non-benzodiazepine evidence-based treatment of insomnia. The primary purpose of this quality assurance and quality improvement project is to evaluate potential benefits and barriers to implementing a multidisciplinary benzodiazepine taper clinic at Edward Hines, Jr. VA Hospital.  

Methods: The project will assess the reduction in high dose benzodiazepines for the pilot clinic patients. The magnitude and time to dose reduction(s) will be evaluated. High dose benzodiazepines will be defined as total daily doses of temazepam >20 mg, diazepam >10 mg, clonazepam >1 mg, lorazepam >2 mg, and alprazolam >1 mg. Patients receiving opioids for cancer pain, patients receiving a benzodiazepine for back spasms in spinal cord patients, hospice patients, and patients with severe mental health disorders (i.e. bipolar disorder, psychosis) will be excluded.  Time spent in preparation for clinic visits, patient contact hours, and time spent for follow up will be logged. Self-reported patient compliance with treatment plans and patient clinic cancellations will be recorded. Additionally, the project will track the use of the newly implemented order set for the treatment of insomnia.  

Results:  Research in Progress  

Conclusion: Research in Progress

Submitting Author: Julie Bucek Cabrera, PharmD, PGY1 Pharmacy Practice Resident

Submitting Organization: Edward Hines Jr., VA Hospital

Authors: Julie Bucek Cabrera, PharmD; Julie Stein, PharmD, VHA-CM; Sue Kim, PharmD, BCPS


ICHP Poster Presentations – Encore #1
Winner: Best Encore Poster Presentation 2016
(presented as Poster #20)

Category: Encore

Title: Implementation of decentralized pharmacy technicians to improve medication delivery and nursing satisfaction

Purpose: To assess the impact decentralized pharmacy technicians (DPTs) can have on the medication delivery process and on nursing satisfaction with the pharmacy service

Methods: A two-week prospective study on one general medicine floor and two intensive care units was conducted between September and October 2015. One decentralized pharmacy technician was assigned to each of these locations Monday through Friday from 9:00 am to 5:30 pm to improve medication availability through timely communication with nursing staff regarding medication procurement issues. Each study floor served as its own control in that data pertinent to the study outcomes was collected in a two-week period preceding the intervention period. The number of medication requests sent to the central pharmacy and the number of medications that required physical pick-up by nurses during the intervention period and the control period were recorded. Nursing satisfaction was surveyed prior to the intervention period and immediately following the intervention period. 

Results: Nursing workflow interruptions due to medication retrieval were decreased by 74%. Post-intervention, mean scores for each nursing satisfaction survey question were significantly higher than the pre-intervention period survey (P < 0.01 for all five questions). Electronic medication requests sent to central pharmacy did not decrease significantly, 463 and 453 requests were sent during the pre-intervention and intervention periods respectively. 

Conclusion: The decentralized pharmacy technician model significantly reduced nursing workflow interruptions and improved nursing satisfaction.

Submitting Author: Whitnee Caldwell, PharmD

Submitting Organization: Northwestern Memorial Hospital

Authors: Whitnee Caldwell, PharmD; Bryan Shaw, PharmD; Fuwang Xu, PharmD; Noelle Chapman, PharmD; Ana Fernandez, CPhT


ICHP Poster Presentations – Encore #2
(presented as Poster #9)

Category: Encore

Title: Global Initiatives to Streamline Pharmacy Education and Workforce Development

PurposeThe FIP Education Initiatives and Pharmacy Education Taskforce developed the Global Competency Framework and the Global Quality Assurance Framework for pharmacy leadership organizations to provide strategic mapping tools for pharmacy education and workforce development. The main purpose of this study is to share educational tools that impact the pharmacy profession and empower educators, leaders, and practitioners to streamline competencies.

Methods:  The educational experts describe national and global initiatives to best streamline Competencies for pharmacy education. Specifically, the experts highlight programs for pharmacy education and workforce development that have been successfully implemented and assessed to assure the quality of pharmacy education on the global level.

Results: A panel of experts of educators, regulators, and practitioners highlight the structure, process, and outcomes of global collaborations to improve the quality of pharmacy education. Specifically, the panel shares the results of a “SWOT” Analysis - Strengths, Weaknesses, Opportunities, and Threats - of streamlining pharmacy educational competencies. The panel also shares examples of pharmacy education and workforce development initiatives that were implemented to continuously improve the quality of pharmacy professional development programs. In addition, the presenters describe collaborations between national and international agencies and opportunities for future scientific contributions.

Conclusions: Global initiatives will enhance the quality of education for pharmacy students and practitioners and ultimately improve pharmacy practice.

Submitting Author: Abby A. Kahaleh, BPharm, MS, PhD, MPH

Submitting Organization: Roosevelt University College of Pharmacy

Authors: Abby A. Kahaleh, BPharm, MS, PhD, MPH; Mike Rouse, BPharm; Ian Bates, PhD-FIP; Andreia Bruno, PhD


ICHP Poster Presentations – Encore #3
(presented as Poster #18)

Category: Encore

Title: Antifungal prophylaxis consideration in patients being treated with blinatumomab for Philadelphia chromosome-negative relapsed or refractory b-cell acute lymphoblastic leukemia: a case report

Purpose: The purpose of this case is to illustrate why antifungal prophylaxis should be considered for patients being treated with blinatumomab for Philadelphia chromosome-negative relapsed or refractory B-cell acute lymphoblastic leukemia (ALL). Based on the National Comprehensive Cancer Network (NCCN) guidelines, consideration of antibacterial, antiviral, and antifungal prophylaxis should be considered for ALL patients being treated with chemotherapy. In this case, AL, a 24-year-old female, upon first diagnosis of B-cell acute lymphoblastic leukemia, was initiated on induction chemotherapy with Cancer and Leukemia Group B (CALGB) 10403 protocol. After four cycles, a bone marrow biopsy was performed and her results were consistent with remission. Two months later, during a routine follow-up visit, AL was noted to have worsening pancytopenia. Her bone marrow biopsy results were consistent with relapsed B-cell ALL involving 80% of the marrow space. The patient was then admitted to the hospital to begin re-induction therapy with newly approved blinatumomab. Blinatumomab is a novel agent that activates T cells by binding to both CD19 expressed on B cells and CD3 expressed on T cells, which results in lysis of the CD19 cells. It is recommended that the first 9 days of the first cycle be administered in the hospital to monitor for cytokine release syndrome (CRS). In addition to CRS, other side effects include neurological toxicities, infections, and elevated liver enzymes. As part of her supportive care regimen, AL continued acyclovir for antiviral prophylaxis and was initiated on levofloxacin for antibacterial prophylaxis. Due to patient’s pancytopenia, antifungal prophylaxis with an azole antifungal was considered, but due to concern for elevated liver enzymes reported with both blinatumomab and azole antifungals, antifungal prophylaxis was held.  AL received the first 9 days of blinatumomab induction therapy inpatient as recommended to monitor for CRS. AL tolerated treatment without any issues and was discharged from the hospital to continue the remainder of blinatumomab therapy at home. One month after the initial induction of blinatumomab, AL was admitted to the emergency department with abdominal pain and headache. AL was afebrile upon admission and blood cultures were obtained. Blood culture results revealed growth of budding yeasts, which was later identified as candida krusei. AL began treatment with micafungin and blinatumomab therapy was discontinued. An infectious disease (ID) team was consulted and due to persistently positive cultures for budding yeast, AL’s central line was removed. Cultures of the line were negative. In addition, a transesophageal echocardiogram was obtained, which was negative for valvular vegetation. After five days of failed treatment with micafungin, persistent fever and now newly hypotensive, AL was transitioned to liposomal amphotericin and flucytosine per ID’s recommendations and also transferred to the medical intensive care unit (MICU) for sepsis. The following day, AL went into respiratory distress and was intubated. Two days after, liposomal amphotericin and flucytosine was discontinued and voriconazole was initiated.  Cultures remained positive for 13 days with fungemia. Given the progressive decline in her condition and poor prognosis, she expired 21 days from when she was transferred to the MICU.  As with any new cancer drug, supportive care treatment is not well defined. Although more experience is needed to draw a definitive conclusion, the purpose of this case report is to share our experience and generate discussion about the need for antifungal prophylaxis, and if so which antifungal agent, in patients receiving blinatumomab therapy. 

Methods: N/A

Results: N/A

Conclusion: N/A

Submitting Author: Margaret Lee, PharmD Candidate

Submitting Organization: Midwestern University Chicago College of Pharmacy

Authors: Margaret Lee, PharmD Candidate; Lisa M. DiGrazia, PharmD, BCPS, BCOP; Amanda N. Seddon, PharmD, BCPS, BCOPr


ICHP Poster Presentations – Encore #4
(listed in Syllabus as Poster #19)

Category: Encore

Title: Differences in Clostridium difficile infection outcomes between guideline concordant and discordant therapy

Poster not presented.


ICHP Poster Presentations – Student #1
(presented as Poster #22)

Category: Student - Research Complete

Title: Assessment of healthcare needs of elderly patients in rural communities of central Illinois

Purpose: To complete an assessment of elderly care to reduce costs, increase quality and access to medical care among patients living in rural Illinois counties.

Methods: A literature review was conducted by the researchers to assess the quality, cost, and access to care among elderly living in rural Illinois. A Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis was conducted to evaluate the feasibility of the project. Search engines, including PubMed and Medline were used for the most currents findings, using relevant subject headings. Comprehensive search strategies were used within the intrinsic limits of each resource. The results were reviewed to select literature for inclusion criteria.

Results: Results of the literature reviews revealed 40 sources from which 17 were utilized. National statistics showed that 20% of the US population lives in rural America, but only 15% of nurses, 12% of pharmacists, and 9% of physicians practice in rural settings. Currently, lack of access to healthcare providers for rural patients has been reported to be the biggest barrier, 31 % were lacking transportation and 37 percent missed their appointments due to transportation issues. Medicare Advantage plan has a high star rating, which is in line for bonus payments from Centers for Medicare and Medicaid Services (CMS). These bonus payments reflect reward for good performance, improved patient outcomes, and health care savings by the plan. In Illinois, Peoria county consists of 187,000 residents, which is the target county in this study. Research indicates that rural elderly residents are more likely to go without needed care. This increases their total out-of-pocket medical costs due to future hospital or specialty care (40% versus 33% of urban patient healthcare costs). This proposal would provide patients with personalized healthcare in the comfort of their own home. The healthcare professional team can provide educational programs at local city centers. These interprofessional teams offer general medical needs, such as blood glucose screenings, medication therapy reviews, and patient counseling.

Conclusions: Interprofessional teams, composed of physicians, pharmacists, nurses and social workers will provide care to elderly patients to reduce costs, increase quality, and improve access to healthcare services. This proposed model will reduce out-of-pocket cost for patients in Peoria by eliminating unnecessary direct and indirect medical costs. This model will optimize individual health care, improve quality of life for patients by providing care at home, and increase patient adherence. Ultimately, providing home care will enhance access to healthcare services amongst elderly patients in Peoria.

Submitting Author: Katarzyna Plis, PharmD Candidate

Submitting Organization: Roosevelt University College of Pharmacy

Authors: Katarzyna Plis, PharmD Candidate; Danielle Cilano, PharmD Candidate; Sarah Bay, PharmD Candidate; Rimple Patel, PharmD Candidate; Abby Kahaleh, BPharm, MS, PhD, MPH


ICHP Poster Presentations – Student #2
(presented as Poster #21)

Category: Student - Research Complete

Title: Effectiveness of Pharmacy Practice Model Initiative Competency

Purpose: The Pharmacy Practice Model Initiative (PPMI) is a national initiative started by the American Society of Health-Systems Pharmacists (ASHP) in 2008 to encourage the most effective use of pharmacists allowing for overall advancement in patient care. PPMI is currently referred to as the Pharmacy Advancement Initiative (PAI) by ASHP; this change was made after the conclusion of the study.

With regards to pharmacy education, there is a lack of literature discussing PPMI/PAI.  Such literature would be beneficial for schools of pharmacy in order to assess the best approach to teaching students regarding PPMI. Education of pharmacy students regarding PPMI and the professional goals of advancing patient care can impact healthcare reform and encourage them to advocate for patient care at all stages in their career.

In 2013, Pharmacy Practice Model Initiative (PPMI) components were incorporated into Southern Illinois University Edwardsville School of Pharmacy's curriculum. Students partook in an educational activity to learn more about PPMI during their Advanced Pharmacy Practice Experience (APPE) preparatory course in their 3rd year. Additionally, a competency requirement on PPMI was developed for students to complete during their Hospital APPE. This study’s primary objective is to determine the effect of the PPMI competency on students’ understanding and discussion of PPMI during their Hospital APPE. The expected outcome was that the mean score for the total number of students would be a 6 or above (indicating an average to moderate understanding of PPMI).

Methods: A survey of SIUE preceptors who taught hospital APPE rotations was determined to be the most practical approach to obtaining the necessary information regarding student knowledge base of PPMI. A survey was created consisting of primarily short answer questions and yes/no options. The 20 question survey collected the following information: hospital and preceptor demographics, staffing model, staff training, automation/technology systems, pharmacy involvement in PPMI initiatives, and student understanding and discussion of PPMI during the rotation. For the questions regarding student understanding of PPMI, preceptors were asked to rank student knowledge from 0 to 10 (0 indicating did not meet expectations and 10 indicating exceeded expectations). The scoring of students was based on the discussion of PPMI knowledge and was not based on whether or not changes to the institution were implemented.

Inclusion criteria were: Illinois or Missouri SIUE preceptors, taught ≥ 6 hospital APPE students for the academic school year, and agreed to the interview.  Exclusion criteria included: those who did not respond or complete the interview. Only one preceptor was selected from each hospital site. Seven preceptors were selected based on the criteria that were eligible to partake in the survey and were subsequently contacted. Preceptors who taught from May 2013-May 2014 were selected to participate.

Results: Six out of the seven preceptors contacted responded and completed the interview. All preceptors interviewed answered every question on the survey. When asked about the average baseline knowledge of their SIUE Hospital APPE rotation students with regards to PPMI on a numerical scale, the responses ranged from 4 to 8.5 (mean ± S.D., 6.4±1.65).When asked about the impact of PPMI within the hospital after discussion with SIUE APPE hospital students, 5 out of 6 preceptors stated that no changes were made based on these discussions. One preceptor noted that three specific ideas for implementing the goals of PPMI were initiated by SIUE APPE students during their hospital rotation. These ideas included: technicians checking the work of other technicians (tech-check-tech), pharmacists managing insulin titrations until physician champion is set, and medication reconciliation done by pharmacy technicians. Another preceptor stated that since there were no changes implemented after student discussions within the 2013-2014 school year, the site decided to adjust the discussion of PPMI to include students filling out the ASHP hospital PPMI survey which allows hospitals to see how well they are doing in terms of implementing PPMI goals.

Conclusions: Based on the study results, the PPMI competency met the expected outcomes of the study. The study showed that the majority of students had an average to moderate understanding of PPMI according to their preceptors. One significant limitation to the study is the number of preceptors interviewed.  Future directions could include performing the study with a larger sample size, studying the long term impact of student discussion on PAI a few years after the rotations, and surveying alumni to see how/if the competency impacted their own practice of pharmacy.

Submitting Author: Saba Mohiuddin, PharmD candidate

Submitting Organization: Southern Illinois University Edwardsville School of Pharmacy

Authors: Saba Mohiuddin, PharmD candidate; Lisa Lubsch, PharmD, AE-C; Jinyang Fan, PharmD, BCPS


ICHP Poster Presentations – Student #3
(presented as Poster #24)

Category: Student - Research in Progress

Title: Desmopressin (DDAVP) Dose Changes Post Discharge in Pediatric Patients with Diabetes Insipidus Receiving Oral DDAVP Compounded from Nasal Spray Inpatient

Purpose:  The purpose of this study is to evaluate desmopressin (DDAVP) dose changes among diabetes insipidus (DI) pediatric patients receiving oral DDAVP solution formulated using DDAVP nasal spray.  DDAVP is not commercially available as an oral liquid in the United States.1 This is problematic for pediatric patients unable to swallow whole tablets.  Consequently, many caregivers must resort to extemporaneously compounding a DDAVP solution prior to immediate use.  Comparing the effect of both formulations, oral tablets and solution compounded from tablets, on decreasing urine volume and increasing urine osmolality have produced equivalent results.2 However, many institutions utilize a compounding recipe that uses desmopressin nasal spray to produce an oral solution that has a 30 day shelf life.3 Following the inpatient administration of this formulation, however, the Pediatric Endocrinology service at the University of Chicago observed that preadmission desmopressin doses were no longer adequate post discharge.

Methods:  This single center retrospective study evaluated the medical records of pediatric patients who received DDAVP oral solution compounded from DDAVP nasal spray. The observation period took place between January 1, 2013 and August 7, 2015. Only patients who received oral desmopressin before admission and after discharge were included in the study. Additionally, a two-month refill history of oral desmopressin tablets with instructions for extemporaneous compounding before and after discharge was required. Patients undergoing neurosurgical procedures and displaying acute renal impairment were excluded.  Doses were then tabulated and analyzed using descriptive statistics. 

Results: Research in Progress 

References
1. Desmopressin.  Micromedex 2.0. Truven Health Analytics, Inc.  Greenwood Village, CO.  Available at: http://www.micromedexsolutions.com.  Accessed December 20, 2015.
2. Argenti D, Ireland D, & Heald DL. A pharmacokinetic and pharmacodynamics comparison of desmopressin administered as whole, chewed, and crushed tablets, and as an oral solution. J Urol. 2001;165(5):1446-51.
3. Michigan Pediatric Safety Collaboration to Standardize Compounded Oral Liquids. University of Michigan College of Pharmacy. Available at: http://www.mipedscompounds.org.  Accessed December 21, 2015. 

Conclusions:  Research in Progress

Submitting Author: Gennaro Anthony Paolella, BS Pharmacy Student

Submitting Organization: University of Chicago

Authors: Gennaro Anthony Paolella, BS Pharmacy Student; Shannon Rotolo, PharmD, BCPS


ICHP Poster Presentations – Student #4
Winner: Best Student Poster Presentation 2016
(presented as Poster #12)

Category: Student - Research in Progress

Title: Retrospective analysis of osteoporosis risk factors among the Chinese population

Purpose:  Assess effects of weight, cigarette smoking, and alcohol intake, on bone mineral density, measured as T-score, among the Chinese population in Chicago’s Chinatown neighborhood. -Determine if length of stay in the US has any impact on BMD.

Methods: A retrospective analysis will be conducted using data collected at Midwest Asian Health Association (MAHA) in Chicago’s Chinatown neighborhood from August 2013 to August 2015. Data from 200 participants will be reviewed. MAHA, located in Chicago, is a community-based, non-profit 501 (c)(3) organization that provides community outreach education, screenings, immunizations and linkage to care in collaboration with community-based organizations, health care providers and academic institutions to reduce health disparities for the Asian population. The majority of the health fair attendees lack or have limited health insurance.  For the last two years, pharmacy school students from Chicago State University College of Pharmacy have partnered with MAHA to offer free bone mineral density screening during MAHA’s monthly health fair.  During these events, MAHA collected demographic information of each participant as part of their record keeping in order to properly assess the participants’ risk of osteoporosis. These demographic information include age, sex, height weight, social and family history. Bone health-bone density screenings were offered to men and women aged 20 years and older using the Lunar AchilllesTMQuantitative Ultrasound System provided by the College of Pharmacy at Chicago State University. All participants signed a consent form to be part of the health screenings.  Descriptive analysis will be used to report demographic and fracture risk factors. A correlation analysis will be used to describe the relationship between length of stay in the US, weight, smoking status, and alcohol consumption and BMD.  

Results:  Research in Progress 

Conclusion: Research in Progress

Submitting Author: Anna Aidonis, PharmD candidate

Submitting Organization: Chicago State University College of Pharmacy

Authors: Anna Aidonis, PharmD candidate; Cindy Leslie A. Roberson, PharmD, BCACP; Hemangini Shah, PharmD Candidate


ICHP Poster Presentations – Student #5
(presented as Poster #23)

Category: Student - Research in Progress

Title: Comparison of oral morphine equivalent doses vs. PHQ9 scores in a family practice setting

Purpose: Determine if a pharmacist is able to decrease opioid use without worsening PHQ9 scores. 

Methods: This retrospective chart review evaluates a sample size of 271 patients receiving pain management by a pharmacist in a family practice setting in southern Illinois. The primary outcome is to determine if decreasing oral morphine equivalent doses increases PHQ9 scores. Opioid use (measured by the oral morphine dose) and depression (measured by PHQ9 scores) were calculated for each patient visit and compared over a two year time frame.  

Results: Research in Progress 

Conclusions: Research in Progress

Submitting Author: Lauren Ashley Kirkpatrick, PharmD candidate

Submitting Organization: Southern Illinois University Edwardsville

Authors: Lauren Ashley Kirkpatrick, PharmD candidate; Chris Herndon, PharmD, BCPS, CPE, FASHP


ICHP Poster Presentations – Student #6
(presented as Poster #11)

Category: Student - Research in Progress

Title: Phytopharmacological evaluation of chamomile (Matricaria recutita L.) for indirect modulation of the endocannabinoid system

Purpose: German chamomile (Matricaria recutita L.) has been known to be a useful antidepressant and anxiolytic in humans. Clinical trials demonstrate the role of the endocannabinoid system in modulating emotional homeostasis. The objective of our research was to identify compounds in chamomile that indirectly modulate the endocannabinoid system through inhibition of the endocannabinoid catabolizing  enzymes, fatty acid amide hydrolase (FAAH) and monoacylglycerol lipase (MAGL). The identification of compound(s) interacting with the endocannabinoid system will provide lead compounds with therapeutic potential against various mood disorders. 

Methods: A bioassay-guided fractionation approach was adopted. Whereas chamomile powder was initially extracted with methanol followed by fractionation with hexane, chloroform, ethyl acetate, and methanol. All fractions were fingerprinted using high performance liquid chromatography.   The fractions were evaluated for FAAH inhibition using an in vitro microplate assay. In the initial screening, the hexane showed the highest activity. The fraction was further subjected to bioassay-guided chromatography until a pure active compound was isolated and identified. All fractions were also evaluated for inhibition of the MAGL enzyme. 

Results: Research in progress. Throughout our experiments, we were able to identify one active compound, linoleic acid. Our current and future research aim at identifying the remainder of compounds and their evaluation in animal models. 

Conclusions: Though our research is still in progress, our experiments demonstrate a procedure that can be replicated for any other herbs of interest. We are still in an early phase of our chamomile project, and many active compounds are yet to be isolated and identified. However, we were able to reliably demonstrate FAAH and MAGL inhibition activity, which show that chamomile has a role in modulating the endocannabinoid system and supports its use as an herbal dietary supplement for depression and anxiety.

Submitting Author: Kristine Manlimos, PharmD Candidate

Organization: Chicago State University College of Pharmacy

Authors: Kristine Manlimos, PharmD Candidate; Nidhi Patel, PharmD Candidate; Ehab Abourashed, MS, PhD; Abir El-Alfy, MS, PhD, PharmD Candidate


ICHP Poster Presentations – Student #7
(listed in Syllabus as Poster #10)

Category: Student - Research in Progress

Title: Comparison of Pharmacist and Physician Attitudes and Knowledge of Pain Management

Poster not presented.

 



ICHPeople

Congratulations to Sister Mary Louise Degenhart, who received ASHP's 2016 Harvey A.K. Whitney Lecture Award.



Congratulations to Katherine Sencion, Student Chapter President of UIC Chicago, who has been named a recipient of the ASHP 2016 Student Leadership Award.



Congratulations to the 2016 Spring Meeting Poster Award Winners!
Bryan McCarthy Jr., Best Platform Presentation Winner
Lianna Serbas, Best Original Presentation
Whitnee Caldwell, Best Encore Presentation
Anna Aidonis and Hemangini Shah, Best Student Presentation





College Connections

Midwestern University Chicago College of Pharmacy
IFN Interprofessional Event

by Aisha Alsliman, PS2, ICHP Philanthropy Chair, Midwestern University Chicago College of Pharmacy

Midwestern University's ICHP Philanthropy Committee hosted an interprofessional brown bag medication event at the Islamic Foundation North mosque in Libertyville, IL, on February 28, 2016. In addition to a brown bag, ICHP set up sleep hygiene education, smoking cessation education, and a free blood pressure screening booth to further address the needs of the community. We invited the Muslim Student Association (MSA) and the Association of Indian Pharmacists in America (AIPhA) to not only volunteer and collaborate with us, but to help each of us learn how to effectively work in an interprofessional healthcare team. Nine interdisciplinary volunteers, including student pharmacists and medical students, worked under the supervision of two pharmacists and a physician to make the event a success! The volunteers arrived at the venue half an hour before the event in order to review the materials that we prepared for the event. This included a step-by-step consultation for the brown bag, blood pressure protocol for the screening, and the poster board information for smoking cessation and sleep hygiene.

Our targeted disease states for this event included cardiovascular disease and respiratory disease. In particular we chose smoking cessation for respiratory disease. We chose cardiovascular disease because we noted the high prevalence of high blood pressure and cardiovascular problems in this particular community. Since we wanted to target the needs of the community, we provided free manual blood pressure screenings and medication adherence counseling, stressing the importance of adhering to blood pressure medications to optimize cardiovascular disease. In addition, smoking cessation was a focus due to the prevalence of tobacco usage within the community. This need of the community was reaffirmed at the event as various community members approached us about tips and medication options to help them quit smoking. To make the smoking cessation and sleep hygiene poster boards more interactive for children, volunteers passed out smoking cessation stickers and the sleep hygiene board was set up so community members could lift a picture flap on the board and the volunteer would explain the meaning of the picture flap in a game format.

The brown bag event was an opportunity for community members to bring their medication bottles and lists to be reviewed by a student pharmacist under the supervision of licensed pharmacists. At the event, we also offered education regarding medication safety and were able to create updated medication lists that schedule medications by time of day, with food and drink, and special storage instructions for community members. We were also able to counsel patients regarding their medication concerns, and advocated the pharmacy profession by explaining the role that pharmacists play in healthcare to community members. Additionally, we stressed the importance of medication adherence during the event, handing out wallet-sized Script Your Future medication adherence lists for community members to keep in their wallet to remind them to take their medications.

Overall, about 60 community members attended the event, of these community members, 45 were also counseled. By the end of the event, we fulfilled our goal of educating patients on medication adherence, cardiovascular disease, respiratory disease, and sleep hygiene. Additionally, we were also able to learn how to successfully collaborate as an interprofessional team, a skill that will undoubtedly aid us in our future careers. The ICHP MWU chapter looks forward to hosting future brown bag events, targeting more individuals and collaborating with a variety of organizations to offer new and exciting philanthropy events that the community can benefit from.


Volunteers from left to right: Fatima Elahi, Krina Modi, Shaziya Barkat, Sumera Bhatti, Reem Farooq, Cassandra Phan, Aisha Alsliman, Samad Farooqi, and Saba Hamid.



Patients being counseled on sleep hygiene and having their blood pressure taken. 
 


Roosevelt University College of Pharmacy
Providing Tools for Success of First-Year Pharmacy Students in a Three-Year Program

by Cony Hartnett, PS3, SSHP Webmaster/Historian; Camille Andrews, PS3, SSHP Treasurer; Jordan Faison, PS3, SSHP President

While numerous factors play a role in the success of a pharmacy student, the appropriate tools can provide first-year students with a solid foundation upon which to build professionally. To meet this need, the Student Society of Healthy Systems Pharmacy at the Roosevelt University College of Pharmacy decided to focus our professional development project on facilitating the preparation of newly admitted pharmacy students to succeed in an accelerated three-year program. We gauged the need and interest of students and collaborated with campus and clinical faculty to implement a fundraiser to provide necessary tools for success in their Introductory Pharmacy Practice Experience class, pharmaceutical laboratory class, and out in the field for rotations. These tools included drug cards, laboratory coats, and clinical pocket reference guides. The money raised from these fundraisers was designated for professional development opportunities and initiatives of our members in the future.

We provided Sigler drug cards, from which students are required to take weekly quizzes; long white laboratory coats, which students must wear in compounding labs; and the UNC Eshelman School of Pharmacy Clinical Pharmacy Pocket Guides, created by the Triangle College of Clinical Pharmacy Student Chapter, which contain lab values, tables, and diagrams for a quick reference, especially useful while on rotation.  Members of our fundraising committee researched different supplies and discounts to maximize profit margins and advertised through social media as well as with printed fliers to adequately promote the fundraisers. We utilized both online order forms and in-person sales and offered multiple payment options to accommodate as many students as possible.

Our chapter was able to raise $1,280 prior to the start of the school year by having a fundraiser where we sold the drug cards, laboratory coats, and clinical pocket guides to first-year students. By having this fundraiser so early, we were able to expose the new students to SSHP. The money we raised for our chapter went towards holding membership drives, having guest speakers, and sending our executive board members to ASHP Midyear to present our chapter’s poster. The fundraiser also gave our chapter the chance to meet and interact with the new students, as well as recruit potential members prior to the start of our Fall Term.

During the student chapter poster presentation at ASHP Midyear in New Orleans, a group of our executive board members distributed handouts and discussed our poster with students from other pharmacy schools. We also walked around and talked about other school’s posters with the other pharmacy students in attendance. This served as an excellent opportunity to network with SSHP members from all over the country and gather ideas from their chapter projects in order to further improve our own chapter. Not only did several other student chapters show marked interest in our poster topic, our poster won an Outstanding Professional Development Project Award!


Chapter executive board members who presented at Midyear, pictured from left to right: Camille Andrews, PS-3, SSHP Treasurer; Amanda Mertsching, PS-3, SSHP Professional Development Chair; Jordan Faison, PS-3, SSHP President; Joelitta Ansong, PS-3, SSHP Secretary






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Welcome New Members!


New Member Recruiter
Sara Abdulrasoul
Mona Adhami
Josephine Adutwumwaa
Gabriel Ahiamadi
Fahad Ahmed
Benish Alam
Shazia Alavi
Saniya Ali
Reem Alsultan
Elnaz Arabian
Megan Asher
Asma Awad
Elizabeth Awoyemi
Mark Badria
Mohammed Baig
Jori Bailey
Sarah Banday
Ellecia Bernard Jordan Faison
Sharril Boda
Ryan Bonomo Oliver Smith
Olivia Brandner
Rob Braylock
Sarah Brockhouse Garry Moreland
Francisco Castaneda
Elena Cheptene Florence Patino
Jessi Cramer Linda Fred
Joseph Desantis
Krystal Earle
April Estes Linda Fred
Meta Jo Floyd
Juliet Franklin
Britrice Goins
Anna Gracheva
Andrew Grigus
Jatin Gumpella
Alexander Heinz
Cynthia Hidden Tobi Sondag
Shirley Huang
Soheileh Hwang
Jiji Isaac
Christina Jacob
Brent Jamison
Carlos Jara-Garate
Simon Lam
Vanessa Leon
Angelique Lintz Trevor Luman
Sarah Lynch
Dezaray McDonald
Ariel McDuffie
Dana Mdanat
Anna Michalec
Lauren Nail
Hannah Nelson Linda Fred
Jennifer Oetgen
Bintu Ogundimu
Ozren Orlovic
Duaa Oshaik
Kevin Park
Ravi Patel
Hetal Patel
Nidhi Patel
Priyanka Patel
Robert Pecho
Kimberly Peterson Ina Henderson
Suzanne Pihlstrom
Sree Prathipati
Damaris Quagrainie
Therese Quijano
Farheen Quraishi Tamkeen Quraishi Abreu
Courtney Reed Linda Fred
Kylie Reikowski
Nichole Reiten
Quratulain Sabir
Ayesha Saleem
Steven Sessions David Silva
Mohammed Sikder
Nichelle Simpkins
Jennifer Sotto
Mark Spitzer
Malia Stark Linda Fred
Steve Tancredi Nadia Tancredi
Jamie Thomas
Aaric Thompson
Rita Tonino
My Trang
Tanya Uddin
Jami Weiland Trevor Luman
Nikki Wilson
Ryan Wilson
Jeremy Wilson
Jasmine Woods
Anne Yeglic



Officers and Board of Directors

JENNIFER PHILLIPS 
President
630-515-7167 
jphillips@midwestern.edu 

LINDA FRED 
Immediate Past President
217-383-3253 
linda.fred@carle.com

CHARLENE HOPE
President-Elect
708-783-5933

MIKE WEAVER 
Treasurer 
815-599-6113 
mweaver@fhn.org

KATHERINE MILLER
Secretary

TRAVIS HUNERDOSSE 
Director, Educational Affairs 
thunerdo@nmh.org

CARRIE VOGLER
Director, Marketing Affairs
217-545-5394

DESI KOTIS 
Director, Professional Affairs
312-926-6961 
dkotis@nmh.org

CAROL HEUNISCH 
Director, Organizational Affairs 
847-933-6811

KATHRYN SCHULTZ
Director, Government Affairs
312-926-6961

ANN JANKIEWICZ 
Chairman, House of Delegates
Ann_M_Jankiewicz@rush.edu

ANA FERNANDEZ
Technician Representative
312-926-6980

DAVID TJHIO
 
Chairman, Committee on Technology 
816-885-4649 
david.tjhio@cerner.com

REBECCA CASTNER
Chairman, New Practitioners Network
773-821-2164

JACOB GETTIG 
Editor & Chairman, KeePosted Committee 
630-515-7324 fax: 630-515-6958 
jgetti@midwestern.edu 

JENNIFER PHILLIPS 
Assistant Editor, KeePosted 
630-515-7167 
jphillips@midwestern.edu 

SCOTT MEYERS 
Executive Vice President, ICHP Office 
815-227-9292 
scottm@ichpnet.org 


Regional Directors

NOELLE CHAPMAN 
Regional Director North
312-926-2547
nchapman@nmh.org 

ED RAINVILLE 
Regional Director Central 
ed.c.rainville@osfhealthcare.org 

LYNN FROMM 
Co-Regional Director South
618-391-5539

TARA VICKERY GORDEN 
Co-Regional Director South
618-643-2361 x2330
Student Chapter Presidents

KATHERINE SENCION 
President, Student Chapter
University of IL C.O.P. 
ksenci2@uic.edu 

JOANNE CHA 
President, Rockford Student Chapter 
University of IL C.O.P. 
cha17@uic.edu

JESSICA PENG 
President, Student Chapter
Midwestern University C.O.P. 
jpeng54@midwestern.edu

BRITTANY HUFF
 
President, Student Chapter 
Chicago State University C.O.P. 
bhuff@csu.edu

WHITNEY MAHER 
President, Student Chapter 
Southern Illinois University Edwardsville S.O.P
whitney.maher@gmail.com

JORDAN FAISON 
President, Student Chapter 
Roosevelt University C.O.P. 
jfaison@mail.roosevelt.edu

VALENTIN PACURARU 
President, Student Chapter 
Rosalind Franklin University C.O.P. 
valentin.pacararu@my.rfums.org


ICHP Affiliates 


KATHRYN SCHULTZ 
President, Northern IL Society (NISHP)

JARED SHELEY 
President, Metro East Society (MESHP)
jpsheley@gmail.com 

AMY BOBLITT 
President, Sangamiss Society
Boblitt.amy@mhsil.com

ED RAINVILLE
 
President, West Central Society (WSHP)  
ed.c.rainville@osfhealthcare.org

Vacant Roles at Affiliates — 
President, Rock Valley Society; Southern IL Society; Sugar Creek Society



ICHP Pharmacy Action Fund (PAC) Contributors

Names below reflect donations between April 1, 2015 and April 1, 2016. Giving categories reflect each person's cumulative donations since inception.

ADVOCACY ALLIANCE - $2500-$10000
Kevin Colgan
Edward Donnelly
James Owen Consulting, Inc.
Frank Kokaisl
Scott Meyers
Michael Novario
Michael Weaver
Thomas Westerkamp


LINCOLN LEAGUE - $1000-$2499
Scott Bergman
Andrew Donnelly
Ginger Ertel
Linda Fred
Ann Jankiewicz
Jan Keresztes
Kathy Komperda
Despina Kotis
William McEvoy
Christina Quillian
Michael Rajski
Carrie Sincak
Avery Spunt
JoAnn Stubbings
Patricia Wegner


CAPITOL CLUB - $500-$999
Margaret Allen
Sheila Allen
Rauf Dalal
Kenneth Foerster
Leonard Kosiba
George MacKinnon
Janette Mark
Mary Lynn Moody
Jennifer Phillips
Edward Rainville
Kathryn Schultz
Jill Warszalek


GENERAL ASSEMBLY GUILD - $250-$499
Jennifer Arnoldi
Peggy Bickham
Jaime Borkowski
Brad Dunck
Nancy Fjortoft
Jo Ann Haley
Travis Hunerdosse
Kim Janicek
Mary Lee
Ronald Miller
Karen Nordstrom
Peggy Reed
Kristi Stice
Heidi Sunday
Tara Vickery Gorden
Carrie Vogler
Marie Williams


SPRINGFIELD SOCIETY - $100-$249
Jill Borchert
Noelle Chapman
Kathy Cimakasky
Christopher Crank
Lara Ellinger
Jennifer Ellison
Joan Hardman
Glenna Hargreaves
Robert Hoy
Dylan Marx
Katherine Miller
James Sampson
Jerry Storm
Brandi Strader
Amanda Wolff


GRASSROOTS GANG - $50-$99
Rebecca Castner
Gunchoo Chadha
Megan Hartranft
Bella Maningat
Bill Middleton
Robert Miller
Julio Rebolledo
Nadia Tancredi


CONTRIBUTOR - $1-$49
Marc Abel
Skylar Boldue
Antoinette Cintron
Janet Engle
Linda Grider
Heather Harper
Ina Henderson
Antoine Jenkins
Levi Karell Pilones
Connie Larson
Barbara Limburg-Mancini
Michelle Martin
Natalie Schwarber
Sarah Sheley
David Silva
Steve Tancredi
Karin Terry


Upcoming Events

Visit the ICHP Calendar for the most up-to-date events!Visit the ICHP Calendar for the most up-to-date events!


Saturday, April 23, 2016
Scott Bergman, PharmD, BCPS
Garth K. Reynolds, RPh
IPhA Certificate Training Program
IPhA Office | Springfield, IL
Accredited for pharmacists | 8.0 credit hours (0.8 CEUs)


Sunday, April 24, 2016 
Garth K. Reynolds, RPh
IPhA Certificate Training Program
IPhA Office | Springfield, IL
Accredited for pharmacists | 4.0 credit hours (0.4 CEUs)


Tuesday, May 17, 2016 | 6:00pm 
Meghan Toth, PharmD
West Central Program
LIVE Program 
Accredited for pharmacists and pharmacy technicians | 1.0 credit hour (0.1 CEU) 


Wednesday, May 18, 2016 | 12:00pm
Overview of Basic Statistics
Milena McLaughlin, PharmD, MSc, BCPS, AAHIVP
Champion Webinar


Tuesday, May 24, 2016
Pharmacy Residency Project Pearls in Chicago
UIC College of Pharmacy | Chicago, IL
Save the date! More info coming soon.

 
Tuesday, June 7, 2016 | 6:00pm
Statistics Review for BCPS
CPRN Program
Northwestern Memorial Hospital | Chicago, IL



KeePosted Standard Ads - 2016 MarApr

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