Official Newsjournal of the Illinois Council of Health-System Pharmacists

ICHP KeePosted

December 2017

Volume 43 Issue 10

Print Entire Issue

2017 Pharmacy Legislative Day

KeePosted Info

Features

Acknowledgement of 2016 Peer Reviewers

ASHP Delegates for 2017-2018

Columns

President's Message

Directly Speaking

Government Affairs Report

Educational Affairs

New Practitioners Network

Leadership Profile

College Connections

Roosevelt University College of Pharmacy

Rosalind Franklin 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
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 © 2017 Thinkstock, a division of Getty Images. 

Copyright © 2017, Illinois Council of Health-System Pharmacists. All rights reserved.

Features

Acknowledgement of 2016 Peer Reviewers

The Division of Educational Affairs and the Division of Professional Affairs each have standing columns in each edition of KeePosted. Articles for both of these columns are peer-reviewed. The editors and ICHP staff would like to acknowledge the following individuals for their willingness to provide valuable feedback to authors in the 2016 calendar year! Thank you for your efforts and contributions to KeePosted!

Maga Beganovic
Lara Ellinger
RaeAnn Hirschy
Christina Jacob
Antoine Jenkins
Jackie Kessler
Milena McLaughlin
Paul O’Donnell
Swati Patel
Jen Phillips
Christie Schumacher
Amanda Seddon
Trisha Shaw

If you are interested in serving as a peer reviewer, please contact Jen Phillips at Jennifer.a.phillips@gmail.com.


ASHP Delegates for 2017-2018

2016-2017 Delegates
Ed Rainville
Noelle Chapman

2017-2018 Candidates
Travis Hunerdosse
Jennifer Phillips
Carrie Sincak
Charlene Hope
Chris Quillian


2017 Alternate Delegates
Scott Meyers
Trish Wegner


Columns

President's Message
The Art of Innovation

by Charlene Hope, PharmD, MS, BCPS, ICHP President

This year at the Annual Leadership Retreat we did something a little different to get the attendees into the innovation mindset. Instead of selecting a book to read, we created a TED Talks playlist of videos that was shared with the group for discussion. If you are not familiar with TED (Technology, Entertainment and Design), it is non-profit organization devoted to spreading ideas usually in the form of short presentations lasting 18 minutes or less by the world’s movers and shakers.

As we start this New Year and keep in mind this year’s theme of innovation, I wanted to share with you some of the highlights of these TED Talks. The great thing about these videos is that they are relatively short, and you can watch (or listen) to one easily during a lunch break, while waiting in a long line or even on your commute to work. When you get the chance, listen to one or all of them!

In the first video, Guy Kawasaki, a Silicon Valley entrepreneur, shares his ten steps to innovating in “The Art of Innovation.” Of the ten steps, the one that resonated with me most was #4 “Roll the DICEE,” which are the five qualities of great innovation:
  1. Deep – having many features and great design and personality
  2. Intelligent – the ease of which the user identifies the problem the innovation was created to solve
  3. Complete – the totality of the product from the inside and out
  4. Empowering – great products make the user feel powerful, more creative and productive and enhance the meaning of your life
  5. Elegant – taking care to ensure a beautiful and functional user interface
DICEE provides a framework that places you in the perspective of the consumer of any new product or service you may be creating for your department.

The next talk gives a great overview of the differences between the generations. In “Creating a culture of collaborative innovation,” Claire Madden entertains us with how Baby Boomers through Generation Z see the world and their contributions to the workforce of today and tomorrow. She makes the case for creating an environment where a diverse community of multi-generational, multi-cultural, multi-skilled people can come together and draw on the strength of this diversity and their shared values.  She also speaks to the role of technology as a platform for creating new connections and fostering contribution as well as consumption.

In “Igniting creativity to transform corporate culture,” Catherine Courage challenges us to rethink our own personal capacity for creative thinking. She states, “Creativity is a birthright…available to all, but used by few.” She also shares her top three strategies of how we can foster creativity within our own work spaces:
  1. Create environments, like that from our childhood learning environments – open, colorful, unstructured seating supplied with blank canvases for writing, sketching and brainstorming
  2. Encourage and embrace a mindset of experimentation, improving ideas through multiple iterations
  3. Develop our storytelling skills to inspire emotion by touching the hearts and minds of those that we are working with.  Try this the next time you create a PowerPoint slide deck for your next meeting – drop in a slide of picture and take that time to share a short story that will bring context to the data you present.

The final video of the morning was “How to get your ideas to spread” by Seth Godin. Although it was first presented about 13 years ago, he shares many key marketing concepts that are still relevant today.  He challenges us to create services and products that are “remarkable” – something that this worth making a remark about. And who defines what is remarkable? The consumer! He also shares the concept of Otaku, a Japanese term for those who have extreme passion for something that is unique or special. The attendees of the leadership retreat liked this idea of Otaku and spent some time discussing what the Otaku of ICHP could be.  

Whether you are seeking to create new pharmacy services or taking your current services to the next level, there are a lot of great ideas that you can gain from watching and discussing these videos. For those who attended the retreat, the videos generated a lot of energy and great ideas of how we can innovate and take ICHP to the next level.

Which one these videos inspired you? If any of these videos generated ideas on how we as ICHP can provide more value to your membership, I would love to hear from you! Feel free to contact me at hopepharmd@gmail.com.




Directly Speaking
What Lies Ahead in 2017?

by Scott A. Meyers, Executive Vice President

Well, 2016 is over, thank goodness! Things got pretty crazy last year, and while our hope is for a better, safer, quieter 2017, my guess it that’s just an optimistic hope that could be shattered early and often.

We at ICHP have a lot of projects in the works for 2017, so while the world might spin out of control, we will, with any luck, move the profession and the organization forward. One of this year’s projects from Marketing Affairs will be to kick off a “Pharmacy Cares” campaign on social media, primarily Facebook and Twitter. The campaign will highlight interventions pharmacists have made on behalf of their patients as a means of increasing pharmacy’s and pharmacists’ public perception. This is very timely, considering the recent Chicago Tribune Investigation.

The Division of Government Affairs is going to tackle a Practice Act revision for the 2017 sunset. This is going to be a great opportunity to broaden the pharmacist and pharmacy technician scope of practice and bring the entire Act up to date or even a little in the future.

The Division of Organizational Affairs will be reviewing ICHP’s process to elect ASHP delegates from Illinois. Currently, a call for delegates is made in the October KeePosted and the election follows closely. However, there is really no policy on candidate requirements, campaigning and the actual election process. This doesn’t sound like a big deal, but it has caused problems in other states so we want to get out in front of any potential future issues.

The Division of Professional Affairs is reviewing current toolkits, one of ICHP’s most underused member resources, and considering which new ones to add. Toolkits now exist on a variety of topics including: Starting a residency, REMs, Continuing Professional Development (CPD), High School Community Outreach, Pharmaceutical Waste, Precepting, Staff Development, Student Internships and Technicians.  

The Division of Educational Affairs will continue to offer Champion continuing pharmacy education webinars on an at least every other month basis and also add some technician-specific presentations in between. In addition, the Division will work to establish educational tracks throughout the year that will guide members in selecting appropriate educational programming. New programming formats for the Spring and Annual Meetings are also on their agenda for 2017.

ICHP’s Technology Committee continues to review new technology advances and evaluate topics for future educational offerings. In addition, committee members monitor advances for hot topic discussions and best practices.

It’s clear to me that ICHP has a plan for the future of practice and it is also indelibly clear that the future for Illinois and the world needs a lot of new plans. I hope that 2017 turns out to be a year that brings positive changes for the world – I know it will for Illinois pharmacy practice.
 


Government Affairs Report
Not Sure We’re Starting the Year on the Right Foot!

by Jim Owen and Scott Meyers

The Tribune article of Sunday, December 19th “Filled without Warning” continues to ripple across the pharmacy profession and probably will for the entire Spring Legislative Session. Follow-up articles on the 20th and 21st poured gasoline on the burning issue of missed drug interactions. With U.S. Senator Dick Durbin, Governor Bruce Rauner and Representatives Mary Flowers and Lou Lang weighing in for tougher regulations on pharmacists and pharmacies.

The investigation (I won’t call it a study because it was conducted far from academic standards) began more than a year ago, and it has come at a most inopportune time. In 2017, the Illinois Pharmacy Practice Act sunsets (requires review and renewal by the General Assembly), and it is our hope to make some significant changes that could help pharmacists provide better care for their patients. Now the focus will be on medication error reporting, workload issues, pharmacy technician to pharmacist ratios and pharmacy technician training. It has potentially made our jobs much tougher for the first half of 2017.  

There could be, however, a silver lining or two related to this issue and these articles. We have known for many years that speed kills! Hurrying to fill hundreds of prescriptions each day with reimbursement tied only to the drug product and not the services the pharmacist and pharmacy technician provide, and unreasonable metrics that each pharmacist and tech is evaluated by every day, week, month and year all add up to a very dangerous situation for our patients.

Think about it, optometrists get paid for the eye exam plus the glasses, audiologists get paid for the hearing test plus the hearing aid, and plumbers get paid for the labor plus the parts! But pharmacists, or correction, pharmacies get paid for the product and a limited overhead for each prescription and not services like interaction screening, medication therapy management or counseling. Perhaps this observation will reach the daylight during all the anticipated discussions to come.

In addition, the combinations used in the investigation included medications that are rarely used any more. Ergotamine lost any luster it might have had when the triptans came to be. The same is true with colchicine, clarithromycin and griseofulvin when newer products were introduced. I’m (Scott) not sure how long tinazidine has been available, and I’ll admit, I haven’t worked in a pharmacy since 1998, but the first time I saw this medication name was in the article! So our questions are, “What did the interaction systems say for each combination? Was the alert prominent or did alert fatigue play a factor?”

There are a lot of questions we have about the investigation and even more concerns that so many failures occurred. Has community pharmacy become such an assembly line process that medication errors are considered production defects and someone else down the line will fix them? These errors shouldn’t have occurred. If nothing else, each pharmacist should have counselled each patient that a problem could develop, and in so many cases, they didn’t!  

This is a problem that we’ve seen coming for a long time. It’s a problem that will haunt pharmacy for some time to come. It’s a problem that we all need to address. We’re pretty sure we’re not starting the year on the right foot, but I know we’re going to work to get back in step and make some more strides for the profession and more importantly for our patients.



Educational Affairs
Updates and New Antiretrovirals for the Treatment-Naïve Adolescent or Adult with Human Immunodeficiency Virus (HIV)

by Kristina Falk, PharmD Candidate 2017 and Thomas D. Chiampas, PharmD, BCPS, AAHIVP, University of Illinois at Chicago College of Pharmacy

Introduction and Significant Treatment Updates 
Current recommendations for treatment-naïve adults and adolescents from the United States Department of Health and Human Services (DHHS) (via the National Institutes of Health) include combination antiretroviral therapy (cART) consisting of three fully-active antiretrovirals (ARVs) from two different classes.1 The preferred recommended regimens are two nucleoside reverse transcriptase inhibitors (NRTIs) and either an integrase strand transfer inhibitor (INSTI) or ritonavir-boosted protease inhibitor (PI). Goals of therapy remain the same: maximally suppress plasma HIV-RNA (viral load), restore and preserve immunologic function, reduce HIV-associated morbidity, and prevent HIV transmission.

Regardless of CD4 T-cell count, data from randomized clinical trials supports initiating treatment when a diagnosis is made and genotype is obtained. Several benefits of early treatment include preserved immunologic function, decreased viral reservoir, delayed disease progression, and decreased mortality.1,2,3 Barring extreme circumstances, a genotype must be drawn prior to starting any treatment-naïve individual on cART, which requires a viral load of ≥ 1000 copies/mL.  However, newer assays may be an option for patients with a lower viral load.4,5 Standard genotypic testing reveals mutations in the reverse transcriptase (RT) and protease (PR) genes, but recent guidelines also recommend testing for INSTI mutations if there is concern for transmitted INSTI resistance.Some mutations may confer resistance to one or more ARVs or potentially an entire ARV class.Once a mutation develops, it is irreversible, thus on future genotypes may be ‘archived’ if no drug pressure is present.7,8,9 This is one reason why obtaining appropriate past medical, ARV, and genotypic histories are essential before recommending a patient-specific regimen. Furthermore, it is important to obtain concomitant medications (drug-drug interactions), social history, and past ARV use for pre or post-exposure prophylaxis (PrEP or PEP).In addition to obtaining a genotype for treatment-naïve patients, there are other routine labs that should be obtained at baseline. A comprehensive list of these labs can be found in Table 3 of the DHHS Guidelines.1

Although guideline recommendations strongly support initiating cART at diagnosis, it is important that the patient be ready and willing to initiate therapy, as treatment is a life-long commitment. Other factors include access to food (some ARVs require food for adequate absorption), substance abuse (altered mental status may affect adherence), pill burden, housing stability, and expense.

There are now nine recommended regimens for treatment-naïve patients (Table 1). Furthermore, there are six single tablet regimens (STR), combining three to four medications into a single tablet and some are included in the initial ARV-naïve treatment guidelines. Seven of the nine preferred regimens are INSTI-based regimens, including each of the three FDA-approved INSTIs: raltegravir, cobicistat-boosted elvitegravir, and dolutegravir. The remaining recommended regimens include a ritonavir-boosted PI, darunavir, plus a two NRTI-backbone.Table 2 shows regimens recently moved from ‘recommended’ to ‘alternative regimen options.’ Refer to the DHHS Guidelines and drug interaction resources such as www.hiv-druginteractions.org for further information regarding ARV characteristics, side effects, drug interactions, and counseling points. Unless otherwise indicated, ARVs should not be crushed or split. Table 3 elaborates on characteristics of the recommended treatment regimens.


Table 1. Preferred 1st line ART in treatment – naïve1
1 INSTI + 2 NRTIs
Dolutegravir/abacavir/lamivudine daily (Triumeq™)

· Patients must be HLA-B*5701 negative (due to abacavir component)

50 mg DTG/600 mg ABC/300 mg 3TC by mouth one time each day
Can be taken with or without food

Dolutegravir daily (Tivicay™) + tenofovir disoproxil/emtricitabine daily (Truvada™)

· 50 mg daily DTG + 300 mg TDF/200 mg FTC by mouth one time each day

Can be taken with or without food

Dolutegravir daily (Tivicay™) + tenofovir alafenamide/emtricitabine daily (Descovy™)

· 50 mg daily DTG + 25 mg TAF/200 mg FTC by mouth one time each day

Can be taken with or without food

Elvitegravir/cobicistat/tenofovir disoproxil/emtricitabine daily (Stribild™)

· Initiate only for patients with eCrCl ≥ 70 mL/min

Should be discontinued if eCrCl falls below < 50 mL/min
Take with food
150 mg EVG/150 mg COBI/300 mg TDF/200 mg FTC by mouth one time each day

Elvitegravir/cobicistat/tenofovir alafenamide/emtricitabine daily (Genvoya™)

· Initiate only for patients with eCrCl ≥ 30 mL/min

Take with food
150 mg EVG/150 mg COBI/10 mg TAF/200 mg FTC by mouth one time each day

Raltegravir twice daily (Isentress™) + tenofovir disoproxil/emtricitabine daily (Truvada™)

· RAL must be taken BID; Truvada™ can be taken with morning or evening dose, but should be consistent

400 mg RAL by mouth twice daily + 300 mg TDF/200 mg FTC by mouth one time each day

Raltegravir twice daily (Isentress) + tenofovir alafenamide/emtricitabine daily (Descovy™)

· RAL must be taken BID; Descovy™ can be taken with morning or evening dose, but should be consistent

400 mg RAL by mouth twice daily + 25 mg TAF/200 mg FTC by mouth one time each day
1 boosted-PI + 
2 NRTIs
Ritonavir-boosted darunavir (Norvir™ and Prezista™) + tenofovir disoproxil/emtricitabine daily (Truvada™)
3 tablets by mouth at the same time daily with food
100 mg RTV + 800 mg DRV + 300 mg TDF/200 mg FTC by mouth one time each day

Ritonavir-boosted darunavir (Norvir™ and Prezista™) + tenofovir alafenamide/emtricitabine daily (Descovy™)

· 3 tablets by mouth at the same time daily with food

100 mg RTV + 800 mg DRV + 25 mg TAF/200 mg FTC by mouth one time each day
DTG= dolutegravir
ABC= abacavir
3TC= lamivudine
FTC= emtricitabine
TDF= tenofovir disoproxil fumarate
EVG= elvitegravir
COBI= cobicistat
TAF= tenofovir alafenamide fumarate
RAL= raltegravir
DRV= darunavir
RTV= ritonavir
eCrCl=estimated creatinine clearance


Table 2. Data Supporting Downgrade of Regimens from ‘Preferred’ to ‘Alternate’1
Regimen
Rationale for Change in Status
Tenofovir disoproxil/emtricitabine/efavirenz daily (Atripla™)

· 300 mg TDF/200 mg FTC/600 mg EFV

April 8, 2015
Efavirenz can have negative central nervous system (CNS) adverse effects including worsening depression or suicidal/homicidal ideation*
Avoid in women who are trying to conceive and in pregnant women in the first trimester
Ritonavir-boosted atazanavir (Norvir™ + Reyataz™) + tenofovir disoproxil/emtricitabine (Truvada™) daily
RTV 100 mg + ATV 300 mg + 300 mg TDF/200 mg FTC
April 8, 2015
Atazanavir can cause an increase in total bilirubin via inhibiting uridine 5'-diphospho-glucuronosyltransferase (UGT), which can subsequently cause scleral icterus or jaundice
Atazanavir requires an acidic environment for adequate absorption, thus potential for drug-drug interactions with over-the-counter (OTC) acid suppressing medications including omeprazole and ranitidine
Compared with raltegravir and darunavir in a randomized open-label trial, atazanavir was found to be less tolerable and potentially less efficacious+21
Tenofovir disoproxil/ emtricitabine/ rilpivirine daily (Complera™)
300 mg TDF/ 200 mg FTC/25 mg RPV
April 8, 2015
Rilpivirine requires at least 400 calories of food for optimal absorption
Should not be initiated if a patient is receiving proton pump inhibitor therapy due to reduced absorption
Rilpivirine requires an acidic environment for adequate absorption, thus potential for drug-drug interactions with over-the-counter (OTC) acid suppressing medications
Should not be initiated if pretreatment CD4 < 200 cells/mm3 or a viral load of  > 100,000 copies/mL (increased risk of virologic failure)
TDF= tenofovir disoproxil fumarate
FTC= emtricitabine
EFV= efavirenz
RTV= ritonavir
ATV= atazanavir
RPV= rilpivirine
ECrCl=estimated creatinine clearance
*While it is appropriate to continue Atripla in patients who are virologically suppressed and without side effects, patients with uncontrolled psychiatric illness or prior suicide attempts should avoid use of this agent as it may exacerbate their illness, including worsening depression symptoms and homicidal or suicidal ideation
The ACTG A5257 trial compared ATV/r vs DRV/r vs RAL all combined with TDF/FTC. Results showed that the ATV regimen was less tolerated across all sub-groups, largely attributed to jaundice and gastrointestinal side effects. While results showed that the three regimens were equal in terms of virologic efficacy, composite assessments showed the superiority of RAL compared to both PI regimens, and the superiority of DRV as compared to ATV.21


Table 3. Restrictions, Considerations, and Characteristics Regarding Preferred Regimens1
Regimen Comment
Elvitegravir/cobicistat/tenofovir disoproxil/emtricitabine daily (Stribild™)
o Initiate only in patients with eCrCl >70 mL/min
o If a patient starts Stribild™ when the eCrCl is >70 mL/min they can continue Stribild™ (assuming they are tolerating it well with excellent virologic control and immunologic function) so long as the eCrCl remains above 50 mL/min
o If the eCrCl decreases below 50 mL/min, Stribild™ must be discontinued as the tenofovir component requires renal dose adjustment. Due to the STR nature of Stribild™ , renally adjusting as a STR is not a possibility
o Cobicistat has no ARV activity
Elvitegravir/cobicistat/tenofovir alafenamide/emtricitabine daily (Genvoya™)
o Initiate only in patients with eCrCl ≥ 30 mL/min
o Cobicistat has no ARV activity
Dolutegravir/abacavir/lamivudine daily (Triumeq™) o Negative HLA-B*5701 allele test required prior to initiation to assess the potential in developing a hypersensitivity reaction (rash, fever, shortness of breath, malaise, and/or GI upset) to abacavir
Raltegravir BID (Isentress™) + tenofovir disoproxil/emtricitabine daily (Truvada™)
or
Raltegravir BID (Isentress™) + tenofovir alafenamide/emtricitabine daily (Descovy™)
o Raltegravir currently may be a less convenient option for patients as it requires twice daily dosing, but the benefit of this drug includes minimal side effects and drug interactions
Dolutegravir daily (Tivicay™) + tenofovir disoproxil/emtricitabine daily (Truvada™)
or
Dolutegravir daily (Tivicay™) + tenofovir alafenamide/emtricitabine daily (Descovy™)
o Dolutegravir is the newest INSTI that may be used in either treatment-naïve individuals or possibly in those with resistance to raltegravir and/or elvitegravir
o In the presence of certain INSTI mutations or concomitant medications (e.g., efavirenz, fosamprenavir +/- ritonavir,  rifampin) dolutegravir should be dosed 50 mg BID
Ritonavir-boosted darunavir (Norvir™ + Prezista™) + tenofovir disoproxil/emtricitabine daily (Truvada™)
or
Ritonavir-boosted darunavir (Norvir™ + Prezista™) + tenofovir alafenamide/emtricitabine daily (Descovy™)
o PI may be considered in patients when there is concern for intermittent adherence or underlying resistance as they are shown to have the highest barrier to resistance
o Darunavir has the potential to cause a rash
o Darunavir has a sulfonamide moiety, darunavir should be used with caution in patients with a known sulfonamide allergy


One of the newest ARVs and HIV treatment updates is the approval of tenofovir alafenamide fumarate (TAF), the newer salt formulation of tenofovir.1 Tenofovir itself is not bioavailable and will not cross the gastrointestinal tract.10 Both tenofovir disoproxil fumarate (TDF) and TAF are prodrugs of tenofovir that become phosphorylated intracellularly to the active moiety tenofovir diphosphate.11,12 The two prodrugs have nearly identical efficacy and tolerability profiles.11,12,13,14 They differ significantly as TAF obtains higher intracellular and lower plasma/extracellular tenofovir diphosphate concentrations. The benefit can be seen in several randomized control trials; TAF has a smaller impact on estimated glomerular filtration, improvements with proteinuria, albuminuria, and increases in spinal and hip bone mineral density.13 Table 4 further compares TAF and TDF. 


Table 4. Tenofovir Alafenamide Fumarate (TAF) vs Tenofovir Disoproxil Fumarate (TDF) Considerations and Restrictions1,11,12,13,14,22,23

TAF TDF
Available Individually for HIV? TAF 25 mg (Vemlidy ™) was approved 11/10/16 for HBV 300 mg TDF (Viread™)
Co-formulated products
25 mg TAF/200 mg FTC (Descovy™)

150 mg EVG/150 mg COBI/10 mg TAF/200 mg FTC (Genvoya™)

25 mg TAF/ 200 mg FTC/ 25 mg RPV (Odefsey™)
300 mg TDF/200 mg FTC (Truvada™)

150 mg EVG/150 mg COBI/300 mg TDF/200 mg FTC (Stribild™)

300 mg TDF/ 200 mg FTC/25 mg RPV (Complera™)

300 mg TDF/200 mg FTC/600 mg EFV (Atripla™)
Potential Side Effects11, 12 (≥ 10%) Listed in Package Insert

•      Nausea

Rash
Diarrhea
Headache
Pain
Depression
Asthenia
Nausea
Renal Dose Adjustments None, if eCrCl >30 mL/min14 None, if eCrCl > 50 mL/min
Activity against Hepatitis B Yes22,23 Yes
TAF= tenofovir alafenamide fumarate
TDF= tenofovir disoproxil fumarate
FTC= emtricitabine
EVG= elvitegravir
COBI= cobicistat
RPV= rilpivirine
EFV= efavirenz
14Small data from a single-arm, multicentered, open label study supports TAF can be dosed in patients with eGFR ≤30 mL/min
eCrCl = estimated creatinine clearance


Navigating Insurance Coverage
Many programs exist to provide prescription coverage for these expensive, albeit life-saving medications. State Medicaid programs, AIDS Drug Assistance Program (ADAP), and pharmaceutical companies provide assistance to patients in need of full prescription coverage or co-payment assistance/copay cards. It is important to check each state’s Medicaid, ADAP eligibility criteria, and formulary prior to prescribing ART to ensure there is no delay in initiating, continuing, or re-starting ART. See Table 5 for recent Illinois Medicaid formulary updates.


Table 5. Illinois Medicaid Formulary, updated July 1, 201624
Drug Class Preferred Non-preferred
Nucleoside reverse transcriptase inhibitor (NRTI)
Abacavir
Abacavir/lamivudine/zidovudine1*
Descovy™ (TAF/emtricitabine)
Didanosine*
Emtriva™ (emtricitabine)
Epzicom™ (abacavir/lamivudine)
Lamivudine
Lamivudine/zidovudine*
Stavudine*
Truvada™ (TDF/emtricitabine)
Viread™ (TDF)
Zidovudine*

Non-nucleoside reverse transcriptase inhibitor (NNRTI)
Edurant™ (rilpivirine)
Intelence™ (etravirine)^
Nevirapine
Rescriptor™ (delavirdine)*
Sustiva™ (efavirenz)

Integrase inhibitor (INSTI)
Isentress™ (raltegravir)
Tivicay™ (dolutegravir)
Vitekta™ (elvitegravir)

Protease Inhibitor (PI)
Aptivus™ (tipranavir)*
Crixivan™ (indinavir)*
Invirase™ (saquinavir)*
Kaletra™ (lopinavir/ritonavir)
Lexiva™ (fosamprenavir)
Prezista™ (darunavir)
Reyataz™ (atazanavir)
Viracept™ (nelfinavir)*
Evotaz™ (atazanavir/cobicistat)
Prezcobix™ (darunavir/cobicistat)
Single Tablet Regimen
· Atripla™
(TDF/emtricitabine/efavirenz)
Genvoya™ (elvitegravir/cobicistat/TAF/
emtricitabine)
Complera™ 
(TDF/emtricitabine/rilpivirine)
Odefsey™ (TAF/emtricitabine/rilpivirine)
Stribild™ (elvitegravir/cobicistat/TDF/
emtricitabine)
Triumeq™
(dolutegravir/abacavir/lamivudine)
Booster Norvir™ (ritonavir) Tybost™ (cobicistat)
Fusion Inhibitor
Fuzeon™ (enfuvirtide)^
Entry Inhibitor
Selzentry™ (maraviroc)^
TAF= tenofovir alafenamide fumarate, TDF= tenofovir disoproxil fumarate 
Although 3 ARVs, not recommended for therapy itself
* Rarely used due to toxicities, inconvenient dosing, and newer, safer, better-tolerated ARVs
^ Typically used in salvage therapy
Adapted from Illinois Medicaid Preferred Drug List24


On the Horizon
Researchers continue to study raltegravir for once daily dosing. Two 600 mg tablets by mouth once daily, in addition to two other fully-acting ARVs (likely two NRTIs) will move forward for approval.15 Another pipeline INSTI is cabotegravir, formulated as a 30 mg oral tablet and 200 mg/mL nanosuspension for intramuscular (IM) injection. The maintenance therapy being studied consists of dual therapy with rilpivirine (a new formulation of an already approved ARV) as a 300 mg/mL nanosuspension for IM injection. Early clinical trials with this unique dosing strategy are promising.16,17 Bictegravir, also a novel INSTI, is in phase III trials being studied as part of a STR that includes TAF and emtricitabine. Preliminary data shows an enhanced resistance profile compared to current INSTIs.18 Two other ARVs in Phase III trials include doravirine and fostemsavir. Doravirine, an investigational NNRTI, has similar efficacy to efavirenz with more favorable CNS safety, once daily dosing, no known acid-suppressing drug-drug interactions, and in vitro activity against common NNRTI mutations.19 Fostemsavir is an attachment inhibitor, preventing HIV from entering the CD4 t-cell. In initial trials, fostemsavir has comparable efficacy to boosted atazanavir.20

Summary and Conclusion
Despite the seemingly complex nature of HIV/AIDS management, treatment may be tailored to fit each patient’s individual needs, with the right patient data and history. Side effects, pill burden, drug-drug interactions, and cost are important factors, but should not limit therapeutic options, as there are many ARV regimens available. Researchers continue to study new medications, formulations, and dosing strategies as evidenced by the approval of TAF as a safer tenofovir salt alternative that also provides excellent virologic efficacy. Pharmacists can play a key role in educating patients and providers on the most current medication therapy recommendations.



References
  1. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. Available at http://aidsinfo.nih.gov/contentfiles/lvguidelines/AdultandAdolescentGL.pdf.
  2. INSIGHT START Study Group. Initiation of antiretroviral therapy in early asymptomatic HIV infection. N Engl J Med. 2015;373(9):795-807.
  3. Temprano ANRS 12136 Study Group. A trial of early antiretrovirals and isoniazid preventive therapy in Africa. N Engl J Med. 2015;373(9):808-822.
  4. Santoro M, Fabeni L, Armenia D, et al. Reliability and clinical relevance of the HIV-1 drug resistance test in patients with low viremia levels. Clin Infect Dis. 2014;58(8):1156-1164.
  5. Richman DD. Extending HIV drug resistance testing to low levels of plasma viremia. Clin Infect Dis. 2014;58(8):1174-1175. Letter.
  6. Kieriburanakul S, Sungkanuparph S. Emerging of HIV drug resistance: epidemiology, diagnosis, treatment and prevention. Curr HIV Res. 2009;7:273-278.  
  7. Bennett D, McCormick L, Kline R, et al. US surveillance of HIV drug resistance at diagnosis using HIV diagnostic sera. Presented at: 12th Conference on Retroviruses and Opportunistic Infections (CROI); February 22-25, 2005; Boston, MA.
  8. Wheeler W, Mahle K, Bodnar U, et al. Antiretroviral drug-resistance mutations and subtypes in drug-naive persons newly diagnosed with HIV-1 infection, US, March 2003 to October 2006. Presented at: 14th Conference on Retroviruses and Opportunistic Infections (CROI); February 25-28, 2007; Los Angeles, CA.
  9. Ross L, Lim ML, Liao Q, et al. Prevalence of antiretroviral drug resistance and resistance-associated mutations in antiretroviral therapy-naive HIV-infected individuals from 40 United States cities. HIV Clin Trials. Jan-Feb 2007;8(1):1-8.
  10. Tenofovir Disoproxil Fumarate. FDA Briefing Document. NDA 21-356. Aug 30 2001. http://www.fda.gov/ohrms/dockets/ac/01/briefing/3792b1_01_gilead.pdf. Accessed August 27, 2016.
  11. Viread [package insert]. Foster City, CA: Gilead Sciences Inc.; 2016.
  12. Descovy [package insert]. Foster City, CA: Gilead Sciences Inc.; 2016.
  13. Sax P, Saag M, Yin M, et al. Renal and bone safety of tenofovir alafenamide vs tenofovir disoproxil fumarate. Abstract 143LB presented at: 22nd Conference on Retroviruses and Opportunistic Infections (CROI); February 23-26, 2015; Seattle, WA.
  14. Pozniak A, Arribas JR, Gathe J, et al. Switching to tenofovir alafenamide, coformulated with elvitegravir, cobicistat, and emtricitabine, in HIV-infected patients with renal impairment: 48-week results from a single-arm, multicenter, open-label phase 3 study. J Acquir Immune Defic Syndr. 2016;71(5):530-537.
  15. Merck’s investigational once-daily formulation of ISENTRESS (raltegravir) meets primary and secondary endpoints in pivotal phase 3 study. Feb 22 2016.  http://www.mercknewsroom.com/news-release/research-and-development-news/mercks-investigational-once-daily-formulation-isentress-r.
  16. Margolis D, Brinson C, Smith G, et al. Cabotegravir plus rilpivirine, once a day, after induction with cabotegravir plus nucleoside reverse transcriptase inhibitors in antiretroviral-naïve adults with HIV-1 infection (LATTE): a randomized, phase 2b, dose-ranging trial. Lancet Infec Dis. 2015;15:1145-1155. 
  17. Margolis D, Gonzalez-Garcia J, Stellbrink H, et al. Cabotegravir + rilpivirine as long-acting maintenance therapy: LATTE-2 week 32 results. Abstract 31LB at: 23rd Conference on Retroviruses and Opportunistic Infections (CROI); February 22-25, 2016; Boston, MA. 
  18. Gilead presents preliminary data on bictegravir, an investigational integrase strand transfer inhibitor for the treatment of HIV. Gilead Sciences, Inc. http://www.gilead.com/news/press-releases/2016/6/gilead-presents-preliminary-data-on-bictegravir-an-investigational-integrase-strand-transfer-inhibitor-for-the-treatment-of-hiv.  Accessed August 30, 2016.
  19. Gatell J, Raffi F, Plettenberg A, et al. Doravirine 100mg QD vs efavirenz + TDF/FTC in ART-naive HIV+ patients: week 48 results. Abstract 470 presented at: 23rd Conference on Retroviruses and Opportunistic Infections (CROI); February 22-25, 2016; Boston, MA.
  20. Thompson M, Lalezari J, Kaplan R. Attachment inhibitor prodrug BMS–663068 in ARV-experienced subjects: week 48 analysis. Abstract 545 presented at: 22nd Conference on Retroviruses and Opportunistic Infections (CROI); February 23-26, 2015; Seattle, WA.
  21. Ofotokun I, Na LH, Landovitz RJ, et al. Comparison of the metabolic effects of ritonavir-boosted darunavir or atazanavir versus raltegravir, and the impact of ritonavir plasma exposure: ACTG 5257. Clin Infect Dis. Jun 15 2015;60(12):1842-1851.
  22. Gilead announces full 48-week results from two phase 3 studies evaluating tenofovir alafenamide (TAF) for patients with chronic hepatitis B infection. Apr 15 2016. http://www.gilead.com/news/press-releases/2016/4/gilead-announces-full-48week-results-from-two-phase-3-studies-evaluating-tenofovir-alafenamide-taf-for-patients-with-chronic-hepatitis-b-infection.
  23. Gilead submits new drug application to U.S. food and drug administration for tenofovir alafenamide (TAF) for the treatment of chronic hepatitis B. Jan 12 2016. http://www.gilead.com/news/press-releases/2016/1/gilead-submits-new-drug-application-to-us-food-and-drug-administration-for-tenofovir-alafenamide-taf-for-the-treatment-of-chronic-hepatitis-b.
  24. Preferred Drug List. Illinois Medicaid. July 1 2016. https://www.illinois.gov/hfs/SiteCollectionDocuments/pdl.pdf.

New Practitioners Network
Match Day XXIV - An Insider Report on Interviews

by Alexandra Goncharenko, PharmD, BCPS

The annual American Society of Health-System Pharmacists (ASHP) Resident Matching Program (also known as the “Match”) is quickly approaching with rank lists due to the National Matching Service website by March 3, 2017 and phase I results scheduled to be released on March 17, 2017.1 Historical match rates have typically been between 60-70%, highlighting the competitive nature of securing a post-graduate pharmacy residency.2 Residency candidate interviews are an integral part of the ranking process for both programs and candidates. In fact, surveys of program directors suggest the personal interview is the most important criterion programs use to rank residents.3,4 This article offers a “play-by-play” on how to tackle interview season in order to optimize the chances of matching with a program. 

“The Pre-Game” - Preparing for your interview
Know the Program. Applicants should review basic information about the program before the interview.5 This includes information gathered from the program’s website and pamphlets collected at residency showcases.6 For example rather than asking, “What are the required rotations?” at the interview, it is better to review the rotations offered at the site beforehand, and then ask preceptors or residents to describe a specific rotation. Prepare a list of other open-ended questions you have about the program ahead of time. Programs commonly provide an interview itinerary ahead of time, including names and titles of interviewers.6,7 Do not presume to be on a first-name basis with those present, and address people formally until told otherwise. Even little things you say or do can be magnified during the relatively short duration of an interview day!

Practice Answering Questions. Take time to verbally practice answering a list of common interview questions, and sign up for any “mock” interview sessions that may be offered by your pharmacy school. Literature suggests participating in mock interviews is associated with increased residency matching rates.8,9 Examples of interview questions can be found on the ACCP and ASHP websites,10,11 or even in pharmacy literature.3 Candidates are usually asked a variety of questions such as how they handle stress, memorable events from rotations (e.g. patient experiences, clinical sites, etc.), why they are interested in the program they are interviewing for, difficult decisions, and career goals.3,10,11 Candidates should reflect back on situations encountered during pharmacy school and Advanced Pharmacy Practice Experiences that can be applied as answers to these types of questions. One frequently utilized method of answering behavioral-type interview questions is the “STAR” technique.5 (Figure 1) This technique can help a candidate deliver a clear, concise, and confident answer while avoiding any distracting rambling.


Figure 1. The “STAR” Technique5
S T A R
Situation Task Action Result
Describe the "who, what, where, when" of the situation. What was your exact role in the situation?

How did you turn it into an opportunity?
Describe the sequence of the steps that were required to solve your task.

Explain the thought process, rationale, and any obstacles that came up. How did you solve them?
What happened as a result of your work?

What did you learn?
Figure adapted from Pharmacy Times, Take the Star Approach to Behavioral Interviews. Available at: http://www.pharmacytimes.com/contributor/donna-kosteva-rph-med/2016/02/take-the-star-approach-to-behavioral-interviews.


Know Yourself. Candidates should be familiar with their curriculum vitae (CV).  Interviewers will have copies in front of them for reference during the interview.6 Anything on the CV is fair game for questioning and serves as a way for an interviewer to get to know the candidate’s background and communication skills. If unable to recall or explain their involvement in a certain activity with confidence, candidates should remove it from the CV. Candidates should also take time to self-reflect on their short- and long-term career goals and practice philosophies. Remember, not only will the program be interviewing the candidate, but the candidate should also be interviewing the program to ensure a good match.

“Game Day” - The day of the interview
Dress Professionally. This may seem obvious, but it is important to review. If you have not already done so, invest in a professional suit and presentable, closed-toe shoes. Ladies, avoid wearing skirts or dresses that are above the knee and if wearing heels, make sure they are comfortable because you will be doing a lot of walking during the tour. Remember to avoid chewing gum. Wearing inappropriate jewelry or clothing can make even the perfect candidate be remembered for the wrong reasons.

Arrive on Time. “To be early is to be on time, to be on time is to be late, to be late is to be forgotten.” - Erin Hilderbrand. Plan ahead so you are familiar with the area where the interview will take place.  f you are driving, be sure to research parking options in advance.  

Be Confident and Engaged. Bring a copy of the itinerary if it was provided ahead of time with any notes and questions you want to ask. Not everyone is an expert at interviewing, and notes can be helpful to remember what you have prepared to ask ahead of time, especially for your first interview. Remember to bring something to takes notes on because you will receive a lot of information throughout the day. Do not be afraid to ask the same question to different people because you may receive different answers. This offers unique perspectives on subjective issues. Similarly, it is not uncommon to be asked the same question by different people throughout the day so do your best to answer it the same way each time, as if it was your first time answering.

“Half-Time Show” - Lunch with the current residents
The majority of residency programs have their current residents participate in the interview process.3 Do not be fooled - even a casual lunch with the residents is still considered to be part of the interview so be careful what you say. Also take time to ask and carefully observe how the current resident(s) describe their experiences, and if there is more than one resident, pay attention to how the residents interact with each other.10

“The Post-Game Analysis” - After the interview
The candidate should take time to follow-up with the residency program director and anyone they had contact with throughout their interview.6,10 It is encouraged to write handwritten “thank you” letters to directors and the people who interviewed you. For some, an e-mail may be appropriate. Take time to reflect on your interview, and take note of any things you liked or disliked. This way, when it is time to rank programs, you can reflect back on your interview day. If any questions come up before the rank list is due, e-mail the program director. Remember, pharmacy residency will be a time of personal and professional growth with both exciting and challenging experiences. Use the interview process to find the program that is the right fit for YOU.




References
  1. American Society of Health-System Pharmacists Resident Matching Program, National Matching Services. Schedule of Dates. https://www.natmatch.com/ashprmp/aboutdates.html (accessed 2017 Jan 2).
  2. American Society of Health-System Pharmacists Resident Matching Program, National Matching Services. Match Statistics. https://www.natmatch.com/ashprmp/aboutstats.html (accessed 2017 Jan 2).
  3. Mancuso CE and Paloucek FP. Understanding and preparing for pharmacy practice residency interviews. Am J Health-Syst Pharm. 2004; 61:1686-9.
  4. Gohlke AL, Ray DB, El-Ibiary SY, and Barletta JF. Characteristics of the ideal postgraduate candidate: a survey of residency program directors. J Pharm Pract. 2014; 27(1):84-8.
  5. Pharmacy Times. Take the Star Approach to Behavioral Interviews. http://www.pharmacytimes.com/contributor/donna-kosteva-rph-med/2016/02/take-the-star-approach-to-behavioral-interviews (accessed 2017 Jan 3).
  6. Oyler DR. Getting the most from residency interviews. Am J Health-Syst Pharm. 2013; 70:2082-5. 
  7. White CA. Common mistakes of pharmacy job seekers. Am J Health-Syst Pharm. 2011; 68 (4) 294-6.
  8. Koengsfeld CF, Wall GC, Miesner AR, et al. A faculty-led mock residency interview exercise for fourth-year doctor of pharmacy students. J Pharm Pract. 2012; 25(1):101-7.
  9. Caballero J, Benavides S, Clauson KA, et al. Role of residency interview preparatory activities as a determinant on pharmacy residency match rates. J Pharm Pract. 2016. [epub ahead of print]
  10. American College of Clinical Pharmacy. Interviewing Tips. http://www.accp.com/stunet/interviewing.aspx (accessed 2017 Jan 2).
  11. American Society of Health-System Pharmacists - Connect. Interview Questions with Follow Ups. http://connect.ashp.org/blogs/sara-white/2014/02/23/interview-questions-with-follow-ups?ssopc=1 (accessed 2017 Jan 3).




Leadership Profile
Antoinette Cintron, CPhT

Where did you grow up and go to school?
I grew up in Ireland, went to Elementary, High School and College in Ireland and also to College in England.

Trace your work history. Where have you trained or worked? Any special accomplishments?
I am a trained Chef with a specialty in Patisserie. I have worked in Ireland, England, Germany and United Sates in the hospitality industry. Then along came family, and I found myself in a conundrum, working for the hospitality industry did not allow for family time.

I was always interested in the medical world and got a job near my home with Walgreens. I found the perfect blend between work and life.

I got PTCB certified in 2002 and eventually moved into hospital pharmacy (MacNeal), which has a broader scope for technicians who want to learn new ideas and methods. I worked at MacNeal for over 8 years and then made the move to RUSH, where I have been for over 4 years.

Describe your current area of practice and practice setting.
Currently I am in our Specialty Pharmacy as a Patient Care Coordinator. I take care of our Allergy/Immunology and our Solid Organ Transplant (SOT) clinics. Here we work in tandem with the clinic and the patient, in setting up their care plan after they have been diagnosed. It offers a lot of patient contact and opportunities to act as patients’ guide as they start their treatment journey. Often patients will call us first, especially since we are a very hands on Pharmacy setting. We will meet with our patients in the clinic, and bring them their meds and contact them in regards to shipping their medications per schedule. So patients almost become an extended family in a sense. It is a very fulfilling job, and I love the satisfaction that I get from work every day.
 
What initially motivated you to get involved, and what benefits do you see in being active in a professional association such as ICHP?
Honestly, I first thought that ICHP was only for pharmacists and did not join for years. But when I came to RUSH, I found out that technicians could also become members, so I joined. I love being a member and even though becoming a pharmacist is not where I see myself going, there is so much that you can gain from being a member.

For starters there is so much out there to learn and your mind gets opened to the possibilities that are available to technicians now and in the future. Attending the Spring Meeting, Annual Meeting and Legislative Day are great ways to see all that ICHP does and learn about opportunities for getting involved. Don't forget the awesome Pharmacy Tech Topics™ modules which are a great way to fulfill technicians’ CE needs!

In addition, you get to meet technicians from other hospitals and institutions and get to hear what they are doing in their workplaces. You can swap and develop ideas that you can bring back to your workplace. Not to be looked over is the great networking that being a member allows…who knows, you might see an opportunity that would open up another avenue in your career.

What advice would you give to a new technician eager to become more involved within ICHP?
Don’t just join, come to the meetings, attend conferences and above all, don't be shy. Talk to people, and if you see a call for volunteers, sign up! You will get more out of ICHP than you put in.

Is there an individual you admire or look up to, or a mentor that has influenced your career?
Alicia Boyce, PharmD, my first hospital pharmacy manager. She was willing to take a chance on me and opened up the world of hospital pharmacy to me. This eventually led to me joining ICHP and being nominated as Tech Rep for NISHP.

What three adjectives would people use to best describe you? 
Hardworking, honest, conscientious.

Do you have any special interests or hobbies outside of pharmacy/work? Any special accomplishments?
Any handcrafts! I just love them and always am trying out something new. I am a sucker for craft stores.

Do you have a favorite restaurant/food? 
Spanish.

What is your favorite place to vacation?
Roadtrips with the family, no destination in particular as long as we are together.

What is the most interesting/unique fact about yourself that few people know?
I can converse in 3 languages (Gaelic, French and German) and have a pretty good understanding of Spanish.



College Connections

Roosevelt University College of Pharmacy
Roosevelt University Fall Update

by Alex Heinz, P2, Secretary; Megan Chan, P2, Professional Development Chair; Selma Dzelil, P2, Vice President

Since our last KeePosted update, we have focused on communication within the chapter, ASHP Midyear preparation, bulletin board improvement, and professional development. Over the last month we have elected a first year pharmacy student (P1) as a liaison to bridge communication between the first year and second year classes. Two students applied by writing a paragraph for the position and the decision was made by a vote from each member of the executive board. The liaison is responsible for posting all SSHP meetings and events on the P1 Facebook page and via email. The P1 liaison is also responsible for the SSHP bulletin board on campus. Any questions that the P1 class may have are directed to the executive board.  With this position, we hope to encourage more students to join and to have students be comfortable asking questions about SSHP. We have already noticed better communication between the P1 and P2 classes, which includes a faster turnaround time for responding to emails. 

After a bulletin board was created in September, we have posted event information and executive board contact information. The bulletin board lies in the hallway near the P1 classroom, where we hope to continue to grab the attention of students. The goal of the bulletin board is to increase student’s exposure to SSHP events, since emails and social media can often be overlooked. We have received complements on the visual presentation of the board. We plan to continue to utilize the bulletin board in addition to other means of communication. 

With ASHP’s Midyear Clinical Meeting & Exhibition less than one month away, many SSHP members have been busy preparing for the meeting, which is being hosted in Las Vegas, NV this year from December 4th - 8th. Many are attending to further learn about fellowships and residencies, participate in events and forums, and even to present posters. From Roosevelt University, four SSHP E-board members will be presenting a poster during the Student Society poster session on the professional development analysis that was conducted. We hope this information will direct organizations at other pharmacy schools to place value on the importance of early exposure to journal club presentations. In addition, three Roosevelt students will be presenting a poster from research conducted through a summer research elective. 

The Student Society poster will represent the need for early journal club exposure in an accelerated 3-year program. We have received feedback from previous fourth year students and professors that journal clubs have been an area that needs improvement for students on APPEs. We have analyzed the current understanding of students on journal clubs, as well as students’ comfort level towards academic literature. On the summer elective research poster, students will present the conclusion of a systematic review on abuse deterrent formulations of oxycodone. 

As a part of professional development, a journal club presentation was hosted by SSHP based on the article Pioglitazone after Ischemic Stroke or Transient Attack. Students were provided with the journal club article approximately one month prior to the presentation date to allow for adequate time for review. For many, it was their first experience attending a journal club and being exposed to this learning experience. Students were welcome to either observe or to participate in the discussion. Preparing students for future journal clubs in courses, rotations, and residencies is a valuable service we hope to continue to promote further learning and preparation. We are planning our next journal club for the early weeks of the winter quarter on a topic that relates to didactic courses in both P1 and P2 classes. 

In December, we plan to house our annual Residency Roundtable event. This event features pharmacy residents from hospitals such as Northwestern, Rush, and Mount Sinai. Each resident will sit at a table with approximately 5 students. The students will get the chance to ask the residents questions and obtain truthful answers in a relaxed atmosphere. The purpose of Residency Roundtable is to encourage the pursuit of residencies, provide unique perspectives, stories, advice, and to calm the anxiety of P1 and P2 students towards residencies. 



Rosalind Franklin University College of Pharmacy
Pharmacy Advocacy

by Cole Heinz, P2, Student Chapter Historian

The presidential election recently took place and there are many questions about what the future holds for our country. Many people in the US have strong opinions and opposing political views, making it difficult to navigate social and professional settings when politics are discussed. I was encouraged by a presentation at Rosalind Franklin University of Medicine and Science in North Chicago, IL on pharmacy advocacy by Scott Meyers, Executive Vice President of ICHP. His passion for advocating for the rights of pharmacists gave me a new perspective on the world of politics. He urged us as pharmacy students to get involved now by attending legislative day in order to experience the lobbying process and supporting a bill that benefits our profession, or blocking one that adversely affects it. Pharmacists are highly educated but often lack the experience or interest when it comes to the intricacies of the law and politics. The pharmacy profession’s lack of involvement makes it very hard to get the support for bills pertaining to the practice of pharmacy. The voice that pharmacists have on political issues is very small compared to other healthcare professions such as nursing, which has large numbers of individuals lobbying for change.

Mr. Meyers encouraged us to take the first step in changing this cycle by getting to know our legislators. The ICHP website has resources for contacting your local legislators, making it easy for you to find out who your representatives are at a state and local level. A great way to begin to advocate for our profession is to meet with our legislators. Things to bring with you include a one-page fact sheet about the requests or concern you would like to bring to their attention, business cards, personal stories and, of course, your address. Many representatives are very familiar with the neighborhood you live in since they live, shop, and dine at many of the same places as you. And be professional! The legislator will have a greater chance of remembering you with a face-to-face meeting. 

Legislative day is a great opportunity for students to advocate for the profession and get to know legislators. The networking is invaluable and will make you stand out as a student and potentially lead to greater opportunities later in your career. In the past few years, pharmacy students from Rosalind Franklin University of Medicine and Science have attended the Illinois legislative day in Springfield, IL. As a member of ICHP, I see this as a great way to get to know students from other pharmacy schools in Illinois and to hear about their specific thoughts and concerns. 

The recent election made me think of the steps that we, as students, can take to advocate for pharmacists. Regardless of political party affiliation, a student can advocate for the profession of pharmacy, such as supporting provider status. Having different political views is not something that should cause separation among pharmacists. It should give us perspective and encourage us to speak up, get involved and make a positive impact on the future of pharmacy. Regardless if you are passionate about politics or not, I hope you join me and take the first steps to make change happen! Do not be afraid, speak up and contact your state legislator today!


RFU students at Legislative Day 2015 in Springfield, IL.



More

Welcome New Members!


New Member Recruiter
Lisa Dubien Kim Janicek
Simone Gunn Milena McLaughlin
Jennifer Halsey Greg Biedron
Alphy Pothan Timothy Hook
Rachel Prusa
Heather Sarabia Christopher Workman



Officers and Board of Directors

CHARLENE HOPE 
President
708-783-5933 
chope@macneal.com

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

TRAVIS HUNERDOSSE 
President-elect
THUNERDO@nm.org 

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

JENNIFER ARNOLDI 
Secretary 
jearnol@gmail.com

LARA ELLINGER 
Director, Educational Affairs 
laelling@nm.org

CARRIE VOGLER
Director, Marketing Affairs
217-545-5394

KRISTI STICE 
Director, Professional Affairs
217-544-6464 ext.44660 
kristi.stice@hshs.org

CAROL HEUNISCH 
Director, Organizational Affairs 
847-933-6811

KATHRYN SCHULTZ
Director, Government Affairs
312-926-6961

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

COLLEEN BOHNENKAMP
Chairman, New Practitioners Network

BRYAN MCCARTHY
Co-Chairman, Ambulatory Care Network

VIRGINIA NASH
Co-Chairman, Ambulatory Care Network

CLARA GARY
Technician Representative

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 
Regional Co-Director South
618-391-5539

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


Student Chapter Presidents

FLORENCE PATINO 
President, Student Chapter 
Chicago State University C.O.P. 

SHAZIYA BARKAT 
President, Student Chapter
Midwestern University Chicago C.O.P. 
sbarkat14@midwestern.edu

KASIA PLIS 
President, Student Chapter 
Roosevelt University C.O.P. 
kplis@mail.roosevelt.edu

JORIE KREITMAN 
President, Student Chapter 
Rosalind Franklin University C.O.P. 
jorie.kreitman@my.rfums.org

MALLORY BELCHER 
President, Student Chapter 
Southern Illinois University Edwardsville S.O.P
mabelch@siue.edu

LEVI PILONES 
President, Chicago Student Chapter
University of IL C.O.P. 
lpilon2@uic.edu 

TREVOR LUMAN 
President, Rockford Student Chapter 
University of IL C.O.P. 
tluman2@uic.edu


ICHP Affiliates 


ANTOINE JENKINS 
President, Northern IL Society (NISHP)

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

KATELYN CONKLEN 
President, Sangamiss Society
Conklen.Katelyn@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 January 1, 2016 and January 1, 2017. 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
Ann Jankiewicz
Jan Keresztes
Kathy Komperda
William McEvoy
Christina Quillian
Michael Rajski
Michael Short
Carrie Sincak
Avery Spunt
Patricia Wegner


CAPITOL CLUB - $500-$999
Margaret Allen
Sheila Allen
Rauf Dalal
Drury Lane Theatre
Kenneth Foerster
Travis Hunerdosse
Leonard Kosiba
Mary Lee
Janette Mark
Jennifer Phillips
Edward Rainville
Kathryn Schultz
Heidi Sunday
Jill Warszalek
Alan Weinstein


GENERAL ASSEMBLY GUILD - $250-$499
Tom Allen
Jennifer Arnoldi
Peggy Bickham
Jaime Borkowski
Donna Clay
Scott Drabant
Sandra Durley
Michael Fotis
Jo Ann Haley
Joan Hardman
Kim Janicek
Zahra Khudeira
Ann Kuchta
Ronald Miller
Peggy Reed
Tara Vickery Gorden
Carrie Vogler
Marie Williams


SPRINGFIELD SOCIETY - $100-$249
Rebecca Castner
Noelle Chapman
Lara Ellinger
Jennifer Ellison
Nora Flint
Carol Heunisch
Lois Honan
Charlene Hope
Robert Hoy
Richard Kruzynski
Kati Kwasiborski
Bella Maningat
Milena McLaughlin
Megan Metzke
Katherine Miller
Kenneth Miller
Danielle Rahman
Jerry Storm
Amanda Wolff


GRASSROOTS GANG - $50-$99
Katrina Althaus
Antoinette Cintron
Jeanne Durley
Linda Grider
Heather Harper
Megan Hartranft
Erika Hellenbart
Ina Henderson
Christina Jacob
Leslie Junkins
Connie Larson
Barbara Limburg-Mancini
Brian Matthews
John McBride
Bill Middleton
Mark Moffett
Kit Moy
Gary Peksa
Daphne Smith-Marsh
Jennifer Splawski
Nadia Tancredi
Thomas Yu


CONTRIBUTOR - $1-$49
Marc Abel
Tamkeen Abreu
Trisha Blassage
Colleen Bohnenkamp
Erick Borkowski
Jeremy Capulong
Josh DeMott
Janina Dionnio
Angelia Dreher
Tim Dunphy
Veronica Flores
Frank Hughes
Lori Huske
Vera Kalin
Levi Karell Pilones
Josie Klink
David Martin
Claudia Muldoon
Jose Ortiz
Lupe Paulino
Amanda Penland
Zach Rosenfeldt
Kevin Rynn
Cheryl Scantlen
Joellyn Schefke
Amanda Seddon
Kushal Shah
Sarah Sheley
Beth Shields
David Silva
Helen Sweiss
Steve Tancredi
Kathryn Wdowiarz
Marcella Wheatley
Tom Wheeler
Junyu (Matt) Zhang



Upcoming Events

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

Tuesday, January 17, 2017
Francesca's on Taylor | Chicago, IL


Thursday, February 9, 2017
David Huhtelin, PharmD
Champions LIVE Webinar
Accredited for pharmacists and pharmacy technicians | 0.5 contact hour (0.05 CEU)
Please note this is a special repeat of a program from the 2016 Annual Meeting. If you received credit for this program at the Annual Meeting, you will not be able to receive credit for the webinar.


Wednesday, February 15, 2017
Part 1: Pathophysiology of Rheumatoid Arthritis: The Role of Effector Immune Cells
Part 2: Streamlining the Crash Cart Model: Less is More
NISHP LIVE Program
Maggiano's Little Italy | Oak Brook, IL
Part 1 is not available for CPE credit. This program is sponsored by Bristol-Myers Squibb.
Part 2 is accredited for pharmacists and pharmacy technicians | 0.5 contact hour (0.05 CEU)
This is an independent program provided by ICHP.


Tuesday, February 21, 2017
Chris Mahaffey, PharmD
Sangamiss LIVE CPE Program
Bella Milano | Springfield, IL
This program is accredited for pharmacists and pharmacy technicians | 1.0 contact hour (0.1 CEU)


Tuesday, February 28, 2017
Clinical Practice and Research Network (CPRN) Meeting
Topic: Pharmacogenomics – Inpatient and Ambulatory Care Implementation
Mark Dunnenberger, PharmD
James Lee, PharmD, BCPS
Save the date! More information coming soon to the ICHP Calendar.


Tuesday, March 7, 2017
Implementing a New Antimicrobial Stewardship Program at Your Institution
Radhika Polisetty, PharmD, BCPS, AQ-ID
Jaime Borkowski, PharmD, BCPS
Champions LIVE Webinar
Save the date! Watch for more information in upcoming CPE news briefs.


Thursday, March 9, 2017
Radhika S. Polisetty PharmD,BCPS, AQ-ID, AAHIVP
Kathleen M. Vest PharmD, CDE, BCACP
NISHP LIVE CPE Program
UIC College of Pharmacy | Chicago, IL
This program is accredited for pharmacists and pharmacy technicians | 1.0 contact hour (0.1 CEU)


Wednesday, March 15, 2017
Illinois State Capitol | Springfield, IL
Save the date! More information coming soon.


Friday, March 31, 2017 - Saturday, April 1, 2017
LIVE Joint Statewide Meeting with Missouri Society of Health-System Pharmacists
Save the date! Watch the Spring Meeting page for more information.


Saturday, July 1, 2017
More information on the 2017 Best Practice Award and Program coming soon.



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