The faces of pharmacy: Students and pharmacists stepping forwardFor those just starting their careers, APhA provides the support of and connections with pharmacists who are practicing at the top of their licenses in innovative integrated care settings. To sustain our rising trajectory, we must encourage and promote continued innovation. In The Innovator's DNA, Clayton Christensen describes associating, questioning, observing, networking, and experimenting as the five characteristics of innovators and makes the point that these elements can be learned. Showing up at local, state, and national association meetings is a great way to learn and refine these skills, as well as a great way to further innovation. It follows that student pharmacist and new practitioner involvement with APhA is vital in our pursuit of provider status. We need you, the next generation of pharmacists, to unite with us as a profession to demonstrate the benefits of including pharmacists in team-based care.The theme for APhA2014, "The Power and Promise of Pharmacy," highlights our embrace of innovation and advances in health care. The March/April issue of the Journal of the American Pharmacists Association described some of the ways innovation may change the face of pharmacy practice. Community pharmacists may one day use virtual reality technology as a motivational tool to help patients implement and sustain positive lifestyle changes. For example, a group at Wingate University School of Pharmacy in North Carolina described the implementation of the I-Tribe Community Pharmacy Practice Model, a Web-based care delivery model that would directly connect pharmacists to patients through an interactive, secure Web presence, thereby eliminating geographic restrictions.We're all trying to make a difference! One of the most powerful ways pharmacists are making a difference in patients' lives is through medication therapy management (MTM) services. APhA highlighted the benefits MTM services has provided to patients in our comments to CMS in response to its proposed rule on the medical loss ratio requirements for Medicare Advantage and Part D programs. We also included examples of CMS's recognition of MTM services.View Large Image Figure ViewerDownload (PPT)On the goAPhA leaders and staff travel throughout the country to promote the profession and be the voice of pharmacy. The following is a sample of recent activity.Peter VanPelt, BSPharm, APhA Associate Director of Corporate Alliances, attended the 2013 National Rx Drug Abuse Summit, which focused on ways pharmacists and other health care providers can make a difference in the fight against prescription drug abuse. The summit is the largest national collaboration of professionals from local, state, and federal agencies, business, academia, clinicians, treatment providers, counselors, educators, state and national leaders, and advocates affected by prescription drug abuse. As an advisory board member, VanPelt served as the moderator of two sessions. Orlando, FLMitch Rothholz, BSPharm, MBA, APhA Chief Strategy Officer; James Owen, PharmD, BCPS, APhA Associate Vice President of Practice and Science Affairs; Stacie Maass, BSPharm, JD, APhA Senior Vice President of Pharmacy Practice and Government Affairs; and Anne Burns, BSPharm, APhA Vice President of Professional Affairs, attended a Pharmacy e-HIT Collaborative strategic planning meeting. Under Rothholz's facilitation, a revised mission and vision statement were crafted, and the goals for the upcoming 3 years were identified. Washington, DCThomas E. Menighan, BSPharm, MBA, ScD (Hon), FAPhA, APhA Executive Vice President and CEO, visited the American Society of Consultant Pharmacists (ASCP) board meeting at the request of the ASCP board and executive director to discuss pharmacists' pursuit of provider status. The group discussed the need for collaboration among pharmacists and identified opportunities for pharmacist engagement in medication therapy management. Alexandria, VADid you know…The APhA Academy of Pharmacy Practice & Management (APPM) Executive Committee is pleased to announce two new Special Interest Groups (SIGs) coming soon. The following SIGs will be accepting members in the spring and summer:■Diabetes Management: A network of pharmacists and student pharmacists interested in diabetes management, connecting with others in the field and discussing up-to-date disease management information■Immunizing Pharmacists: A professional network providing opportunities for leadership development and involvement of immunizing pharmacists in the Academy's policy, advocacy, and awards processes■Medical Homes/Accountable Care Organizations (ACOs): A network of practitioners, administrators, and educators who share an interest in the development, implementation, and dissemination of information regarding new models for patient care, specifically the patient-centered medical home and ACOs APhA-APPM is also seeking to form two new SIGs in the following areas:■Compounding: A network community where pharmacists and student pharmacists share ideas, education, and advocacy for compounding pharmacy■Transitions of Care: A professional network of pharmacists and pharmacy technicians working to overcome the transitional challenge and enhance collaboration among pharmacists in all practice areas as they provide care to patients during transitions between settingsSupport these SIGs by signing up for the compounding (http://apha.us/YzDGu6) or transitions of care (http://apha.us/11oh5CZ) group today!Media vibeDuring March, APhA external communications and media advisors responded to 10 media inquiries, including the following:■Better Thinking for Better Health (http : //betterhealth.mckesson.com/): How can physicians and pharmacists work together to encourage use of generic versions of prescribed medications?■NPR: Drug diversion and the use of forged prescriptions■Collaborative Care: Regulation of pharmacy techs■Pocono Record: How can pharmacists guard against illegal prescription activity, and what are warning signs?Spring 2013 340B Peer-to-Peer leading practice sites announcedThe Health Resources and Services Administration and APhA are pleased to announce the nine leading practice sites for spring 2013. The 340B Peer-to-Peer Network was established in 2011 to recognize leading practice sites that would serve as resources and models of excellence for 340B-covered entities to raise the integrity and quality of the 340B program.All leading practice sites are 340B-covered entities and were selected based on 340B program compliance and exemplary performance in four cornerstone areas of clinically and cost-effective pharmacy services: access to affordable medications, efficient business practices, outcomes-driven clinical programs, and quality assurance programs. The following 9 new sites join 10 existing 340B Peer-to-Peer leading practice sites.Children's Healthcare of AtlantaThis large urban pediatric hospital in Atlanta has excellent and comprehensive operational practices, comprehensive policies and procedures, and precise inventory management and split billing. It hosts 10 student pharmacists through undergraduate pharmacy rotations.CommUnityCare/Central HealthAs a community health center (CHC), this urban-based multiservice system in Austin, TX, has multiple contract pharmacy programs for 10 to 12 clinics. Its leading practices include extensive patient access programs, real-time patient tracking, and integrated clinical programs, as well as clinical pharmacy rotations.Community Health Association of SpokaneThis multisite, rural/urban CHC in Spokane, WA, has seven locations with in-house pharmacies. Highlights include a growing clinical program, a large system with students and administrative support, strong finances, and supportive senior leadership.El Rio Community Health CenterEl Rio is a large multisite, rural/urban CHC in Tucson, AZ, with extensive clinical pharmacy services spanning 18 sites, including 7 pharmacies that serve 275,000 patients. El Rio has implemented a team-based care approach to providing clinical pharmacy services, working collaboratively with clinicians.Health Partners of Western OhioThis rural CHC in Lima, OH, has a very strong organizational commitment to its pharmacy program and excellent formulary management. It accepts about 14 students yearly.Holyoke Health Center, Inc.This CHC in Holyoke, MA, has two in-house pharmacy programs and excellent business operations and reporting, including revenue maximization, perpetual inventory, auditing and reporting systems, and access to medications for all patients. It maintains two sets of student rotations every 6 weeks and hosts clinical programs, including multiple disease management.Park Ridge HealthThis small rural disproportionate share hospital (DSH) in Hendersonville, NC, has multiple outpatient clinics and one outpatient pharmacy, a contract pharmacy, and telepharmacy. Highlights include strong performance in all areas of operations and clinical programs and use of cutting-edge technology in inventory management and purchasing. It is partnering with Wingate University to build the first remote pharmacy school in western North Carolina.Shands Jacksonville Medical CenterShands is a large urban DSH in Jacksonville, FL, with an onsite ambulatory pharmacy, multiple clinic sites, and pharmacies for indigent patients. Its best practices include an integrated approach to medication therapy management combining traditional dispensing and clinical practices, a tiered system ensuring that all patients have access to medications, comprehensive quality analysis programs in all practice areas, a sophisticated formulary management system, and extensive training programs.Zufall Health CenterZufall is a small urban CHC in Dover, NJ, with an integrated multiple-contract pharmacy program. The center has an organizational commitment to maintaining lowcost, high-quality service to uninsured patients, a high rate of medication access through low-cost prescriptions and selective use of Patient Assistance Programs, revenue maximization, integrated clinical programs through a contract pharmacy partnership, and a quality improvement committee.Stephanie RileiCommunications Manager, APhA Federal Contracts & GrantsWilliam Edwards: A life in pharmacyView Large Image Figure ViewerDownload (PPT)Edwards served as Speaker of the APhA House of Delegates from 1979 to 1981 and Treasurer from 1982 to 1984. He also chaired the APhA Pharmacists' Insurance Trust and served on the boards of many other pharmacy and cultural organizations.Edwards was born in Comanche, TX, in 1926 and studied pharmacy at the University of Texas-Austin after serving in Europe during World War II and the occupation in Japan, according to his obituary in the Galveston Daily News. He moved with his former wife, Lela Carroll Edwards, to Galveston in 1950 and worked for the Veterans Administration pharmacy and later for Tommy Youngblood Sr., before starting Edwards Prescriptions in 1955. His brother, L.D. Edwards Jr., joined him a year later.An active member of the pharmacy community for many years, Edwards received numerous awards for outstanding contributions to the profession, including APhA's Hugo M. Schaefer Award in 1986 and Merck Sharp & Dohme's award for outstanding achievement in pharmacy. The Texas Pharmacy Association presented Edwards with its first Preceptor of the Year Award for his mentorship of student pharmacists.Edwards "loved Galveston, his pharmacy practice, cultural arts, and most of all, his family and friends," according to the Daily News. He is survived by his last wife, Merri Scheibe Edwards, five children, and seven grandchildren.Inspiring future pharmacistsBethany Boyd, BSPharm, PhD, worked for Bill Edwards, BSPharm, as a student pharmacist from 1987 to 1988 at Edwards Prescriptions in Galveston, TX, the pharmacy he opened in 1955."When I found out I was going to Galveston for rotations with the University of Texas at Austin College of Pharmacy, I was hoping I would have the chance to work with Bill Edwards," wrote Boyd in an email to Pharmacy Today. "Prior to starting my rotations, I boldly approached him at a reception, introduced myself, and said, 'I want to do a rotation at your store.' Luckily, he didn't run quickly in the opposite direction but graciously said that he and his brother, L.D., would love to have me."Boyd highlighted Edwards' calm nature and gentlemanly manners. His "endless collection of bowties displayed a level of sophistication that his patients and the community admired and respected," she wrote. "He challenged me to serve my profession, patients, and community with compassion and kindness. We had 'life' conversations that made me appreciate and respect the profession I had chosen."Members are looking atAre you looking for ways to enhance your knowledge, practice, and networking opportunities? Consider joining one of APhA's Special Interest Groups (SIGs) e-Communities. APhA currently offers the following SIGs:■Medication Management■Nuclear Pharmacy Practice■Pain, Palliative Care, and Addiction■PreceptingTo join a SIG, log on to pharmacist.com and select "Your Profile." Click on "APhA Preferences" and choose your primary Academy. Then select the SIGs of your choice under the Special Interest Groups options. From there select the e-Communities link in the Get Involved area of pharmacist. com and sign up for the corresponding SIGs. Information about joining APhA's SIGs is also available at the APhA Academy of Pharmacy Practice and Management homepage (www.pharmacist.com/ apha-appm)."There continues to be reason for concern about sterility deficiencies and other problems in some compounding pharmacies across the country—problems that could potentially affect the health of patients."FDA Commissioner Margaret A. Hamburg, MD Read more on the FDA Voice blog: http://apha.us/14k2qyaThe latest drug newsWant to catch up on the latest clinical trials, médication news, drug approvals, and practice guidelines? Check out APhA DrugInfoLine, an online pharmacotherapy news resource for APhA members. Each week, DrugInfoLine editors work with a panel of pharmacy experts in 20 disease states to highlight the most relevant studies and guidelines published in peerreviewed journals that affect drug therapy choices. To read all of the articles and updates on new drug approvals, alerts, recalls, and product withdrawals, visit www.aphadruginfoline.com. Read this month's top trending article below.APhADrugInfoLineTMDiabetesCharles D. Ponte, Section AdvisorDiabetes meds: FDA alert, new data on pancreatitis fuel controversy over safety concernsKey pointUse of sitagliptin (Januvia, Janumet, Janumet XR, Juvisync—Merck) or exenatide (Byetta—Amylin, Bydureon— Bristol-Myers Squibb, AstraZeneca) was associated with increased odds of hospitalization for acute pancreatitis, according to a recent study. In a March 2013 safety communication, FDA announced it was investigating pancreatic adverse effects of these and other incretin mimetics based on new unpublished findings.Finer pointsThere have been reports of acute pancreatitis in patients with diabetes taking the glucagonlike peptide 1 (GLP-1) agonists exenatide and sitagliptin. However, data are inconclusive, and patients with diabetes have a higher prevalence of acute pancreatitis.In the current population-based case–control study, investigators identified adults under age 64 with type 2 diabetes in a prescription insurance database from 2005 to 2008. A total of 1,269 cases of individuals hospitalized for acute pancreatitis were matched to 1,269 randomly selected controls. Prescription data were used to determine exposure to exenatide or sitagliptin before pancreatitis diagnosis.Mean age of cases and controls was 52 years; 57.45% were male. Individuals with pancreatitis were more likely to have hypertriglyceridemia, alcohol use, gallstones, tobacco abuse, obesity, and neoplasms. After adjusting for confounders, use of exenatide or sitagliptin within 30 days (adjusted odds ratio 2.24 [95% CI 1.36-3.69]), within 30 days to 2 years (2.01 [1.37-3.18]), or with any use (2.07 [1.36-3.13]) were associated with higher odds of acute pancreatitis (P = 0.01 for all comparisons).What you need to knowInvestigators acknowledged study limitations but concluded that these results "support findings from mechanistic studies and spontaneous reports submitted to [FDA] that such an association may be causal."However, a joint response issued by the American Association of Endocrinologists and the American Diabetes Association urged caution in interpreting study findings and warned against making treatment changes based on these results. "While there are risks and benefits associated with any therapy, the retrospective analysis indicates GLP-1 based therapies are associated with a relatively small excess risk of hospitalization for acute pancreatitis, with only two additional cases per 100 patients over a 3-year period," joint statement authors wrote.A March 2013 FDA warning, released on the heels of this study, announced that FDA is evaluating new unpublished findings that suggest an increased risk of pancreatitis and precancerous cellular changes in patients with type 2 diabetes treated with incretin mimetics.If acute pancreatitis is suspected in a patient taking an incretin mimetic, pharmacists should alert the patient's primary care provider and submit an adverse event report to FDA's MedWatch Program. Signs and symptoms of acute pancreatitis include abdominal pain, nausea and vomiting, and fever.What your patients need to knowA recent study showed a potential link between the diabetes drugs sitagliptin and exenatide and acute pancreatitis. Although it is not known whether these agents can cause adverse pancreatic effects, FDA is also investigating this link. Until more is known, patients should not stop taking these medications without the approval of their health care provider. Patients with questions should talk to their pharmacist or other health care provider.SourcesSingh S et al. Glucagonlike peptide 1-based therapies and risk of hospitalization for acute pancreatitis in type 2 diabetes mellitus: a populationbased matched case–control study [published online ahead of print February 25, 2013]. JAMA Intern Med.Gier B et al. Glucagonlike peptide 1-based drugs: clarity at last, but what about pancreatic cancer [editorial; published online ahead of print March 5, 2013]? JAMA Intern Med.Also trending on APhA DrugInfoLine■Too much of a good thing: New studies show vitamin C has limited benefits, increased risks■Treatment-resistant depression: Time to consider folate supplementation■Not just grapefruit anymore: Data mounting for apple, orange juice-drug interactionsA minute with …Ashley Mishoe, PharmDPETNET Solutions, a Siemens companyJacksonville, FL APhA member since 2008My current job is ... positron émission tomography (PET) nuclear pharmacist.I first became interested in being a pharmacist ... in college when I saw the direct impact pharmacists have on patients' lives.My most memorable APhA experience was ... being awarded with the National Association of Nuclear Pharmacies Outstanding Nuclear Pharmacy Student scholarship at the 2012 APhA Annual Meeting. I was so excited and felt very honored.The advice I give to pharmacists who want to follow my career path ... is to shadow nuclear pharmacists in both PET and low energy, because the two can be very different. Get involved with the Nuclear Special Interest Group within APhA to learn about the various areas within nuclear pharmacy and to connect with other students and practitioners in nuclear.Professionally I want to ... learn all I can about nuclear pharmacy and become a board-certified nuclear pharmacist. I'd like to teach a nuclear program someday and inspire students to consider nuclear pharmacy as a career path.If I weren't a pharmacist ... I'd be a baker, for sure! Being in the kitchen helps me wind down after a long day and allows me to be creative.People would be surprised to know ... I've been playing the piano since I was 7 years old, and I minored in music in undergrad at Clemson University.Updated resource that fits in your pocketPeripheral Brain for the Pharmacist, 3rd edition, is a pocket-sized go-to resource for student pharmacists and clinicians from all practice levels for answering questions about drug information. The quick-reference format contains clinical numbers and key components of guidelines that are used most often by practitioners. Students may find this to be a helpful tool when first starting on their advanced pharmacy practice experiences as they familiarize themselves with specific goals of therapies or learn to triage patients.Peripheral Brain for the Pharmacist arranges 30 core reference materials on durable, laminated, color-coded pocketsized cards that are hole-punched with a metal ring to hold the collection together. A majority of the material is organized in chart or table format, making the resource easy to read on the go. Contents include frequently used laboratory values and equations, goals and targets for commonly seen disease states, approaches to pharmacotherapy of various chronic conditions, and patient counseling tools.Although this edition reflects the latest updates in clinical guidelines, Peripheral Brain for the Pharmacist also provides websites and sources that direct pharmacists to the latest guideline updates. For example, the cards regarding hypertension and cholesterol treatment are based on the JNC VII and NCEP ATP III guidelines, respectively, but a note on these cards indicates that updates are in progress and further information can be found on the listed websites. Appropriate clinical judgment should always be used and patient-specific decisions be made.From rounding on the hospital floors to working in the community, staying up to date is critical. This handy reference belongs in the pocket of every new practitioner and student pharmacist regardless of practice setting.Christine Chim, PharmDNortheastern University Bouvé College of Health Sciences School of PharmacyTop six best-paying careers for women in 2013a Earnings aspercentage of men's earningsSource: Goudreau J. The best-paying jobs for women in 2013. Forbes. www.forbes.com/sites/jennagoudreau/2013/02/28/the-best-paying-jobs-for-women-in-2013/Show full captionBased on full-time wage andsalary workers in 2012, the latest data available, as tracked by the U.S. Bureau of Labor Statistics.View Large Image Figure ViewerDownload (PPT)Pharmacists respond to Saipan health crisisFour pharmacists were part of a 16-member multidisciplinary public health team that traveled to the Commonwealth of the Northern Marianas Islands (NMI), located in the South Pacific, to help the commonwealth's only hospital gain CMS certification. Saipan is the largest of NMI's 15 islands."The team was fully embedded in the hospital," said RADM Chris A. Bina, PharmD, Assistant Surgeon General with the U.S. Public Health Service. "The hospital had a very good staff, but they just didn't have the technical expertise needed to create certain processes in order to meet certification from CMS." Bina served as the Officer in Charge for an 8-week period during the 90-day intervention, which took place from December 2012 to March 2013.A joint effort between the Department of the Interior, the Department of Health & Human Services, and the Office of the Surgeon General, the hospital assistance team improved the overall function of the hospital in terms of patient care, business processes, and personnel performance; maximized the safe and efficient functioning of the clinical laboratory, nursing care, and pharmacy operations; and supported the maintenance of the hospital's CMS certification.In addition to Bina, there were three pharmacists on the hospital assistance team: CDR Kathleen Dotson, PharmD, Chief Pharmacist at the Bureau of Prisons (BOP) Federal Medical Center facility in Springfield, MO; LT Jacklyn Finocchio, PharmD, staff pharmacist at the BOP Federal Medical Center facility in Butner, NC; and LCDR Kendall Van Tyle, PharmD, with the Indian Health Service at the Northern Navajo Medical Center in Shiprock, NM. The pharmacists assisted with developing the hospital's chemotherapy program, setting up a pharmacy electronic medical record system, and implementing pharmacy operations.By the end of the 90-day deployment, the assistance team created a 50-page sustainability plan, which included more than 200 recommendations and served as a "playbook for everything that needed to be addressed for the hospital to meet CMS certification," said Bina. The assistance team also helped the hospital respond to the CMS audit and implement a series of corrections in order to maintain certification. The faces of pharmacy: Students and pharmacists stepping forwardFor those just starting their careers, APhA provides the support of and connections with pharmacists who are practicing at the top of their licenses in innovative integrated care settings. To sustain our rising trajectory, we must encourage and promote continued innovation. In The Innovator's DNA, Clayton Christensen describes associating, questioning, observing, networking, and experimenting as the five characteristics of innovators and makes the point that these elements can be learned. Showing up at local, state, and national association meetings is a great way to learn and refine these skills, as well as a great way to further innovation. It follows that student pharmacist and new practitioner involvement with APhA is vital in our pursuit of provider status. We need you, the next generation of pharmacists, to unite with us as a profession to demonstrate the benefits of including pharmacists in team-based care.The theme for APhA2014, "The Power and Promise of Pharmacy," highlights our embrace of innovation and advances in health care. The March/April issue of the Journal of the American Pharmacists Association described some of the ways innovation may change the face of pharmacy practice. Community pharmacists may one day use virtual reality technology as a motivational tool to help patients implement and sustain positive lifestyle changes. For example, a group at Wingate University School of Pharmacy in North Carolina described the implementation of the I-Tribe Community Pharmacy Practice Model, a Web-based care delivery model that would directly connect pharmacists to patients through an interactive, secure Web presence, thereby eliminating geographic restrictions.We're all trying to make a difference! One of the most powerful ways pharmacists are making a difference in patients' lives is through medication therapy management (MTM) services. APhA highlighted the benefits MTM services has provided to patients in our comments to CMS in response to its proposed rule on the medical loss ratio requirements for Medicare Advantage and Part D programs. We also included examples of CMS's recognition of MTM services. For those just starting their careers, APhA provides the support of and connections with pharmacists who are practicing at the top of their licenses in innovative integrated care settings. To sustain our rising trajectory, we must encourage and promote continued innovation. In The Innovator's DNA, Clayton Christensen describes associating, questioning, observing, networking, and experimenting as the five characteristics of innovators and makes the point that these elements can be learned. Showing up at local, state, and national association meetings is a great way to learn and refine these skills, as well as a great way to further innovation. It follows that student pharmacist and new practitioner involvement with APhA is vital in our pursuit of provider status. We need you, the next generation of pharmacists, to unite with us as a profession to demonstrate the benefits of including pharmacists in team-based care. The theme for APhA2014, "The Power and Promise of Pharmacy," highlights our embrace of innovation and advances in health care. The March/April issue of the Journal of the American Pharmacists Association described some of the ways innovation may change the face of pharmacy practice. Community pharmacists may one day use virtual reality technology as a motivational tool to help patients implement and sustain positive lifestyle changes. For example, a group at Wingate University School of Pharmacy in North Carolina described the implementation of the I-Tribe Community Pharmacy Practice Model, a Web-based care delivery model that would directly connect pharmacists to patients through an interactive, secure Web presence, thereby eliminating geographic restrictions. We're all trying to make a difference! One of the most powerful ways pharmacists are making a difference in patients' lives is through medication therapy management (MTM) services. APhA highlighted the benefits MTM services has provided to patients in our comments to CMS in response to its proposed rule on the medical loss ratio requirements for Medicare Advantage and Part D programs. We also included examples of CMS's recognition of MTM services. On the goAPhA leaders and staff travel throughout the country to promote the profession and be the voice of pharmacy. The following is a sample of recent activity.Peter VanPelt, BSPharm, APhA Associate Director of Corporate Alliances, attended the 2013 National Rx Drug Abuse Summit, which focused on ways pharmacists and other health care providers can make a difference in the fight against prescription drug abuse. The summit is the largest national collaboration of professional