Dear member:

I want to reach out to you and personally thank you for being a member of NJSHP. As you know, our organization is committed to helping our members stay abreast of changes in medication therapy and health-system practice. We remain a leader in providing pharmacy continuing education to insure you have the knowledge to enhance your career and better serve your patients. This is possible through the valuable feedback we receive from our membership and the dedication of the officers elected to serve you. I'm sure you have found that NJSHP meetings also provide an excellent venue for networking with other health-system pharmacists and technicians as well as members from other practice settings.

The key to insuring our organization achieves its goals is open communication with our members. This newsletter, our website, a new Facebook page, as well as direct communication at meetings are some of the ways we stay in touch with you. Please do not hesitate to contact me with any feedback you may have regarding programs and services you would like NJSHP to provide. Most importantly, talk to your chapter and state officers to provide feedback on those things you think we are doing well and those that we could do better. This feedback is important for us to stay focused on making sure our organization continues to grow and meet the needs of our members. Spread the word to your co-workers about NJSHP and recommend that they become members as well.

I am also reaching out to all members to invite you to get more involved in NJHSP at the chapter and/or state levels. Chapter officers are always looking for input in improving meetings and welcome volunteers to help plan chapter educational and social events. At the state level, you also may be interested in helping with one of our five working councils, described below:

1. Council on Public Policy - monitors all legislative activities with potential impact on institutional pharmacy practice, and coordinates the release of all publicity pertaining to the Society.
2. Council on Organizational Affairs - develops and maintains Society organizational activities and services; and works to strengthen relationships with Regional Chapters and the American Society of Health-System Pharmacists.
3. Council on Educational Affairs - coordinates the Society's educational and informational programs and services; seeking improved methods to better prepare and/or inform institutional practitioners; and pharmacists in particular.
4. Council on Professional Affairs - works to improve the professional and economic aspects of pharmacy practice.
5. Council on Technician Affairs - to represent the interests and activities of technician members.

Thanks again for being a member of NJSHP. If you are interested or have questions regarding volunteering in one of the above state councils or at the chapter level, please do not hesitate to contact your chapter officers, Stella Williams, Administrative Director, at (609) 936-2205, or myself by email (william.rickley@atlantichealth.org). We hope you find your NJSHP membership rewarding and will continue to support our organization. Please remember to encourage your colleagues to join as well.

NEW JERSEY SOCIETY OF HEALTH-SYSTEM PHARMACISTS

2011
ANNUAL MEETING/EXHIBITION & INSTALLATION DINNER
FRIDAY, APRIL 8, 2011
HILTON EAST BRUNSWICK 3 TOWER CENTER BLVD. EAST BRUNSWICK, NEW JERSEY (732) 828-2000
PLEASE MARK YOUR CALENDAR!

NJSHP is now accepting nominations for state-level officers. Are you interested in getting more involved with NJSHP? Do you know someone who would be great in the following positions? Now’s the time for you to get more involved or nominate a fellow peer. NJSHP can even help you prepare your nomination. Here are the available positions:

• President-Elect (1)
  This leadership position offers an individual the opportunity to direct our organization. Term of president-elect is for one year, after which this position assumes the presidency.
• Secretary (1)
  Position serves to oversee the management of the day-to-day finances of the Society. Additional functions are secondary to the treasurer’s participation in other activities.
• Director of the Council (2)
  Two positions will be available. One involves the council on educational affairs, and the other, council on professional affairs. Both positions allow an individual with the right motivation to have an impact on the course of the profession of pharmacy practice.

If you want more information about serving as a state-level officer, contact Stella Williams, Administrative Director, at (609) 936-2205 or swilliam@njha.com

North Chapter

September 23, 2010
Botulinum Toxins
Location: TBA
Time: TBA
Speaker: David Bandola, MD, DMD
Assistant Clinical Professor
Department of Anesthesiology
Division of Pain Medicine
Columbia University Medical Center
New York, NY
RSVP: TBA

October 29, 2010
Medical Safety Symposium
St. Joseph’s Wayne Hospital
224 Hamburg Turnpike
Wayne, NJ
Time: TBA
Speakers: TBA
RSVP: TBA

North Central Chapter

September 21, 2010
New Treatment Options for Type 2 Diabetes: Incretin-Based Therapy
Wallace Auditorium at Overlook Hospital
99 Beauvoir Avenue
Summit, NJ
Time: 5:30PM — 8:00PM
Speaker: Damian Peters, PharmD, Certified Consultant Pharmacist
Graduate of Rutgers University College of Pharmacy
Working as a consultant pharmacist in the LTC and Behavioral Health Setting
RSVP: http://www.mycecenter.com

October 2010 (Tentative)
Update on Management of COPD
Location: TBA
Time: TBA
Time: TBA
Speaker: Deepali Dixit, PharmD, BCPS
Clinical Care Pharmacist
Saint Michael’s Medical Center
Newark, NJ
RSVP: TBA

November 2010 (Tentative)
Quiz Bowl — Joint meeting w/North Chapter
Location:TBA
Time:TBA
Speaker:TBA
RSVP:TBA

December 2010 (Tentative)
Management of the Poisoned Patients: A Case-Based Approach
Location: TBA
Time: TBA
Speaker: Bruce Ruck, PharmD
Director of Drug Information & Professional Education
New Jersey Poison Information and Education System
Newark, NJ
RSVP: TBA

Central Chapter

September 30, 2010
Poison Control
Location: TBA
Time: TBA
Speaker: Bruce Ruck, PharmD
Director of Drug Information & Professional Education
New Jersey Poison Information and Education System
Newark, NJ
RSVP: TBA

Looking for a job or to attract a candidate to your organization? Take advantage of NJSHP’s Recruitment Site designed especially to connect our members with new employment opportunities. Job seekers and employers can post resumes/positions and manage their accounts easily. Check out this special site here.

Get into the Society Spirit and order your state pin today. State pins can be ordered easily through the NJSHP website.

The Accreditation Council for Pharmacy Education (ACPE) has granted full accreditation for the Feik School of Pharmacy of the University of the Incarnate Word in Texas. The Feik School achieved all necessary requirements for accreditation after it graduated its first class in May 2010. The ACPE board of directors will make a follow-up visit to the school during the 2011-2012 school year, at which time they will consider extending full accreditation status to the pharmacy school for an additional four years.

A recent study, presented at the 2010 annual meeting of the American Society of Clinical Oncology, found that the use of roving pharmacist/nurse teams can significantly improve the quality of patient care at adult oncology clinics. The study looked at care provided by the Supportive Care Consult Service at the University of North Carolina at Chapel Hill. The program allows oncology clinics to request visits from the team where the pharmacists and the nurse conduct consults together. Once the team develops a plan of action, they present it to the patient's physician and, if approved, work to implement the treatment. Researchers reviewed outcomes in 89 patients seen in the first 18 months of the program. They found that, out of a total of 292 patient consults, pain was the reason given for 75 percent of cases, constipation was responsible for 11 percent, nausea/vomiting for 8 percent, anxiety for 4 percent, and 2 percent for spiritual concerns. Tumor types included lung, gynecologic, head and neck, genitourinary, gastrointestinal, and breast. In a sample of 49 patients, average pain scores decreased from 4 to 2.7 while nausea scores dropped from 4 to 1.4, and constipation went from 2.0 to 1.6, all by the second visit. Those clinical improvements also persisted beyond the second visit. Additionally, researchers analyzed the type and frequency of interventions by pharmacists in the program. In the first 18 months after inception, the team recommended an increase in medication in 57 percent of cases, a decrease in 4 percent, no change in 21 percent, a switch of medication in 21 percent, additional medications in 32 percent, and a discontinuation of medication in 6 percent.

Israeli researchers recently looked at the effect of a promotional and educational intervention program to increase flu vaccination among staff in primary care clinics. The study included 344 staff members with direct patient contact--including physicians, nurses, pharmacists, and administrative staff--in 27 primary care community clinics in the Jerusalem area during the 2007-2008 seasonal flu season. Investigators randomly chose 13 clinics to participate in an intervention that consisted of a lecture session by a family physician, literature and reminders via email, and individual approach by a key figure from the local staff. The immunization rate was 52.8 percent in the intervention group compared with 26.5 percent in the control group. When compared with the previous flu season, the intervention clinics experienced a 25.8 percent increase in immunization, versus 6.6 percent in the control clinics. The authors concluded that their intervention program was effective in increasing vaccination rates among primary healthcare workers. "This simple intervention," they write, "could be reproduced easily in other clinics and organizations with an expected substantial increase in influenza immunization rates."

A customized computerized provider order entry (CPOE) drug warning system was recently found to cut the rate of drug errors for elderly patients from 11.56 to 9.94 per day at Beth Israel Hospital in Boston, according to a study published in the Archives of Internal Medicine. The study, led by Dr. Melissa L.P. Mattison, also found that the system did not appear to cause "alert fatigue" nor did rates of prescription for other medications change. The study followed prescription data for patients 65 years and older between June 1, 2004 and Nov. 29, 2004, before the CPOE system was installed, and from March 17, 2005 to Aug. 30, 2008, after its installation. The system alerted physicians if any drugs they prescribed could be found on a list of medications geriatric medical specialists consider high risk for elderly patients, including diazepam (Valium), naproxen (Aleve), clorazepate dipotassium (Tranxene), and fluoxetine hydrochloride (Prozac). The system would then recommend an alternative drug or a dose reduction.

An advisory panel to the U.S. Food and Drug Administration (FDA) reached a mixed vote regarding the fate of the diabetes drug rosiglitazone (Avandia) on Wednesday. Although 12 of the 33 panelists voted to withdraw rosiglitazone from the market entirely, the majority voted to keep it available, possibly with new, tougher restrictions. The intense debate over rosiglitazone was illustrated by the FDA panel votes, which came after reviewing more than 1,000 pages of information and hearing from 18 speakers. FDA Commissioner Margaret A. Hamburg is expected to make the final decision about the drug. Seven members of the FDA panel voted that rosiglitazone should remain available, with additional warnings on the drug's label, and 10 voted for label revisions and sale restrictions. Another three members voted for no change in the drug's status, and one member abstained. The panel also concluded that there was sufficient evidence that rosiglitazone may increase the risk of heart attacks and strokes, but not enough evidence that it increased the overall risk of death. The committee also voted to recommend that the FDA continue to allow a large, international study by drugmaker GlaxoSmithKline that intends to compare the safety of rosiglitazone with pioglitazone (Actos), another popular diabetes drug.

A recent study, published in the Archives of Internal Medicine, found that the medication information legally required by the FDA to be included in pharmaceutical packaging is often not helpful to patients. University of Florida researchers analyzed the experiences of a number of consumers filling prescriptions for lisinopril (Zestril, Prinivil) and metformin (Glucophage, Glucophage XR, Glumetza, Fortamet, Riomet). Their assessment of the written information provided with those prescriptions found that the "directions for use" section lacked specific directions that would allow patients to manage potential risks associated with the medication. They also concluded that the high reading level required to comprehend the presented information and inadequate formatting could also seriously inhibit patient understanding of the materials provided. Additionally, only 6 percent of pharmacists provided patients with verbal clarification of these materials. Experts say these findings indicate that skilled pharmacists are often underused in the current healthcare system. For this reason, healthcare observers advise patients to ask questions of pharmacists before using any medications. As Julie Donohue, an associate professor of health policy and management at the University of Pittsburgh, argues, "In terms of the number of hours spent studying drug effectiveness, pharmacists are better trained than physicians."

Pharmacists are in an excellent position to provide patients with information regarding sun-damage prevention, writes Trinity Hospital pharmacist Stephen Milstead BS, MS, PharmD. He recommends that pharmacists start such a discussion by pointing out certain factors such as tropical regions, high altitudes, infrequent sun exposure, skin blemishes, or light coloring that can increase a patient's risk of skin cancer. Patients should also always be advised of medications that cause photosensitivity, including birth-control products, tetracycline, sulfa drugs, some antibiotics, nonsteroidal anti-inflammatory drugs, phenothiazines, tricyclics, thiazide diuretics, and sulfonylureas. Additionally, pharmacists should ensure patients are aware of proper sunscreen application by advising them to put on the product 15 to 30 minutes before exposure and reapplying every two hours or after heavy sweating, towel-drying, and water exposure, even if the product is labeled water-resistant. Patients should also be counseled to use products with "broad spectrum" protection and a SPF of 15 or greater. However, pharmacists should also warn that there are no standardized labels for UVA radiation, which is considered more damaging than UVB radiation, and that any SPF higher than 30 will not generally improve sun protection because the sun's cumulative effects increase and the product's integrity decreases with lengthy exposure.

The US Food and Drug Administration (FDA) recently held a two-day public meeting devoted to gaining feedback on risk evaluation and mitigation strategies (REMS) as part of its two-year implementation of the program. Speakers at the meeting included representatives from the American Society of Clinical Oncology, patient advocates, Kaiser Permanente, and the Pharmaceutical Research and Manufacturers of America (PhRMA). In a recent announcement, FDA summarized concerns from various stakeholders including questions regarding the costs associated with such programs, the burden that REMS may impose on doctors and pharmacists, and the potential that REMS may restrict access to certain medications. PhRMA, for its part, has told FDA that it would like the agency to more clearly identify why certain aspects of a REMS are necessary and to explain how it weighs risk mitigation against the burden on patients and providers.

The Zynx Health Device Network and B.Braun have joined forces to implement the Prime-A-Pump program for creating and updating drug libraries onto B.Braun smart infusion pumps. Prime-A-Pump provides evidence-based and experience-based clinical decision support, balancing the number of dosing alerts to offer important patient safety data but not interfere with workflow and result in staff avoiding the safety features. Users can review evidence, customize their drug library recommendations, have virtual conversations with colleagues, vote on recommendations, and archive as many versions as necessary to be accessed 24 hours a day.

To reduce the risk of errors in administering injectable medications, the U.S. Pharmacopeial Convention (USP) has advocated new labeling requirements. Under these requirements, the information permitted on the highly visible area of medication vials would be standardized to contain only cautionary statements intended to prevent life-threatening situations. This area of the vial must remain blank if the medication contained does not need a cautionary statement, preventing company logos, names, and other such information from being printed in these locations. "The situations in which injectable products are often administered to patients can be very busy, such as emergency rooms or intensive care units," said Roger L. Williams, MD, chief executive officer of USP. "The new requirements being announced today are intended to make it more likely that doctors, nurses, pharmacists and other healthcare practitioners using injectable products will be able to better see and act on labeling statements that convey important safety messages critical for the prevention of life-threatening situations that may result from the misadministration of a product." Research has shown that the labeling on injectable products could be linked to medication errors when these products are administered. Patient safety data from U.S. hospitals indicate that the most severe errors related to injectable medication have been largely related to human performance deficits, particularly at the time of administration and often due to environmental distractions. The new USP requirements apply to the top surface of the ferrule and cap overseal of a vial that contains an injectable medication. According to the FDA, manufacturers will need to provide a rationale to the FDA if the manufacturer wants to include a cautionary statement about an imminent life-threatening situation on the ferrule or cap overseal of their product. Under the new requirements, other information will still be permitted elsewhere on the medication vials.