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!

The Annual Awards will be presented during the installation dinner at the Annual Meeting on April 8, 2011. Now is the time to nominate your peers for their accomplishments, whether big or small, in the areas of continuous process improvement, innovation or enhanced patient care.

Want to learn a little history about these awards first? View Indu Lew’s presentation.

It’s easy to nominate someone who fits the criteria for excellence and recognition. Several categories of achievement are listed for each award candidate here.

You need not give a response for every section of the core values noted. At times, small changes, achievements, and innovative thinking are all that is needed to cite a candidate for recognition. You can complete your application on-line.

Questions about this process? Contact Stella Williams at swilliam@njha.com or at 609-936-2205.

Russ Lazzaro, Director of the Council on Public Policy

New Jersey’s Medical Marijuana Program (MMP) New Jersey, the latest state to approve the use of Marijuana for medical use, was set to start on January 1st, 2011, but has, for now, been postponed until July 2011.

A draft of New Jersey’s MMP is online and can be viewed at the following NJ.Gov site: http://www.state.nj.us/health/med_marijuana.shtml.

Here is a bulleted outline of the program draft:

Sites:
Limited sites are now down to eight (8):
     2 Growers, 4 ATC (Alternate Treatment Center) Dispensaries, 4 Satellites,
     Two growers supplying 4 dispensers (no mention of “pharmacies”,
     Each ATC dispensary can set up one (1) satellite in the same area.

State imposed conditions:
Medical Marijuana Prescribers must:
     Be treating the patient for at least one (1) year,
     Must have seen the patient at least 4 times,
     Vouch that traditional relief has failed,
     Patient must have no criminal background i.e.
          CDS conviction or evidence & proof of rehabilitation
     Prescribers are limited to one of nine (9) conditions:
     Certification statement (already scripted - online),
     Patient provided Informed Consent,
     Letter attesting to the following limited conditions:
          Cancer,
          Glaucoma,
          Seizure Disorder (including epilepsy),
          ALS (Lou Gehrig’s Disease),
          MS (Multiple Sclerosis),
          Muscular Dystrophy or Severe Muscle Spasm,
          HIV/AIDS,

          IBD (including Crohn’s Disease),
          Any patient with a terminal illness with < a year to live!

Multiple written instructions up to 90 days can be provide to the patient:
     Earliest date to fill each of the 3 x 30 day prescriptions,
     As long as there is no undue risk of diversion or abuse,
     Patient or Primary Caregiver has a NJ State Registry card.

Additional Debilitation Medical Conditions:
     Will be considered for review annually
     By a panel of 15 health care professionals
     A majority of the panel will be physicians
     At least three (3) members must be:
     Nationally board-certified in Pain & Symptom Management
     Other physicians & non-physicians
          Knowledgeable in petition requests
     (No specific mention of pharmacists).

Dispensary or Alternative Treatment Centers (ATC):
     Four (4) non-profit ATC locations:
     $20,000 fee ($18,000 back if rejected) – annually
     Must be submitted as two (2) checks $2,000 & $18,000
     Each ATC can open one (1) Satellite per ATC site only.
     Must be in the same region as the primary ATC
     Fee is $10,000 extra, to open a satellite
     Any physical building/plant change or modification is $2,000

State is divided into two (2) regions:

Central: Hunterdon, Middlesex, Mercer, Monmouth, Ocean, Somerset & Union

Northern: Bergen, Essex, Hudson, Morris, Passaic, Sussex & Warren

Patient/Caregiver requirements:
     Patient Application & Costs:
          $20 or $200, depending on patient’s income,
     Limit two (2) ounces per month – possibly more, depends!
     Home delivery – at a cost?
     Choice of method of ingestion:
          Enhanced Lozenges,
          Laced Lotion,
          Smoking,
          The active ingredient, THC is set at 10%.

My personal thoughts:

July 1st 2011 start date may not be realistic at this point. DOH vs. Christie – who will decide ultimately, is unknown November elections may have an impact DEA still has to weigh in on legality! Nebraska BOP rejected – back to the FDA

Finally, this is a mere synopsis of the draft, not a complete review or what the final law will be. If interested, please go online and review the entire draft, since there are numerous regulations, rules and stipulations about the dispensary, delivery trucks, signage for each, security for both the site and delivery trucks concerning for both the product and monies being handled and transported.

Thanks!

Upcoming Events

o Residency Roundtable, October 27th

o Current residents from different hospitals will share their experiences with students about residencies.

o Topics of discussion will include: application process, the match-up, and what they do while on rotation.

o Monster Mash, Oct 29th

• Students will dress up in Halloween costumes and give candy to children whose neighborhoods are too dangerous to trick-or-treat in.

• NJSHP will be having a penny pitch activity at their table for children to play for prizes.

• This event takes place on Cook Campus.

Recent Events Summary

o Residency Showcase, September 28th

• NJSHP had a table to promote Midyear, ASHP, and NJSHP to students.

• We provided handouts and talked with students about the benefits of being a member of ASHP and NJSHP.

• We also gave information to students about what Midyear was about and what to expect.

o Clinical Skills Competition, September 29th

• 15 teams competed in the competition this year ranging from PP2 students to P4 students.

• The top 4 teams made a presentation and provided a verbal defense to their plan.

• Congratulations to Julius Li and Christine Rash (P4’s) for their win. They will be attending Midyear to compete on behalf of Rutgers.

• I am still collecting the checks from each chapter to go to the winners for their travel/hotel costs.

o Pharmacy Month Kickoff Event, October 1st

• This event was sponsored by APhA and PLS.

• Guest Speaker John O’Brien spoke about the importance of advocating pharmacy.

• Each organization presented a poster on a current issue in pharmacy to be judged by the guest speaker and officers of PGC. Each poster was on the problems with their issue and student solutions to these problems. NJSHP’s topic was Medicare Part D.

• NJSHP was awarded 1st place for their poster. I am very proud of my E-board for their hard work.

o Policy Advocacy Event, October 13th

• To celebrate National Pharmacist Month, we discussed current pharmacy policy and the issues affecting hospital pharmacy.

• Guest speaker Russ Lazzaro, the director of the Council on Public Policy for NJSHP, discussed current issues such as: medical marijuana, herbs and supplements, and the requirements for license when working as a technician versus an intern.

• Students broke up into 3 groups and discuss possible solutions to these issues then got feedback from Russ.

• This was a joint event with AMCP, PDC, and LKS.

Visit our website www.njshprutgers.weebly.com gallery for pictures of our past events!

Please feel free to contact me via e-mail, laurenfaust@comcast.net or cell: 856-261-1128 with any questions or comments. – Lauren Faust, NJSHP Rutgers Chapter President

Northern Chapter

November 30, 2010
JCAHO Medication Management (2-hr law CE)
Location: Wallace Auditorium at Overlook Hospital
99 Beauvoir Avenue
Summit, NJ
Time:TBA
Speaker: Andre Emont, Pharm.D.
RSVP:TBA

December 14, 2010
Management of the Poisoned Patients: A Case-Based Approach
Location:Seton Hall University
West Orange, NJ
Time:TBA
Speaker Bruce Ruck, Pharm.D., DABAT
Director of Drug Information & Professional Education
New Jersey Poison Information and Education System
Newark, NJ
RSVP:TBA

Southern Chapter

November 9, 2010
Topic:Anemia Management & Parenteral Iron
Location:The Mansion
3000 Main Street
Voorhees, NJ
Time:5:00 p.m. – 8:30 p.m.
Speaker:Indu Lew, Pharm.D.
Vice President Corporate Pharmacy
Education and Research
Saint Barnabas Health Care System
South Plainfield, NJ
RSVP:Email: NJSHPSOUTH@hotmail.com

December 15, 2010
Aerosolized Antibiotics in Hospital Acquired Pneumonia
Location:Kennedy CV Conference Room
Cherry Hill
Time:6:00 p.m. – 9:00 p.m.
Speaker:Quinn A. Czosnowski, Pharm.D., BCPS
Assistant Professor of Clinical Pharmacy
Department of Pharmacy Practice & Pharmacy Administration
Philadelphia College of Pharmacy
University of the Sciences in Philadelphia
Philadelphia, PA
RSVP:TBA

January, 2011
Topic: Management of Heparin Induced Thrombocytopenia
Location: Kennedy CV Conference Room
Cherry Hill
Time: 5:30 p.m. – 9:00 p.m.
Speaker: Helen LoSasso, Pharm.D.
Clinical Manager Pharmacy Services Kennedy Health System
Stratford, NJ
RSVP:TBA

February, 2011
Topic: Stroke Prevention in Atrial Fibrillation Patients
Location: Virtua Center for Learning
Mt. Laurel, NJ
Time: 5:30 p.m. – 9:00 p.m.
Speaker: Stephanie Polli, Pharm.D.
Clinical Pharmacy Specialist in Cardiovascular Diseases
Cooper University Hospital
Camden, NJ
RSVP: TBA

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

Cheryl A. Thompson BETHESDA, MD 13 October 2010-A medication guide and warning about the possible increased risk of atypical thigh-bone fractures in patients who take a bisphosphonate to treat or prevent osteoporosis will be added to products' labeling, FDA announced today.

The labeling will also state that the optimal duration of therapy with bisphosphonates to treat or prevent osteoporosis has not been established.

"Subtrochanteric femur, or thigh-bone, fractures are known to occur in patients with osteoporosis-always have been," FDA's Sandra Kweder, deputy director of the Office of New Drugs, told reporters during a briefing. "However, in recent years, there has been an increasing number of reports of femur fractures with some unusual features in patients taking bisphosphonates."

One of those unusual features, she said, is that the fractures do not necessarily occur after trauma.

Read More

10/13/2010 Thinking about retiring but not ready to retire just yet? ASHP has developed a new tool, the Retirement Planning Resource Center, to help members who are transitioning into retirement and to help the society utilize and retain their experience and wisdom. The resource center is online at www.ashp.org/retirementplanning.

While the first crop of baby boomers became eligible for early retirement in 2008, many plan to continue working longer. ASHP’s members are no exception. A recent survey of members ages 50 and above shows that nearly two-thirds plan to work part-time or consult after they stop working full time and three out of ten members plan on working full time beyond age 66.

Our 50+ members indicated they’d like to have ASHP help with retirement planning - by providing information to assist with planning, by creating forums to connect with others transitioning into retirement, and by providing special rates to benefit fully retired members.

The Retirement Planning Resource Center was created to address these needs and to show our 50+ members how to stay active in ASHP and how to continue to contribute to the pharmacy profession as they transition to some form of retirement. The center is a resource for those planning on retiring in the near future or long-term and for those already retired. Find information and join in the conversation today!

Read More

Kate Traynor BETHESDA, MD 14 October 2010 - FDA today ordered eight companies to stop selling nonprescription chelation therapy products because the agency considers them to be illegally marketed products that are dangerous to consumers.

Michael Levy, director of FDA's Division of New Drugs and Labeling Compliance, said that although many of the chelation products affected by the action are sold as dietary supplements, all are actually unapproved drugs.

"These companies falsely claim that their products treat a variety of ailments, including autism and cardiovascular disease. Some of the companies also claim to treat Parkinson's disease, Alzheimer's disease, macular degeneration, and other serious conditions," Levy said.

Treatment claims such as these violate the federal Federal Food, Drug, and Cosmetic Act, according to the agency.

Read More

The FDA has announced that Abbott Laboratories will voluntarily withdraw its obesity drug sibutramine (Meridia) from the U.S. market because of clinical trial data indicating an increased risk of heart attack and stroke. The FDA requested the market withdrawal after reviewing data from the Sibutramine Cardiovascular Outcomes Trial (SCOUT). SCOUT was initiated as part of a postmarket requirement to look at cardiovascular safety of sibutramine after the European approval of this drug. The trial demonstrated a 16 percent increase in the risk of serious heart events, including non-fatal heart attack, non-fatal stroke, the need to be resuscitated once the heart stopped, and death, in a group of patients given sibutramine compared to another given placebo. There was a small difference in weight loss between the placebo group and the group that received sibutramine.

Computerized physician order entry systems with electronic hard stop alerts could have unintended consequences, according to a randomized trial conducted among almost 2,000 clinicians. The study found that a hard stop alert reduced concomitant ordering of warfarin and trimethoprim-sulfamethoxazole (Bactrim, Septra) by 88 percent compared with standard practice. However, use of the hard stop and the study itself were halted after researchers found the stop caused clinically important treatment delays in four patients who needed immediate drug therapy. The researchers recommend that hard stops only be used in cases where there were no exceptions. The low-tech answer developed at the University of Pennsylvania's hospital had been for pharmacists to call physicians to warn about the bleeding risk when co-prescribing warfarin and trimethoprim-sulfamethoxazole.

Elkhart General Hospital, in Elkhart, Ind., has instituted a new program based on the concept of lean management to improve medication administration while reducing costs. By doing so, the hospital was able to cut IV preparation waste by approximately 90 percent. It also allowed for the redeployment of two pharmacists to full-time clinical duties, and reduced annual operating expenses by approximately $1 million. The hospital used a system known as total value management, said Pharmacy Director Susan Hawes. Instead of looking at healthcare by department, it looks at healthcare as a process or stream that is focused on the patient. Every step in the stream either adds value, such as improved patient outcomes or improved safety, or it is a defect that detracts from value, such as medication errors or unused medications. The goal is to increase the value of the stream by reducing or eliminating defects and enhancing steps that add value. The improvements in such a system stem from pharmacists, physicians, technicians, nurses, risk managers, clerks, and information technology specialists who play a part in the administration of every medication. One example of this streamlining process is how the hospital manages drug stocks. Elkhart was using carts that were filled once every 24 hours. Orders that had to be given between fills were walked from the pharmacy to the floor. IV medications were stored in a separate location and refrigerated medications in another location. In order to make this process more efficient, the hospital went cartless using Omnicell cabinets. Creating a one-stop medication flow also meant changing IV fill routines. Mixing IVs a day ahead meant that patients were only using 53 percent of IVs. The rest were wasted because the order had been changed or the patient discharged. Pharmacy went to a two-hour fill system.

Hand hygiene is the most effective way to curb Hospital-Acquired Infections (HAIs), according to the U.S. Centers for Disease Control and Prevention (CDC). More than 30 states have implemented standards encouraging hospitals to improve hand hygiene practices. According to a recent IRB-approved clinical trial study published in The Journal of Hospital Infection by Virginia Commonwealth University Medical Center, the use of BioVigil technology can improve the use of hand sanitizer among healthcare workers. The system electronically monitors the use of alcohol-based hand sanitizer when medical staff enter or exit a patient's room, with a badge that lights up red or green so hygiene can be tracked. Data is then complied statistically in a real-time database to ensure accurate reporting. The baseline for hand-washing compliance was 73 percent, but upon the first day implementing BioVigil, compliance skyrocketed to 93 percent. Moreover, more than 50 percent of nurses in the trial exceeded 95 percent compliance.

Nine national pharmacy organizations have launched the Pharmacy e-Health Information Technology Collaborative. The collaborative is designed to develop a unified approach to pharmaceutical information into electronic health records. Organizations participating in the new initiative include the Accreditation Council for Pharmacy Education, the American Association of Colleges of Pharmacy, the American College of Clinical Pharmacy, the American Society of Consultant Pharmacists, and the American Society of Health-System Pharmacists.

The Veterans Affairs (VA) Department's pharmacy re-engineering project has been divided into several smaller initiatives in order to bring it back on track. The project is designed to modernize the way VA pharmacists perform medication ordering and dosage control and is expected to reduce drug dosing errors. At this time, the project is being piloted at a VA hospital in South Carolina and will expand to four more hospitals soon.

The Diabetes Prevention and Control Alliance's purpose is to help people who are at risk for getting diabetes and improve the outlook of people who already have the disease. Novo Nordisk is joining the alliance, which also includes the Centers for Disease Control and Prevention and pharmacists. A spokesman for UnitedHealth, which formed the alliance last spring, explained that pharmacists work with physicians to ensure that diabetes patients keep up with their treatments and that they have the necessary tests performed. He added that representatives of the Danish drugmaker will work with physicians that have been identified as having large number of people with diabetes or pre-diabetes.

The National Foundation for Infectious Diseases (NFID) convened on October 7 many leading U.S. medical and public health groups to call on all Americans to receive vaccinations for seasonal influenza this year. The Centers for Disease Control and Prevention (CDC) has issued a new universal influenza vaccination recommendation for all Americans over six months of age, and the vaccine supply is estimated to surpass 150 million doses this season, with a greater number of locations for receiving them. "The best way to protect yourself and your family from the flu is to get vaccinated each and every year," said CDC director Dr. Thomas Frieden. He said, "Today no one needs to ask, 'Should I get the vaccine?' The answer for everyone is 'yes.'" Frieden and other U.S. public health officials and leading medical experts gathered at a news conference sponsored by NFID and held in collaboration with the CDC, American Medical Association, American Academy of Pediatrics, American College of Obstetricians and Gynecologists, American Pharmacists Association, AARP, Indian Health Services, National Medical Association, and National Influenza Vaccine Summit. Frieden also said that any Americans who are recommended for pneumococcal vaccination but have not yet received it should receive that vaccine at the same time as the influenza vaccine, as pneumococcal disease is one of the most common and deadly complications of influenza. A new NFID survey indicates that 95 percent of U.S. physicians will be vaccinated against influenza this season. The survey also found that 96 percent of doctors recommend influenza vaccination to their family and friends, and 92 percent recommend it for their patients. An NFID consumer survey found that physician advice can be a strong influence on patient behavior. Of those who already received the influenza vaccine or who plan to do so this season, 76 percent say they received a recommendation from a healthcare provider, while only 35 percent of those who do not plan to receive a vaccination report receiving a healthcare provider recommendation.

In order to ensure doctoral-level trained pharmacists are used to the best of their potential, healthcare observers say hospitals should ensure pharmacists are given the time to counsel patients about complex polypharmacy regimens and spearhead interventions to eliminate medication errors. Joseph B. Gugielmo argues that many hospitals have already achieved this goal, reducing mortality and readmission rates through the use of clinical pharmacy services such as pharmacist-provided anticoagulation treatment; pharmacist patient rounding; and pharmacist-provided drug protocol management. Research suggests that these types of pharmacist interventions may also be useful in outpatient clinical settings. For example, studies have shown that pharmacist-physician collaborative treatment is associated with improved blood pressure reduction, cholesterol control, and healthcare expenditures.

Insurers are attempting to boost medication adherence among patients and lower healthcare costs through incentive programs. Aetna is financing a number of pilot projects that test how rewarding patients for prescription compliance, giving drugs for free, and other creative incentives can enhance adherence, according to Edmund Pezalla, MD, with Aetna Pharmacy Management. With partial funding from Aetna, University of Pennsylvania researchers recently established a daily lottery with potential financial rewards for patients who had been prescribed warfarin. Patients had a one-in-five chance of winning $10 or a one-in-100 chance of winning $100 each day they remembered to take the drug. Professor Stephen Kimmel, MD, says the primary goal of the program was to engage patients and boost their motivation, and it appears to have worked. Patients began taking their medication more frequently and reported being more motivated in taking it on a daily basis. "The question is, how low an incentive is still an incentive?" notes Pezalla. "That's an important thing for the researchers to help us find out. What are the appropriate levels of incentives? What are the appropriate intervals?" Other strategies to spur medication adherence are being tested by Aetna, including improved communication from physicians and patient education, regular counseling from pharmacists, and the improvement of discharge processes and utilization of case managers by hospitals.