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.

North Chapter

October 29, 2010
Medical Safety Symposium
Location:St. Joseph’s Wayne Hospital
224 Hamburg Turnpike
Wayne, NJ
Time:7:00 a.m. – 5:00 p.m.
Speakers:Panel of Presenters
RSVP: Required by October 22nd, 2010 to: http://www.surveymonkey.com/s/medsafety

North Central Chapter

October 27, 2010
Update on Management of COPD
Location: Saint Barnabas Medical Center
Livingston, NJ
Time: TBA
Speaker: Deepali Dixit, PharmD, BCPS
Clinical Care Pharmacist
Saint Michael’s Medical Center
Newark, NJ
RSVP:TBA

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

October 13, 2010
Safe Medication Use in the Elderly: Key Concepts to Prevent Inappropriate Use in the Elderly
Location:Ram’s Head
9 West White Horse Pike
Galloway, NJ
Time:5:30 p.m. – 9:00 p.m.
Speaker:Edward Dix, Pharm.D.
Assistant Director of Pharmacy
Underwood Memorial Hospital
Woodbury, NJ
RSVP:Required by October 8, 2010 to: njshpsouth@hotmail.com or 856-266-4302

November 9, 2010
Topic:TBA
Location:TBA
Time:TBA
Speaker:Indu Lew, Pharm.D.
Vice President Corporate Pharmacy
Education and Research
Saint Barnabas Health Care System
South Plainfield, NJ
RSVP:TBA

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

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

Celebrate your hard work and dedication in your pharmacy career! Share your accomplishments with NJSHP! Our monthly Newsbriefs is an excellent opportunity to provide education and information about your contributions to the practice of pharmacy. Your story can be an inspiration to others! So don’t be shy. To submit your contribution, please contact Stella Williams at 609-936-2205 or email at swilliam@njha.com. We’d love to hear from you!

New Study Reveals that Pharmacists Help Reduce Adverse Drug Events and Improve Outcomes for Patients with Chronic Diseases

8/30/2010
Incorporating pharmacists as members of the health care team in direct patient care roles is a viable solution to help improve U.S. health care, according to the results of a comprehensive, systematic review of the health care literature set to be published in the October 2010 edition of Medical Care. The study has been published prior to print and is available online.

The article, "US Pharmacists' Effect as Team Members on Patient Care: Systematic Review and Meta-Analyses," examines the effect of pharmacist-provided direct patient care on therapeutic, safety, and humanistic outcomes. Researchers, led by Marie A. Chisholm-Burns, Pharm.D., M.P.H., FASHP, found that involving pharmacists in direct patient care activities has favorable effects, including reducing adverse drug events and improving outcomes for patients with chronic diseases.

The research was funded by the American Society of Health-System Pharmacists (ASHP) and the ASHP Research and Education Foundation. Chisholm-Burns is a professor and department head at the University of Arizona College of Pharmacy in Tucson.

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New Edition of Manual for Pharmacy Technicians Available Now

9/13/2010
The role of pharmacy technicians is rapidly expanding, and demand for well-trained technicians continues to grow. The American Society of Health-System Pharmacists (ASHP) has released a new edition of its best-selling training resource, Manual for Pharmacy Technicians, 4th Edition, by Bonnie S. Bachenheimer, Pharm.D., which helps pharmacy technicians master the practical skills and gain the foundational knowledge they need to be successful.

"Pharmacy technicians are assuming more responsibilities and are taking on greater leadership roles," said Bachenheimer. "Quality training material is increasingly important for new technicians entering the field, and current technicians looking to advance."

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Cheryl A. Thompson
BETHESDA, MD 13 September 2010—The contrast agents gadodiamide, gadopentetate dimeglumine, and gadoversetamide must not be given to patients with acute kidney injury or chronic, severe kidney disease, FDA announced last week.

Patients with either condition, the agency said, are at the greatest risk for nephrogenic systemic fibrosis, which is associated with the use of gadolinium-based contrast agents.

The labeling for gadoversetamide already declares as contraindications acute or chronic severe renal insufficiency—defined as a glomerular filtration rate of <30 mL/min/1.73m2—and acute renal insufficiency of any severity due to the hepatorenal syndrome or in the perioperative liver transplantation period. Covidien added those contraindications in November 2009, a month before FDA convened a meeting of advisers to discuss the safety of agency-approved gadolinium-based contrast agents.

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The College of Notre Dame of Maryland School of Pharmacy has been awarded candidate accreditation status from the Accreditation Council for Pharmacy Education (ACPE). The college recently welcomed its second incoming class of students pursuing doctoral studies in pharmacy. The classification marks ACPE's expectation that Notre Dame's program will become fully accredited as it develops in accord with stated plans and within a defined time period (generally by the time the first class has graduated). Graduates of a class designated as having Candidate status have the same rights and privileges as graduates of an accredited program. The School of Pharmacy, the first on the campus of a women's college in the country, welcomed its first class in fall 2009. Nearly 500 applications were received for the 70 seats, with students coming from 15 states. The number of applications for the fall 2010 class nearly doubled, with 966 received for the 70 seats in the second class. The School of Pharmacy is a four-year, first professional degree program (doctor of pharmacy) consisting of 148 credit hours of study. The program's fourth year is dedicated to a prescribed set of courses delivered in actual practice settings. There are five focus areas used as the basis for the School's curriculum: leadership development; women's health across the lifespan; public health; the care of diverse populations; and professionalism.

The FDA has issued its latest quarterly report regarding potential safety issues identified based on its Adverse Event Reporting System (AERS). Medications listed in the latest report include clindamycin injection (Cleocin), which may pose a medication error risk; dronedarone hydrochloride (Multaq), which may be associated with Torsade de Pointes; and etonogestrel implant (Implanon), which may increase a patient's risk of convulsions. Tapentadol hydrochloride (Nucynta) was also listed as having a risk of convulsions, hallucinations and serotonin syndrome. Additionally, the FDA named omeprazole products saying there is a risk the drugs could cause hypomagnesemia; everolimus, which may cause Hepatitis B reactivation; and febuxostat (Uloric), which may carry an increased risk of hypersenstivity. Other identified alerts include ferumoxytol injection (Feraheme) for serious cardiac disorders; tetracycline products for Stevens Johnson Syndrome, Toxic Epidermal Necrolysis, and Erythema Multiforme; trastuzumab (Herceptin) for neonatal pulmonary hypoplasia; and lanthanum carbonate (Fosrenol) for intestinal obstruction.

A recent Pennsylvania law, known as Act 29, will permit the development of collaborative practice agreements between physicians and pharmacists. While some medical organizations in the state already have informal collaborative agreements with pharmacists,the new law gives pharmacists more latitude to help improve patient care. The law not only allows these agreements, it also permits a pharmacist to be employed on staff at private practices. Thus far, collaborative practice agreements in the state have allowed pharmacists to visit institutions to collaborate with physicians but not to serve as paid staff members of a physician's practice. The law is expected to take effect within the next two years because of the state's complex legislation process. However, if that term expires, pharmacists will still be permitted to enter into such agreements.

The FDA has reversed its recent decision to withdraw midodrine (ProAmatine) from the market. The agency says that it will continue to make midodrine available to the approximately 100,000 patients who use the drug as it works to resolve legal concerns over the need for further postmarketing studies. FDA representative Sandy Walsh reports that the law still requires those studies to be conducted, and the agency will "continue with that formal process" while still allowing access to midodrine. She also indicated that the reversal of the decision had come as a result of lobbying from patients and physicians. The drug's manufacturer, Shire Pharmaceuticals, had originally agreed with the FDA's decision to withdraw midodrine, arguing that the product was not profitable enough to warrant the additional postmarketing studies. However, the company also appears to have changed its decision and intends to formally appeal the FDA withdrawal request.

A recent study conducted by Tennessee researchers concluded that medication reconciliation accuracy in an ambulatory internal medicine setting. They also found that, although education interventions showed a trend toward improvement, continued education training for staff and patients is needed in addition to other interventions to optimize this process and prevent medication errors. The study included 180 patients attending an internal medicine appointment. On each patient's arrival, a nurse completed the medication reconciliation form. In Phase 1 of the study, a pharmacist randomly selected and reviewed a patient's medication reconciliation form, interviewed the patient, and verified information if indicated. A total of 90 forms were reviewed and compared to determine baseline medication reconciliation accuracy. Education interventions were held with the medical and nursing staff, targeting areas for improvement. In Phase 2 of the study, 90 additional medication reconciliation forms were reviewed in the same manner. Phase 1 and Phase 2 results were compared to evaluate differences in accuracy after the pharmacist's education interventions. In Phase 1, 14.4 percent of medication reconciliation forms were correct. The remaining forms contained 190 potentially significant errors. After the education interventions, 18.9 percent of medication reconciliation forms were correct and the others contained 139 potentially significant errors.

A multidisciplinary team at the Hospital of the University of Pennsylvania was recently able to reduce the facility's 30-day readmission rate on a high-turnover general medicine unit from 13.6 percent to 10.8 percent. The reduction was produced as part of the multi-hospital initiative- Project BOOST (Better Outcomes for Older Adults through Safe Transitions). Richard F. Demers, RPh, MS, FASHP, director of pharmacy services at the Hospital of the University of Pennsylvania (UPenn), in Philadelphia points out that these programs are so important because, “Some authors have estimated that the percentage of [patient rehospitalizations] can be upward of 20 percent and the range can double that when you get to a 90-day period after [discharge]." Mr. Demers was part of a UPenn hospital pharmacy team that presented the results of the BOOST program at the American Society of Health-System Pharmacists’ Summer Meeting. Other studies also have shown that improving discharge instructions to patients and following up afterward can pay off in fewer trips to the emergency department and rehospitalizations. Janelle Ocampo, PharmD, BCPS, pharmacy practice specialist at the UPenn hospital, cited a 2009 Boston Medical Center effort that resulted in 30 percent fewer readmissions and emergency room visits among patients who received detailed predischarge instructions from a nurse and medication follow-up calls from a pharmacist, compared with a group that did not receive similar services. For the purposes of the UPenn program, pharmacists worked as drug therapy advisers to patients and medical and nursing staffs. With limited time to perform medication reconciliation and counseling for all discharges, Dr. Ocampo said, pharmacists used BOOST’s “7P” screening tool, which lists seven high-risk factors including problem medications (anticoagulants, antiplatelets, digoxin, insulin and narcotics), polypharmacy and principal diagnoses of stroke, chronic obstructive pulmonary disease, diabetes, heart failure or cancer. Patients with depression or poor health literacy and lack of home support also are considered at high risk. Dr. Ocampo said pharmacists added antibiotics to the problem medications. As Dr. Ocampo says, “Our pharmacists attend daily medical rounds in order to optimize inpatient medication regimens. We serve as a drug information resource for everyone on the floor, including patients, nurses and physicians. We perform discharge medication reconciliation and we provide discharge medication counseling for high-risk patients.”

The FDA is requiring changes in the drug label for gadolinium-based contrast agents (GBCAs) to minimize the risk of nephrogenic systemic fibrosis (NSF). These label changes are intended to help ensure these drugs are used appropriately, and that patients at risk for NSF who receive GBCAs are actively monitored for the development of NSF. Labeling changes include contraindications against the use of GBCA drugs in patients with AKI or with chronic kidney disease as well as recommendations that patients be screened for AKI or chronic kidney disease before administration of GBCA medications. Additionally, the labeling asks that patients be monitored for symptoms of NSF after administration of a GBCA and advises against repeat administration of any GBCA during a single imaging session.

Researchers at the University of Illinois at Chicago polled pharmacy directors at 102 acute-care hospitals regarding their strategies to detect and treat methicillin-resistant Staphylococcus aureus (MRSA). Patients were screened for MRSA at 43 percent of the hospitals surveyed, and a majority have hand-hygiene rules in place. Some hospitals also use gowns and gloves and isolate MRSA-positive patients as part of their prevention strategies. The study, published in the American Journal of Health-System Pharmacist, also found that almost three-quarters of the hospitals review antimicrobial prescription orders and restrict the use of antimicrobials. According to Yoojung Jan, Center for Pharmacoeconomic Research fellow and the study's lead researcher, "The results of our survey suggest that pharmacists play a key role in the treatment of MRSA infections, because they have the knowledge of how best antimicrobials can be used."

With studies showing the average woman takes from three to five medications while pregnant, the FDA recommends that pharmaceutical manufacturers and pregnant women participate in pregnancy registry studies that track the risks that may be associated with medications taken during pregnancy or breastfeeding. Such registries collect data regarding the use of already approved medications in pregnant women and compare the adverse events found in these groups to the effects found in women who are not pregnant. The recommendations in favor of such registries follow a May 2008 proposed rule that includes putting information learned from registries—as well as contact information for registries—on labeling for health professionals.

Individuals with pre-existing cardiovascular conditions who are given long-term sibutramine (Meridia) treatment have an increased risk for nonfatal myocardial infarction and nonfatal stroke, but not cardiovascular death or all-cause mortality, researchers say. The study population consisted of 10,744 overweight or obese subjects 55 years or older. During a six-week, single-blind, lead-in period, all participants received sibutramine and took part in a weight management program. Subsequently, 9,804 subjects were randomly assigned to receive sibutramine or a placebo, with mean treatment duration of 3.4 years. During the lead-in period, mean weight loss was 2.6 kg. After randomization, participants receiving sibutramine achieved and maintained an additional weight reduction of 1.7 kg. Although both groups had a decline in mean blood pressure, the placebo group had greater reductions than the sibutramine group. For the sibutramine group, the risk for a primary outcome event was 11.4 percent compared to 10.0 percent in the placebo group. Nonfatal myocardial infarction occurred in 4.1 percent of the sibutramine group and in 3.2 percent of the placebo group. For nonfatal stroke, rates were 2.6 percent and 1.9 percent, respectively. Rates of cardiovascular death and all-cause mortality were not increased, the researchers note.