Pharmacy News

Entries for January 2019

Regional Society Update: Capital Area Pharmacists Association
By Cathy Edick, PharmD, CDE, pharmacy program coordinator, McLaren Greater Lansing, Lansing

The Capital Area Pharmacists Association (CAPA) schedules five continuing education (CE) programs each year. Our first 2019 CE event is "Direct Oral Anticoagulants in Atrial Fibrillation" and will be given by Heather Schalk on Jan. 24. The four remaining 2019 CE program dates/topics are tentatively planned for:
  • Wednesday, March 20: Pain
  • Monday, May 6: Antibiotics
  • Tuesday, Oct. 15: Wits & Wagers
  • Thursday, Dec. 5: Law Update
Every year in October during Michigan Pharmacists Week, CAPA tries to make the public more aware of what pharmacists do. In 2018, CAPA decided to try a different community outreach location instead of the Lansing City Market. We still had the "Know Your Pharmacist, Know Your Medicine" banner hung over two busy Lansing area intersections, but instead of the Lansing City Market, we partnered with the YMCA. During the months of October and November, two CAPA members went with their pharmacy students to two different YMCAs (Oak Park and Westside) to take blood pressures and perform medication counseling. Given their busyness while at the YMCA, the pharmacists both said it was a great outreach event and worth doing again.

Also in October we held a CE medication safety Wits & Wagers game show which was very well received, having multiple participants saying at the end, "Do this again. It was fun". This game show will return again this fall with a different topic. In addition to the CE, we also honored our 2018 CAPA $500 scholarship winners: Patricia Whiting and Nick Miehlke, both students at Ferris State University. Patricia is a P3 who has served on the executive board of APhA-ASP and is also involved in SMPA and Phi Lambda Sigma. Nick is currently a P1 who has been a member of the Ferris State Honors College for three years and has participated in several FSU volunteer events, including CAPA Advent House events.

On Nov. 15 CAPA again partnered with Blaze Pizza in the Frandor Plaza to help raise money for their scholarship fund. Although this most recent event was not as successful as expected due to poor winter weather, we have another Blaze fundraiser tentatively scheduled for May 9.

Dec. 29 was the lastfifth Saturday of 2018 where CAPA members served the evening meal at the Advent House in Lansing. On average 80-100 people are usually there to enjoy the meal and there are four more opportunities to serve or coordinate the meal in 2019. It is so much fun to work with other CAPA members to help prepare the meal in the kitchen or serve the meal to the community. Mark your calendar for the Advent House dates in 2019 if you would like to help organize or serve the meal and watch for the email reminders:
          March 30          June 29                 Aug 31              Nov 30
 
Poison Prevention week (March 17 through March 24) is the next up and coming community outreach event where CAPA will be looking for volunteers. An event is tentatively planned for either Saturday, March 16 or Saturday, March 23 at the Impression 5 Museum in Lansing.
Posted in: Member News
Interesting Residency Programs at Michigan Medicine
By Jola Mehmeti, Pharm.D., MBA; Megan O'Connell, Pharm.D., and Katherine H. Cho, Pharm.D., Michigan Medicine, Ann Arbor

PGY1/PGY2 Investigational Drugs & Research Pharmacy Residency
The Michigan Medicine PGY-1/2 Investigational Drugs & Research Pharmacy Residency is an ASHP accreditation candidate currently in its first year. This two-year specialty residency training program is designed to provide the resident with a wide array of experiences in clinical drug research while affording opportunities for collaboration with renowned clinicians and world-class experts in research, education and population health. The program is designed to provide a strong clinical foundation while developing analytical, leadership, teaching and writing skills. It will also provide experiences in clinical trial research. The first year is aligned with the Michigan Medicine PGY1 program, with elective and longitudinal experiences in research-related areas.
 
The PGY2 year provides specialized experiences in clinical research. Upon completion of the program, the resident will be prepared to secure a specialized pharmacist position in a variety of clinical research, regulatory and drug development settings, including pharmaceutical industry, academia and IDS practice.
 
PGY2 Psychiatric Pharmacy Residency
The PGY-2 Psychiatric Pharmacy Residency is currently in its second year and is a one-year post-graduate training program designed to develop essential knowledge and skills for contemporary health-system pharmacy practice at a major academic medical center, community-based hospital or other mental health facility (e.g. VA, state hospital, community mental health center.) Residents in the program work closely with a multidisciplinary team to provide optimal patient care in addition to providing provider, student, and patient education and answering clinical questions. Training is provided through concentrated clinical rotations and longitudinal experiences.
 
Upon completion of this residency program, residents are prepared for psychiatry specialty and are qualified to practice in a variety of mental health environments including, but not limited to: inpatient psychiatry (acute, general adult, dual diagnosis, geriatric, child/adolescent), emergency psychiatry, consult liaison psychiatry and outpatient clinics. As part of the extensive training they will receive as residents, they will also be able to identify, prevent, and resolve medication-related problems, participate as active members of a multidisciplinary healthcare team, demonstrate leadership skills and provide education to various healthcare providers.
 
PGY2 Ambulatory Care Pharmacy Residency and Fellowship in Nephrology
Michigan Medicine's PGY-2 Ambulatory Care Pharmacy Residency/Fellowship in Nephrology is currently in its first year. This program provides an initial PGY-2 Ambulatory Care residency year of intense experiences in ambulatory practice settings followed by a fellowship year with a strong focus in clinical research. Residents spend time managing patients with chronic conditions in collaborative practice settings and collaborating with other healthcare providers in a multidisciplinary nephrology clinic and outpatient dialysis centers to provide comprehensive care. A fellowship year will emphasize clinical research skills through the development and implementation of a robust research study, as well as scientific writing.
 
Pharmacists who complete this program will have the clinical expertise and research skills to obtain positions in academia. As pharmacy education evolves, there is a growing need for meaningful clinical research and alumni of this program can draw on their experiences to improve patient outcomes and advance pharmacy practice.
Posted in: Member News
MSHP Member Benefits - Are You Taking Advantage of Every Opportunity?
By Mike Wolf, director of membership, Michigan Pharmacists Association, Lansing
 
As a member of the Michigan Society of Health System Pharmacists (MSHP), are you aware of all the benefits available to you? Not only do you receive exclusive benefits for being an MSHP member but you receive all the membership benefits of the Michigan Pharmacists Association (MPA) as well. You have access to educational programs like the MSHP Annual Meeting held in the fall each year designed specifically to address health-system related issues, as well as MPA conferences like the MPA Annual Convention & Exposition occurring Feb. 22-24 in Detroit. You receive complimentary subscriptions to the monthly MSHP Monitor written by health-system practitioners on topics ranging from transition of care to information technology as well as the MPA quarterly journal and bimonthly e-News to keep you up-to-date on industry news. You have access to practice-related resources like the Ambulatory Toolkit, Michigan PGY1 Pharmacy Residency Program Site and Outcome Data or emergency preparedness tips-all easily found on the MSHP webpages found at www.MichiganPharmacists.org.
 
Some of the other great benefits you receive by joining the only state-based pharmacists association in Michigan include:
  • Member-only access to our expert staff who can assist you with practice-related questions or refer you to additional resources to help you find answers to your questions
  • Access to members-only content hosted on our website including the latest legislative and regulatory news
  • Representation and action at the state and federal level to promote pharmacy-friendly legislation through Michigan Pharmacy PAC and MPA's Pharmacy Advocacy Response Team (PART)
  • Professional discounts on educational programs, references and events
  • Group rates on insurance with PSI Insurance Agency, the only agency in Michigan owned by a pharmacy association who specializes in providing you with the best coverage to meet your needs
  • Financial planning resources through Washington Avenue Advisors who have years of experience working with pharmacy professionals
  • Personal discounts on car rentals, student loan consolidation, personal attire at JoS. A. Bank and so much more!
To find out more about these great member benefits, and learn what it means to be part of the strongest state pharmacy association in the nation, visit www.MichiganPharmacists.org/MemberBenefits.
Posted in: Member News
Innovating the Integration of Pharmacy Trainees Into Practice: The Beaumont Hospital, Dearborn Experience
By Insaf Mohammad, Pharm.D., BCACP, clinical assistant professor, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit and ambulatory care pharmacist specialist, Beaumont Hospital, Dearborn, and Sean McConachie, Pharm.D., BCPS, clinical assistant professor, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit and Beaumont Hospital, Dearborn

Embracing Interprofessional Education via Shared Diabetic Medical Appointments
Pharmacists and pharmacy trainees have integrated themselves into the interprofessional team in a multitude of practice settings, demonstrating their value in a variety of capacities. In the Beaumont Hospital, Dearborn Schaefer Internal Medicine Clinic, pharmacy and medical trainees provide care to uncontrolled diabetic patients via shared medical appointments with designated roles and responsibilities. This clinic serves as the outpatient training site for both pharmacy trainees and medical residents. Therefore, trainees benefit significantly by embracing the true essence of interprofessional education (IPE). The Center for the Advancement of Interprofessional Education (CAIPE) defines IPE as the involvement of educators and learners from two or more health professionals who create and foster a collaborative learning environment.1
 
In the Beaumont Schaefer Internal Medicine Clinic, pharmacy trainees (either the first year pharmacy resident or the fourth year Wayne State University pharmacy student) and the medical resident conduct the visit for uncontrolled diabetic patients together, addressing different components of the patient interview. Then, the trainees present the patient case, including their assessment and plan, with myself (the ambulatory care pharmacist specialist/preceptor) and the medical faculty in clinic. The plan is then discussed and agreed upon as a team. This discussion allows for teachable moments, and the trainees are given the opportunity to discuss the rationale for the plan they have created together. This is contrary to models where the pharmacy trainee and medical resident conduct their visits independently, which may not facilitate trainees' learning and providing care with one another. Indeed, this type of model has fostered a collaborative environment where the trainees are able to learn, while providing exceptional care delivered by the interprofessional team.
 
Student Pharmacist Involvement in Transitions of Care
The pharmacy profession has demonstrated its potential to improve economic and clinical outcomes in transitions of care (TOC) by improving the accuracy of medication reconciliation (MR), providing medication counseling, and reducing 30-day hospital readmissions.2 Although the benefits of pharmacy are well-described, one commonly cited issue with pharmacy-led TOC services is the difficulty in scaling the processes hospital-wide.3  One time and motion analysis found that 46 to 92 minutes were required per medication reconciliation.4 Thus, for a hospital with 23,500 annual admissions, 11 full-time pharmacy faculty would be required for MR alone.3 To expand services, some institutions have turned to pharmacy technicians and pharmacy students to lead medication reconciliation efforts.5
 
At Beaumont Hospital, Dearborn, the TOC pharmacist specialist has incorporated five Introductory Pharmacy Practice Education students from Wayne State University and the University of Michigan into the MR process. Every day one to two students are given high-risk patients to interview for a best practice MR. This semester, the students are on track to interview more than 80 patients and have identified, on average, more than four medication errors per patient interaction. The students are involved with allergy clarification and identification of social issues such as lack of insurance coverage, transportation problems, and low medication adherence. They also collect clinical data which will be used to identify clinical and social variables that are most highly associated with medication errors to create a more targeted MR program. Student and preceptor feedback have been positive regarding the process from both process and educational standpoints.
 
References

1.Buring SM, Bhushan A, Broeseker A, et al. Interprofessional education: definitions, student competencies, and guidelines for implementation. Am J Pharm Educ 2009; 73(4): 59.

2.Mekonnen AB, McLachlan AJ, Brien JE. Effectiveness of pharmacist-led medication reconciliation programmes on clinical outcomes at hospital transitions: a systematic review and meta-analysis. BMJ Open 2016; 6: 1-14.

3.Pevnick JM, Shane R, Schnipper, JL. The problem with medication reconciliation. BMJ Qual Saf 2016; 25(9): 726-730.

4.Meguerditchian AN, Krotneva S, Reidel K, Huang A, Tamblyn R. Medication reconciliation at admission and discharge: a time and motion study. BMC health Services Research 2013; 13(485): 1-11.

5.Gortney JS, Moser LR, Patel P, Raub JN. Clinical outcomes of student pharmacist-driven medication histories at an academic medical center. J Pharm Pract 2018; XX(X): 1-8.

Posted in: Member News
Implementing a Pharmacist into an Existing Ambulatory Care Clinic
By Thomas Breeden, Pharm.D., clinical pharmacist, Ascension Genesys, Genesys Heart Institute, Grand Blanc

Approximately one year ago I had the opportunity to implement myself into an established heart failure clinic. This was an opportunity I was very excited about, as I have always enjoyed being part of an interdisciplinary team as well as interacting directly with patients. This opportunity, however, did not come without hurdles since I would need to establish myself within a clinic that had operated without a pharmacist up to that point. I had no clear guideline on to how to do this, nor did I know exactly what my role would look like. Now one year later, I can say the implementation has been a success and I want to take the opportunity to give a brief overview of my personal implementation. 
 
Upon my arrival to the clinic I had my ideas of how I felt I could integrate myself, but I wanted to see how the mid-level providers I would be working with foresaw my role in the clinic. Fortunately for me they did not have anything too specific in mind, but were excited to have me. This left me with the opportunity to define my own role.
 
Initially I observed the clinic's process of seeing patients. In doing so, I concluded I would be most effective if I could see the patient after the medical assistants work-up and prior to the provider. This allowed me to give my assessment of the patient's status as well as ideas for medication optimization prior to the provider seeing the patient. It also allowed me to address any medication questions from the patient, thus freeing up the provider's time to address other concerns and perform a thorough physical exam. As needed, I am also available to revisit the patient to discuss medication changes and provide an updated medication list.
 
Once I established where in the process I was going to fit, I had to connect with the patients and let them know why they are seeing a pharmacist and how I can make an impact on their care. I usually address this with first time patients by letting them know that I am there first and foremost to act as their advocate by answering questions about any of their medications; what they do, why we want them to use it, or even addressing concerns about side effects. I also inform them that I am there to help them overcome any barriers that inhibit proper medication use such as cost, obtaining medications, or even just taking the drugs as prescribed. Finally, I let them know I am there to get to know them personally so I can make the best medication recommendations to optimize their care and avoid things like drug-drug and drug-disease state interactions.
 
After defining my role in the heart failure clinic it was important to make myself known to the rest of the office, as this was a general cardiology office with many other providers and patients outside of those I was seeing. I made sure to introduce myself to the other providers, nurses, and even the medical assistants, letting them know I was available if needed and would be happy to talk to any of their patients or help them with medication related issues. This has been fruitful, as I have been utilized for quite a wide range of tasks including leading drug class topic discussions with the nursing and MA staff.
 
Lastly, I became involved with the ambulatory care committee within MSHP. I was able to meet pharmacists who are well established in ambulatory care and discuss topics such as what kind of interventions they were making, what a standard visit looks like at their clinic, how they were tracking their successes, documentation, and so forth. This committee also brought to my attention the ambulatory care tool kit, a great resource available to all members that is a reference for any pharmacist established in or looking to become established in an ambulatory care setting.
 
This is a very brief overview; please feel free to email me at Thomas.Breeden@ascension.org if you find yourself trying to get started in the growing area of ambulatory care pharmacy.
 
P.S. with flu season ramping up I have found the clinic to be a perfect opportunity for screening and discussing vaccinations with patients. We are also screening for other vaccination needs and have paired with our outpatient pharmacy to deliver them onsite.
Posted in: Member News
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