85 posts categorized "Pharmacy Practice"

04/07/2014

Pharmacy Students, Leaders Unite for Pharmacy Legislative Day at Capitol

PCPMore than a dozen student pharmacists from University of the Sciences' Philadelphia College of Pharmacy gathered at the Pennslyvania Capitol for the Pennsylvania Pharmacists Association's (PPA) Pharmacy Legislative Day on Wednesday, April 2.

The students and their faculty advisors helped to “paint” the Capitol white, wearing their identifying lab coats and pushing the importance of “Pharmacists: We Make a Difference!” More than 250 pharmacy students from seven schools of pharmacy across the Commonwealth, as well as more than 80 pharmacists, walked the halls of the Capitol, participated in the Pharmacy Rally, and made legislative visits.

Pharmacy Legislative Day attendees met with a significant number of legislators or their staff and delivered packets of information to any legislative offices for which visits were not able to be scheduled.  The visits covered important issues of the profession focusing on pharmacy benefit managers' regulation and transparency, fair pharmacy audits, and expanded immunization opportunities. This valuable opportunity for PPA members to have their voices heard - and to stress the importance of issues facing pharmacy today - was an important and crucial step in educating legislators about pharmacists and their concerns.

Each of the pharmacy schools had displays showcasing information on the value pharmacists provide and performed various health related screenings. Information on medication adherence, smoking cessation, immunization awareness, hypertension assessment, heart health, blood pressure and cardiovascular risk assessment, and blood glucose was displayed in the East Wing Rotunda throughout Pharmacy Legislative Day. Philadelphia College of Pharmacy’s table focused on medication adherence and taking medications appropriately. The PPA also arranged for group tours of the Capitol and some special legislative meetings for students.

USciences' pharmacy students who participated, include: Stephanie Yenner PharmD'14, Priya Patel PharmD'14, Monica Huon PharmD'14, Courtney Spina PharmD'15, Kevin Farrow PharmD'15, Matthew Garin PharmD'15, Breanna Kester PharmD'16, Fidelia Bernice PharmD'16, Colleen D'Amico PharmD'16, Kevin Pak PharmD'19, Justin George PharmD'19, and Antonella Frattarelli PharmD'15. Pharmacy professor Dr. Dan Hussar is also pictured here.

04/02/2014

Medication Adherence in the Elderly Population

Which population do you see most at your local pharmacy? It is the elderly population (ages >65), that are usually at the pharmacy trying to fill multiple prescriptions. There are many areas that the elderly population needs assistance with, in order to achieve optimal medication therapy and prolong life. Barriers such as polypharmacy, comorbidities, and growing disabilities can be analyzed to provide better treatment outcomes.

Barriers: The elderly population struggles with an increasing number of medications or polypharmacy as they age. Italian researchers concluded that number of drugs prescribed at hospital discharge and minimal comprehension about the purpose of each medication contributed to overall non-adherence. The average patient in the study had a total of 9 drugs to take on a regular basis. It is this pill burden that the elderly population needs help managing. Because of multiple medications, patients may feel overwhelmed and even stop taking their medication accurately according to schedule. Patients are taking multiple medications for hypertension, diabetes, cholesterol and other comorbidities.

Comorbidities, if not managed properly can lead to future complications and decrease patients’ life expectancy. Schuz and colleagues concluded that if older people with multiple illnesses are convinced that their medication serves their specific needs, the more likely they will stay adherent. Elderly patients may not see a purpose in taking so many medications and may even consider one disease state more important the other. Thus, it is important to explain the use of each medication in treating a specific illness.

Additionally, growing disabilities such as vision loss can contribute to a patient’s overall adherence. It is common for elderly patients to lose their eye sight as they age and therefore contribute to unwanted difficulties. Patients will have trouble reading medicine labels or treatment directions. With this inconvenience, patients may even ignore the direction on the prescription bottle and start taking the medication on their own terms. It is these arising issues with age that may result in poor adherence and unsuccessful disease management.

Hypertension: Most elderly patients are on antihypertensive agents to prevent future cardiac issues. Although patients may not see physical changes, it is important for them to be adherent for long term results. Multiple questionnaires showed that illness perception and beliefs about antihypertensive medications played a role in patients’ adherence. It was more likely that patients followed a drug regimen if they knew that the long-term health consequences of cardiac complications, stroke, and mortality can be decreased. Elderly patients tend to take antihypertensive medication if they know that it is purposeful and efficacious for their health.

Barriers such polypharmacy, comorbidities and other disabilities should be resolved so that the elderly can better manage their health. Pharmacists can work one-on-one with these patients so that they can provide better resources for these patients. Resources such as pill kits, large font instructions or even a counseling session can go a long way in assisting elderly patients. The pharmacy has a lot of valuable information that patients can use in order to improve their overall medication adherence.

Sheenu Joseph, PharmD '15

03/20/2014

All Grown Up - Medication Adherence in Adults

As individuals grow older, the more likely they are to depend on medications to manage a disease state or to even extend their life. Therefore, in order for a medication regimen to be successful in treating a patient, it is important to stress the value of medication adherence. The adult population (ages 19-64) takes many medications on a regular basis, either for acute or chronic diseases. To improve adherence in adults, barriers such as cost, health literacy, and pill burden should be addressed.

Barriers: Prescription medication can be very expensive and therefore may play a role in adult patients’ adherence levels, even if they are not in good health. Cost influence on the patient can be verified by questions such as whether patients got their prescriptions filled, used herbal medications rather than prescription medications, or even stretched out the time till next refill. During a study, it was seen that when there is a cost barrier to medication adherence, adults tend to have a low income status, no drug coverage, or have multiple disease states. Therefore, different programs can be used to assist patients in decreasing medication expenses and thus improve adherence.

Besides cost, health literacy is also a barrier that prevents adults from reaching optimal medication adherence. Most adults will have to manage certain illnesses for the rest of their lives and thus it is important for them to have the necessary disease knowledge. Presentation about the medication include the purpose, mechanism of action, and other drug benefits which may lead patients to have increased medication adherence because they are expecting better health outcomes.

Additionally, many adults have multiple diseases to manage, which results in difficulty to many medications rather than just one. It is during this age that adults are newly diagnosed with chronic diseases such as diabetes, asthma, and hypertension. Therefore issues such as pill burden can be problematic when there are comorbidities involved. Patients may feel overwhelmed if they have to take multiple medications for diabetes, then asthma and also manage another serious condition of HIV. Options of combination medication therapy should be considered to decrease pill burden.

Asthma: The disease of asthma requires abundant counseling in order for patients to receive optimal therapy and avoid complications. With many inhaler options for both rescue and maintenance therapy in avoiding asthma exacerbations, it can become real confusing for patients to manage. When asthma is not appropriately managed it can lead to increased hospital visits and unwanted health expenses. Recent studies have concluded that patients with increased knowledge, attitude and self-efficacy in managing asthma can improve adherence. This is a disease state that, if patients understand signs and symptoms of asthma and use personal skills in managing the complications, it will result in a better quality of life. It is important to review both disease state and therapy schedule with adult patients every time they receive an inhaler, so patients can be in charge of their own health.

Pharmacists are constantly dispensing medications to adults and thus they have the perfect opportunity to help adults overcome barriers such as cost, health literacy and pill burden. Adulthood is a time in life where patients have to take care of their own health, income, and knowledge. Although adults are independent, pharmacists can step in to provide cost effective solutions and information about managing chronic illnesses such as inhaler techniques for managing asthma exacerbations. Pharmacists can use their knowledge about medications, cost coverage and managing disease states, in order to help adults improve medication adherence.

Sheenu Joseph, PharmD '15

03/18/2014

WOLB Talk 1010 Highlights PCP's First Female Graduate

HayhurstIn observance of Women's History Month, Philadelphia College of Pharmacy alumna Susan Hayhurst was recognized as a "pioneer female pharmacist" on Baltimore's WOLB Talk 1010 on March 18.

After graduating from the Woman's Medical College of Philadelphia in 1857, Hayhurst served on the College's staff and ran its pharmaceutical department for many years. In 1883, at the age of 63, Hayhurst became the nation's first woman pharmacist, when she graduated from the Philadelphia College of Pharmacy.

Click here to listen to the segment.

Video: Pharmacy Experts Discuss Hotly Debated Painkiller Zohydro on NBC10

Dr. Andrew Peterson, Dean of Mayes College of Healthcare Business and Policy; and Dr. Dan Hussar, Remington Professor of Pharmacy, recently shared their expertise regarding the hotly debated painkiller, Zohydro, on Philadelphia's NBC10 @ Issue. The program aired on Sunday, March 16, and is attached below in two 5-minute clips:

At isssue

Part 1: NBC @ Issue
Part 2: NBC @ Issue (Profs featured here)

03/14/2014

Pharmacy, Health Policy Experts to be Featured on NBC10 @ Issue on Sunday

At issueThe U.S. Food and Drug Administration's approval of the potent opioid painkiller Zohydro ER has been met with fierce criticism, both locally and across the nation. Tune into Philadelphia's NBC10  @ Issue on Sunday, March 16, at 11:30 a.m., as University of the Sciences' pharmacy and health policy experts discuss this drug in further detail.

Andrew Peterson PharmD, PhD, Dean of Mayes College of Healthcare Business and Policy; and Dan Hussar, PhD, Remington Professor of Pharmacy, joined reporter Tracy Davidson for a discussion regarding the pros/cons of this drug, as well as its potential dangers and health implications.

NBC10 @ Issue is a weekly public affairs discussion program that takes an in-depth look at local, state and national issues and politics. Watch NBC10 @ Issue every Sunday at 11:30 a.m. on NBC10, or at 6:30 p.m., on NBC10.com

03/06/2014

Young Adults and Medication Adherence

There is little focus on the young adult population (ages 16 to 24) when trying to understand the relationship between age and medication adherence. It is important to categorize them separately from other age groups since they are at a distinctly different developmental point in their life compared to children and adults. There are many factors that influence medication adherence in adolescents. Exploring these factors, particularly the barriers, through a disease state such as human immunodeficiency virus (HIV), will allow us to appreciate the many challenges young adults face when taking medications.

Barriers:  Adolescent years are crucial years, behaviorally and developmentally, as it is when children gain independence and start to develop personal opinions. Matsui sheds light on the relationship between parent and adolescents and their involvement in medication adherence, by noting that there may be a chance for family conflict and rebellion. It may be a new concept for adolescents to be in charge of their own health and therefore they may stop taking medications or listening to their parents. Although young adults attain greater independence, these are the years that parents can assist adolescents manage their own health, in contrast to when they were children.  

Besides new gained independence, the lack of knowledge regarding medication therapy may also act as a barrier for young adults to take medications. Once young adults take charge of their own medications, they may worry about adverse events. In a review article, Matsui states that cosmetic changes such as acne and weight gain may prevent young adults from continuing therapy. An unfortunate event of adverse effects may prevent adolescents to better understand their disease state and find a solution to improve medication adherence.

Another barrier that author Huang mentions is that young adults tend to focus on what their peers may think and therefore cancel doctor visits and follow ups. This factor/barrier may influence adolescents to discard their therapies because of the fear being judged for having a specific disease state. Adolescents may not want their friends to know that they have a disease such as diabetes or asthma that needs to be managed with prescription medications.  A disease state that depends on adherence for improvement but adolescents counter many challenges is HIV.

HIV:  It is very important to address adherence issues in adolescents with HIV, because viral load is controlled when adolescents abide to an adequate therapy. A study conducted by MacDonell and colleagues, focuses on the influence of situational temptation and non adherence in young adults with HIV. They defined situational temptations as lack of support, needing a break from medications and not seeing a need for prescribed medications. The study results showed that family support or reminder and limited knowledge regarding purpose of HIV medication, were all significant factors that played a role in the young adults’ temptation to disrupt HIV medications. It was evident that adolescents who experienced optimal adherence had a lower number situational temptations showing that barriers do influence medication adherence.

As healthcare providers it is essential that pharmacists identify and help overcome the challenges that many adolescents face when managing medication therapies.  Pharmacists can recommend solutions such as getting parents involved to improve support and providing prescription information to increase the patient’s medical knowledge. Pharmacists also have the opportunity to help young adults navigate negative peer influence that may act as an obstacle to optimal adherence. Therefore, it is important for pharmacists to recognize and address adherence barriers unique to this population of patients.

Sheenu Joseph, PharmD '15

03/04/2014

Commendation for CVS!

By Dr. Daniel A. Hussar, the Remington Professor of Pharmacy at University of the Sciences' Philadelphia College of Pharmacy. He serves as the author and editor of The Pharmacist Activist newsletter (http://www.pharmacistactivist.com) from which this editorial was taken.

On February 5, CVS announced that it will stop selling cigarettes and other tobacco products at its more than 7,600 stores in the United States by October 1, 2014. CVS President and CEO Larry Merlo stated, “Ending the sale of cigarettes and tobacco products at CVS/pharmacy is the right thing for us to do for our customers and our company to help people on their path to better health…. Put simply, the sale of tobacco products is inconsistent with our purpose.”

Larry Merlo and CVS have made an excellent decision and are to be commended! They have provided important leadership for chain pharmacies in addressing the issue of selling tobacco products. Among those who are the most pleased by the decision are CVS’s own pharmacists.

Commendation for the Pharmacies that Never Sold or have Discontinued the Sale of Tobacco Products!

It is understandable that an organization as large as CVS would receive extensive media coverage of its decision to discontinue the sale of tobacco products. It is also important to recognize that thousands of other pharmacy owners have either never sold or have discontinued the sale of tobacco products. These individuals have provided a very positive example and leadership for the profession of pharmacy and their communities. Their decisions are to be commended!

The Tipping Point Should Become a Domino Effect!

The CVS decision will be the tipping point that will result in other chain pharmacies also making decisions to stop the sale of tobacco products. CVS, Walgreens, and Rite Aid are so competitive with each other that Walgreens and Rite Aid can’t be satisfied to be perceived as having less concern for the health of their customers than CVS has for its customers. I anticipate that Walgreens, Rite Aid, and other chain pharmacies will also make decisions to stop the sale of tobacco products, and that this will happen sooner rather than later. Indeed, my expectation is that Walgreens and Rite Aid will stop the sale of tobacco products by the end of 2014. I and others will be continuing to urge them to do this. However, these companies have already considered this action and their CEOs will have the wisdom to recognize the importance of making this decision on a timely basis. If CVS can make the decision to stop the sale of tobacco products, there is no valid reason for which Walgreens, Rite Aid, and other chain pharmacies can’t make the same decision!

What about the large retail organizations (i.e., “big box”/department stores, grocery stores) that have pharmacies that only occupy a small percentage of the space in their facilities and that account for a small percentage of their overall business? If they choose to have pharmacies in their facilities and derive the accompanying benefit of a positive reputation for improving the health of their customers, they must not sell products that are recognized to cause harmful/fatal consequences. Target does not sell tobacco products. If Target can make a decision to stop the sale of tobacco products, there is no valid reason for which Wal-Mart and other “big box”/department stores with pharmacies can’t make the same decision! Wegmans is a regional organization of grocery stores with pharmacies that does not sell tobacco products. If Wegmans can make a decision to stop the sale of tobacco products, there is no valid reason for which other grocery store organizations with pharmacies can’t make the same decision!
The blatant contradiction of selling tobacco products in pharmacies and facilities that include pharmacies has persisted far too long. There must be no more excuses! CVS’s decision has provided the tipping point. However, the momentum associated with a tipping point may vary in rate and intensity. A domino effect occurs very quickly. We have seen television stories or videos of long chains of hundreds or thousands of dominoes standing in close proximity to each other. When the first domino is tipped, it starts a rapid cascade of falling dominoes. With respect to the decisions still to be made to discontinue the sale of tobacco products in pharmacies and facilities that include pharmacies, we should accelerate the momentum of the tipping point into a domino effect.

Many pharmacists employed in chain pharmacies or other large corporations have been reluctant to recommend that their company stop selling tobacco products because of concern that their suggestion would not be positively received or that their job might even be in jeopardy if their well-intended recommendation is perceived as being critical of the company. However, things are different now. For example, pharmacists at Walgreens and Rite Aid should encourage their pharmacy supervisors to convey a recommendation to upper management that their company should stop selling tobacco products, rather than having to respond to continuing negative comparisons in the context of the CVS decision. Similarly, state boards of pharmacy have been reluctant to consider recommendations that they discontinue issuing/renewing licenses to pharmacies that sell tobacco products. The CVS decision provides reason to reconsider this matter (please see my editorial, “Boards of Pharmacy Should Discontinue Issuing Licenses to Pharmacies that Sell Tobacco Products…” in the September 2013 issue of The Pharmacist Activist at www.pharmacistactivist.com). There are also other strategies that can be used but they may not be necessary after the domino response.

02/19/2014

First Pharmacy Students Now Trained in Advanced Life Support

BinghamWith critical care pharmacy surfacing as a staple in intensive care, prospective pharmacists now complete high levels of life support training to increase patient survival.

Advanced Cardiovascular Life Support (ACLS) is a team-based response strategy used to optimize the survival of patients in life-threatening cardiac emergencies. Pharmacist participation on these rapid-response teams is associated with lower mortality rates, emphasizing a need for future pharmacists to get trained.

“Pharmacy students on their Advanced Pharmacy Practice Experience rotations in the hospital setting will likely encounter code situations. Many of the treatment algorithms require pharmaceutical intervention, and it is valuable for pharmacy students to be involved and educated on how to treat patients in these situations,” said Meghan Tolan PharmD’14, who became ACLS certified in 2013.

Prior to taking the course, students are expected to understand pharmacological aspects specific to cardiopulmonary arrest and reach proficiency in identifying cardiac arrhythmias. Basic Life Support for Healthcare Provider certification is also required.

“As part of the curriculum at USciences, student pharmacists receive didactic education regarding ACLS that is reinforced through high-fidelity mannequin simulation,” said Angela L. Bingham PharmD, BCPS, BCNSP, (pictured above) an assistant professor of clinical pharmacy at USciences' Philadelphia College of Pharmacy (PCP).

To achieve ACLS certification, students must then complete a 12-hour training program through the American Heart Association. Developing their skills, students practice and perform these life-saving interventions at an on-campus simulation laboratory.

Three PCP students have completed the certification thus far, including Tolan, Julia Weiner PharmD’14, and Michael Flacco, Jr., PharmD’15.

“By developing fundamentals in basic life support, management approaches for various life-threatening situations, related pharmacology, and effective resuscitation team dynamics, Julia, Meghan, and Michael are ready to save lives when they become licensed pharmacists,” said Dr. Bingham.

Trained critical care pharmacists will use their expertise to assist in a variety of scenarios as part of an interdisciplinary team. To find more information on ACLS certification, email Dr. Bingham at a.bingham@usciences.edu.

Article written by Christine Luczka
University of the Sciences Marketing and Communications Dept.

Pharmacy Student Values MLK Day of Service Experience

Mlk dayAditi Bhogal PharmD'17 shares her experience from the University’s MLK Day of Service on Jan. 20.

Martin Luther King, Jr., Day commemorates a national leader who helped our overcome segregation, ignorance and prejudice. This year was the first year Philadelphia College of Pharmacy, and the entire University, celebrated MLK Jr., Day, by cancelling classes and encouraging students to develop and/or participate in volunteering events. Generation Rx, a patient care initiative developed by The Ohio State University College of Pharmacy and funded by the Cardinal Health Foundation, is an educational program that increases public awareness of prescription medication abuse and encourages health care providers, community leaders, parents, teens, and college students to actively work to prevent abuse.  APhA-ASP partners with Cardinal Health on this educational program to expand the breadth and depth of this important initiative to the communities surrounding our nation’s schools and colleges of pharmacy. 

At our PCP-APhA chapter of Generation Rx, we tried to carry on the message of MLK. Jr., of overcoming segregation, ignorance, and prejudice by having an interactive workshop with pharmacy students and faculty about prescription drug abuse. The workshop was titled “Be Part of the Conversation.” The workshop included a presentation, which presented facts, ideas about preventing drug abuse, pharmacist roles in preventing prescription drug abuse, and the importance current trends and data surrounding this. This was followed by an interactive activity including drug abuse questionnaires and pretend patient counseling. The purpose of this was to get the conversation going about the unique position pharmacists are in to help prevent prescription drug abuse.


The most rewarding activity in this workshop was the discussion component. We discussed important questions such as policy changes that could be needed, efforts that could be taken at a nationwide, local, and campus level. One of the primary activities we found needed to be focused on was just an awareness of the physiological and medical effects of the body when prolonged drug use occurs. Another issue we focused on was the stigma attached to mental illnesses and addiction, as opposed to conditions like diabetes and heart disease.  One of the key components we realized we could do on a campus level is to have presentations/awareness on the pathophysiology of addiction, both mentally and on the body and how that ties into the most commonly abused drugs. Another idea we had was to integrate conversation and steps towards intervention in our Pharmacy jobs/rotations/volunteering. The Generation Rx “Be Part of the Conversation” workshop was the perfect way for students and faculty to come together, discuss, and take steps towards a more knowledgeable, cohesive, and tolerant society, much like the vision Martin Luther King, Jr., had for our society.

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