Congratulations to Kathy Boland, Pharm D, for being named the VtSHP/Pfizer Pharmacist of the Year.

Kathy is currently a Pharmacist Clinician in Family Practice at Milton Family Practice, FAHC. She is also clinical assistant professor in the Dept. of Family Practice at UVM and on the faculty of the Albany College of Pharmacy, Vermont Campus.

Kathy is a 1994 BS graduate of URI College of Pharmacy. She completed her Pharm D degree in 1996 at Medical University of South Carolina, followed by a residency in Family Medicine at MUSC. Kathy started her career at FAHC in August, 1997.

Kathy has always been very dedicated to teaching pharmacy students. She has collaborated with ACP long before they expressed interest in opening a Vermont campus. She has been instrumental in getting the pharmacy residents at FAHC to present at various VtSHP programs.

Kathy is also very involved in the education of family practice medical residents. She recently received a promotion at UVM with the office of Family Practice.

Kathy has been involved in numerous multidisciplinary teams within the hospital, including medication safety, anticoagulation programs, diabetes, and P&T activities.

VtSHP has also benefited from Kathy's dedication to the pharmacy profession. She served on the VtSHP board from 2001-2004, serving as president in 2002-3. She is currently a member of the Program Committee.

A colleague says: "Kathy is a very dedicated pharmacy practitioner at all levels; administrative, clinical, and educational. She recently took up the challenge of learning and working more with the new computer system and distributive process."

Kathy is a very deserving recipient of this award. Be sure to congratulate Kathy when you see her.

The ASHP 2009 Summer Meeting & Exhibition is where concentrated, highly relevant educational programming combines with serious networking in the delightfully walk-able and amenity-rich Village of Rosemont, just five minutes from O’Hare Airport.

You’ll return to your practice regenerated, with immediately applicable new skills and knowledge--and with energy restored.

Click below to register now!

The following officers will be serving on the VtSHP board for 2009-2010:

Sal Morano President, Mike Carroll President-elect, Clare Coppock Past-President, Dave Dransfield Treasurer, Lisa Jackman Secretary, Michele Reed Technician Representative

Welcome aboard!!!

The following presenters and topics were featured at the VtSHP May Clinical Pearls Meeting at the Waybury Inn on May 21st, 2009.

Jayde Bednarik, "Determining time to late-onset ventilator-associated pneumonia in a trauma population"

Kelli Rothenberger, "Guideline compliance in the treatment of community-acquired meningitis: experience at a rural academic medical center"

Saisha Branchaud, "RRMC Anticoagulant Program"

Joanna Schwartz, "New Oncology Medications"

Wes McMilliam, "Methadone or MethaDONE: Renewed Focus on Safe Prescribing"

Kevin Marvin, RPh, MS, FASHP will serve as a Vermont delegate to the ASHP Summer Meeting in Chicago. Kevin is a national leader in Pharmacy Informatics and was past chair of the ASHP Pharmacy Practice Section Advisory Group on CPOE and Informatics.

Michele Havens, Pharm D has agreed to serve as a Vermont delegate to the ASHP summer meeting in Chicago. Michele is a clinical pharmacist at Rutland Regional Medical Center. She is a graduate of the Albany College of Pharmacy.

ASHP, together with several other pharmacy organizations, met on May 5, 2009 with the White House Health Care Reform Team to emphasize the critical role for pharmacists in health care reform. ASHP and other pharmacy stakeholders requested the meeting to educate key leaders in the Obama administration about the unique value that pharmacists bring to patient care, and how the patient care services of pharmacists should be an integral part of health care reform.

Click the web link below to learn more

ASHP’s H1N1 Flu Resource Center has the most up-to-date drug information on the appropriate uses of antivirals to treat patients with confirmed cases of swine flu. The site contains drug information monographs for patients and health professionals featuring the latest treatment and prophylaxis recommendations from the Centers for Disease Control & Prevention (CDC). The monographs provide information that pharmacists can use to guide the appropriate use of the medications in their institutions.

Other resources on the site include a dynamic flu tracker map plotting reported cases and pandemic planning tools from the ASHP Foundation and others.

Members can also use the new "2009 H1N1 Flu" online discussion board on ASHP Connect to share experiences, questions, or comments. Information contributed to the discussion board will also be useful to ASHP staff members in their discussions with personnel at the CDC, Food and Drug Administration, and other groups to ensure that the pharmacy perspective is considered when decisions are being made. The H1N1 discussion thread is in the "Pharmacy Practice" category.

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The College of Pharmacy at the University of New England (UNE) is scheduled to welcome its first class of 100 students in September, according to school officials. The students, who were selected from 790 total applicants, will attend classes in a new $12.3 million facility in Portland, Maine. Eventually the college will have a four-year enrollment of 400 students and will employ 47 faculty and staff members. UNE is one of two Maine universities scheduled to open pharmacy schools in the fall of this year. The other is Husson University in Bangor. Both schools are currently seeking initial program approval from the national Accreditation Council for Pharmacy Education. The schools are part of a larger movement to fulfill the nation's growing need for qualified pharmacists. A 2002 study predicted the nation will need a total of 157,000 pharmacists and 15 new pharmacy schools by 2020. Seventy percent of hospital pharmacies described the shortage of experienced pharmacists as "severe", while public hospitals reported an average vacancy rate of 11 percent for pharmacist positions. Maine has been ranked as one of the states most in need of pharmacists, with the state Department of Labor reporting a 3.7 percent vacancy rate for pharmacist positions.

According to a recent study led by Michael D. Murray, PharmD, of the UNC Eshelman School of Pharmacy, pharmacist intervention significantly improves medication use in outpatients with cardiovascular disease by reducing the risk of adverse drug events and medication errors. Dr. Murray and colleagues conducted a pooled analysis of two randomized controlled trials that included a total of 800 outpatient cases of complicated or uncomplicated hypertension. Based on this analysis, Murray found that pharmacist intervention reduced the risk of adverse events by 35 percent and reduced the risk of medication errors by 37 percent. Among the patients included in the study, there were 210 medication errors or adverse drug reactions. The most common medication errors were prescribing a drug contraindicated for elderly patients, yeast infections in women taking antibiotics, and the prescription of multiple medications containing acetaminophen.

A number of hospitals are now creating outpatient specialty-drug infusion centers in order to improve communication between pharmacists and prescribing physicians. As Steve Pate, DPh, manager of outpatient pharmaceutical services for St. Jude Children's Research Hospital, points out, "One of the biggest reasons for developing the specialty pharmacy center is from a continuity-of-care standpoint. To be able to provide as many specialty meds as possible reduces the fragmented care continuum." In order for specialty-drug infusion to run smoothly for the hospital, Pate has three pharmacy reimbursement technicians on staff. When the hospital opens its own outpatient specialty infusion center, there are plans to add a fourth technician. These technicians ensure the hospital does not spend high sums on specialty drugs for which the facility will not be reimbursed. A common reimbursement complication for infusion centers are the "brown bag" policies instituted by Medicaid and some insurance companies that require certain specialty drugs to be shipped to the patient. Hospital pharmacists face a difficult choice regarding such drugs: to risk administering a drug that has had its integrity compromised, or to institute restrictions on brown bag medications. While such restrictions are excellent from a risk management standpoint, they can limit access to some drugs.

Web-based interaction with pharmacists has been found to improve hypertension control and increase engagement with healthcare teams in patients with hypertension. This conclusion is based on a study presented by Dr. Beverly B. Green of the Group Health Cooperative at the annual meeting of the American Society of Hypertension. For the purposes of their study, Green and colleagues randomly assigned patients to home blood pressure monitoring and/or Web-based pharmacy care or usual care and found that the combination of home monitoring and Web-based care resulted in net reductions of 9 mm Hg in systolic blood pressure and 3.5 mg Hg in diastolic blood pressure, as well as a 25 percent greater likelihood of optimal control.

One healthcare IT solution would eliminate a number of the potential error points that can occur when administering medications by establishing an electronic medication administration database that all pharmacists can use as a source. Susan Newbold, a Vanderbilt School of Nursing associate professor of nursing informatics, explains that such a record could mitigate errors resulting from illegible prescriptions, contra-indicated drugs, identical-looking pills and rushed nurses administering medications to troves of patients. Once a hospital has implemented computerized physician order entry (CPOE) with physician approval, it can "close the loop" even more by adding bar-coding, she says. Many hospitals can begin the automation process by updating their pharmacy platforms and rearranging workflow patterns to fit new systems instead of tailoring new systems and technologies to older workflows, say healthcare consultants.

The FDA has updated labeling for antiepileptic drugs used to treat epilepsy, psychiatric disorders, and other conditions to include information regarding an increased risk of suicidality that may be associated with these products. The FDA also required development of a Medication Guide, to be issued to patients each time the product is dispensed. These changes were made following a pooled analysis of placebo-controlled clinical trials of 11 antiepileptic drugs. This analysis found that the increased risk of suicidal thoughts or behaviors was generally consistent among the 11 drugs, with varying mechanisms of action and across a range of indications.

Recent guidelines for developing institutional antimicrobial stewardship programs have recommended that program teams include a pharmacist with infectious diseases training in their core members. There are currently no established training and certification requirements for infectious diseases-trained clinical pharmacists, and so the Society of Infectious Diseases Pharmacists and the American College of Clinical Pharmacy Infectious Disease Practice and Research Network have issued several recommendations. These recommendations include a postgraduate year 1 residency and a postgraduate year 2 residency in infectious diseases. The authors also recommend practitioners become board-certified pharmacotherapy specialists and maintain a portfolio of educational experiences to maintain qualifications. A certification examination in infectious diseases should also be established, and currently nonaccredited training programs should seek accreditation.

A study of three U.S. hospitals presented at the Society of Healthcare Epidemiology Association's 19th Annual Scientific Meeting shows that one way to control the spread of antibiotic-resistant bacteria is through the practice of "positive deviance," which encourages nurses, custodians, and front-line workers to think of ways to implement small improvements. Hospital staff members are also encouraged to be assertive in promoting sanitary habits, such as reminding doctors to wash their hands. The study found effectiveness in smaller measures, such as disposing of used surgical gowns by wadding them up in a rubber glove, testing all high-risk intensive care unit patients for methicillin-resistant Staphylococcus aureus (MRSA) with a nasal swab, and following rigorous hand hygiene. Researchers with the Centers for Disease Control (CDC) conducted the study at Billings Clinic in Montana, Albert Einstein Medical Center in Philadelphia, and the University of Louisville Hospital in Kentucky. After 20 months, the incidence of MRSA at these locations declined by between 26 percent and 62 percent. CDC epidemiologist and SHEA Board member Dr. John A. Jernigan said, "Showing it can be done fundamentally changes the way hospitals around the country think about the problem. He also noted "the level of engagement [this method] seems to have engendered among the frontline staff, the way it involves what they call the unusual suspects."

The FDA and the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) have formed a partnership with the purpose of improving public education regarding the safe use of methadone. The initiative, called "Follow Directions: How to Use Methadone Safely," was created in response to rising numbers of poisoning deaths associated with the drug over the past several years. Methadone has been used for many years to reduce drug withdrawal symptoms; however, recently, it’s increasingly being used as a pain reliever in patients with moderate-to-severe chronic pain that does not respond to non-narcotic pain medications. According to the Centers for Disease Control and Prevention, the percentage of all poisoning deaths linked to methadone increased from 4 percent in 1999 to 14 percent in 2004, a larger increase than any other narcotic drug. In order to reduce these figures, SAMHSA and the FDA will work with other federal agencies, states, health professional societies, patient advocacy groups, and other stakeholders. Outreach materials distributed as part of the initiative will include posters, brochures, fact sheets, and point-of-sale information for pharmacists.

The Institute for Safe Medication Practices (ISMP) has issued a warning that recommends against storing insulin vials inside their cardboard cartons after the packages have been opened. According to the institute, this practice could lead to a vial being accidentally returned to the wrong carton after being used, potentially causing a serious insulin mix-up if the next user reads the label on the carton and assumes it reflects the product inside. As an alternative to this practice, the ISMP recommends the cartons be discarded in the hospital pharmacy before the insulin is dispensed or when it is received at the nursing station.