December 2014 issue - Montana Pharmacy Association

Montana Pharmacy
Montana Pharmacy
PRESORTED STD
U.S. POSTAGE PAID
HELENA, MT 59601
PERMIT #221
TODAY
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JOIN US FOR MPA WINTER MEETING/CE in Big Sky!
Register for MPA Winter CE Meeting
The MPA 2015 Winter
CE will
again
be CE
held
The MPA
2013
Winter
will be held
beautiful
Big
andhours
will offer a total
at Big Sky and willinoffer
a total
ofSky
15 CE
of 15
CE hours for
pharmacists
for pharmacists and
technicians
attending
all 3 and
technicians attending all 3 meeting days.
meeting days. The program sessions will include
The program sessions will include topics
topics relevant to various
pharmacy practice
relevant to various pharmacy practice
settings including settings
hospital,including
ambulatory
care,ambulatory
and
hospital,
community. Clinical
experts
will speak on
suchexperts
care,
and community.
Clinical
topics as Pets Arewill
People,
Interspecies
speakToo:
on topics
including diabetes,
hypercholesterolemia,
geriatrics,
Medications, Bringing
Blood Pressure Down
andand
pediatrics.
Additionally,
updates
Community Pharmacy Teams Up. Additionally, on
federal policy affecting Pharmacy, Patientupdates on the MPA
Health-Systems Academy
centered medical home model, and
will be provided and
the
conference will conclude
medication errors will be discussed. The
with a review of state
and national
issues affecting
conference
will conclude
with a review of
the profession of pharmacy.
state and national legislative issues.
skiing at the world-renowned
Big
Enjoy skiing at theEnjoy
world-renowned
Big Sky
Sky Resort
or take
advantage
Resort or take advantage
of the
many
other of the many
other local activities while sharpening
Winter CElocal
& activities while
sharpening practice skills,
practice skills, enhancing business
, Montana
enhancing business
strategies, and networking.
strategies, networking, and connecting
Board of
with friends.
Register online by visiting our website at www.
Montana
ard of
Register
ourBig
website at
rxmt.org and to book
your online
room by
justvisiting
contact
www.rxmt.org
To book your room
Sky Resort at 406.995.5750
or 800.548.4486.
See just
you in Big Sky! contact Big Sky Resort at 406.995.5750 or
800.548.4486. See you in Big Sky!
hwest
ur d’Alene,
Montana Pharmacy Association
Winter C E + Ski Meeting
MPA Membership Time for Annual Renewal—Use enclosed invoice or pay on-line
MPA Membership Time to Renew and JOIN—Use enclosed invoice or pay on-line
our updated
We are
rials and urge
for legislative
E updates and
The Montana Pharmacy Association (MPA) appreciates the support of pharmacy professionals across the
The Montana Pharmacy Association (MPA) appreciates the support of pharmacy professionals across the
State and we remind members, and potential members, to renew your membership or join us at this time.
state and we remind members, and potential members, to renew your membership or join us at this time.
a member
MPA
just
outand
andreturn
returnthe
theenclosed
enclosedinvoice
invoice OR
OR visit
visit the MPA
MPA website
To To
be be
a member
of of
MPA
just
fillfillout
websiteat,
at
www.rxmt.org
and
click
on
the
JOIN
link
to
pay
your
dues
on-line.
Thank
you!
www.rxmt.org and click on the JOIN link to pay your dues on-line. Thank you!
In This Issue:
Farewell from Lori Morin
Student News
New MPA Coordinator
MPA Prepares for
Legislative Session
Addiction Versus
Pseudoaddiction
MPA Academy Updates
Upcoming Events
2
Montana
FAREWELL FROM LORI MORIN
It is with a great deal of pleasure that I reflect
on my many years as a pharmacist and faculty
member at the University of Montana. If I combine
my teaching years and my student years, then I
have spent over 40 years in one place. Who would
have thought this would be possible?
There have been tremendous changes in pharmacy
practice and pharmacy education over these
many years. We experienced the transition from
typewriters to computers; from manual counting
to dispensing machines; from everything live to
some things tele! There was a time when we did not talk to
patients to a time when we are often their first stop for medical
and medication advice. Giving immunizations is routine and
drug monitoring is essential. Prescribers have come to value
our advice, where they may have once resented our efforts. The
downside of our practice is the omnipresence of the third party
payers; wouldn’t we all like to go back to cash only?
And all the while practice has been changing, education has
as well. For my first 20 or so years, there were 76 schools of
pharmacy. Today there are about 136! In the shortage years,
many new schools opened and existing schools added to
their class size. I am happy that we have remained one of the
smaller schools as a small class size has allowed for better
student-faculty interactions, which has translated into superior
pharmacists. Nothing gives me greater pleasure than to hear
from an alum who says they were better trained than their
TO
“other school” counterparts. Or having a recruiter
say they love hiring our students because of their
ability to reason and the fact that they possess a
strong work ethic. To be a part of the students’
transition has given me immense satisfaction.
What else have I learned over this time? It is
good to have high standards-students will rise to
the occasion and meet those standards as long
as they know what is expected. It is essential
to be able to adapt as change is inevitable and
essential. Teamwork makes everything so much
more enjoyable and efficient. I love my University colleagues
who work hard and are like-minded; they keep me focused and
grounded. I love my pharmacy colleagues, particularly those
who I have gotten to work with through MPA. They too, keep
me focused and grounded. And I love all my students, present
and past, who have allowed me to be their teacher, mentor
and, when needed, their task master. Mutual respect is and will
always be my goal. Thank you for allowing me to be a part of
your personal and professional lives; I will miss you all.
Mike and I will be in Florida for a much needed rest, relaxation
and warm weather break. Then we’ll return to Montana where
we’ll hang out on Flathead Lake. And lest you think I am leaving
forever, I am not. I’ll be back at UM in June to direct the Native
American Center of Excellence grant. So long for now.
Gail Tronstad to serve as new Association Coordinator for MPA
Members should know that Norine Rice, the Association Coordinator for MPA since 2008, is pursuing a new career opportunity starting
December 1st when she became the new Administration Team Manager for her church. While we are sad to see Norine go, we do
appreciate all that she has done to support MPA and the quality services she has provided for the organization.
The person who has been chosen to be the new Association Coordinator is Gail Tronstad of Helena who will work with Executive Director,
Stuart Doggett to provide association/lobbying services for MPA. Gail has more than 25 years experience in the meeting planning/
association services profession and for the last two years she has worked as the Training and Events Manager for the Montana Nonprofit
Association. Some of you may have met Gail who helped out at the 2012 MPA Winter Meetings. She is someone with extensive experience
in meeting management, association work and she has a good sense of humor. Gail can be reached at [email protected].
3
Pharmacy
ODAY
Addiction Versus Pseudoaddiction, By Anna Howard, PharmD Candidate
Pseudoaddiction and addiction can display similar behaviors
making it difficult to tell the two syndromes apart.1 However,
they are caused by different mechanisms and should be
treated differently. Addiction is a complex disease with genetic,
psychosocial, and environmental factors.2 Pseudoaddiction is
related to pain control, not addiction pathology.
Both addiction and pseudoaddiction can present with aberrant
drug-related behaviors (ADRBs), which are medication-related
behaviors that do not follow the prescribed therapeutic plan.3
Pseudoaddiction causes ADRBs because a patient’s pain
is uncontrolled.1-4 These ADRBs can look like drug-seeking
behavior, but once the patient’s pain is adequately treated,
these behaviors should abate.4 Addiction causes ADRBs that
are related to euphoria-seeking behavior.1
Some ADRBs are more indicative of addiction.4 ADRBs
may present differently when a patient is trying to control
pain versus seeking euphoria (ie, pseudoaddiction versus
addiction).1 Recognizing the differences between ADRBs in
practice will help providers accurately diagnose addiction and
pseudoaddiction and provide appropriate care.1-4
ADRBs more indicative of addiction:1-4
• Injection of prescribed medications
• Buying or selling prescription drugs from nonmedical
sources
• Obtaining prescriptions from multiple prescribers without
pain clinician’s knowledge or “Doctor shopping”
• Illicit drug or alcohol abuse
• Decrease in work, social, or home functioning
• Multiple “lost” or “stolen” prescriptions
ADRBs less indicative of addiction:1-4
• Complaining to staff about need for more medication
• Openly attaining medications from other providers
• Asking for certain medications
• Drug hoarding between pain exacerbations
Patients with chronic pain taking chronic opioid therapy may
display tolerance, physical withdrawal with discontinuation,
and continuation of use despite harmful consequences (e.g.,
side effects).1 This makes diagnosing addiction very difficult
in these patients. Patients with chronic pain may be reluctant
to change therapy because they are afraid to experience
increased pain levels.4 Providers should carefully watch
patients who refuse to change therapy when the patient’s life is
seriously adversely affected by physiological and psychological
side effects of the medication.4
To prevent abuse and limit pseudoaddiction/pain
undertreatment, prescribers should implement universal
precautions for all controlled analgesic prescriptions:
• Appropriately diagnose and treat underlying disorders2
• Explore alternative therapies4
• Perform addiction risk assessment including family and
personal history of addiction4
• Set realistic goals for pain control with patient2
• Monitor for medication abuse and ADRBs2
• Perform random drug screens and pill counts2
• Talk with friends and family of patient (with patient consent)
about patient’s behavior and pain control2
• Have patient agree to a medication contract2
• Give appropriate medications based on duration of action
of medications2
• Provide patient education about prescription misuse/abuse
and how to safeguard medications at home4
Aberrant drug-related behavior can lead to considerable friction
between patients and medical personnel.2 These behaviors can
be frustrating but may signal that a patient needs the support
of his/her clinician more than ever. Pain can be very distressing,
and patients should not be labeled as “addicts” without proper
analysis of symptoms and behavior. If ADRBs become a
problem with a particular patient and addiction is suspected,
the provider may prescribe smaller amounts of medication at
a time, see the patient more frequently, or support the patient
with non-opioid therapy. Discontinuing care should be the last
resort because the provider/patient relationship can be very
beneficial in patients’ pain perception and addiction treatment
and prevention.2
REFERENCES:
1. Lusher J, Elander J, Bevan D, et al. Analgesic addiction and pseudoaddiction
in painful chronic illness. Clin J Pain 2006;22(3):316-324.
2. Weaver M, Schnoll S. Abuse liability in opioid therapy for pain treatment in
patients with an addiction history. Clin J Pain 2002;18:S61-S69.
3. Passik SD. Issues in long-term opioid therapy: unmet needs, risks, and
solutions. Mayo Clin Proc 2009;84(7)593-601.
4. Fishbain D, Cole B, Lewis J, et al. What percentage of chronic nonmalignant
pain patients exposed to chronic opioid analgesic therapy develop abuse/
addiction and/or aberrant drug-related behaviors? A structured evidencebased review. Pain Med 2008;9(4):444-459.
4
MPA Health-‐Systems Academy Updates December 2MPA
014 Newsletter Health-Systems
Academy Updates
Health-‐Systems Academy Executive Committee In October, the MPA Health-‐Systems Academy updated its policy to allow for expansion of the Academy’s Executive Committee. Previously, the Executive Committee was comprised of only the MPA Board of Directors members working in health systems. Now, the Executive Committee is comprised of the following: 1) Health-‐system members of the MPA Board of Directors 2) Immediate Past Chair of the Academy 3) Montana ASHP Delegates, including Alternate Delegates 4) Two At-‐Large members The Immediate Past Chair of the Academy, Montana ASHP Delegates and Alternate Delegates, as well as the At-‐Large members will all serve one-‐year terms (June – May). MPA Board of Directors members serve four-‐year terms. The Executive Committee changes should allow for growth of the Academy and better representation of health-‐system pharmacy needs throughout the state. MPA Health-‐Systems Academy Executive Committee Member Current Role(s) Employer/Location Melanie Townsend Chair, Health-‐Systems Academy MPA Board of Directors ASHP Alternate Delegate – 2014 Billings Clinic; Billings, MT Mark MPA Board of Directors Montana Association of Healthcare Purchasers; Helena, MT Eichler Lyndee MPA Board of Directors Barrett Hospital & Healthcare; Dillon, MT Fogel Kerry Past Chair, Health-‐Systems Academy University of Montana; Missoula, MT Haney ASHP Delegate – 2014 Lonnye ASHP Delegate – 2014 St. Vincent Healthcare; Billings, MT Finneman Jeffrey ASHP Alternate Delegate – 2014 Kalispell Regional Medical Center; Kalispell, MT Sullivan Stacey At-‐Large Member Montana State Hospital; Warm Springs, MT Pascoe Logan At-‐Large Member Benefis Health System; Great Falls, MT Tinsen For questions or to find out more about the Academy, please contact: [email protected] Health-‐Systems Academy Spring Seminar – 2015 Mark your calendars! Plans are underway for the 2nd Annual Health-‐Systems Academy Spring Seminar. The conference is tentatively scheduled for Friday and Saturday, May 1 – 2, 2015 in Billings, MT at the Mansfield Health Education Center, which is associated with St. Vincent Healthcare. More details to follow in the upcoming months! 5
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6
Montana
STUDENT Corner….
The 2014-2015 members of the Kappa Epsilon Delta chapter at
the University of Montana are very excited to welcome our new
members during our initiation ceremony and dinner. Kappa Epsilon
continues to support breast cancer awareness. The chapter hosted
our annual booth at the hosted a bake sale to raise funds, and again
held “Bras for a Cause”, a bra decorating contest that involves
participation from all the University of Montana Pharmacy student
groups. We continue to support the local Ronald McDonald House
through preparation of monthly meals and prepared a special
TO
Thanksgiving Dinner on November 25. Plans for a future blanket
drive for the Povarello center are also in progress. One project we
are particularly excited about is the expansion of our “Shadow a
Pharmacy Student” program. Brady Conner and Harrison Wood,
along with the help of Donna and Howard Beall are working hard
to offer the opportunity to more students, and this year we will host
students from all three Missoula high schools. Our upcoming spring
activities will include the annual Race for a Cure and Relay for Life.
Kappa Psi’s News:
Over the sumer, Gamma Eta had two brothers attend the Summer
Provence meeting in Boise, ID. Kaylyn and Brianna were able to
reunite with brothers from other chapters, get advice on career
advancement and advocate for our chapter. It was a wonderful
opportunity for them to strengthen their passion for the fraternity.
Gamma Eta has had a strong start to the semester, holding several
events for new pharmacy students to discover the joys of Kappa
Psi and encourage them to pledge themselves to the chapter.
New students have been invited to annual events such as the
Welcome Back BBQ, the evening hike to the “M”, and our biannual
highway cleanup. Gamma Eta adopted a portion of a road close
to campus several years ago and each semester we make sure
the road is cleared of any wastes. Our monthly community events
were continued with enthusiasm as we cook dinner at the Ronald
McDonald House and play dodgeball with the Boys and Girls Club.
Our most recent event was the annual Kappa Psi Olympics that
tested each brothers fraternity, pharmacy, faculty and current event
knowledge as well as a few endurance and strategy games to build
teamwork and brotherhood. In the near future we have plans to
seek donations for the Poverello Center and gift another deserving
family with an abundant Christmas morning treat. If you have any
questions or suggestions about our fraternity’s inolvement please
let Amber Yaeger know at [email protected]. We thank
the MPA for their continued support!
American College of Clinical Pharmacy:
Last February the University of Montana established a student
chapter of the American College of Clinical Pharmacy. Our chapter
is one of only 42 student chapters in the nation. We currently
have 91 members and 47 of them are founding members from
last spring. The focus of this new student group is on student
professional development. We want to provide unique opportunities
for students to learn more about the clinical field of pharmacy. The
past year we brought in numerous speakers including an oncology
research nurse, a medication safety officer, and a 4th year
pharmacy student. We have also provided an exclusive opportunity
for ACCP members to tour an ambulance. The paramedic walked
students through what a typical response would look like, complete
with common medications used depending on the injury and scene.
We have a similar tour scheduled this November of a MedStar
helicopter. One fun event ACCP puts on is the Clinical Pharmacy
Challenge. Any pharmacy student can compete on a team of three
in this “quiz bowl” event. There are three rounds in the challenge:
lightning, clinical case, and jeopardy. The winners of the local
challenge are eligible to compete at the national level. Last spring
the University of Montana’s championship team consisted of
Kelsie Hanson, Ali Pryne, and Lori Scott. We are excited to see
our student chapter grow and join the already prestigious student
groups at the Univeristy of Montana Skaggs School of Pharmacy.
Montana Pharmacy Association Like us on Facebook
Facebook users have a new destination. The Montana Pharmacy Association has a
Facebook page, available through the Association’s website at www.rxmt.org. This
MPA feature will serve as a popular and easy way for members and anyone interested
in Montana pharmacy related issues to stay connected. We hope you will join us!
7
Pharmacy
ODAY
Rho Chi News – 2014:
Rho Chi members have coordinated various community activities
throughout the year of 2014. To promote community outreach,
the group often hosts a blood drive
in collaboration with Missoula’s Red
Cross donor center. This fall, Rho Chi
members volunteered at Missoula Aging
Services to help senior citizens choose
optimal Medicare Part D insurance plans.
Members interviewed seniors about
their medication regimens, acting as
volunteer intake specialists for Missoula
Aging Services. At last year’s JDRF
(Juvenile Diabetes Research Foundation)
Fundraising Walk, Rho Chi held an
obstacle course and selected a prize
(Amazon Kindle®) for participants of the
event.
Rho Chi has also hosted pint nights such
as “Biers for Benefits” at Bayern Ale in
attempts to further fund group projects. In
addition to “pint nights”, another reputable
Rho Chi fundraiser is coined “Rent a
Student”. In this activity, professors from
the Skaggs School of Pharmacy at UM hire students from the group
to perform various tasks such as raking leaves, shoveling snow,
and cleaning house. This is a prominent
source of the group’s fundraising.
Rho Chi provides a positive outreach
to the student community at UM. To
support education, group members hold
study sessions for P1 and P2 pharmacy
students to prepare them for difficult
exams. Rho Chi also hosted a residency
panel last spring, where PGY1 pharmacy
residents provided insight and guidance
to students who attended. Members also
hold an annual Game Night for students,
in attempts to relieve stress before finals.
Finally, the group appreciates the hard
work of the school’s faculty by hosting
a “Professor of the Month”. Pharmacy
students vote for one professor to be
chosen for a free lunch. During April, the
student population selects a “Professor of
the Year”.
MPA Prepares for 2015 Legislative Session – Association pursuing key legislative initiatives
The Montana Legislature convenes on January 5 and the MPA
legislative committee has been active in preparing to advocate for
the profession in the halls of the State Capitol. To date lawmakers
have requested over 2,000 bills and of those MPA has flagged
approximately 60 for our “bill tracking list.” This list of bills can be
found on the MPA website.
This bill will be similar to legislation passed in other states and the
intent is to provide such things as clarity for pharmacists on how MAC
prices are determined and updated by PBMs, establish an appeals
process in which a dispensing provider can contest a listed MAC
price and standardization for how products are selected for inclusion
on a MAC list.
This session MPA will be pursuing two bills and supporting
other key legislative initiatives. One is LC 344, a bill to expand
immunization authority for pharmacist that will reduce the age
limit and collaborative practice requirements to provide common
immunizations. The intent of LC 344 is to simplify and expand the
process to allow Montana pharmacist to provide immunizations on
the CDC list down to 7 years old.
Other bills MPA intends to support includes legislation to allow for
e-prescribing of controlled substances and measures that provide
funding and assistance to enhance the current Prescription Drug
Registry Program.
The second bill is LC 345, a bill to provide transparency as well as an
appeal process for items listed on MAC drug pricing list by PBMs.
The MPA legislative committee will be seeking the assistance of all
members in passing keys bills and in defeating others that may be of
harm to Montana pharmacy professionals. Similar to previous sessions
MPA will be providing members with frequent legislative bulletins and
updates throughout the 2015 meeting of the Montana Legislature.
PRESORTED STD
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PERMIT #221
M O N TA N A
P.O. Box 1569
•
Helena, Montana 59624
•
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•
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•
www.rxmt.org
Pharmacy Association
PO Box 1569
Helena, MT 59624
www.rxmt.org
Return Service Requested
Montana Pharmacy Association:
“One of America’s Most Trusted Professions”
MPA Officers
MPA Office
Calendar of Events
Chair:
Tony King, PharmD, Missoula
PO Box 1569, Helena, MT 59624
Ph: (406) 449-3843 Fax: (406) 442-8018
Executive Director: Stuart Doggett, Helena
[email protected]
January 9-11, 2015: MPA Winter CE & Ski,
Big Sky Resort, Big Sky, MT
Vice Chair:
Eric Beyer, RPh, Frenchtown
Director:
Chad Smith, RPh, Stevensville
Director:
Mark Eichler, BS Pharm, RPh, Helena
Director:
Lyndee Fogel, PharmD, Dillon
Director:
Melanie Townsend, PharmD, Billings
Director:
Paul Brand, RPh, Florence
Director:
Josh Morris, PharmD, Missoula
Director, Skaggs School of Pharmacy:
Lori Morin, PharmD, Missoula
Director, Registered Pharmacy Technician:
Angela Jensen, CPhT
Student Directors:
Alacia Cole, Pharmacy Student, Missoula
Taylor Redfern, Pharmacy Student, Missoula
Association Coordinator: Gail Tronstad,
Helena, [email protected]
January 9, 2015: Montana Board of
Pharmacy Meeting, Big Sky Resort, Big
Sky, MT
Skaggs School of Pharmacy
May 1-2, 2015: MPA Health Systems
Academy Spring Seminar, Mansfield
Center, St. Vincent’s, Billings
32 Campus Drive, 340 Skaggs Building
Missoula, MT 59812-1512
Ph: (406) 243-4621
Fax: (406) 243-4209
May 28-31, 2015: Northwest Pharmacy
Convention, Coeur d’Alene, Idaho
Montana State Board of
Pharmacy
Executive Director: Marcie Bough, PharmD
[email protected]
301 S. Park Ave. -or- PO Box 200513
Helena, MT 59620-0513
Ph: (406) 841-2371
www.pharmacy.mt.gov
MPA Website
www.rxmt.org
MPA members should visit our updated
web-site at, www.rxmt.org. We are
continuing to add new materials and urge
members to visit frequently for legislative
news, regulatory updates, CE updates and
links to other useful sites.

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