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August 31, 2017

Hurricane Harvey’s Devastation and ASHP’s Efforts

Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP

THE AFTERMATH AND ONGOING EFFECTS of Hurricane Harvey have been truly devastating to many of the citizens of the Gulf Coast of Texas. I know that we are all extending our heartfelt sympathies and concern for the families, friends, and communities impacted by this devastating event.

We at ASHP have been in ongoing contact with ASHP affiliate the Texas Society of Health-System Pharmacists (TSHP). We are also hearing directly from our members in Texas, some of whom have been directly affected by this catastrophic event. The stories are both frightening and compelling, including from members who have continued to provide round-the-clock care to their patients while their loved ones are dealing with flooding and evacuations. It’s a true reminder about the fragility of life and the power of Mother Nature, as well as the selfless and vital roles that pharmacists play as the medication therapy experts on the interprofessional team at all times, including during times of crisis.

Given the catastrophic nature of this terrible event, ASHP will be making a cash donation to the Texas Hospital Association (THA) Employee Assistance Fund, along with a dollar-for-dollar match for our ASHP staff members who also wish to contribute. ASHP will also make available various ASHP products and services on an in-kind basis. THA created the Employee Assistance Fund for hospital employees whose lives have been impacted by the destruction caused by Hurricane Harvey, and 100 percent of the donations will go to those who were affected. There are, of course, many charities that ASHP members and others can consider contributing to, some of which are included in this list from National Public Radio.

ASHP stands ready to assist in any way we can. We will remain in ongoing contact with our affiliate, TSHP, and our members in the Gulf Coast area, and we will keep you up-to-date as new developments arise. ASHP also continues to monitor Hurricane Harvey’s impact on Louisiana and is in touch with our affiliate, the Louisiana Society of Health-System Pharmacists, and our members in Louisiana. We will be prepared to assist if the situation in Louisiana escalates.

I know that we, as pharmacists, members of ASHP, and citizens of this great country, all stand together with our colleagues and their families and friends, and all members of the Gulf Coast communities that were affected by this terrible storm. Please continue to keep them in your thoughts and prayers, and do whatever you can to provide support through whatever means.

 

Sincerely,

Paul

August 24, 2017

Student Pharmacist Sheds Light on Leadership Gender Disparity

Editor’s Note: This story is part of a special series examining the growing number of women in pharmacy leadership.

Sharon Karina, Pharm.D. Candidate (2018)

AS A THIRD-YEAR STUDENT PHARMACIST at Midwestern University in Chicago, Sharon Karina observed that it was rare to find women in pharmacy leadership roles. When she learned through a leadership program offered by her school that a female pharmacy leader named Desi Kotis, Pharm.D., FASHP, was willing to speak with her, she jumped at the opportunity.

“I wanted to meet with leaders in various areas of pharmacy to better understand their challenges and passions,” Karina said. “I’m a naturally curious person; I have a unique drive to ferret out areas for improvement and find solutions.”

Karina learned from Dr. Kotis that there is a current challenge in the profession of pharmacy — gender disparity in leadership. Karina had already noticed that mostly men attended pharmacy networking events, so Dr. Kotis’ revelation didn’t come as a complete surprise. “But I didn’t realize what a significant issue it was until meeting Desi,” she said.

Gender Disparity Research

Dr. Kotis is the Director of Pharmacy at Northwestern Memorial Hospital in Chicago, an active ASHP volunteer, and a member of ASHP’s Women in Pharmacy Leadership Steering Committee. She invited Karina to research the topic of gender disparity with her over the summer of 2016. Dr. Kotis served as Karina’s mentor and sponsor. “She wanted a student perspective on the leadership gap; I was happy to provide it,” Karina explained.

After researching Midwestern University’s reports for incoming class statistics from 2014, 2015, and 2016, Karina learned that each year more women are entering the pharmacy profession. “According to reports from the Accreditation Council for Pharmacy Education, my graduating class [2018] as well as all incoming classes of 2018 students consist of more than 60% women, a climb from previous years,” she said.

This got Karina thinking. Although the profession is trending upward with female-to-male ratios, leadership positions are still held primarily by men. “As a highly pragmatic problem-solver, my next step was to think about where the pharmacy profession is failing with leadership development,” Karina said.

Karina with her mentor, Desi Kotis, Pharm.D., FASHP, Director of Pharmacy at Northwestern Memorial Hospital in Chicago.

Dr. Kotis and Karina’s research included literature reviews and first-person perspectives from webinars posted on ASHP’s website, articles from the Harvard Business Review, and casual conversations with student pharmacists and pharmacists in numerous practice areas and specialties.

Karina and Dr. Kotis learned that some women might find leadership undesirable because they are more interested in work-life balance. “But through networking, and by hearing people’s stories and experiences, women can find solutions on how to integrate their work and professional responsibilities with their personal lives,” Karina said. “I think a woman can still be a leader and also be a wife, mother, caretaker, coach, and so forth. There seems to be a notion that you need to choose one or the other, but women can do them both.”

Another reason why women may not pursue leadership roles is a lack of confidence. “They may think they don’t have sufficient expertise and may not be self-promoters,” she said.

The duo also evaluated a 2011 survey conducted by Zenger Folkman. The survey of more than 7,000 executive corporate leaders ranked women as better leaders than men in a variety of leadership competencies, including taking initiative, practicing self-development, and driving results. Reflecting on her research, Karina noted that women make good leaders because of their soft skills, such as emotional intelligence, and their ability to be relationship-builders.

Karina and Dr. Kotis presented their research at a panel discussion at the Illinois Council of Health-System Pharmacists (ICHP) in September 2016. “The ICHP meeting attendees felt that the topic was very important, and that we should continue to offer programming and networking geared toward women in pharmacy,” Karina said.

A Student with a Cause

The topic of gender disparity in pharmacy leadership remains near and dear to Karina. “The pharmacy industry, and healthcare in general, has a large pool of female talent that we should be capitalizing on,” she said. “We need to have more open discussions about why this is the case and start instituting plans of action to change it.” In particular, she’d like to identify the strategic and financial implications of continuing in this direction and what weaknesses in the system exist so they can be corrected.

Regarding how to get more women into leadership positions, Karina believes pharmacy student curriculum should include a focus on leadership development, regardless of a student’s chosen direction. “I say this because all pharmacists are leaders in one way or another,” she said. For example, beginning as early as when she was first accepted into pharmacy school, Karina’s friends and family members started asking her medication-related questions. “When you’re viewed as an expert, you have to be cognizant about your power,” she explained.

Although fewer women have pharmacy leadership roles, many are taking on positions in managing personnel and running hospital systems and other organizations. “It seems negligent for female pharmacy students to not invest in ourselves in developing and upholding our leadership qualities,” Karina said.

Leadership Today and Tomorrow

Karina has already embraced multiple leadership roles as a pharmacy student. At Midwestern, she volunteers at the school’s annual community health fair. “It enables students to have one-on-one outreach to the community,” she said. “This helps us to identify what issues exist there. It’s also important for community members to see pharmacists’ value.”

Karina practices blood pressure techniques at the Clinical Skills and Simulation Center at Midwestern University with Ozioma Odili and Patsy Berko, who are both Pharm.D. Candidates (2018).

Karina also volunteers during her school’s new-student orientation. “New students are excited about beginning their careers. I want to give them the best advice possible to succeed, because it is very challenging,” she said.

Karina is passionate about heart disease prevention and management, and volunteers as a member of the American Heart Association (AHA) of Chicago’s Young Professionals Board. “Currently, I am looking at ways to fund-raise, and I’m interested in advocacy,” she said. “I want to build a relationship between pharmacy students and the AHA. Pharmacy students have many opportunities for community outreach, whether it’s conducting blood pressure screenings, testing blood glucose, or trying to help the community understand the importance of taking care of their health.”

Karina hasn’t nailed down what her future role in pharmacy will be, but ideally it will enable her to connect with people. “Whenever I meet people, I try to find out what they’ve accomplished and what areas in pharmacy and healthcare can be improved,” Karina said. “Then, I consider what my role might be.”

But Karina does foresee herself becoming a pharmacy leader, because she appreciates opportunities to learn from others. “My ideal role is to collaborate with people inside and outside of healthcare to pragmatically solve problems and share ideas,” she said.

As a proven student leader, Karina’s future as a trailblazer in the pharmacy profession certainly looks bright.

By Karen Appold

 

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August 21, 2017

Happy 75th Anniversary, ASHP!

Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP

I AM HONORED to have the privilege of writing this message to you in celebration of ASHP’s 75th anniversary. On this day in 1942, ASHP was founded by an exceptional group of leaders who envisioned a future where pharmacists would be the medication therapy experts on what we now refer to as the interprofessional patient care team. In reflecting on the past 75 years, it is clear that ASHP and its exceptional members created a future that far exceeded the expectations of our visionary founders.

Over the course of 75 years, ASHP has been a leader in:

  • Conceptualizing and advancing pharmacy as a clinical profession.
  • Establishing standards of practice.
  • Creating accredited residency training.
  • Supporting pharmacist specialization.
  • Advancing the roles of pharmacists in ambulatory clinic settings.
  • Advocating for the effective utilization of pharmacy technicians.
  • Creating the modern drug formulary system.
  • Developing evidence-based drug information.
  • Advocating for the entry-level doctor of pharmacy degree.
  • Being the first organization to hold a national conference dedicated to high-level clinical education — the ASHP Midyear Clinical Meeting.

These are just a few of the many areas where ASHP has been the leader in helping to move pharmacists closer to the patient in the interest of improving patient care and medication safety.

ASHP is proud of these accomplishments; however, we are now focused on creating a future where all patients have access to and receive the appropriate level of comprehensive medication therapy management in all care settings. ASHP’s vision is that medication use will be optimal, safe, and effective for all people all of the time, and we are steadfast in our resolve to achieving this bold vision.

Being a member of ASHP has always been about being part of something much bigger. It’s been about working collectively to help pharmacists achieve their full potential and, in doing so, improving the lives of the patients we serve.

I hope you will join me in December at the ASHP Midyear Clinical Meeting in Orlando for the grand finale of our 75th anniversary year celebration. We’ve planned a great event that includes the best educational program, opportunities to network with over 25,000 colleagues, an anniversary celebration space called 75th Street, and the chance to hear a very special guest at our opening session. And, we’ve reserved the entire Universal Studios Florida Theme Park for our closing party. We can’t wait to see you there!

We want to thank each and every one of our nearly 45,000 members for making ASHP the best organization in pharmacy, and for the contributions you have made to our collective efforts to advance pharmacy practice and improve patient care. You are all a very special part of something wonderful that our founders would be truly amazed by and proud of. Thank you so much for being a member of ASHP and for everything you do for your patients.

Sincerely,

Paul

August 7, 2017

Pharmacists Serve as Trusted Providers of Transgender Care

Ajay Patel, Pharm.D., and Hyojin Sung, Pharm.D., discuss alternative hormone formulations for a patient who no longer wanted to use injectable hormones.

WHEN IT COMES TO CARING FOR TRANSGENDER INDIVIDUALS, placing a rainbow flag in the pharmacy and using an individual’s preferred pronoun may be as significant as providing good clinical care. Experts say these measures help ensure that the underserved transgender population receives the healthcare they need.

“Transgender patients can have a lot of fear around seeking care because of societal stigmas and experiences of discrimination,” said Bryan Bishop, Pharm.D., BCPS, Assistant Professor in the Department of Pharmacy Practice at the University of Toledo College of Pharmacy and Pharmaceutical Sciences in Toledo, Ohio.

The transgender community is growing rapidly, with a 2016 survey estimating the population at 1.4 million — twice what it was a decade ago, according to the Williams Institute. Similarly, the number of transgender individuals seeking medical care is growing exponentially, as noted in a study in the Journal of Urban Health.

With this surge in numbers, pharmacists need to know the unique needs of the transgender population. One of the most important is to feel safe and welcome in a space, said Dr. Bishop. “Being friendly, showing empathy, and using patient-preferred names and pronouns are some of the best things pharmacists can do when interacting with transgender individuals,” he advised.

Health Disparities
As the Human Rights Campaign reports, transgender populations have more healthcare needs than the general population. For example, transgender people are 68% more likely to smoke, and rates of substance abuse are up to fivefold higher. The prevalence of anxiety and depression is more than twice as high in the transgender population, and the risk of attempted suicides is also higher.

Jessica Conklin, Pharm.D., Ph.C., AAHIVP, BCACP, CDE

Jessica Conklin, Pharm.D., Ph.C., AAHIVP, BCACP, CDE

Pharmacists have a role in screening transgender patients and referring them to the right providers, but pharmacists also have a good opportunity to address the health needs of transgender individuals directly, said Jessica Conklin, Pharm.D., Ph.C., AAHIVP, BCACP, CDE, Assistant Professor in the Departments of Pharmacy Practice and Administrative Sciences at the University of New Mexico in Albuquerque.

“We are uniquely placed to help patients with a variety of health needs,” she said, “for example by providing smoking cessation and lifestyle counseling to reduce the risk of cardiovascular complications of hormone therapy or to help promote weight management, since obesity can be an adverse effect of hormone therapy.”

Dr. Conklin takes on a variety of roles as a clinician at the Truman Health Services Clinic, a multidisciplinary medical home affiliated with the University of New Mexico. She collaborates with patients to establish treatment goals and sets out treatment timelines. She also has in-depth discussions with patients about the risks and benefits of hormone therapy, both medical and social.

“It’s important to talk about the possibility of losing housing and employment, and experiencing changes in family dynamics,” Dr. Conklin said. “We can be a huge support to our transgender patients and make sure they are treated as a whole person during their care process.”

Insurance issues can present barriers to care among those who do have coverage, Dr. Conklin explained. “For example, standards of care recommend using GnRH [gonadotropin-releasing hormone], but many of these are not covered, or are only covered under certain conditions,” she said. “I do a lot of work educating insurance companies to help get those covered.”

Dr. Conklin also helps patient obtain prior authorizations, orders and interprets laboratory tests, identifies comorbidities that need to be addressed, and assesses barriers to care.

Education Lacking
According to Ajay Patel, Pharm.D., the cornerstone of transgender healthcare is most often, although not always, gender-confirming hormone and non-hormonal therapies. However, he added that the likelihood a pharmacist will be familiar with these treatments is low, since most pharmacy schools do not include transgender care in their curriculum.

Ajay Patel, Pharm.D.

“If pharmacists want to bridge gaps in care and provide comprehensive and whole-person care for transgender patients, we first need to be educated in transgender health,” explained Dr. Patel, Pharmacy Associate at the University of Minnesota/Community-University Health Care Center in Minneapolis. Topics in transgender care have a place in a variety of educational areas, such as endocrine pharmacotherapeutics, drug delivery, and pharmacokinetics, he added.

The scant numbers of pharmacy students who do receive in-class education on transgender care have few placement opportunities in clinics that specialize in transgender populations, Dr. Conklin noted. The medical home where she practices is one of those rare places. “Our students participate in interprofessional clinic sessions, topic discussions, and drug information reviews, and are taught how to collect patient information and provide patient education to this sensitive population, as well as how to collaborate with other providers,” Dr. Conklin said. Such real-world experiences are invaluable, offering pharmacists something they cannot learn in the classroom, she explained.

“I’ve developed a real sense of humility that I now bring to the care process,” she said. “I’ve come to understand that it’s ok to make mistakes, as long as you can learn from them.” Most importantly, Dr. Conklin said, she has learned to treat transgender individuals with great dignity and respect.

For additional resources on transgender and lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ) health, visit the Human Rights Campaign (HRC), the nation’s largest LGBTQ civil rights organization. The HRC website includes information about providing LGBTQ services at your pharmacy and how pharmacists can support LGBTQ patients. More information can be found at the National Center for Transgender Equality and the National LGBT Health Education Center.

The February 1, 2017 issue AJHP includes several articles and an AJHP Voices podcast about providing pharmacy care to transgender persons.

By David Wild

 

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