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September 30, 2020

Sense of Community and Social Justice Characterize Pharmacy School Deans

Dean Marie Chisholm-Burns, Pharm.D., M.B.A., M.P.H.

EVERY DAY, AS SHE WALKS THROUGH THE LOBBY of the College of Pharmacy at the University of Tennessee Health Science Center (UTHSC), Dean Marie Chisholm-Burns, Pharm.D., M.B.A., M.P.H., passes a wall covered with the portraits of all eight of the college’s deans to date. While all have made important academic and clinical contributions, there is a distinct contrast between her portrait and the seven pictures that precede hers: all of the deans leading up to her were white males.

Addressing social inequalities

“Funny enough, it wasn’t until my students pointed out how impactful it was to have my picture up on the wall that I noticed how striking the difference between me and the deans before me was,” said Dr. Chisholm-Burns, who has been an ASHP member for over 25 years. “I hope that when people see my picture up there, they dwell on possibilities that they may not have otherwise considered.”

Dr. Chisholm-Burns was recently named a UTHSC Distinguished Professor and the Chair of ASHP’s new Section of Pharmacy Educators Executive Committee. Throughout her career and during her deanship, Dr. Chisholm-Burns has made it a priority to address social inequalities. For example, she has made an effort to ensure equal access to education, which she sees as a civil rights issue by cutting tuition costs. “I came from a humble background, so I know that the cost of college can be prohibitive, and I also know that education can help lead you out of poverty,” she said.

Gender inequality has been another target of Dr. Chisholm-Burns’s energy. Before becoming dean, she was involved in an initiative that taught economically disadvantaged young girls how to play chess to encourage them to pursue their aspirations.

“In chess, if you advance your pawn all the way to the other side of the board, you can change it into any piece – except for the king – but many would say the most powerful piece on the board is a queen,” said Dr. Chisholm-Burns. “The message, which I think is a strong one, is that your future is not necessarily dictated by your past.”

On her own career path, one accomplishment Dr. Chisholm-Burns has been incredibly proud of is establishing the Medication Access Program, which provides access to treatment for solid organ transplant recipients.

“As a clinical pharmacist working with transplant patients, I noticed that the cost of medications sometimes prevented people from being adherent to their medications,” she said. “That bothered me a lot, and I felt an obligation to improve the situation.”

With a long list of achievements to date and a long career still ahead of her, there is every indication that Dr. Chisholm-Burns will continue to help right the wrongs that she sees around her, whether in the clinic, the college, or the community.

“As long as there are social injustices out there, I would like to be a part of efforts to address them,” she said.

A responsive leader

For Natalie Eddington, Ph.D., FAAPS, FCP, Dean of the School of Pharmacy at the University of Maryland, Baltimore, being a good leader has meant serving her faculty and students, and also the residents of her city.

Dean Natalie Eddington, Ph.D., FAAPS, FCP

During her 12 years as dean, she has been involved in several initiatives aimed at improving the lives of those around her. For example, she co-leads the university’s Center of Addiction Research, Education and Service – or CARES – which employs faculty and students to address the impact of addiction on Baltimore’s communities.

“Addiction is one of those things that we might not necessarily want to talk about, but it is really important to treat if we want to improve the lives of those in the community and our school,” Dr. Eddington said.

Dr. Eddington has tried to be a responsive leader on campus, tending to students and readying them to thrive after graduation. She has led the roll-out of innovative pharmacy degrees in regulatory science, pharmaceutical metrics, palliative care, and even the first Master of Science program in the country focusing specifically on medical cannabis.

“The practice of pharmacy today is nothing like it was when I graduated over 20 years ago, and we have to prepare students to meet the demands of this new world,” she said.

An initiative at the college that Dr. Eddington is particularly proud of is the “Pharmapreneurism” program, which teaches students the innovative mindset that enterprising pharmacists need to reach their career aspirations. “Students who want to go out and change the way we practice pharmacy need to have the confidence and knowledge to do things differently,” she said.

Recently, Dr. Eddington has focused on increasing diversity in academic pharmacy, which she has found remains a priority. In her research, she discovered that the number of pharmacy schools almost doubled over a recent 10-year period, but diversity in academic pharmacy hasn’t changed much.

“We need diversity because it widens what we know and what we understand as healthcare professionals treating patients from diverse backgrounds. It makes sure we implement in practice the ways that are most appropriate for our patients,” Dr. Eddington emphasized.

Cheerleader-in-Chief

When long-time ASHP member Toyin Tofade, Pharm.D., M.S., BCPS, CPCC, FFIP, took up the office of Dean at Howard University’s College of Pharmacy in Washington, D.C., in 2016she found an abundance of impressive work being done by faculty and students alike, but discovered that their achievements were “one of the best-kept secrets around.”

Dean Toyin Tofade, Pharm.D., M.S., BCPS, CPCC, FFIP

“I was surprised by how many contributions were going unrecognized, so I decided to adopt the role of cheerleader-in-chief,” said Dr. Tofade, who was recently appointed to ASHP’s Task Force on Racial Diversity, Equity, and Inclusion.

One of the first things she did as cheerleader-in-chief was let her faculty and students know that their work was valued by publishing an annual report and a weekly e-newsletter celebrating their accomplishments.

Like Drs. Chisholm-Burns and Eddington, Dr. Tofade has made it a priority to address inequalities in the college and the wider community. She co-directs a center to help individuals from unrepresented minority backgrounds prepare for undergraduate and professional STEM and healthcare professions. Under her leadership, the college is planning to place clinical pharmacists in independent community pharmacies to implement ambulatory care services.

Having those services in place will help “transform practice in the District” and ensure lower-income community members have access to medication therapy management and basic chronic disease care, she noted. “These are the kinds of things we need here in D.C., where the health of some communities is very low,” said Dr. Tofade.

Further afield, Dr. Tofade has been working with the International Pharmaceutical Federation, which collaborates with the World Health Organization to implement pharmacy care and related policies in developing countries. Serving in multiple roles and paying her success forward, she mentors budding academic pharmacy leaders abroad so that they can make their mark in the field.

“I feel very privileged and honored to be working to help transform pharmacy education and support academic pharmacy leaders around the world,” she said of this experience.

And with trademark humility, Dr. Tofade acknowledged that while her ambitions have been critical to getting to where she is today, the help of others has been as instrumental to her success.

“I am so grateful to God, my mentors, and supervisors who have taken the time over the years to invest in my growth as a leader,” she said.

 

By David Wild

 

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May 15, 2020

ASHP Launches New Section of Pharmacy Educators and Continues to Advocate for Pharmacists During the COVID-19 Pandemic

Dear Colleagues,

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

AS YOU KNOW, ASHP staff and members have been working tirelessly during the COVID-19 pandemic to support our members and all healthcare providers to enhance the safe use of medications, deliver quality care, and enhance patient outcomes. This work has served as continued reinforcement of our long-standing commitment to supporting pharmacists across the continuum of care and elevating the vital role that pharmacists play as patient care providers. In our 78-year history, we have continually supported heightened standards and training for pharmacy professionals regardless of practice setting.

In this vein, I am pleased to share that the ASHP Board of Directors has approved the creation of a new membership section that will further strengthen and significantly enhance ASHP’s leadership in the preparation and training of the pharmacy workforce. The new ASHP Section of Pharmacy Educators will provide a unique and distinct membership home and leadership voice within ASHP for pharmacy school faculty, deans, and preceptors who are involved in the training of pharmacists.

The COVID-19 pandemic has shown how quickly healthcare and the pharmacy profession can change, and how critical education and training are to meet evolving patient care demands. Building on our existing world-class educational offerings and professional development expertise, ASHP is well-positioned to support educators in all settings, preparing the next generation of practitioners to provide the highest level of interprofessional patient care in highly dynamic and complex environments. This new section will play a key role in ensuring we can provide our educators with an even greater voice as we work together to face the immense healthcare challenges of today and tomorrow.

ASHP President-elect Tom Johnson will appoint an executive committee in August to lead the section’s work, and the committee will begin meeting virtually this fall. ASHP members interested in serving on the section’s leadership should submit an application by July 24.

Support for Pharmacy Residents

Over the past several weeks, I have shared information on ASHP’s efforts to support residents and our accredited residency programs facing uncertainty during the COVID-19 pandemic. Many members and residency programs tell us about ongoing issues, including the potential impact of licensing exam cancellations prompted by stay-at-home orders and social distancing requirements as well as financial challenges faced by their hospitals and health systems. In response to these concerns, on Monday, ASHP’s Commission on Credentialing and Board of Directors approved an extension of the licensure requirement for residents until January 1, 2021. This action, for the 2020–21 residency year only, temporarily waives the requirement that residents be licensed for two-thirds of the residency year (e.g., a July 1 residency start normally requires licensure by November 1). Our Accreditation Services team, through our partners at the National Association of Boards of Pharmacy, continues to monitor pandemic-related effects on residencies and will take any necessary future actions to alleviate burdens caused by delays in testing or licensure. In the meantime, ASHP will do everything it can to ensure the maximum amount of flexibility to our accredited programs during these extremely challenging times. If programs or others have questions, please reach out to Janet Silvester, vice president of Accreditation Services, or Stephen Ford, director of Residency Accreditation Services, for assistance.

Taking ASHP Meetings Virtual

The impact of COVID-19 has extended beyond our hospitals and health systems and challenged us to think differently when “business as usual” is no longer possible. Public health and safety measures are likely to remain in place in some form for months to come. In response to this changing landscape, ASHP announced on Wednesday that we will be moving three important fall events to virtual forums.

Policy Week, which includes our annual Legislative Day on Capitol Hill, will become a virtual experience in September. ASHP’s National Pharmacy Preceptors Conference and Conference for Pharmacy Leaders will take place in October as virtual events. Watch for forthcoming programming details and registration information about these valuable meetings. We remain committed to leveraging technology solutions to deliver the dynamic, high-quality educational content and professional development experiences our members expect from us.

One of the first ASHP events affected by COVID-19 was our Summer Meetings & Exhibition, initially planned for the first week of June in Seattle. Instead of gathering there, we are offering a free series of educational “Summer Sessions” at the end of June, featuring select content from the ASHP 2020 Summer Meetings as well as sessions on the latest COVID-19 updates. These sessions will be open to all practitioners, regardless of ASHP membership status. Continuing education credits will be available to participants. Stay tuned to ASHP’s NewsLink, social media channels, and other communications for additional information about these Summer Sessions.

Remdesivir Resources and Advocacy

Since my last blog, there has been promising news on the efficacy of remdesivir as a treatment for COVID-19. Last week, the Food and Drug Administration (FDA) issued an emergency use authorization for remdesivir to speed access to the investigational antiviral — the first to show promise against SARS-CoV-2 infection. Subsequently, a remdesivir monograph was published in AHFS Drug Information. As a reminder, ASHP has opened access to AHFS DI to all healthcare professionals for a limited time with the username ahfs@ashp.org and password “covid-19.”

Our AHFS drug information staff continue to update ASHP’s Assessment of Evidence for COVID-19-Related Treatments. The document outlines evidence about remdesivir, supportive therapies, and other medications used to treat patients with COVID-19. SafeMedication.com, ASHP’s consumer-friendly medication information resource, is an excellent place for patients to learn more about remdesivir.

We also held a live webinar this week describing the early use of remdesivir for COVID-19 patients. The second part of the webinar series, scheduled for May 20, will share clinical experiences in using remdesivir and a discussion of clinical trial results by the Nebraska Medical Center–Nebraska Medicine pharmacy team. Recorded versions of ASHP’s COVID-19 webinars are available for those unable to attend the live sessions.

While remdesivir shows promise in early studies, access to medication is of great concern to pharmacists across the country. Last week, I sent a letter to Vice President Mike Pence urging the administration to make public its process for determining which hospitals will receive allocations of remdesivir, communicate information about the allocations to all hospitals, and provide information on the timeline and details for the commercial availability and distribution of remdesivir. We also asked the administration to coordinate with the FDA and the Department of Health and Human Services (HHS) to allow hospitals the flexibility to reallocate product to meet changing needs.

Our letter was extensively quoted in an Associated Press article picked up by The New York Times — a testament to ASHP’s commitment to being a voice for our profession and leading national efforts to optimize medication use, improve patient safety, and advance clinical pharmacy practice.

At the urging of ASHP and others, last weekend, HHS announced that state health departments will distribute remdesivir to appropriate hospitals in their states. HHS noted that “state and local health departments have the greatest insight into community-level needs in the COVID-19 response, including appropriate distribution of a treatment in limited supply.” We encourage ASHP members who need remdesivir for their patients to contact their state health departments.

ASHP’s Promise to Support the Essential Role of Pharmacists

I wanted to highlight ASHP’s advocacy on behalf of the vital role pharmacists play in the COVID-19 response. Last week, Rep. Carolyn Maloney introduced the Student Loan Forgiveness for Frontline Health Workers Act (H.R. 6720). Unfortunately, pharmacists are not specifically identified as healthcare workers in this important legislation. ASHP, in collaboration with other pharmacy organizations, wrote to Rep. Maloney and urged her to include pharmacists in the loan forgiveness program. We look forward to working closely with Rep. Maloney’s office to support that effort.

Finally, in my last blog, I discussed a letter that I sent to the chief executive officer of Novo Nordisk responding to their advertisements, which omitted pharmacists from a list of individuals, including nurses, doctors, researchers, and other essential workers, who were acknowledged for their caring efforts on the front lines of the COVID-19 response.

I requested that pharmacists be explicitly recognized as healthcare providers and noted for the essential role they are playing, in addition to doctors, nurses, communities, and essential workers. I was pleased to quickly receive a response from Novo Nordisk’s leadership, acknowledging the vital role of pharmacists and agreeing to specifically highlight pharmacists in a new version of the advertisement, which has already been in print.

In closing, I want to reassure our members that ASHP will continue to work across multiple fronts to represent your perspectives and needs as we collectively navigate the ongoing pandemic response so you can provide the best care possible for your patients. Providing you with the latest information and new resources on our COVID-19 Resource Center remains a top priority. Please watch our weekly NewsLink emails to learn about new and updated resources and live webinars, and continue to connect with your peers on our COVID-19 Connect Community. You can also subscribe to @ASHPOfficial to receive content from our daily podcasts.

Thank you for being a member of ASHP and for everything that you do for your patients and our profession.

Sincerely,

Paul

April 30, 2020

ASHP Continues to Support Members and the Healthcare Community Through the COVID-19 Pandemic

Dear Colleagues,

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

THE COVID-19 PANDEMIC is changing our country’s healthcare landscape every day. Critical health policy changes are occurring at an unprecedented rate. We continue to engage with state and federal policymakers to ensure that pharmacists’ expertise is fully utilized and that healthcare providers are equipped to safely and effectively respond to the pandemic.

Update on States’ Response Efforts

State governors are issuing executive orders that expand pharmacists’ ability to provide high-quality care to patients during this crisis. For example, Michigan now permits pharmacists within licensed health facilities to contribute to routine health maintenance and manage chronic disease states without physician supervision. This expansion alleviates burdens on primary care providers and expands access to care, especially in rural and underserved communities where pharmacists are the most accessible healthcare professionals.

We are also seeing a positive trend in pharmacists’ ability to manage therapeutic interchange. In Iowa and Kentucky, executive orders grant pharmacists the authority to substitute medications in response to drug shortages.

Point-of-care testing for COVID-19 is critical to the national pandemic response. Some states already permitted pharmacists, under their scope of practice or through collaborative practice agreements, to order and administer these tests. Pennsylvania, which previously allowed pharmacists to order and administer tests, has taken emergency measures to grant pharmacists explicit authority to order and administer COVID-19 tests. States like Florida, Illinois, Kentucky, and, most recently New York, issued executive orders that permit pharmacists to order and administer COVID-19 tests. State-level COVID-19 response is a rapidly changing situation as local healthcare providers respond to patient surges and the demand for testing. Please check with your state’s board of pharmacy for more information about the status of COVID-19 testing in your area. Helpful information on COVID-19 testing can also be found on the National Community Pharmacists Association’s website.

ASHP applauds state governors’ efforts to expand pharmacists’ scope of practice during this state of emergency. However, we are concerned that authorizing the expansion of pharmacists’ services without authorizing payment for those services will limit the delivery of care in some pharmacy practice settings. COVID-19 is already highlighting shortcomings in state Medicaid payment systems and commercial payer policies that prevent qualified pharmacists from fully serving patients. ASHP is working closely with our state affiliates and other organizations to request reimbursement for the new services they are providing under the state of emergency. This advocacy aligns with ASHP’s Pharmacy Readiness for Coronavirus Disease 2019 (COVID-19) Recommendations for State Policymakers. The recommendations address shortages of drugs and medical supplies and reimbursement of pharmacists for patient care services and also provide readiness and resilience resources for clinicians.

Pharmacists are Essential Healthcare Personnel

ASHP continues to voice our support for all pharmacists who are working tirelessly across the continuum of care in response to the COVID-19 pandemic. Yesterday, I sent a letter to the chief executive officer of Novo Nordisk responding to a full-page NovoCare ad that ran last weekend in the Wall Street Journal and other publications. Pharmacists were omitted from a list of individuals, including nurses, doctors, researchers, and other essential workers who were acknowledged for their caring efforts on the front lines of the COVID-19 response.

In the letter, I reinforced that pharmacists are highly skilled, licensed healthcare professionals who play a key role in selecting and optimizing medication therapy for patients. Pharmacists also oversee the entire medication-use process in hospitals and health systems, including the purchasing, distribution, preparation, and administration of pharmaceuticals. I further explained that, as members of interprofessional healthcare teams, pharmacists are providing a broad range of patient care services during the COVID-19 public health emergency, from directly caring for mechanically ventilated patients in critical care settings, to providing point-of-care testing and medication management to patients in community pharmacy settings and beyond.

It is my hope that Novo Nordisk will appropriately recognize pharmacists and the important role they play in future communications.

ASHP’s Response to Disruptions in Residency Training

In last week’s blog, I discussed the COVID-19 pandemic’s impact on residency training. As a result of disruptions in routine or elective procedures and reductions in inpatient hospital stays, some hospitals and health systems are facing the difficult situation of furloughing their PGY1 and PGY2 pharmacy residents. These actions can disrupt patient care and make residents ineligible for board certification and professional positions that require postgraduate pharmacy residency training. We believe that educating future generations of pharmacists is more critical than ever, and ASHP has issued a statement opposing the furlough of residents.

As always, ASHP is here to support residents and residency programs. If you need assistance with a furlough situation, please reach out to Janet Silvester, vice president of Accreditation Services, or Stephen Ford, director of Residency Accreditation Services.

ASHP is Here for You and the Entire Healthcare Community

Over the past several weeks, I have been sharing information about new and timely resources that ASHP has developed and made available to optimize medication use and patient outcomes during this public health emergency. The response to these offerings, which is captured in a new ASHP infographic, has been tremendous. We are immensely proud of our staff and volunteers who have been working tirelessly to deliver highly relevant information across multiple channels. Our COVID-19 Resource Center is updated regularly with new content and I hope you continue to find the tools and information produced by ASHP valuable as needs related to the pandemic response evolve.

Thank you for being a member of ASHP and for everything that you do for your patients and our profession.

Sincerely,

Paul

 

April 9, 2020

Important Wins on the Advocacy Front in the Fight Against COVID-19

Dear Colleagues,

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

AS THE IMPACT OF THE COVID-19 PANDEMIC CONTINUES TO ESCALATE ACROSS THE COUNTRY, there is increased urgency to ensure that frontline pharmacists, pharmacy technicians, and our healthcare partners have the medications and equipment they need to successfully treat their patients. ASHP continues to spearhead multiple advocacy efforts that support your ability to provide the best care possible for those in need.

Mitigating shortages of critical medications like propofol, fentanyl, midazolam, paralytics, and others remains a high priority. We continue to engage with relevant federal agencies to improve access to medications. I am pleased to report that the Drug Enforcement Administration (DEA) and the Food and Drug Administration (FDA) have taken critical actions in direct response to ASHP’s advocacy efforts.

ASHP, in coordination with the American Medical Association, the American Hospital Association, the Association for Clinical Oncology, and the American Society of Anesthesiologists, sent a letter last week to the DEA requesting an immediate increase in the annual production quota allocations for Schedule II controlled substances. This would enable manufacturers and 503B outsourcing facilities to increase the supply of opioids critical to the care of COVID-19 patients on ventilators. As a direct result of this collaborative advocacy effort, the DEA announced yesterday that it is taking immediate actions to address this critical issue. These actions include increasing the annual production quota for controlled substances, including fentanyl, morphine, and hydromorphone, that are used for the treatment of mechanically ventilated COVID-19 patients, and increasing the amount of ketamine, diazepam, and other controlled substances that can be imported into the United States.

We also sent a letter to the FDA advocating for regulatory flexibility in compounding drugs in shortage and compounding in hospitals. ASHP’s advocacy efforts, including significant staff engagement on the issue, directly triggered the FDA to clarify existing compounding guidance, including the removal of the one-mile radius requirement for hospitals compounding medications. FDA’s quick action to reduce regulatory hurdles for health systems is an important step to help clarify compounding guidance during this crisis.

ASHP will continue to advocate for additional compounding flexibility, including the expansion of FDA’s drug shortage list to include products ASHP has identified as in shortage. We will also continue to seek 503B outsourcing facility flexibility, particularly for hospital-owned or affiliated 503B operations, to help ensure they can meet hospitals’ medication needs.

Yesterday, we were pleased to see that the Department of Health and Human Services (HHS) authorized pharmacists to order and administer COVID-19 tests pursuant to the Public Readiness and Emergency Preparedness (PREP) Act. The authorization is responsive to the joint COVID-19 recommendations we created with other national organizations. While this authorization does not address pharmacist reimbursement, we are encouraged to see HHS providing pharmacists with a greater role in supporting the COVID-19 response, and we continue to work on that issue.

We also continue to actively advocate for Congress to recognize pharmacists as providers in the Medicare program to further support the COVID-19 response and beyond. Yesterday, ASHP and 11 other national organizations sent a letter requesting that Congress immediately support legislation that would establish pharmacists as providers in Medicare Part B on an emergency basis to provide COVID-19 and flu testing. This authority is an important step in being able to rapidly expand access to testing across our country to support the national response to this crisis. We also see this as a step toward expanded recognition of pharmacists by payers, including Medicare.

Finally, ASHP is also working with our members and other stakeholders to gain access to medications from the Strategic National Stockpile (SNS). Most recently, we joined with several organizations to request that FEMA immediately release all available quantities of a number of critical drugs from the SNS to the New York and New Jersey Departments of Health to address urgent patient care needs. We are also working to support other state affiliates and members across the country with these important requests.

ASHP and its government relations team will continue to work tirelessly with our collaborating partners to ensure that U.S. regulatory authorities are responding to the current needs of pharmacists and healthcare providers.

While our collective attention is on the needs of frontline practitioners, I wanted to take an opportunity to highlight some positive news about the newest members of our profession. ASHP’s 2020 Residency Match concluded this week, and I want to congratulate the 5,269 future pharmacists who matched with 2,551 PGY1 and PGY2 pharmacy residency programs across the country. This number represents a 46% increase in the number of available positions over the past five years – a remarkable rate of growth. I am pleased that our accredited residency programs have demonstrated an outstanding commitment to training during the pandemic. While managing multiple critical priorities, these programs continued to interview applicants virtually. This undoubtedly will be a unique time during which to begin a residency program regardless of its focus. ASHP is committed to ensuring that these young practitioners and their programs have the needed resources to successfully conduct critically important resident training this year and beyond.

In the same vein, please know that ASHP stands ready to offer you and your healthcare colleagues that same level of steadfast support. In addition to advocating to give you access to critical medications, ASHP continues to update and create new resources and tools that can be found on our COVID-19 Resource Center. We have also opened access to many evidence-based online resources and tools on ashp.org, making them widely available to all pharmacists and the broader healthcare community.

Over the last few weeks, I have heard countless stories from members and others about the challenges they are facing, but I’ve also heard many stories of hope and heroism. I, and David Chen, ASHP assistant vice president for Pharmacy Leadership and Planning, have listened in on calls from pharmacy leaders at major health systems in New York City, the pandemic’s current epicenter. We are incredibly impressed by how these leaders have shared their information and experiences and how they support each other and their frontline staff. This is a tremendous example of how peer-to-peer connection and communication can aid in the pandemic response. Their experiences and willingness to share their stories will undoubtedly help others in responding to COVID-19 in facilities across the country. We applaud them for these efforts.

Please also know that ASHP is here to support your well-being, which should remain a priority for all healthcare personnel during this challenging time. Please make sure that you are taking care of yourself and your family.

“ASHP has our backs.” These are the words of a member who recently reached out to us. This really resonated with me, and I can assure you that we will continue to work across all fronts, leveraging our talented staff, our valued partners, and our amazing members to provide you with the information, connections, and resources you need today and in the future.

Thank you for everything you do for your patients and the profession.

Sincerely,

Paul

March 26, 2020

Update on ASHP Resources and Efforts to Help Combat COVID-19

Dear Colleagues,

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

I WANT TO CONTINUE TO UPDATE YOU on our most recent efforts on your behalf to face the rapidly evolving impact of the COVID-19 pandemic.

New COVID-19 Resources for All

ASHP continues to work to create up-to-date, evidence-based tools and provide the most current resources that you can trust to support your work on the front lines of patient care.

ASHP, through the leadership of our drug information staff in AHFS, created an evidence table to help practitioners better understand current approaches related to the proposed treatment and care of patients with COVID-19. ASHP’s Assessment of Evidence for COVID-19-Related Treatments also includes an assessment of the evidence around supportive treatments and selected chronic medications that may be used in this population.

This resource provides a concise summary – for pharmacists, physicians, and other health professionals – of published studies related to the use of hydroxychloroquine, azithromycin, and remdesivir and other antivirals in the treatment of people with COVID-19. We are updating this document regularly as new evidence becomes available.

We have made this valuable resource available for free to everyone, both domestically and internationally. We encourage you to share it with anyone who you believe would benefit from it, including your colleagues in medicine, nursing, state and local government, and others.

Earlier this week, we published our newest resource, supporting the stewardship of off-label treatments for COVID-19. Inappropriate prescribing can lead to an inadequate supply of medications for those who need them most. Stockpiling and hoarding may also create or exacerbate shortages. This resource was created to support the interprofessional care team as it makes decisions about the off-label use of medications for confirmed or suspected COVID-19 cases, allowing clinicians to weigh supporting evidence, risks, and potential benefits.

Yesterday we issued a joint statement with the American Medical Association and the American Pharmacists Association addressing the inappropriate ordering, prescribing, or dispensing of medications to treat COVID-19. The statement cautions about the lack of strong evidence for the off-label use of medications for COVID-19 as well as stockpiling medications, and opposes the prophylactic prescribing of medications currently identified as potential treatments for COVID-19.

You can find the full text of the joint statement, tools, and many other resources on ASHP’s COVID-19 Resource Center, which is updated frequently with the latest information and news. Our resources, along with many other practice and educational tools on ashp.org, are now open access and available to all healthcare professionals. We encourage you to share these materials with anyone who may need them in your network and community. 

Personal Protective Equipment Survey

ASHP is closely monitoring personal protective equipment (PPE) shortages that we know are affecting many of our members and other healthcare providers. We are conducting a bi-weekly survey to obtain an updated status of supplies and the availability of medical masks, including surgical masks, N-95 respirators, or mask alternatives currently being used in healthcare settings.

According to the results of our first survey, 15% of respondents indicated either a major or moderate disruption in the availability of medical masks, and over half indicated their vendor is allocating supplies of PPE. ASHP has been in contact with The Joint Commission, United States Pharmacopeia, and other experts and stakeholders to call attention to the critical nature of some PPE supplies and to develop guidance for compounding pharmacies. The United States Pharmacopeia Compounding Expert Committee has developed recommendations in response to shortages of garb and PPE for sterile compounding.

The second ASHP PPE survey is currently in the field, and we will continue to update you on the results.

ASHP Connect Community

Last week ASHP launched the COVID-19 Connect Community. ASHP members — and any healthcare provider — can use this resource to ask questions, receive answers, share experiences, post resources, receive updates, and learn best practices to support your patients and each other. We will also post updates about new resources, guidance documents, news, and announcements to this community. I encourage you to join your healthcare colleagues in the new ASHP Connect Community.

ASHP Advocacy Efforts

Finally, I’m pleased to share with you that several of ASHP’s recommendations to mitigate the risks that drug shortages pose to patients and the healthcare system were included in the Coronavirus Aid, Relief, and Economic Security (CARES) Act that Congress voted to advance yesterday. The legislation, passed unanimously in the Senate, includes five key drug shortages provisions, including:

  1. Prioritizing reviews of drug applications, including expediting inspections and reviews for abbreviated new drug applications
  2. Mandatory manufacturer reporting of some drug shortage information that is currently voluntary
  3. Expansion of current manufacturer reporting requirements to include interruptions or disruptions of a drug’s active pharmaceutical ingredient’s availability
  4. Requiring manufacturers to develop risk management and redundancy plans for their supply chains
  5. Including medical devices in shortage reporting requirements during a public health emergency

While the CARES Act provides significant resources to assist hospitals in responding to COVID-19, unfortunately, pharmacist provider status in Medicare, which is language that we have been working to include, is not in this legislation. Please know that we will continue to actively advocate for Congress to recognize pharmacists as providers in the Medicare program, including and beyond the current pandemic.

ASHP is here to support you in every way we can during this public health emergency. We will continue to bring you new and updated resources to meet your evolving needs and advocate on your behalf. Thank you for being a member of ASHP and for everything that you are doing for your patients and our profession during this pandemic.

Sincerely,

Paul

August 27, 2019

Ohio ASHP Members Successfully Advocate for Provider Status

Jackie Boyle, M.S., M.B.A., BCACP, BCPS

ON APRIL 5, 2019, AN OHIO LAW went into effect that will help pharmacists practice at the top of their license by officially recognizing them as providers. This groundbreaking legislation occurred thanks to the dedication and persistence of pharmacists across the state, including ASHP members Jackie Boyle, Keith D. Posendek, and Mary Ann R. Dzurec.

Under S.B. 265, which was signed by Governor John Kasich on January 4, 2019, pharmacists are allowed to bill public and private insurance companies directly for the services they provide to patients. “As a result of having provider status and the ability to bill directly for their services, pharmacists will be able to create new and innovate ways of delivering patient care,” said Jackie Boyle, M.S., M.B.A., BCACP, BCPS, Associate Professor of Pharmacy Practice at Northeast Ohio Medical University. She is also the Immediate Past President of the Ohio Society of Health-System Pharmacists (OSHP). “Several healthcare models already exist—the traditional hospital model, the clinic model, and the community pharmacy model,” Boyle explained. “As we see more and more technology moving into healthcare like telehealth and artificial intelligence, we can create care models that are more convenient for patients.”

A Passion for Advocacy
Boyle, an ASHP member since 2008, has always been interested in advocacy. She completed an elective residency experience during her PGY2 with the ASHP Government Relations Division in 2014. During that time, Boyle had the opportunity to review several new pieces of legislation that were being introduced, including one concerning biosimilars. She also visited Capitol Hill to talk with legislators about provider status and the role of the pharmacist on the healthcare team—all of which fueled her passion for advocating on behalf of her colleagues and profession.

Keith D. Posendek, Pharm.D., BCPS, BCGP

Since cultivating this interest, Boyle has become a voice for pharmacy in Ohio. When the opportunity arose to advocate for provider status for pharmacists, she jumped at it. Boyle testified in front of the Ohio Senate in support of S.B. 265, where she stressed the importance of provider status. “I explained that this bill is critically important to the public health of the state. It expands pharmacists’ ability to work in direct patient care roles and use their expertise to achieve positive health outcomes,” Boyle said. “This change would increase patient access to pharmacist-provided care.”

Boyle included several anecdotes about how pharmacists can impact patient care in her testimony. For example, she explained how one of her patients recovering from a heart attack was prescribed a medication that influenced his heart rate. Boyle identified a more appropriate medication. A few years later, the patient came back to tell her about the progress he had made and thanked her for changing his life.

A Team Effort
Although Boyle was instrumental in pushing S.B. 265 forward, she stressed that getting the law passed was very much a team effort. Many pharmacists in Ohio, including ASHP members, contributed to the cause.

Keith D. Posendek, Pharm.D., BCPS, BCGP, Clinical Pharmacist Specialist at Adena Regional Medical Center in Chillicothe, participated in a letter-writing campaign, including emails and handwritten notes, in support of S.B. 265. He also called politicians’ offices. Although he didn’t speak to legislators directly, he talked to staff members about the services pharmacists provide.

Mary Ann R. Dzurec, Pharm.D., BCACP

Dr. Posendek, who has been an ASHP member since 2015, noted that another valuable part of his advocacy was to spread the word about S.B. 265 to other pharmacists. He urged his pharmacy colleagues to remind lawmakers that pharmacists make vital contributions to the community and improve the health of the constituents politicians represent.

“Anything helps, whether it’s writing to your politician, calling them, visiting them, or going to local political action committee meetings,” Dr. Posendek said. “It’s nice to remind [your local lawmakers] that you are a constituent and part of their community. Tell them that you are advocating for an issue because you’re a pharmacist and also because you’re part of the community and can make a difference.”

A Seat at the Table
Mary Ann R. Dzurec, Pharm.D., BCACP, Ambulatory Care Pharmacy Specialist at MetroHealth, a safety net health system providing inpatient and outpatient care to the underserved in Cleveland, also lobbied legislators by sending letters encouraging them to support S.B. 265.

Dr. Dzurec, who has been an ASHP member throughout her nearly 35-year career, precepts a longitudinal advocacy rotation for pharmacy residents at MetroHealth. Throughout the year-long rotation, she teaches the residents about the importance of working with state lobbyists and directly reaching out to legislators. Dr. Dzurec and the residents review pending legislation and Ohio Board rule proposals, and provide formal written comments.

She believes that pharmacists are well-equipped to create a pathway to better healthcare for patients. “My advice to pharmacists and pharmacy students is to take a leadership role in promoting the pharmacist’s role in a health care setting. You’ll find a great deal of satisfaction in your work, and your patients will appreciate you for it,” said Dr. Dzurec.

 

By Kenya McCullum

 

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