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April 3, 2020

ASHP Update on COVID-19

Dear Colleagues,

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

WEDNESDAY EVENING I had the opportunity to participate on a director of pharmacy roundtable call with members of the New York State Council of Health-System Pharmacists. On the call, the current situation on the ground and lessons learned regarding the COVID-19 pandemic were shared by New York City pharmacy leaders. These individuals and their teams are true healthcare heroes. They are dealing with patient care situations that are beyond compare. Patient care needs have required an increase of propofol, fentanyl, and midazolam utilization by 400-600% in the past 14 days as they manage the demands of the intensive care unit and ventilated patients. One healthcare system shared that three weeks ago, it had 18 COVID-19 positive patients. As of Wednesday, they had 1,100.

We have all watched and listened to reports from New York, New Jersey, and other COVID-19 epicenters responding to this national pandemic. Listening firsthand to the heroic efforts of pharmacists on the front lines underscores the urgent need to proactively provide data to our health system, local, state, and national leaders on the pharmacy staff resources and drug supply needed to meet the needs of our COVID-19 patients. These extraordinary times will require remarkable coordination and responsiveness among our industry partners and government agencies.

ASHP has put the full weight of our advocacy efforts toward resolving these issues. This week, ASHP and the American Hospital Association, the American Medical Association, the Association of Clinical Oncology, and the American Society of Anesthesiologists, sent a letter to the Drug Enforcement Administration (DEA) requesting an immediate increase in controlled substances (CII) annual production quota allocations to manufacturers and 503B outsourcing facilities to increase the supply of opioids critical to COVID-19 patients on ventilators. ASHP’s letter notes the tightening CII supply and the need to increase production of fentanyl, hydromorphone, and other supportive CIIs as quickly as possible to avoid exacerbating existing shortages. ASHP will continue to work with the DEA, the Food and Drug Administration, manufacturers, and distributors to provide hospitals with the CIIs and other medications that are in short supply and critically needed to treat patients during the COVID-19 response.

Yesterday we sent a letter to Vice President Mike Pence, imploring him to encourage agencies to coordinate their efforts to increase manufacturing capacity for critical medications, including opioids, sedatives, and paralytics, to the greatest extent possible.

A colleague in New York expressed that a “tsunami” of drug shortages is coming as more hospitals and health systems struggle to manage the exponential rise in patient load. It is ASHP’s number-one priority to keep this issue at the forefront of public attention, and we will activate all of our partners and resources to help ensure you have the medications your patients need.

Launch of New Free Service: ASHP CareerPharm Rapid Connect

ASHP has been working on many fronts to assist you, our members, and all healthcare professionals to combat the COVID-19 pandemic. We continue to create new resources to support your valuable work on the front lines of patient care.

As the impact of the pandemic escalates, we are hearing from healthcare organizations nationwide that pharmacy departments are struggling to keep pace with the demands of the growing COVID-19 patient population. In response, I am pleased to share that ASHP has quickly developed and launched a new free service, ASHP CareerPharm Rapid Connect, to help healthcare organizations connect with pharmacists who can provide critical services including surge support with temporary onsite staffing, remote medication order review, remote clinical pharmacy specialist services, and other staffing needs. ASHP’s CareerPharm Rapid Connect also will help organizations connect with pharmacy technicians. We hope this free service will provide opportunities for hospitals, health systems, and others to fill a growing demand for pharmacy personnel during this urgent time of need.

PPE Shortages

In addition to the troubling issue of drug shortages related to COVID-19 patient care, ASHP members and other healthcare providers continue to face shortages of personal protective equipment (PPE). As I noted in last week’s blog, we are continuously surveying our members to understand the real-time impact of this issue. According to our most recent survey results, 58% of respondents whose organizations perform sterile compounding reported the need to reuse masks, and 42% reported a major or moderate disruption in the availability of medical masks. This is a substantial increase from the first survey, where 15% of respondents indicated disruptions in their supplies. We will continue to survey this situation and provide you with updates in the weeks ahead.

Given the data, ASHP is advocating for increased production and supply of PPE to ensure pharmacy personnel and other healthcare providers have adequate protection from exposure. We also continue to advance ASHP’s policymaker recommendations that address shortages of PPE for pharmacists and drug shortages to Congress, HHS, and the Vice President’s COVID-19 Task Force. Over 5,000 ASHP members have contacted their members of Congress to share those recommendations. If you haven’t yet, please consider reaching out to your members of Congress to ensure your concerns are heard.

We also created a dedicated section on ASHP’s COVID-19 Resource Center with the latest sterile compounding and PPE guidance and health policy statements. Resources include additional tools that ASHP created to support your needs as well as guidance from others, including the United States Pharmacopeia Compounding Expert Committee’s recommendations in response to shortages of garb and PPE for sterile compounding.

In addition, we continue to work on creating tools and resources to protect and assist you, our members, and all healthcare professionals as you work on the front lines of patient care. Today, we released our newest recommendations for pharmacists and pharmacy technicians on ways to prevent exposure to COVID-19 while in the workplace as well as recommendations on how to protect your family and friends to reduce exposure at home. Given the rapidly evolving guidance and recommendations supporting this effort, we will be updating these materials regularly.

Extending the Reach and Impact of the ASHP Community

ASHP supports our members by serving as a professional home and facilitating a sense of community. During this challenging time, we’ve expanded that community to include and support the interprofessional teams that are working together to treat patients in the face of unprecedented challenges.

In this spirit, you may recall that a few weeks ago, we opened access to our evidence-based online resources and tools on ashp.org, making them widely available to all pharmacists and the broader healthcare community. It gives us great satisfaction to know that members and non-members alike are using and sharing many of our important COVID-19 resources. More than 32,000 professionals have taken advantage of our free offering of ASHP’s Critical Care Pharmacy Specialty Review Course, Practice Exam, and Core Therapeutic Modules package, including more than 24,000 who are not currently ASHP members.

ASHP will continuously offer credible, trusted resources and share best practices, advice, and experiences from those on the front lines across the country. We recently launched a daily COVID-19 podcast on our @ASHPOfficial podcast channel with episodes featuring ASHP members and pharmacy practice leaders who discuss the evolving clinical, operational, and leadership challenges surrounding the COVID-19 pandemic. In the latest podcast episode, nationally recognized drug shortage expert Erin R. Fox and ASHP experts share the most recent information on drug shortages related to COVID-19 and the impact the recent relief bill passed by federal legislators will have on managing the supply chain. I encourage you to subscribe to @ASHPOfficial to receive this free, timely content.

As a reminder, we also recently established a COVID-19 Connect Community that ASHP members — and all healthcare providers — can use to ask questions, receive answers, share experiences, post resources, receive updates, and learn best practices related to COVID-19. Since it was launched less than two weeks ago, this active community has grown to more than 51,000 members and has generated nearly 500 discussions. It’s a wealth of real-time, real-life information. Please join and participate if you haven’t already.

Summer Meetings

Finally, I’d like to address our decision announced earlier this week to cancel the Summer Meetings in June. Our top priority is the safety of our meeting participants and staff, and supporting your patients’ needs. We are working on a plan to deliver many of the important activities from the Summer Meetings virtually, including educational programming and the House of Delegates. We’ll share the details as they become available.

In the meantime, please take care of yourself and your families. Be assured that we will continue to work tirelessly on your behalf. 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

March 12, 2020

ASHP Update on Activities During and in Response to the COVID-19 Pandemic

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

THE COVID-19 PANDEMIC is taking a major toll on people in the United States and around the world. The pandemic is taxing our entire healthcare system and public health apparatus and has or will affect all of our daily lives. ASHP wants you to know that we are here for you as you work on the front lines of patient care to help ensure your healthcare organizations are ready and that your patients get the best care possible. We understand that you and your loved ones may be at risk and the difficulty that this presents as you work to serve your communities and care for your patients during this crisis. We also know that the risks of drug shortages present major challenges in the care of your patients. ASHP and our colleagues at the University of Utah will continue to work to keep the ASHP Drug Shortages Resource Center updated, and we will continue to advocate on your behalf through continued outreach to policymakers as you stand ready to fight this public health emergency.

Last week, we developed two white papers detailing recommendations for federal and state policymakers to address the outbreak. Today, we also sent a letter to Vice President Mike Pence urging the Administration to take immediate steps to maximize pharmacist engagement in COVID-19 preparedness and response efforts. We also asked that decisive action by the Centers for Medicare & Medicaid Services be taken to remove barriers to pharmacists’ patient care services.

ASHP also developed a COVID-19 Resource Center, and we are continually updating it with new resources from various sources, including ASHP.

Due to the current COVID-19 developments, the “Safe, Effective, and Accessible High-Quality Medicines as a Matter of National Security” summit, originally planned for next week, will be postponed. We will be working with the other co-conveners, including the American Hospital Association, American Medical Association, and United States Pharmacopeia, to reschedule this important event in the coming months to continue to drive solution-focused recommendations that address global pharmaceutical manufacturing as a national security priority.

In addition, I would like you to know what we are doing to protect our staff, members and volunteers, and everyone we interact with at ASHP headquarters in Bethesda, Maryland. This includes preparing the organization for a scenario that could include closing our offices. However, we also recognize the need to be able to continue to serve our members even if our physical offices must be closed. We are prepared to run the organization remotely so that we can continue to work on your behalf and provide the tools and resources you need to care for your patients and yourselves.

Furthermore, I would like you to know that ASHP is also assessing all of our upcoming member events on a daily basis. The ASHP Regional Delegates Conferences that are taking place at the end of April in cities around the country are being planned to be held virtually if necessary.

In regard to the ASHP Summer Meetings that are scheduled to take place in Seattle in early June, it is too early to make a final decision. However, we will be fully prepared to make that difficult decision if there is any risk whatsoever to our participants. Safety comes first, no exceptions.

During this crisis, ASHP will remain focused on how we can best assist you, our members, and work at the local, state, and federal levels to be a partner in bringing this unfortunate public health crisis to an end. If you need our assistance, please don’t hesitate to contact ASHP. Please also continue to look to ASHP for up-to-date information and resources on the COVID-19 crisis. We will get through this difficult time together, and be stronger as a profession, citizens, and as a country and global community. In the meantime, ASHP will do everything we can to support you and the patients you serve.

Thank you for everything you do, and please know that we are here for you during this very difficult time.

Sincerely,

Paul

 

February 21, 2020

New Mexico Legislation Expands Access to Pharmacist Care

Dear Colleagues,

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

A concerted and highly organized effort has resulted in a significant step forward for pharmacists and patients in New Mexico. Pharmaceutical Services Reimbursement Parity (House Bill 42), passed by the New Mexico Senate on February 20, will expand access to healthcare by enabling pharmacist clinicians and other pharmacists with prescriptive authority to be reimbursed for clinical services.

ASHP’s Government Relations team worked closely with the New Mexico Society of Health-System Pharmacists (NMSHP), the New Mexico Pharmacy Association, the UNM College of Pharmacy SSHP, and others to mobilize grassroots support urging Gov. Michelle Lujan Grisham and members of the New Mexico legislature to pass the bill.

This is a wonderful achievement for pharmacists and their patients in New Mexico. It also serves as a strong building block as we work toward achieving pharmacy provider status nationally. Supporting states in expanding access to pharmacist care is a key part of ASHP’s larger vision that medication use will be optimal, safe, and effective for all people all of the time.

Multiple studies have shown that pharmacist-provided clinical services expand access to care, improve chronic disease outcomes, and help decrease the cost of care with research estimating that every $1 invested in clinical services by pharmacists reduces overall healthcare costs by $4.[1] We are working hard to make sure that policymakers across the country recognize that value and the impact you bring to patient care.

I would like to express my thanks to all of the individuals and organizations that worked so hard to support the passage of the bill, including Keenan Ryan, NMSHP president, Dale Tinker, executive director of the New Mexico Pharmacists Association, and the students at UNM College of Pharmacy who worked to make sure every legislator in New Mexico understood the importance of this legislation.

We have great momentum on this critical issue and look forward to continuing our advocacy efforts on expanding access to pharmacist care in other states to help improve patient health for all.

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

Sincerely,

Paul

 

[1] Avalere. Exploring Pharmacists’ Role in a Changing Healthcare Environment. May 21, 2014, available at https://avalere.com/insights/exploring-pharmacists-role-in-a-changing-healthcare-environment

 

 

 

December 17, 2018

ASHP Continues to Lead on Pharmacy Workforce Well-Being & Resilience

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

I am pleased to share with you that over the last year ASHP has continued to increase our efforts to support the well-being and resiliency of the pharmacy workforce. ASHP is an original sponsor of the National Academy of Medicine (NAM) Action Collaborative on Clinician Well-Being and Resilience and is honored to support the pharmacy profession on this important patient care and workforce issue. As the NAM Action Collaborative on Clinician Well-Being and Resilience approaches the two-year mark, I would like to share some updates with you on our efforts to help address this important issue facing pharmacists, pharmacy residents, student pharmacists, and pharmacy technicians.

These past 15 months, through the NAM Action Collaborative and ASHP’s own organizational efforts, we have raised the visibility of clinician burnout, depression, stress, and suicide. Over that time, ASHP has developed resources, educational programming at our national meetings, and community connections for members to learn more about the issue. Former U.S. Surgeon General Vivek Murthy kicked off our 2018 ASHP Summer Meetings by challenging attendees to include well-being as the core of what we do as healthcare workers.

Summer Meetings attendees also heard about some of the science behind resilience and were introduced to interventions for building individual and team resilience through two interactive presentations by Dr. Bryan Sexton, Director of the Duke Patient Safety Center. Conversations on the topic continued in the ASHP House of Delegates, where delegates approved an ASHP policy on Clinician Well-Being and Resilience. We are very pleased to have an official professional policy for members to reference as they begin and continue discussions at their institutions. Efforts by the ASHP House of Delegates also helped form a joint ASHP Council and Commission session on the pharmacists’ role in suicide prevention during the 2018 ASHP Policy Week.

We know that burnout is associated with compromised patient safety and a loss of productivity in the healthcare workforce. As such, we continue to help advance pharmacy-specific research on resilience and well-being. ASHP recently partnered with the Pharmacy Technician Certification Board (PTCB) and Duke University Health to study the prevalence of burnout in pharmacy technicians and identify resources to support this important and growing segment of ASHP’s membership. While both NAM and ASHP are improving baseline understanding of challenges to clinician well-being, we are reminded that this is a local issue that requires local solutions to address it. ASHP members continue to share their strategies on how to foster the creation of resilience in clinical learning and managing preceptor burnout. If you traveled to Anaheim for the recent Midyear Clinical Meeting, there were multiple educational sessions on workforce well-being. Many of these sessions were recorded and will be available on ASHP eLearning in early 2019.

NAM recently kicked off a consensus study to examine systems approaches to improve patient care by supporting clinician well-being. ASHP nominated M. Lynn Crismon, Dean, University of Texas, College of Pharmacy, to serve on this committee, which will issue a report with recommendations for system changes to streamline processes and manage complexity, minimize the burden of documentation requirements, and enhance workflow and teamwork to support the well-being of all clinicians and trainees. In the meantime, the NAM clinician well-being knowledge hub continues to grow with solution strategies for leaders, organizations, and individuals, including ASHP contributions to a discussion paper on implementing optimal team-based care to reduce clinician burnout. ASHP state affiliates are also an important part of the conversation, and ASHP has created a state affiliate toolkit on well-being and resilience to assist them in their state-level efforts.

Our continued work in advancing workforce well-being and resilience is ultimately growing a foundation for long-term culture change. We have enhanced our SSHP Recognition Program for the 2018–2019 academic year to encourage our students to address the issue. We know that many of you are working on well-being and resilience within your organizations, and we would appreciate hearing from you. We encourage you to share your stories through our community on ASHP Connect. Or, maybe you know of an individual or an organization that is demonstrating positive progress on resilience and supporting a healthy and engaged workforce. If so, we encourage you to fill out this brief survey so that we can create case studies others can learn from.

I hope you share our enthusiasm about this very important work to support the resilience and well-being of the entire pharmacy workforce and about the impact this work will have on improving patient care.

Thanks so much for being an ASHP member and for everything you do for your patients and pharmacy teams. I look forward to sharing more with you in the future as ASHP’s efforts continue in this important area. Have a safe holiday season.

Sincerely,

Paul

August 20, 2018

Get Ready to Join the New ASHP Section of Specialty Pharmacy Practitioners

Filed under: From the CEO — Tags: , , , , , — Amy Erickson @ 7:33 pm

AS MANY OF YOU KNOW, the ASHP Board of Directors approved the creation of a new Section of Specialty Pharmacy Practitioners during its June meeting. The creation of this important new section is an example of how ASHP is providing leadership to shape the evolving healthcare landscape. The new section is the membership home for all pharmacy practitioners who are interested or engaged in specialty pharmacy.

All current and new members who practice in broad and diverse specialty pharmacy areas are invited to join the new section. We encourage those who provide direct patient care services and help manage and support the interface between specialty pharmacies, their organizations, and the patients they serve to also join the new section. ASHP members can add the section to their already existing benefits, providing an enhanced value to their membership at no additional charge.

Section of Specialty Pharmacy Practitioner members will provide ASHP with overall direction for a broad range of education, tools, resources, strategic initiatives, professional policies, and more. This member-driven approach ensures that the resources ASHP provides reflect the current and f

uture state of pharmacy practice, and it does so in a way that helps pharmacists provide optimal care to their patients. We’re eager for the members of the new Section of Specialty Pharmacy Practitioners to contribute in meaningful ways and guide ASHP on the path forward for specialty pharmacy practice.

The new section will meet the needs, address the challenges, and identify opportunities of this unique and growing industry and patient populations. The role of specialty pharmacy practitioners is vital to improving health outcomes, identifying accessible and affordable medications for rare and chronic conditions, and ensuring the highest quality of care for these complex and highly specialized patients. ASHP envisions many new professional growth opportunities for our members in this exciting and evolving pharmacy practice area.

We plan to have the new Section of Specialty Pharmacy Practitioners fully up and running this fall. The inaugural ASHP Section Executive Committee will be appointed at the end of August and will begin its important work on behalf of the new section during its first meeting in October. ASHP will be seeking additional volunteers to serve in advisory group capacities. We will be reaching out to you soon to encourage you to join the ASHP Section of Specialty Pharmacy Practitioners and spread the word about this new endeavor.

The energy and excitement for the new ASHP Section of Specialty Pharmacy Practitioners is very high, and we look forward to engaging many current and new ASHP members in its important activities.

Thank you for being a member of the fastest-growing and most forward-looking organization in pharmacy, and for everything you do for your patients and our profession.

Sincerely,

Paul

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