Join Us
VSHP Spring Seminar 2020
Virginia Crossings Hotel
Richmond, VA
March 6-7, 2020
12 hours of live CE available
For agenda, registration and other details, visit: http://vshp.org/page-1075368
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Call for Nominations
The 2020 VSHP Committee on Nominations is pursuing members who wish to get or stay active and involved in VSHP. These candidates should exhibit qualities of leadership, vision and professional awareness that will sustain the enterprising and pioneering spirit that has characterized VSHP.
The offices of President-elect, Secretary, Board Member at Large, and Technician at Large are included in this election cycle. Nominees for President-elect, Secretary, Board Member at Large must be a pharmacist member of VSHP. Nominees for Technician Board Member at Large must be a technician member of VSHP.
The term of office for the President-elect will be June 2020-June 2021; President from June 2021-June 2022; Chair of the Board June 2022-June 2023.
Secretary and Board member at large are 2 year terms from June 2020-June 2022.
Additionally, VSHP is accepting nominations for Regional President-elect for each of the 8 VSHP Regions
. (see map attached).
Region Presidents-elect are 2 year terms from June 2020-June 2021 as president-elect and June 2021-June 2022 as Region president.
All interested VSHP members who would like to self-nominate or nominate a colleague for any VSHP or Regional office are encouraged to do so via email to the VSHP Nominations Chair, c/o Steve Glass, Executive Director (contact@vshp.org) Nominations will be accepted through Friday, March 13, 2020.
Although any member may nominate a pharmacist for VSHP office, VSHP bylaws state that only pharmacist members may vote in the election.
Candidates for state office will be vetted by the VSHP Nominations Committee and ballots will be administered electronically after nominees have accepted and been verified.
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FREE CE for VSHP Members!
Webinar-Thursday, March 19, 2020 - 12:00pm-1:00 pm
Title: ASHP Pharmacy Forecast 2020
Presenter:
Cindy Williams, BS Pharm, FASHP
Vice President/Chief Pharmacy Officer
Riverside Health System
Learning Objectives:
1. Review the 2020 ASHP Pharmacy Forecast and it's role in advancing the pharmacy profession
2. Discuss practice recommendations related to patient centered care
3. Evaluate forecast panelist predictions concerning Pharmacy education and workforce
Virginia Society of Health-System Pharmacists is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. Participants of t
he sessio
n who complete the evaluation and provide accurate NABP e-Profile information will have their credit for 1.0 contact hours (0.10 CEU) submitted to CPE Monitor as early as 14 days after the event and no later than 60 days after the event. Please know that if accurate e-Profile information is not provided within 50 days of the event, credit cannot be claimed after that time. The participant is accountable for verifying the accurate posting of CE credit to their CPE Monitor account within 60 days.
UAN # 0108-0000-20-023-L04-P; 0108-0000-20-023-L04-T
This is a member service of VSHP. There is no charge for members to attend.
Dues must be current to receive CE credit.
Non-members will be charged $20.
After registering, you will receive a confirmation email containing information about joining the webinar.
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VSHP Leadership Profile
Jonathan Puhl, Pharm.D.
What is your current leadership position in VSHP?
Currently I am president-elect for Region 2.
What benefits do you see in being active in a professional association such as VSHP?
I think the benefits are numerous. But for me personally, it is a great way to build a network of pharmacists. We are all tackling the same projects, and same issues at each of our institutions. This a great way to reach out and discuss.
What initially motivated you to get involved in VSHP?
My initial motivation was to connect with the pharmacists in my area. There are several that are involved from my institution and they encouraged me to be more involved.
Where did you go to pharmacy school?
Duquesne University in Pittsburgh, PA
Where have you trained or worked?
I did my residency training at Kaiser Permanente (mid-Atlantic States) and then went on to work at Georgetown University Hospital for almost 10 years.
Describe your current area of practice and practice setting:
Currently I am the Ambulatory Clinical Pharmacy Manager for the Inova Health System. I support our Inova Medical Group and our larger Signature Partners clinically integrated network. I provide pharmacy support and also oversee the ambulatory clinical operations. We have a great partnership with Shenandoah University and several faculty practice at our clinic sites.
What advice would you give to student pharmacists?
I think the best advice I would give is to try and experience as many things as they can in pharmacy school and residency. There are so many unique jobs for pharmacists, you may never know about. There might be something really interesting that you would never consider.
What pharmacy related issues keep you up at night?
The rising costs of medications because I see patients unable to afford things first hand. I think also the future of pharmacy when it comes to recognition as providers. We need this to continue to further out profession.
Do you have any special interests or hobbies outside of work?
I am big fan of sports (any Pittsburgh team), technology and computers, and traveling when I can now that I have two kids.
What is your favorite place to vacation?
I lived overseas for years, so I like to travel, not really vacation. I go to unique countries and get into cities and experience them. I tend to not do cookie-cutter traveling.
But if I have to, it would probably be a beach, something all-inclusive.
What 3 adjectives would people use to best describe you?
Fun, hard-working, team player
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A Review of the Updated Diagnosis and Treatment of Adults with Community-acquired Pneumonia from the American Thoracic Society and Infectious Diseases Society of America
Tonya Byrum, PharmD Candidate 2020 and Khalida O. Amini, PharmD, BCPS
Hampton University School of Pharmacy, Hampton, Virginia
Community-acquired pneumonia (CAP) remains a common cause of severe sepsis and is the leading cause of infection-related death in the United States. Mortality rates in severe CAP range between 30% to 40% and have remained virtually unchanged for four decades. Inadequate antibiotic treatment, illness severity, age, and comorbidities, including diabetes, heart disease, and chronic lung disease, continue to challenge improvements in clinical outcomes.1,2
The severity of illness, presence of comorbidities, and site of care provide the basis for standard regimen selection. E
mpiric antibiotic therapy targets the major bacterial pathogens:
Streptococcus pneumoniae
,
Haemophilus influenzae
,
Mycoplasma pneumoniae
,
Staphylococcus aureus
,
Legionella
species,
Chlamydia pneumoniae
, and
Moraxella catarrhalis. Patients with a history of prior respiratory isolation or at risk for methicillin-resistant
Staphylococcus aureus (MRSA) and
Pseudomonas aeruginosa receive additional antibiotic coverage for these pathogens. Multidrug-resistant
Enterobacteriaceae and other similar multidrug-resistant gram-negative bacteria are treated similarly to
P. aeruginosa.
2
Treatment guidelines for the management of CAP were last updated in 2007. In 2019, a multidisciplinary team evaluated the latest studies
and released updated recommendations for the diagnosis and treatment of CAP. The clinical practice guidelines for the management of adult patients with CAP were endorsed by the Society of Infectious Disease Pharmacists (SIDP) in July 2019 and approved by the American Thoracic Society (ATS) and Infectious Disease Society of America (IDSA) in May 2019 and August 2019, respectively. The guidelines were published in the
American Journal of Respiratory and Critical Care Management on October 1, 2019. It focused on pneumonia acquired outside of the hospital setting in adults without immunocompromised conditions. The updated CAP guidelines provide improvement opportunities from the time of clinical diagnosis to treatment and follow-up.
2
The current guidelines abandoned the previous narrative style of the 2007 guidelines in favor of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) format. The updated format follows a question-oriented style with evidence-based answers presented in a "is option A better than option B" format using the Patient or Population, Intervention, Comparison, Outcome (PICO) framework. There are 16 core PICO questions, providing new and revised recommendations on specific areas such as obtaining sputum and blood cultures, macrolide monotherapy, standard empiric therapy for severe CAP, the use of corticosteroids, and the routine follow-up chest imaging.
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Recommendations and Supported Evidence
In the diagnosis and treatment of CAP, sputum and blood cultures are typically obtained to determine the etiology, identify the pathogen, and narrow antibiotic therapy. On one hand, obtaining an acceptable sputum specimen can be challenging, and recent antibiotic therapy can further complicate the validity of the culture results. On the other hand, there is no strong evidence to argue against their collection, and they may be beneficial in improving antimicrobial stewardship. Therefore, the updated 2019 guidelines endorse the collection of sputum and blood cultures in severe disease, similar to the 2007 guidelines recommendation. In addition, they are now also recommended in all inpatient cases empirically treated for MRSA or
P. aeruginosa.
2
In the 2007 guidelines, the decision to treat CAP patients in the outpatient setting or admit into the hospital was based on the severity-of-illness scores, such as the CURB-65 or Pneumonia Severity Index (PSI). The guidelines did not establish a preference for one over the other.
3 In the updated 2019 guidelines, in addition to clinical judgment, PSI is strongly recommended over CURB-65 to determine the need for hospitalization. Of note, these tools should not be used to determine the escalation of care into the ICU since both CURB-65 and PSI tools were not designed for selecting the level of care. Therefore, the current guidelines recommend against their use for this purpose. The panel recommends using the minor severity criteria from the 2007 IDSA/ATS's
Criteria for Defining Severe Community-acquired Pneumonia, along with clinical judgment to guide the escalation of treatment intensity.
2
In the 2007 guidelines, macrolide monotherapy was recommended for the treatment of CAP in the outpatient setting. In the new guidelines, the routine
use of a macrolide antibiotic as monotherapy for outpatient CAP was downgraded from a strong recommendation to a conditional recommendation, depending on the rate of resistance to pneumococcal pathogens in the area. For a local resistance rate of <25%, a macrolide may still be used as monotherapy. The panel rationalizes the decision based on
case-control and surveillance studies of macrolide failure in patients with
S. pneumoniae.
2,4,5,6 The 2011 "
Active Bacterial Core Surveillance (ABCs)" report from the Centers for Disease Control and Prevention (CDC) stated a resistance rate of >30%, and
McGeer et al. concluded that macrolide resistance contributes to an increased risk of macrolide failure
.5,6
Therefore, for standard treatment of CAP in the outpatient setting, in patients with no comorbidities or risk factors for MRSA or
Pseudomonas aeruginosa, the current guidelines strongly recommend Amoxicillin 1 g three times daily over doxycycline 100 mg twice daily or a macrolide
(azithromycin 500 mg on first day then 250 mg daily or clarithromycin 500 mg twice daily or clarithromycin extended release 1,000 mg daily). In patients with comorbidities, including chronic heart, lung, liver, or renal disease, diabetes mellitus, alcoholism, malignancy or asplenia, the guidelines strongly recommend either a respiratory fluoroquinolon
e (levofloxacin 750 mg daily, moxifloxacin 400 mg daily, or gemifloxacin 320 mg daily) as monotherapy or a combination regimen of either amoxicillin/clavulanate
(500 mg/125 mg three times daily, 875 mg/125 mg twice daily or 2,000 mg/125 mg twice daily) or
cephalosporin (cefpodoxime 200 mg twice daily or cefuroxime 500 mg twice daily) plus a macrolide, over the combination of amoxicillin/clavulanate plus doxycycline.
2
For the empiric treatment of non-severe CAP in the inpatient setting, in patients with no risk factors for MRSA or Pseudomonas aeruginosa, the 2019 guidelines strongly recommend either a β-lactam (ampicillin + sulbactam 1.5-3g every 6 hours, cefotaxime 1-2g every 8 hours, ceftriaxone 1-2g daily, or ceftaroline 600mg every 12 hours) plus a macrolide (azithromycin 500 mg daily or clarithromycin 500 mg twice daily) or monotherapy with a respiratory fluoroquinolone (levofloxacin 750 mg daily, moxifloxacin 400 mg daily) over a β-lactam plus doxycycline 100 mg twice daily regimen.2
For the empiric treatment of severe CAP in the inpatient setting, the 2007 guidelines awarded a higher level of evidence to the β-lactam plus fluoroquinolone combinations (level I, high) over the β-lactam plus a macrolide (level II, moderate). In the new guidelines, both combinations carry a strong recommendation; however, the panel sites stronger evidence in favor of macrolide-based regimens.
2,3
The new macrolide-centered recommendations were rationalized based on meta-analysis and systematic review of observational studies in which macrolide-containing therapies, often in combination with β-lactams, were associated with reduced mortality compared to non-macrolide regimens.
7,8
Sligl et al. conducted a review of 28 observational studies, including nearly 10,000 critically ill patients with CAP. Based on the primary analysis, macrolide use was associated with an 18% relative reduction (3% absolute) in mortality compared with non-macrolide therapies. An even larger mortality rate reduction was observed in studies that provided adjusted risk estimates.
7
In the treatment of inpatient CAP, the current guidelines no longer recommend using the algorithm for healthcare-associated pneumonia (HCAP) to drive antibiotic selection. The panel recommends empirically treating patients with MRSA or P. aeruginosa if deemed appropriate based on the presence of validated risk factors. These risk factors are defined by the 2007 IDSA/ATS's Criteria for Defining Severe Community-acquired Pneumonia. Patients meet the criteria in the presence of either one major criterion or three or more minor criteria. The current guidelines recommend vancomycin (15 mg/kg every 12 h, adjust based on levels) or linezolid (600 mg every 12 h) for MRSA coverage and piperacillin-tazobactam (4.5 g every 6 h), cefepime (2 g every 8 h), ceftazidime (2 g every 8 h), aztreonam (2 g every 8 h), meropenem (1 g every 8 h), or imipenem (500 mg every 6 h) for P. aeruginosa empiric coverage.
2
A newly-assessed and noteworthy update addresses the use of corticosteroids. The 2007 guidelines did not address their use. However, corticosteroids have been commonly used, mainly attributed to two randomized controlled studies (Confalonieri et al. and Nafae et al.) that reported reductions in mortality, hospitalization, and organ damage.
9,10 Since the studies, these findings have not been replicated, raising concerns over their validity. Overall, there is an absence of quality of data supporting the benefit of corticosteroids use in patients with CAP. In addition, the risk of adverse effects, such as hyperglycemia and hypertension raise legitimate safety concerns.
2,11,12 The panel acknowledges the need for large, multi-center randomized trials to define patients who may benefit or those who may be harmed. At this time, the panel strongly recommends against their routine use in patients with non-severe CAP and conditionally recommends them in severe CAP. The committee emphasizes that recommendations do not supersede the clinically appropriate use of steroids for comorbid diseases, such as COPD, asthma, and autoimmune diseases.
2 The guidelines still endorse the Surviving Sepsis Campaign's recommendations on the use of corticosteroids in patients with CAP and refractory septic shock
.
2,13
New Therapeutic Agents
The need for better evidence in support of β-lactam plus doxycycline combinations, concerns over macrolide resistance, and safety issues with fluroquinolones increase the need for additional therapeutic options.
2
The guidelines acknowledge two new, FDA-approved agents for the treatment of CAP, lefamulin (a novel pleuromutilin antibiotic)
and omadacycline (an aminomethylcycline antibiotic derived from the tetracycline class). However, the panel defers any definitive recommendations pending further validation and establishment of safety profiles.2
In the OPTIC trial, omadacycline was shown to be non-inferior to moxifloxacin monotherapy in patients with non-severe CAP and is reported to demonstrate effectiveness in the setting of tetracycline resistance.14 Similarly, the LEAP-1 trial demonstrated lefamulin to be non-inferior to moxifloxacin monotherapy in patients with non-severe CAP. It was generally safe and well-tolerated, and both
agents boast intravenous to oral formulations.14,15
Omadacycline and lefamulin demonstrated notable atypical coverage against
Mycoplasma pneumoniae
, Legionella
pneumophila
, and
Chlamydia pneumoniae. Coverage was
comparable to their respective moxifloxacin groups. The atypical activities observed in both drugs were consistent with their class effect.
14,15
Omadacycline and lefamulin are bacterial protein synthesis inhibitors. Omadacycline is a minocycline derivative that binds to the 30S ribosomal subunit of bacteria. Lefamulin binds to the peptidyl transferase component of the 50S ribosomal subunit. Both drugs provide promising options in patients who need atypical coverage. They could also be a viable alternative to macrolide in case of concerns for macrolide resistance.14,15,16
Table 4: Omadacycline and Lefamulin-
Comparison of Study Design and Inclusion/Exclusion Criteria14,15
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Trial
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Authors
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Design
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Inclusion
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Exclusion
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Omadacycline for Pneumonia Treatment in the Community (OPTIC) trial
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Stets et al
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Phase 3, double-blind, randomized, noninferiority trial
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- Adults greater than or equal to 18 years of age
- Three or more of the following:
- cough, purulent sputum production, dyspnea, or pleuritic chest pain
- At least two abnormal vital signs
- At least one clinical sign or laboratory finding associated with CABP
- Radiologically confirmed pneumonia
- Pneumonia Severity Index (PSI) risk class II, III, or IV
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- Systemic antibiotic within 72 hours before the first dose of trial drug
- Confirmed or suspected pleural empyema
- Clinically significant liver or renal insufficiency
- Immunocompromised
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Lefamulin Evaluation Against Pneumonia (LEAP 1) Trial
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File et al
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Phase 3, double-blind, randomized, non-inferiority trial
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- Adults greater than or equal to 18 years of age
- Fulfilled FDA entry criteria for CABP trial, including:
- Radiographic findings suggestive of pneumonia
- Pneumonia Outcomes Research Team (PORT) risk classes ≥III
- Acute illness (≤7 days)
- CABP symptoms (dyspnea, new or increased cough, purulent sputum production, chest pain) ≥3
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- Systemic antibiotic within 72 hoursbefore randomization
- Confirmed or suspected pleural empyema
- Clinically significant liver or renal insufficiency
- Immunocompromised
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CABP; Community acquired bacterial pneumonia
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Table 5: Omadacycline and Lefamulin-
Comparison of Outcomes, Results, and Adverse Effects 14,15
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Trial
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Endpoints
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Results
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Adverse Effects
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Omadacycline for Pneumonia Treatment in the Community (OPTIC) trial
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Primary efficacy endpoint
- Achievement of ECR, assessed at 72 to 120 hours after the first dose of trial drug on the basis of 4-point scale (absent, mild, moderate, or severe)
Secondary endpoint
- Achievement of IACR* at post-treatment evaluation, 5 to 10 days after the last dose of antibiotic
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- 774 patients randomized 1:1
n=386 omadacycline
n=388 moxifloxacin
- Omadacycline was noninferior to moxifloxacin for ECR
-
- 81.1% and 82.7%, respectively
- 95% CI −7.1 to 3.8
- Rates of IACR at the post-treatment evaluation
- o 87.6% and 85.1%, respectively
- o Difference, 2.5 percentage points
95% CI, −2.4 to 7.4
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Most frequent events:
-
Gastrointestinal (10.2% and 18.0%)
(1.0% and 8.0%).
Clostridium difficile
- No reports in the omadacycline group
- 2.1% in the moxifloxacin group
Reported deaths
- 8: omadacycline
- 4: moxifloxacin
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Lefamulin Evaluation Against Pneumonia (LEAP 1) Trial
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Primary endpoint
- Achievement of ECR 96 hours ± 24 hours after the first study drug dose of study drug
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- 551 patients randomized 1:1
n= 276 lefamulin
n = 275 moxifloxacin
- If MRSA was suspected, either linezolid or placebo was added to moxifloxacin or lefamulin, respectively
- Lefamulin was noninferior to moxifloxacin for ECR
- 87.3% vs 90.2%, respectively
- Difference −2.9%
- 95% CI −8.5 to 2.8
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TEAEs occurring in >2%:
- Lefamulin: hypokalemia, nausea, insomnia, and infusion site pain (all 2.9%)
- Moxifloxacin: diarrhea (7.7%)
Most common AE
Lefamulin vs Moxifloxacin ± Linezolid:
(0.7% and 7.7%)
(7.7% and 3.7%)
Infusion site pain (2.9% and 0%)
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ECR; early clinical response IACR; Investigator-assessed clinical response TEAEs;
treatment-emergent adverse events
*clinical response defined as resolution or improvement in signs or symptoms where no further antibacterial therapy was unnecessary
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Summary
More than twelve years have passed since the last CAP guidelines were published. The management of CAP remains challenging, and improvements in clinical outcomes remain elusive. The multidisciplinary team assessed and analyzed the most current data, leading to revised evidence-based recommendations for empiric treatment and other management strategies. Concerns related to safety and antibiotic resistance prompted a shift in treatment preferences and validated the need for new therapeutic options. The new guidelines promote improvement in a
ntimicrobial stewardship, which will optimize clinical outcomes and reduce microbial resistance. Throughout the guidelines, the panel acknowledges the need for higher quality evidence and continued research. They emphasize the intrinsic value of clinical judgment and experience in guiding treatment decisions.
- Nseir S, Mathieu D. Antibiotic treatment for severe community-acquired pneumonia: beyond antimicrobial susceptibility. Crit Care Med. 2012;40(8):2500-2002. doi: 10.1097/CCM.0b013e318256b9c7.
- Metlay, J. P., Waterer, G. W., Long, A. C., Anzueto, A., Brozek, J., Crothers, K., ... & Griffin, M. R. (2019). Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. American journal of respiratory and critical care medicine, 200(7), e45-e67.
- Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, et al.; Infectious Diseases Society of America; American Thoracic Society. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis 2007;44:S27-S72.
- Lonks JR, Garau J, Gomez L, Xercavins M, Ochoa de Echagüen A, Gareen IF, et al. Failure of macrolide antibiotic treatment in patients with bacteremia due to erythromycin-resistant Streptococcus pneumoniae. Clin Infect Dis 2002;35:556-564.
- Daneman N, McGeer A, Green K, Low DE; Toronto Invasive Bacterial Diseases Network. Macrolide resistance in bacteremic pneumococcal disease: implications for patient management. Clin Infect Dis 2006;43:432-438.
- Centers for Disease Control and Prevention. Active Bacterial Core surveillance (ABCs) report, Emerging Infections Program Network, Streptococcus pneumoniae, 2016. Available from: https://www.cdc.gov/abcs/reports-findings/survreports/spneu16.pdf
- Sligl WI, Asadi L, Eurich DT, Tjosvold L, Marrie TJ, Majumdar SR. Macrolides and mortality in critically ill patients with community-acquired pneumonia: a systematic review and meta-analysis. Crit Care Med 2014;42:420-432.
- Vardakas KZ, Trigkidis KK, Falagas ME. Fluoroquinolones or macrolides in combination with β-lactams in adult patients hospitalized with community acquired pneumonia: a systematic review and meta-analysis. Clin Microbiol Infect 2017;23:234-241.
- Confalonieri, M., Urbino, R., Potena, A., et al. Hydrocortisone infusion for severe community-acquired pneumonia: a preliminary randomized study. Am J Respir Crit Care Med 2005;171:242-248.
- Nafae, R.M., Ragab, M.I., Amany, F.M., Rashed, S.B. Adjuvant role of corticosteroids in the treatment of community-acquired pneumonia. Egypt J Chest Dis Tuberc 2013;62:439-445.
- Briel M, Spoorenberg SMC, Snijders D, Torres A, Fernandez-Serrano S, Meduri GU, et al.; Ovidius Study Group; Capisce Study Group; STEP Study Group. Corticosteroids in patients hospitalized with community-acquired pneumonia: systematic review and individual patient data metaanalysis. Clin Infect Dis 2018;66:346-354.
- Waljee AK, Rogers MA, Lin P, Singal AG, Stein JD, Marks RM, et al. Short-term use of oral corticosteroids and related harms among adults in the United States: population-based cohort study. BMJ 2017;357:j1415.
- Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving sepsis Campaign: international guidelines for management of sepsis and septic shock: 2016. Intensive Care Med 2017;43:304-377
- Stets R, Popescu M, Gonong JR, Mitha I, Nseir W, Madej A, et al. Omadacycline for community-acquired bacterial pneumonia. N Engl J Med 2019;380:517-527.
- File, T. M., Goldberg, L., Das, A., Sweeney, C., Saviski, J., Gelone, S. P., ... & Gasink, L. B. (2019). Efficacy and Safety of Intravenous-to-oral Lefamulin, a Pleuromutilin Antibiotic, for the Treatment of Community-acquired Bacterial Pneumonia: The Phase III Lefamulin Evaluation Against Pneumonia (LEAP 1) Trial. Clinical Infectious Diseases.
- Honeyman, L., Ismail, M., Nelson, M. L., Bhatia, B., Bowser, T. E., Chen, J., ... & Macone, A. (2015). Structure-activity relationship of the aminomethylcyclines and the discovery of omadacycline. Antimicrobial agents and chemotherapy, 59(11), 7044-7053.
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Did You Know...
There are 2 options for viewing-one with one hour of pharmacist or pharmacy technician CE credit ($10 CE processing fee) and one without CE.
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Clinical Writing Opportunities for APPE Students
As a new year of APPE rotations begin, writing a clinical article for the VSHP newsletter is a great way for students to get publication experience. As preceptors we can co-author these articles with our students, engage them in the writing process, and enhance their rotation experiences. Topics can be anything related to hospital-system pharmacy. Examples include (but are not limited to): new drug updates, national policy updates for hospital pharmacy, guideline updates, therapeutics reviews, and clinical controversies. Articles are generally 1-3 pages in length, and can include tables and figures. Interested member and students should email Steve Glass,
contact@vshp.org for more details.
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Copyright© 2019, Virginia Society of Health-System Pharmacists. All rights reserved.
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