July/August 2021 Newsletter |
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In This Issue:
- President's Message
- Board of Director's Update
- Annual Summary Update
- Public Policy Update
- R & E Foundation Update
- SOP Update
- Pharmacist Continuing Education Articles
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Old Dogs Gout New Tricks: Exploring New Indications for Gout Medications
- Weighing Your Options: Strategies in Managing Obesity
- Featured Clinical Topic: Cardiology/Anticoag
- Evaluating Bleeding Risk with use of Direct Oral Anticoagulants in Patients with End-Stage Renal Disease
- Anticoagulants for thrombosis prevention in patients with COVID-19
- Intravenous Iron Therapy in Acute Decompensated Heart Failure
- Sacubitril/Valsartan for Heart Failure with Reduced Ejection Fraction
- Direct Oral Anticoagulant Use for Venous Thromboembolism Treatment in Morbidly Obese Patients
- Affiliate Chapter News and Events
- Upcoming Newsletter Info
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By Christina Stafford, PharmD, BCPS; MSHP President; CoxHealth, Springfield |
““Live as is you were to die tomorrow. Learn as if you were to live forever.”- Mahatma Gandhi
“Look for the helpers. You will always find people who are helping.” – Fred Rogers’ mother Nancy
As I reflect on the past 16 months, I cannot help but be amazed by the perseverance and dedication that all of you have displayed. I feel so extremely fortunate to be starting off my term as president serving alongside all of you!
In my inaugural address, I stated that my vision for this next year is to focus on continuing to increase our efforts; providing educational opportunities for our members and our patients; supporting the ASHP Task Force on Racial Diversity, Equity, and Inclusion; and continuing the fight against the opioid epidemic. I am deeply passionate about these topics and look forward to making advances in each of them.
The theme that I chose for this year is another of my passions- sports! The teamwork involved to be successful reminds me of this organization. Many professionals coming together for a common goal. In our case, that goal is being the best advocates for our patients that we can be.
I look forward to working with all of you and hope so badly to see many of you in person at the Spring Meeting next year!!
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Board of Director's Update |
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By Christina Stafford, PharmD, BCPS- MSHP President; CoxHealth, Springfield
May
- PDMP passed the MO state House and Senate!!! It’s headed to the Governor’s desk for signature
- The Board voted to approve the Public Relations Policy as written
- The Membership Committee developed list of ASHP members who were not MSHP members and sent out for review
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Strategic Planning Meeting to occur on June 4th
June
- Welcome to our new Board Members! Thank you to members finishing their terms on the Board!
- Diane McClaskey, Davina Dell-Steinbeck, Carolyn Huninghake, and Val Ruehter submitted an article to AJHP about MSHP/KCHP remote/virtual rotations survey results
- Public Policy Team met with MPA/MHA to discuss PDMP efforts
- DHSS has proposed draft tech-check-tech language for rule-making process
- The BOD voted to approve all updates to the Operational Policies & Procedures
- MSHP signed onto ASHP’s letter to Congress for Support for the Pharmacists and Medically Underserved Areas Enhancement Act
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MSHP Annual Report of Organization Activities
By Sarah Cook, Pharm.D., BCPS; SSM Health St. Joseph’s Hospital – St. Charles
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Although the 2020-2021 brought many new challenges to MSHP due to the COVID-19 pandemic, the Board of Directors and committees still accomplished a lot! Read below to hear about all of the accomplishments from the last year. |
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Annie Stella, PharmD, BCPS; Centerpoint Medical Center, Independence, MO |
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Increasing Access, Reducing Medication Waste
In 2019, the Department of Health and Senior Services rules for hospitals were updated. Under CSR 30-20.100 Pharmacy Services and Medication Management now states that Missouri hospitals and emergency departments can send bulk medications home with patients upon discharge. Any multi-dose container that was used for or administered to the patient during their hospital stay may be sent with the patient at discharge when ordered by an authorized practitioner. This includes, but is not limited to, inhalers, ointments, creams, medications requiring the original container for dispensing, insulin pens, eye drops, ear drops, and infusions that are currently connected to the patient’s infusion device.
Written instructions for use shall be provided by a pharmacist, prescriber or a registered nurse at the time of discharge.
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The R&E foundation just concluded our every three year transfer of leadership. A huge thank you to Jackie Harris for her three years of service in the Executive Chair role. She was able to successfully navigate many challenges, not the least of which was continuing the vital R&E Foundation activities during our annual spring meeting, twice during the ongoing pandemic. Additionally, we would like to thank Becca Nolen and Christina Stafford for their service to the Foundation. Becca has served her three-year commitment and Christina has assumed the role of President of MSHP.
We have added the following members to the Foundation:
- Tony Huke-Executive Director
- Nathan Hanson-MSHP President Elect
- Davina Dell-Steinbeck-MSHP Immediate Past President
- Sayo Weihs-MSHP Treasurer
- Kristin Peterson MSHP Treasurer Elect
- Alex Oschman
Additionally, we have several returning Foundation members to ensure a consistent and smooth transition period.
The R&E Foundation has many activities planned for the upcoming year. We are excited to return to supporting student travel for the ASHP Clinical Skills Competition during the AHSP Midyear Clinical Meeting. We plan on our usual Spring Meeting activities of awards, posters, best practice projects and a social event to help raise funds for the Foundation. We have some new and exciting opportunities coming soon, so please keep an eye on your inbox!
Respectfully submitted,
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Tony Huke, Pharm.D., BCPS
MSHP R&E Executive Director
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University of Health Sciences
and Pharmacy in St. Louis
from Interim Dean Brenda Gleason
The 2020-21 academic year has been one filled with exciting changes and extraordinary accomplishments at University of Health Sciences and Pharmacy in St. Louis.
A RETURN TO IN-PERSON LEARNING
Following our pivot to an online learning format in spring 2020 due to the COVID-19 pandemic, we were thrilled to welcome students back to campus for in-person learning and living for the fall 2020 semester. Maintaining health and safety as our top priorities, we were able to successfully deliver in-person and virtual learning opportunities throughout the 2020-21 academic year while reducing the risk of exposure for the campus community. As we continue to navigate the pandemic, I’m enormously proud of how well our students, faculty and staff continue to adapt and excel during these extraordinary times.
A NEW NAME
The fall semester also ushered in a new era for our institution with the unveiling of our new name and brand identity to better reflect our growth in degree offerings and research. In September, the institution formally announced its name change to University of Health Sciences and Pharmacy in St. Louis. The University umbrella includes both St. Louis College of Pharmacy, which houses the Doctor of Pharmacy program, and the College of Arts and Sciences, which houses the University’s undergraduate programs. The new name and brand identity is designed to honor our institution’s past while highlighting its dedication to being a health-care focused, interprofessional learning environment educating the next generation of pharmacy and health care practitioners, leaders and innovators.
A PLAN FOR THE FUTURE
In step with our new name and brand identity, the University’s Board of Trustees approved a new, three-year strategic plan in January outlining six, key strategic directions designed to provide a new vision for the University and position it for the future during a time when higher education is facing new challenges and rapid changes.
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Teaching & Learning: Facilitate a world-class education.
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Discovery & Innovation: Demonstrate impactful research, scholarship, personal growth and continuous improvement.
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Student, Faculty and Staff Experience: Provide an enriching environment and opportunities for a meaningful experience for all.
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Diverse Perspectives: Expand horizons to foster social awareness and cultural sensitivity.
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Community Engagement: Leadership, service and advocacy to build stronger communities.
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Resources and Infrastructure: Grow resources, improve administrative processes and provide an optimal infrastructure to support our community.
These strategic directions will represent our foremost charges moving forward.
A NEW CHAPTER BEGINS WHERE A LEGACY ENDS
This summer, we are congratulating John A. Pieper, Pharm.D., FCCP, FAPhA, FFIP, on beginning his well-deserved retirement following 11 years as president of the University and a 41-year career in academic pharmacy. As we say farewell to President Pieper, we are excited to welcome President David D. Allen, RPh, Ph.D., into the UHSP family. Serving as the University’s fifth president, President Allen comes to UHSP having most recently served as dean of the School of Pharmacy, professor of biomolecular sciences, and executive director and research professor in the Research Institute of Pharmaceutical Sciences at the University of Mississippi.
ST. LOUIS COLLEGE OF PHARMACY DEAN SEARCH UPDATE
The start of the FY 2021-22 academic also brought a change in leadership within St. Louis College of Pharmacy. On July 1, 2021, Giovanni Pauletti, M.Pharm., Ph.D., associate dean of graduate studies and Gustavus and Henry Pfeiffer Professor of Pharmacy, officially assumed duties as interim dean of St. Louis College of Pharmacy.
With Dr. Pauletti’s appointment as interim dean, I have transitioned to a new role as Vice President of Program Development and Strategic Initiatives. It’s been a pleasure to have had the opportunity to serve as interim dean over the past 18 months, and I am excited to work alongside Dr. Pauletti, who brings with him a wealth of experience in pharmaceutical and administrative sciences, and pharmaceutical research.
Dr. Pauletti will provide his leadership and guidance to St. Louis College of Pharmacy as we prepare to resume our search for a new dean of St. Louis College of Pharmacy in spring 2022.
NEW PROGRAM OFFERINGS
As we look to the 2021-22 academic year, we’re excited for the further expansion of our academic programs. This fall, we will begin offering a Master of Science in Global Health and Equity, and beginning in fall 2022, the University will offer a Master of Science in Medicinal Chemistry.
Also in 2022, the University will add eight new undergraduate majors to our program mix, pending approval from the University’s regional accrediting agency, the Higher Learning Commission:
- Bachelor of Arts in Applied Behavioral Sciences
- Bachelor of Arts in Biochemistry
- Bachelor of Arts in Biopsychology
- Bachelor of Science in Computer Science
- Bachelor of Science in Data Science
- Bachelor of Science in Exercise Physiology
- Bachelor of Science in Health Care Administration and Management
- Bachelor of Science in Neuroscience
Developed following an examination of health care workforce trends and job market forecasts, as well as opportunities and strengths already existing within our institution, these new programs will capitalize on the University’s strength in the basic sciences and our connections with health care and higher education institutions to create unique career paths and learning opportunities for our students.
PHARMACISTS ON THE FRONTLINES
As we have continued to weather the COVID-19 pandemic over the past academic year, our extraordinary St. Louis College of Pharmacy faculty have continued to go above and beyond to educate our student pharmacists and serve their communities, and I can’t thank them enough for their tireless efforts inside and outside of the classroom.
In addition, as the COVID-19 vaccine rollout has evolved, many of our faculty members have been directly engaged in getting members of the local community vaccinated. In recent months, I have been proud to collaborate with several of our faculty to create and host on-campus and offsite vaccine clinics which have played an important role in helping members of the St. Louis community gain greater access to COVID-19 vaccines.
On Feb. 26, the University hosted its first on-campus clinic for eligible individuals and 2,453 vaccine doses were provided through the campus clinics over the course of 12 weeks. More recently, the University has partnered with local high schools to bring mobile vaccine clinics directly into local communities, helping to vaccine hundreds of middle and high school students, and their friends and family members.
Through our on-campus and mobile clinics, we have been able to deliver 3,808 vaccine doses to individuals across the St. Louis community. These clinics have been a great accomplishment for our institution and have also served as an invaluable way for our pharmacy students to gain real-world experience during this historic time.
ACPE SITE VISIT PREPARATIONS UNDERWAY
Over the past several months, St. Louis College of Pharmacy faculty members have been hard at work preparing for the Accreditation Council for Pharmacy Education’s (ACPE) site visit next spring. We are currently conducting our formal self-study process, which is designed to capture the college’s compliance with pharmacy education standards, with the goal of achieving full ACPE accreditation status. The internal study, which is completed every eight years, requires the college to examine 25 standards focused on various aspects of its functions including academics, faculty, curriculum, assessment, student services, and institutional leadership and governance structure. Our work on the self-study will continue over the next several months, with our final draft to be submitted to ACPE in advance of its three-day visit to campus in March 2022.
FACULTY RECOGNITION
As in years past, I’m thrilled to note that this academic year has been highlighted by a wide range of recognition for members of the University community.
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Anastasia Armbruster, Pharm.D. ’09, AACC, BCPS, BCCP, associate professor of pharmacy practice, was awarded an American College of Clinical Pharmacy Seed Grant for her study on medications used for atrial fibrillation, and was also recognized as a Fellow by the American College of Cardiology for her exceptional commitment to cardiovascular patient care.
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Erica Crannage, Pharm.D., FCCP, BCPS, BCACP, associate professor of pharmacy practice, was named a Fellow of the American College of Clinical Pharmacy.
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Gloria Grice, Pharm.D., FNAP, BCPS, professor of pharmacy practice and associate dean for academic affairs, and Alison Stevens, Pharm.D., BCPS, associate director of the Office of Experiential Education and assistant professor of pharmacy practice, were recognized with the Award of Excellence in Experiential Education from the American Association of Colleges of Pharmacy.
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Gloria Grice, Pharm.D., FNAP, BCPS, professor of pharmacy practice and associate dean for academic affairs, was elected speaker of the house of the American Association of Colleges of Pharmacy.
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Joel A. Hennenfent, B.S. ’96, Pharm.D., ’97, MBA, BCPS, FASHP, chief pharmacy officer and associate administrator for laboratory and medical imaging at Truman Medical Centers University Health in Kansas City and member of the UHSP Board of Trustees, was one of 15 pharmacy professionals named to the American Society of Health-System Pharmacists Pharmacy Executive Leadership Alliance Advisory Panel.
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Kendra Holmes, B.S. ’99, Pharm.D. ’00, senior vice president of Affinia Healthcare and secretary of the UHSP Board of Trustees, was recognized as a 2020 Next-Generation Pharmacist Awards finalist, and was also named a Leader of Distinction by YWCA Metro St. Louis.
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UMKC School of Pharmacy
from Dean Russell Melchert
Warm wishes to all of our friends in MSHP and thank you for the opportunity to provide an update on things happening in our school. In my update last year, I called for a “mulligan” year given the pandemic, but was hopeful it would be far in our rear-view mirror by now. Unfortunately, it is not, yet our students, staff, and faculty have continued to stay persistent and courageous and have had significant positive impact on our communities. I am very proud of all of them and what they have done to keep the school going and for assisting our communities.
Fighting the Pandemic Head On! We all know what a few good pharmacists can do, and that is have a major positive impact on helping people live healthier lives. Our students, staff, and faculty rose to the occasion to assist head on in fighting the pandemic through numerous vaccination events. Our work began with Dr. Cameron Lindsey leading the way working with the UMKC pharmacy and dental faculty, staff, and students as well as the Medical Reserve Corps of Kansas City to provide a mass vaccination event for local area dental practitioners and first responders. Dr. Lindsey went on to lead efforts for weekly vaccine clinics for UMKC faculty and staff. Through her hard work in leading UMKC’s vaccination efforts, Dr. Lindsey was awarded the UMKC Board of Trustees Leo Morton Community Service Award. We were so thankful for her work but also that of hundreds of pharmacy students and faculty who not only assisted directly with UMKC efforts, but also participated as vaccinators and many of our partner organizations and pharmacies. Most recently, we have developed plans to put our student pharmacists in our clinics in the School of Dentistry as needed to provide vaccinations for dental patients at UMKC. Our students, staff, and faculty have had a huge impact!
National Recognition for UMKS Student Pharmacists. Our students once again brought home many honors and awards in the 2020-2021 academic year. We were very proud of Brooke Jacobson, Kathryn Rechenberg and Jamie Sullivan for winning the 2020 ACCP Clinical Pharmacy Challenge. No doubt their great accomplishments were facilitated by faculty advisors including Drs. Sarah Billings, Jamie Hall, and Andy Smith. We were also very proud of Allison Baker who finished first in the patient counseling competition hosted by the Illinois Pharmacists Association and Missouri Pharmacy Association at the 2020 MPA-IPhA annual meeting. And, once again, our APhA-ASP chapter won their division in annual chapter competitions finishing in the top four programs in the country once again! Many thanks to their advisors Drs. Brandi Bowers, Angela Brownfield, Lisa Cillessen, Sarah Cox, Kathryn Holt, Cameron Lindsey, Jordan Rowe, and Heather Taylor for all of the mentoring they provided for our APhA-ASP chapter. Kristen Koch was selected for the 2020 Paul Ambrose Scholars Program of the Association for Prevention Teaching and Research; and Amelia Godfrey was selected as 1 of only 89 nation-wide who won the United States Public Health Service Excellence in Public Health Pharmacy Award in 2021 marking the fourth consecutive year that UMKC students were recognized by the USPHS. Of course, the number one measure of student success is on-time graduation. The path to the PharmD degree is a long one that takes many years, and time is money. Therefore, we do all we can to help our students succeed, and the vast majority of them complete their degree requirements on time. The average on-time graduation rate for our program over the past six years has been 93% which is very good considering the difficulties of not only pharmacy school, but life in general, but we still strive for 100% on-time graduation. We also look at NAPLEX pass rates of classes because it would not do any good to graduate on-time if a student could not complete the board exams. Fortunately, again here the NAPLEX pass rate for first time takers has averaged 91% over the past three years (not including 2021 graduates as we do not have that data yet). Important to also note that over the same time period, an average of 97% of students passed the NAPLEX by the end of the calendar year. So, overall, we are very pleased with the student success at UMKC, but we will never give up working harder to improve and to ensure that our students receive the support that they need.
National Recognition for UMKC Pharmacy Faculty in 2020-2021. Our students continue to receive so many accolades because of a lot of hard work, mentorship, and instruction they get from our outstanding faculty. It is no surprise then that our faculty have also been heavily decorated with many recognitions this past year. In our Division of Pharmacy Practice and Administration, Dr. Andy Smith was elected Chair of the Cardiology PRN for ACCP. Dr. Paul Gubbins was recognized by the AACP Pharmacy Practice Section with their Distinguished Service Award. Dr. Amanda Stahnke was elected to Secretary of the Rho Chi national organization. Drs. Yifei Liu and Morgan Sperry brought in new grants and contracts as well bringing even more positive attention to the division. And, we were so proud of professor Diane McClasky for receiving the prestigious MSHP Garrison Award. In the Division of Pharmacology and Pharmaceutical Sciences, Dr. Kun Cheng received the Chancellor’s Award for Graduate Mentoring as well as Fellow recognition from the American Institute for Medical and Biological Engineering. Further, he just received an additional grant from the National Institutes of Health (NIH) to devise better treatment options for Alzheimer’s Disease. Dr. Simon Friedman received a new grant from NIH as well, and Drs. Emma Meyer and Jerry Wyckoff received a BioNexus KC Grant. There were so many faculty and staff successes in the past year, that it is impossible to name them all. But I would like to recognize those receiving promotion in faculty rank in 2020 and 2021 to Clinical Associate professor including: Drs. Dominick Salvatore (2020), Lisa Cillessen (2021), Kendall Guthrie (2021) and Heather Lyons-Burney (2021). And, our student pharmacists recognized Drs. Emma Meyer, Valerie Ruehter, Pete Silverstein, Steve Stoner, Diana Tamer, Karen Turla, Eric Wombwell and Gerald Wyckoff as Teachers of the Year in 2020-2021.
Into the Future: All of the staff and faculty at UMKC are eagerly awaiting the arrival of our new group of students and returning students. Students are the lifeblood of our school and the reason why we are here. At this time, we are planning for fully open campuses in the fall of 2021, but we stand ready and able to make any changes as necessary to continue high quality instruction, service, research, and discovery even if the pandemic continues to get worse. That again speaks to the grit and resilience of our people.
Like previous years, there are many other accolades that our students, staff, and faculty achieved this year, far too many to list in this update. If you can make time to come by and see us, we’d be happy see you. You are all welcome to visit the school anytime at our sites in Kansas City, Columbia, and/or Springfield. We also would greatly appreciate your assistance in helping us identify any students who might be interested in pursuing pharmacy careers. Just let us know, we love to talk to anyone about our great profession! Best wishes to everyone in MSHP!!
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Old Dogs Gout New Tricks: Exploring New Indications for Gout Medications
By: Nicole Diveley, PharmD CoxHealth | Springfield, MO
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Program Number: 2021-07-01
Approval Dates: August 1, 2021 – February 1, 2022
Approved Contact Hours: 1 hour
Learning Objectives
- Describe the epidemiology of myocardial infarction.
- Describe the mechanism of action of colchicine.
- Discuss approved indications for colchicine.
- Examine current literature for new indications for colchicine.
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Investigate a place in therapy for new indications.
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Weighing Your Options: Strategies in Managing Obesity
By: Emily Humphrey, PharmD; PGY1 Pharmacy Resident
Mentor: Brandi Bowers, PharmD, BCACP; Clinical Assistant Professor, UMKC School of Pharmacy at MSU
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Program Number: 2021-07-02
Approved Dates: August 1, 2021 – February 1, 2022
Approved Contact Hours: 1 hour
Learning Objectives
- Evaluate efficacy of various non-pharmacological interventions on reducing weight and improving overall health
- Identify when to initiate pharmacological treatment for obesity
- Compare benefits and risks associated with pharmacological agents available for weight loss management
- Determine appropriate weight loss agent based upon patient-specific characteristics
- Evaluate new agents coming to market for weight loss management
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Featured Clinical Topic: Cardiology/Anticoag
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Evaluating Bleeding Risk with use of Direct Oral Anticoagulants in Patients with End-Stage Renal Disease
By: Joanna Callier, Pharm. D. Candidate Class of 2023; University of Health Sciences and Pharmacy in St. Louis
Mentor: Emily Reinke, Pharm. D., CVS Pharmacy
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Chronic kidney disease (CKD) affects more than 14% of the general population with over 660,000 of those individuals having kidney failure, 468,000 having end-stage renal disease (ESRD) requiring dialysis, and 193,000 currently living with a functioning kidney transplant.[1] The incidence of ESRD is steadily rising with approximately 21,000 new cases each year with limited treatment options and increasing morbidity and mortality. 1 Most landmark clinical trials evaluating the use of direct oral anticoagulants (DOACs)—including apixaban, rivaroxaban, edoxaban, and dabigatran—exclude patients on hemodialysis (HD) and those with severe CKD. The majority of the available clinical trials exclude CKD when the creatinine clearance is below 25 mL per minute or requiring dialysis, resulting in a lack of safety and efficacy data for DOAC use in patients with ESRD.2 Patients who suffer from CKD and ESRD are at an increased risk of experiencing a thromboembolic or major bleeding event.2 Renal impairment decreases platelet adhesion and aggregation increasing the risk of bleeding events in these individuals.3 Due to DOACs renal clearance, patients with CKD are more prone to serious complications such as anemia, cardiovascular disease, hypertension, fluid retention, and electrolyte disorders.4
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Anticoagulants for thrombosis prevention in patients with COVID-19
Author: Veeraya White, PharmD Candidate 2022 – University of Health Sciences and Pharmacy in St. Louis
Mentor: Brooke E. Gengler, PharmD, BCCP; Pharmacy Clinical Specialist, Cardiology, SSM Health Saint Louis University Hospital
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Introduction
Coronavirus disease 2019 (COVID-19) is a viral respiratory infection caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) which has become a significant threat worldwide. The infection triggers host defense systems resulting in activation of coagulation and thrombin generation, called thromboinflammation.1 As a result, some patients with COVID-19 encounter complications associated with cytokine overproduction, hypercoagulability, and thrombosis. Thromboinflammation may lead to a life-threatening condition, disseminated intravascular coagulopathy (DIC), a condition in which blood clots throughout the body use up available clotting factors thereby increasing the risk of bleeding.2,3 Anticoagulants (ACs), such as low molecular weight heparin (LMWH), and unfractionated heparin (UFH), are used to prevent thrombosis.2 This article will discuss the appropriate criteria for anticoagulant venous thromboembolism (VTE) prophylaxis in patients with COVID-19.
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Intravenous Iron Therapy in Acute Decompensated Heart Failure
Author: Ethan Cowell, PharmD Candidate 2022; University of Health Sciences and Pharmacy in St. Louis
Mentor: Joseph Van Tuyl, PharmD, BCCP; Assistant Professor of Pharmacy Practice/Pharmacy Clinical Specialist – Cardiology; University of Health Sciences and Pharmacy in St. Louis/St. Louis University Hospital
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Heart failure (HF) affected 6 million adults in the United States from 2015 to 2018 and costed approximately $30.7 billion dollars in 2012 alone.1 Economic estimates predict the total cost of HF will increase to $69.8 billion by 2030.1 Costs are primarily due to hospitalizations to treat HF and the comorbidities that commonly accompany this disease state. In 2014, the projected mean cost of primary HF hospitalizations was $11 billion (approximately $11,552 per hospitalization).2
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Sacubitril/Valsartan for Heart Failure with Reduced Ejection Fraction
By: Michelle Tulchinskaya, Elena Stroman, and Katherine Nguyen; PharmD. Candidates
Mentor: Anastasia L. Armbruster Pharm.D., FACC, BCPS, BCCP
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Since 2017, new therapies for Heart Failure with Reduced Ejection Fraction (HFrEF) have emerged reducing both mortality and hospitalizations for heart failure in this population. In particular, two drug therapies have emerged: angiotensin receptor-neprilysin inhibitors (ARNIs), and sodium-glucose cotransporter-2 inhibitors (SGLT2s). Overall, ARNIs, SGLT2s, and other guideline directed medical therapy (GDMT) are underutilized. CHAMP-HF has exhibited the underutilization of these medications.1 Specifically sacubitril/valsartan (Entresto®), has been underutilized even after the 2016 ACC/AHA/HFSA Focused Update on HF included it as a Class I recommendation for patients with HFrEF.2 In outpatient settings, 86.1% of patients without contraindications did not receive sacubitril/valsartan. Patients with the following characteristics were less likely to receive treatment; older age, Hispanic ethnicity, chronic insufficiency, and higher EF (p ≤ 0.009). Patients with higher systolic blood pressure and a history of hypertension were associated with achieving a ≥50% target dose (all p ≤ 0.037).1
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Direct Oral Anticoagulant Use for Venous Thromboembolism Treatment in Morbidly Obese Patients
By: Jaynika Patel, PharmD Candidate 2023; University of Health Sciences and Pharmacy at St. Louis College of Pharmacy, Saint Louis, Missouri
Mentor: Priyam Patel, PharmD; Aurora St. Luke’s Medical Center, Milwaukee, Wisconsin
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Background
Obesity is a prevalent condition in the United States (U.S.) with nearly one in every three adults being affected.1 The body mass index (BMI) is utilized to determine the weight classification of an individual and can be calculated by dividing the weight in kilograms by the height in meters squared. Obesity is defined as a BMI of 30.0 kg/m2 or above and is further classified into three subcategories: class I (BMI 30-34.9 kg/m2), class II (35-39.9 kg/m2), and class III (≥ 40 kg/m2). Morbidly obese patients are considered Class III based on their BMI.
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Clinical Presentation and Management of Heparin-Induced Thrombocytopenia
Authors: Elizabeth Nash, St. Louis College of Pharmacy Pharm.D. Candidate 2022 and Morgan Luttschwager Rose, MBA, St. Louis College of Pharmacy Pharm.D. Candidate 2022
Mentor: Michelle Jeon, Pharm.D., BCACP, Assistant Professor of Pharmacy Practice, St. Louis College of Pharmacy at UHSP
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Epidemiology
Heparin-induced thrombocytopenia (HIT) is an unusual drug reaction involving heparin exposure. Overall, HIT epidemiology is not well documented; however, reports indicate it will occur in about 0.1-0.5% of patients on heparin therapy including low molecular weight heparin (LMWH) and unfractionated heparin (UF). Based on a population study conducted in 2018, the incidence of HIT diagnosis are relatively low. HIT seems to be more common after cardiac surgeries compared to after orthopedic surgeries.1
Once HIT occurs, the most common complication is thrombosis, occurring in 30% of cases, with bleeding occurring in 6.2%. In patients that experience bleeding, 25% of patients do not survive regardless of treatment.1
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St. Louis College of Pharmacy at UHSP-SSHP
SSHP President: Leah Blocker, PharmD Candidate 2023
University of Missouri-Kansas City – SSHP
UMKC SSHP Presidents: Kelly Williams & Jenny Ohnesorge, Pharm.D. Candidates 2023
Greater Kansas City Society of Health-System Pharmacists (GKCSHP)
President: Kerra Cissne, PharmD, BCPS
Mid-Missouri Society of Health-System Pharmacists (MMSHP)
MMSHP inducted their officers for the upcoming year on May 6th, 2021
Immediate Past-President: Sandy McGraw, PharmD, BCPS
President: Alexandria Stringberg, PharmD, BCPS
President-Elect: Pamela Sanford, PharmD, BCPS
Treasurer: Jordan Anderson, PharmD, BCPS, BCPPS
Secretary: Erin Collard, PharmD, BCPS
President: Alexandria Stringberg, PharmD, BCPS (stringberga@health.missouri.edu)
Saint Louis Society of Health-System Pharmacists (STLSHP)
There are no upcoming events planned in the next couple months so members can focus on spending quality time with friends and family – we hope you all have a wonderful summer!
President: Yvonne Burnett, Pharm.D., BCIDP (Yvonne.Burnett@uhsp.edu)
Southeast Missouri Society of Health-System Pharmacists (SEMSHP)
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Upcoming Featured Clinical Topics
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Sept/Oct 2021 - Transitions of Care/Geriatrics - FULL
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Nov/Dec 2021 - Infectious Diseases/Vaccines - FULL
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Jan/Feb 2022: Endocrinology/Obesity Management
- March/April 2022: Psychiatry/Pain/Substance Use Disorder
- May/Jun 2022: Critical Care/Pulmonary/Emergency Medicine
- July/August 2022: Cardiology/Anticoagulation
- Sept/Oct 2022: Special Populations (Geriatrics, Pediatrics, Women’s/Men’s Health)/Transitions of Care
- Nov/Dec 2022: ID/Vaccines
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Newsletter Submission Deadlines:
Jan/Feb 2022: Due December 27, 2021
March/April 2022: Due February 28, 2022
May/Jun 2022: Due April 25, 2022
July/August 2022: Due June 27, 2022
Sept/Oct 2022: Due August 22, 2022
Nov/Dec 2022: Due October 24, 2022
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Newsletter Submission Guidelines
- Pharmacists, pharmacy technicians, and pharmacy students in Missouri are eligible to submit content for publication in the MSHP Newsletter. Student submissions need to include pharmacist oversight.
- Submit content to the current Newsletter Committee Chair on or before the established deadlines.
- CE and Featured Clinical Topics must be approved by the Newsletter Committee Chair in advance of article submission, to prevent duplicates. Duplicate articles submitted without advanced approval may not be published.
- Recommended length of submissions for committee, affiliate, college/schools of pharmacy, and student chapter reports is half to one page in length.
- Recommended length of submissions for featured clinical topics is 1 to 2 pages, without references.
- Recommended length of CE articles is individualized, based on the amount of CE provided.
- Recommended length of submission for other categories is 1 to 2 pages.
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MSHP Board of Directors & Committee Chairs |
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2021-2022 Board Members
President:
President-Elect:
Immediate Past President:
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2021-2022 Committee Chairs
Vendor Relations Board Liaison:
Membership Committee:
Public Policy Committee:
Newsletter Committee:
Education and Programming:
Website & Social Media:
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If you have any questions, comments, or wish to submit an article to for MSHP Newsletter, please contact the Newsletter Committee Chair (Laura Challen) or another Newsletter Committee member.
2021-2022 MSHP Newsletter Committee Members
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