Table of Contents
Section 1: About this Guide...... 5 Introduction...... 6 Acknowledgements...... 7 Why train Pharmacists?...... 8
Section 2: Recommendations for Multi-Level Program Development ...... 9 AETC Training Levels...... 10 Developing Level 1 Trainings...... 11 Developing Level 2 Trainings...... 12 Developing Level 3 Trainings...... 13 HIV Clinical/Hospital-based Preceptorships ...... 13 HIV Community Pharmacy-based Preceptorships ...... 16 Adapting Existing Preceptorships...... 19 Frequently Asked Questions about Level 3 Preceptorships ...... 21 Developing Level 4 Trainings...... 23
Section 3: Helpful Training Materials...... 24 Pharmacists’ Café...... 25 Needs Assessment Surveys and Program Agendas ...... 26
Section 4: Marketing Strategies ...... 27 Overview...... 28 How to Identify Pharmacies ...... 28 How to Reach Pharmacists ...... 28
Section 5: Continuing Pharmacy Education...... 30 Definition of Continuing Pharmacy Education ...... 31 Continuing Education for Pharmacists ...... 31 Providing Continuing Pharmacy Education ...... 31
Conclusion ...... 32
References...... 32
Table of Contents continued
Abbreviations...... 33
List of Helpful Resources...... 34
Appendixes...... 35 A. Drug Interactions Workshop B. HIV Pharmacology Workshop C. Summary List of Common Training Topics for Pharmacists D. Sample Needs Assessment Survey E. Program Agenda: HIV Clinical Pharmacy Practicum F. Program Agenda: HIV Pharmacy Practicum in the Community Pharmacy Setting G. Program Agenda: Family-Centered HIV Pharmacy Practicum H. Program Agenda: HIV Update for Pharmacists I. Quick Tips on How to Reach Community Pharmacists J. State Pharmacy Associations K. Accredited Pharmacy Schools
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Introduction
The AIDS Education and Training Center’s (AETC) Meeting the Resource Needs of Community Pharmacists Workgroup is pleased to share with the AETC network a resource entitled Developing Regional Approaches to Training Community Pharmacists – An AETC Program Coordinator’s Guide. Based on excerpts of a training guide produced in 2002 by the San Francisco AETC, a Local Performance Site (LPS) of the Pacific AETC, this tool is a collection of HIV pharmacy training recommendations and educational resources.
Recommendations presented in this Guide by the workgroup members represent their collective experiences to date with targeted clinical and community-based pharmacists for multi-level HIV programming. The target audience for the Guide includes AETC program coordinators and others involved in developing AETC pharmacy training programs such as HIV-specialty pharmacists and medical directors. The goals of this Guide are to:
1) Outline successful strategies and alternate methods of developing AETC pharmacy programs. 2) Describe marketing tips for training programs. 3) Offer helpful training tips and resources on the development of pharmacy-specific training programs.
Membership of the Meeting the Resource Needs of Community Pharmacists Workgroup is comprised of AETC pharmacy faculty and program coordinators from diverse settings across the United States who have delivered targeted HIV trainings for pharmacists for a decade. By illustrating proven strategies that have been used for producing effective HIV pharmacist training programs in this Guide, workgroup members hope to encourage all regional AETCs to examine their current methods for delivering pharmacy trainings and utilize this Guide to enhance their current pharmacy training efforts.
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Acknowledgements
This Guide was developed by members of the Meeting the Resource Needs of Community Pharmacists Workgroup.
Authors: • Kirsten Balano, PharmD; Pacific AETC • Whitney Buckley, PharmD; Mountain Plains AETC • Jean Lee, PharmD; BCPS; Midwest ATEC (MATEC) • Supriya Modey, MPH, MBBS; AETC National Resource Center • David Rosen, MSW, LCSW, C-ASWCM; New York/New Jersey AETC (Workgroup Leader) • Suellyn Sorensen, PharmD, BCPS; Midwest ATEC (MATEC)
Other collaborating members: • Edward Dillon, R.Ph.; National Community Pharmacists Association (Workgroup Leader) • Cristina Gruta, PharmD; National HIV/AIDS Clinicians' Consultation Center • Blake Max, PharmD; Midwest ATEC (MATEC) • Andrea Norberg, MS, RN; AETC National Resource Center • Trushar Sheth, R.Ph., CCP; Giannotto’s Pharmacy
Guide book Reviewers: • Cristina Gruta, PharmD; National HIV/AIDS Clinicians' Consultation Center • Andrea Norberg, MS, RN; AETC National Resource Center • Jamie Steiger, MPH; AETC National Resource Center
Workgroup Coordinators: • Supriya Modey, MPH, MBBS; AETC National Resource Center (Managing Editor) • Monique Valentine, MSPH ; AETC National Resource Center
Graphic Designer: • Karen A. Forgash, BA ; AETC National Resource Center
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Why Train Pharmacists?
The role of a pharmacist in HIV care has evolved over the years. Today, pharmacists are an integral part of the HIV care team and fill an important niche in areas of HIV management such as patient education and identification and prevention of medication errors.
Pharmacists and HIV Patients: Optimizing HIV Therapy
Pharmacists play a crucial role in educating patients about HIV medications. The introduction of highly active antiretroviral therapy (HAART) in 1990s has added complexity to HIV treatment such as adverse effects and drug-drug interactions (Hardy, 2005). Also, the introduction of new antiretroviral (ARV) drugs in the last few years brought new set of potential pharmacologic problems. It is important for pharmacists to educate patients about possible drug interactions and alleviate any fears or misconceptions that patients might have about side effects or drug interactions. Unresolved patient concerns could lead to poor adherence, which may increase the risk of ARV drug resistance, a serious global treatment problem. Pharmacists should help patients understand HIV therapy goals and help design interventions to enhance adherence, especially for those patients on long term treatment who may experience “pill fatigue”. Ongoing communication with patients also helps foster a trusting relationship between the patient and the pharmacist.
Preventing Medication Errors
Pharmacists also play an important role in the identification and prevention of medication errors. These errors could be caused by prescriber, patients, or the pharmacy itself. Due to the complex nature of HIV and its co-morbidities, patients are often prescribed medications for other opportunistic infections, which may cause drug-drug or food-drug interactions with HIV medications. Pharmacists should communicate with the prescriber to clarify any medication or dosing changes, or any unclear prescriptions (e.g., similar sounding medications or abbreviations) to help reduce prescription errors. Pharmacists can also help patients prevent medication errors by asking them to repeat dosing instructions. They can help patients get organized with pillboxes, timers, and alarms.
With HIV management evolving at a rapid pace, successful training will keep HIV-specialty pharmacists well informed about the latest advancements in HIV care, which in turn will help them excel in their vital role as part of the HIV care team.
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Overview Each year, regional AETCs and their Local Performance Sites (LPS) conduct various training programs. AETC Training Levels provide a framework for these training programs. This section includes an overview of these guiding levels and describes how to implement AETC pharmacy- specific training programs for training levels 1-4 in particular. Program coordinators may adapt the information shared in this section based upon their regional or local needs. AETC Training Levels There are five basic AETC training levels that range from didactic presentations to clinical consultations and programmatic technical assistance. Table 1 provides Pacific AETC’s brief description of the five levels of training. Table 1: AETC Training Levels AETC Training Level Description Level 1: Participants are often passive learners, with programs varying in length Didactic Presentation from brief lectures to conferences. Format used: • Panel discussions • Journal clubs • Self-instructional • Teleconferences materials • Didactic presentations Level 2: Participants may engage in interactive and skills-building activities Skills Building characterized by active trainee participation. Workshops Format used: • Simulated patients • Case discussions • Train the trainer (TOT) • Role play • Other skill building activities Level 3: Participants may engage in training that includes activities where the trainee Clinical Training is actively involved with clinical care experiences involving patients. Format used: • “Mini-residencies” • Preceptorships • Observation of clinical care at either AETC training site or the trainee’s worksite Level 4: Participants may engage in training that includes patient-specific Clinical Consultation clinical consultation provided to health care professionals. Format used:
• Clinical consultation • Case-based discussions Level 5: Technical Assistance Technical assistance offered by the Local Performance Site (LPS).
For more specific examples and resources under these training levels, please visit AETC NRC website: www.aidsetc.org
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Developing Level 1 Pharmacy Trainings
Level 1 trainings are primarily lecture-style trainings where most learners are introduced to the AETC and begin their learning relationship. Successfully engaging participants at this level of training is likely to start a relationship where participants will want to return for more training and engage in more active learning opportunities. These can be stand alone events (i.e., dinner/lunch time lectures) or part of a full-day/multi-day program.
Since differences between Level 1 trainings offered to community pharmacists and other healthcare providers (i.e., physicians, physician assistants (PA) and nurses) are few, AETCs/LPSs can use the training skills and tools they have for other healthcare providers and market them for community pharmacists. Common Level 1 training topics for community pharmacists are listed below.
Common Level 1 Training Topics include: • New Antiretroviral Medication Updates • Managing Adverse Reactions to HIV Medications • Pharmacokinetics/Pharmacogenomics and Therapeutic Drug Monitoring • Medication Errors in HIV • Medicare Part D and Access to HIV Medications
Some helpful tips for developing pharmacy-specific Level 1 trainings are as follows: • Invite community pharmacists to programs currently being offered to other professional disciplines. Having the whole “healthcare team” sit side-by-side can create an interesting learning environment. • Connect with local professional pharmacist organizations (e.g., state and/or local pharmacy association) that often offer continuing education (CE) opportunities on HIV-specific topics. Solicit important training topics from their representatives. • Consider offering pharmacist-specific CE credits administered by the Accreditation Council for Pharmacy Education (ACPE). Refer to Sections 4 and 5 for more information on marketing strategies and continuing pharmacy education (CPE). • Advertise future training opportunities, particularly those that offer skills-building and more in- depth HIV content, i.e., attend higher level AETC trainings. • Use evaluation forms to rate the training event and solicit future training topics.
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Developing Level 2 Pharmacy Trainings
Level 2 trainings are interactive learning opportunities such as case discussions and other skills building activities. These are often novel training modalities for community pharmacists, who more often have access to lecture-style learning. Given the complexities and rapidly evolving information in HIV care and treatment, Level 2 trainings provide the opportunity for participants to learn how to research and utilize information to care for their patients. Level 2 trainings can be stand-alone trainings, or part of larger programs. Community pharmacists can be invited to Level 2 training opportunities with other disciplines and this can allow problem- solving opportunities among the “healthcare team”. NOTE: In developing cases for community pharmacists, keep in mind that often they do not have access to laboratory information (i.e., CD4 cell counts, viral load, and genotype). Common Level 2 training topics for community pharmacists are listed below
Common Level 2 Training Topics include: • Use of New Antiretroviral Medications • Adherence Counseling • Identifying and Managing Drug-Drug Interactions • Managing HIV Adverse Drug Reactions • Providing Culturally Competent HIV Care • Role of the Community Pharmacist in the HIV Care Team • HIV 101: When to Start Antiretroviral Therapy and What to Start With
As mentioned earlier, participants are more actively involved in Level 2 trainings. Interactive, case- based workshops are ideal for Level 2 trainings. Two examples are below:
Drug Interactions Workshop: In this workshop, participants are broken into small groups and provided with case scenarios that review antiretroviral drug interactions. Participants are encouraged to discuss the case with their group members, identify various drug interactions, and develop a pharmaceutical care plan. See Appendix A for more information about this workshop and related case scenarios.
HIV Pharmacology Workshop: This workshop encourages participants to work in teams to identify the appropriate category for the different antiretroviral medicines (both generic and brand names). See Appendix B for HIV Pharmacology Workshop exercises.
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Developing Level 3 Pharmacy Training Level 3 training programs consist of clinical training which requires a certain amount of observational patient-pharmacist contact hours, or preceptorships. There are several methods for designing pharmacy-specific Level 3 preceptorships that will be described step-by-step in this section. They are as follows: • HIV Clinical/Hospital-based Preceptorships • HIV Community Pharmacy-based Preceptorships • Adapting Existing Preceptorships/Mini-Residencies
HIV Clinic/Hospital-based Preceptorships Most Level 3 pharmacy trainings are clinic/hospital-based preceptorships. Members of the Meeting the Resource Needs of Community Pharmacists Workgroup have recommended the following steps to develop a training program in a HIV clinic or hospital (also shown in Figure 1): 1. Identify a clinic/hospital-based preceptorship site: a) The clinic/hospital should be a facility that treats a significant number of HIV-infected patients and is staffed by a physician (MD), nurse practitioner (NP), or physician assistant (PA) who is considered to be an expert in HIV care. b) The clinic/hospital should be a facility that employs a HIV-specialty pharmacist to assist with the medical co-management of HIV-infected patients. This pharmacist may be direct staff of the clinic/hospital or an intern through a pharmacy residency program.
2. Choose a HIV-specialty pharmacist from the clinic/hospital to serve as the primary pharmacy preceptor: Request a meeting with the clinic/hospital’s HIV-specialty pharmacist to discuss their interest in working with your AETC/LPS in building a new HIV clinic/hospital pharmacy preceptorship at their site. During the meeting, several key issues will need to be addressed, including: a) Purpose of the program and key participant learning objectives b) Operational issues such as: participant attendance, training structure (half-day, full-day, multi-day, etc.), HIPAA concerns, financial compensation for faculty and/or site , required paperwork for ACPE-accreditation, AETC and any clinic/hospital internal policies regarding external learners on the premises, and delineation of responsibilities and required staff time commitment 3. Get medical administration buy-in: meet with the Clinic/Hospital’s Medical Director If buy-in occurs by the HIV-specialty pharmacist, request a second meeting to be scheduled by the HIV-specialty pharmacist with the clinic/hospital’s Medical Director to discuss the above points. Address any issues the Medical Director may have.
4. Draft the program details The process for program development begins if buy-in occurs by the Medical Director. This process may involve the following steps:
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a) Identify a regional ACPE provider. Discuss costs and processes for accrediting the Level 3 preceptorship. b) Set the program agenda, ensuring that the minimum required patient observational contact is included. NOTE: Be sure to involve an HIV-specialty pharmacist in determining program details.
NOTE: The patient observation component should focus on the role of the HIV-specialty pharmacist in the co-management of patients with the clinician in terms of regimen choices, drug interactions, adherence counseling and side effects management. Other training components (i.e., inclusion of case review, didactic lectures on ARVs, HIV 101, etc.) should evolve from your discussions with the HIV-specialty pharmacist and the Medical Director. c) Develop an agreement with the clinic/hospital detailing: 1) curriculum payment, 2) management of participant enrollment, 3) policies and HIPAA requirements, and 4) roles and responsibilities.
NOTE: Payment methods may vary across AETCs. Also, in some regions, once there is a consensus between the AETC/LPS and the clinic/hospital, a memorandum of agreement is signed. d) Provide faculty with the learning objectives and request a draft PowerPoint slide presentation for the didactic component. The AETC/LPS program coordinator should review the slides, which will then be reviewed by the ACPE accreditation team. e) Develop an evaluation tool that includes a set of pre/post test questions and answer key. f) Prepare handout materials including the program agenda, slide sets and any other relevant materials. g) Pilot test your training by selecting a known HIV pharmacist as your “test subject.” Request any feedback he/she may have. h) Implement the suggested changes and select a second pharmacist who is not an HIV expert to attend a second pilot training. Be sure to request feedback from the second pharmacist. i) Submit the curriculum for ACPE accreditation once the necessary changes have been made. j) Design marketing materials for the preceptorship (see Section 4 on Marketing Strategies for marketing tips).
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Figure 1: Summary of Developing HIV Clinic/Hospital-Based Preceptorships
Step 1: Identify a clinic or a hospital Characteristics of the clinic/hospital: • Treats a number of HIV-infected patients • Employs a HIV-specialty pharmacist
Step 2: Choose a HIV-specialty pharmacist from the clinic/hospital to serve as the primary preceptor Discussion Points: • Purpose of the program and learning objectives • Operational issues
Step 3: Meet with the Clinic/Hospital’s Medical Administration
Discussion Points: • Purpose of the Program • Other operational issues
Step 4: Draft program details This process may involve the following steps: • Identify a regional ACPE provider • Set the program agenda • Develop an agreement with the clinic/hospital regarding operational issues • Provide the faculty with learning objectives • Develop an evaluation tool • Prepare handout materials • Pilot test your training • Submit the curriculum for ACPE accreditation • Market the training program
Common training topics for clinical/hospital-based preceptorships include: • HIV Pharmacotherapy Update and Drug Interactions • Co-Management Approach to HIV Care • HIV Medical Update
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HIV Community Pharmacy-based Preceptorships
There are several similarities, as well as differences, when developing pharmacy-focused training programs based in a community practice (or retail) pharmacy setting versus one in a clinic/hospital- based setting. To help develop community pharmacy-based training preceptorships, Workgroup members recommended the following steps (also summarized in Figure 2): 1. Identify a community pharmacy preceptorship site with the following characteristics: a) Significant number of ARVs provided to HIV-infected patients b) Staff dedicated to client well-being c) Staff willing to communicate regularly with medical providers d) Staff committed to addressing adherence issues with clients within the community setting e) Separate consultation room is available to engage patients in adherence discussions
2. Meet with the Pharmacy store owner Request a meeting with the Pharmacy owner and/or the primary staff pharmacist to discuss their interest in developing a new HIV pharmacy preceptorship at their community site. During the meeting, several key issues will need to be discussed, including: a) Program’s purpose and key participant learning objectives b) Operational issues such as: • participant attendance, • training structure (half-day, full-day, multi-day, etc.), • site’s policies and HIPAA concerns (i.e., community pharmacy internal policies regarding external learners on the premises), • financial compensation for faculty and/or site , and • paperwork for ACPE-accreditation c) Staff time commitment, including faculty who will receive the training d) Program roles and responsibilities for AETC program coordinator and pharmacy faculty. e) Patient flow on the training date. The community pharmacy will have to ensure enough HIV-infected patients visit the store on the training date for refills and adherence counseling to provide the learner with the minimum required patient observation contact hours.
HELPFUL TIP: To ensure adequate patient flow in the store on the training date, pharmacies could offer the following incentives: • Pay patients to come in at set intervals • Offer patients store coupons or vouchers if they came in during the training date and time for their refills
3. Develop program details If buy-in occurs by the pharmacy store owner/pharmacist, begin the process for development of the program, similar to what is described under the HIV Clinic/Hospital-based Preceptorship section. The Workgroup members suggest the following steps: a) Identify a regional ACPE provider. Discuss costs and processes for accrediting the Level 3 preceptorship.
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b) Set the program agenda, ensuring that the minimum required hours of patient observational contact is included.
NOTE: Patient observation component should focus on the role of the community pharmacist in the co-management of patients with the HIV medical provider. Other training components (i.e., inclusion of case review, didactic lectures on avoiding drug errors, improving communication between community pharmacist and HIV medical provider, etc.) should evolve from your discussions with the pharmacist/store owner.
NOTE: Be sure to involve Pharmacy owner/primary staff pharmacist in determining program details. c) Develop an agreement with the community pharmacy site detailing: 1) training payment, 2) management of participant enrollment, 3) site’s policies and HIPAA concerns, and 4) roles and responsibilities.
NOTE: Payment methods may vary across AETCs. Also, in some regions, once there is a consensus between the AETC/LPS and community pharmacy store, a memorandum of agreement is signed. d) Engage the AETC HIV-specialty pharmacist in discussions with current community pharmacy issues to develop the preceptorship collaboratively.
NOTE: It is advisable to pay the AETC faculty and the community owner separately for curriculum development. e) Provide the curriculum writer(s) with the learning objectives and draft a PowerPoint presentation for the didactic component. The regional AETC or LPS program coordinator should review the slides, which will then be reviewed by the ACPE accreditation team. f) Develop an evaluation tool which includes a set of pre/post test questions and answer key. g) Prepare handout materials consisting of the agenda, slide sets and any other relevant materials. h) Assess the community pharmacist faculty candidate’s ability to represent the AETCs as the main community pharmacy trainer. This assessment should be completed by the AETC HIV-specialty pharmacist. i) Pilot test your training. Use the AETC HIV-specialty pharmacist as your “test subject” and solicit any feedback he/she may have. h) Implement the suggested changes and select a community pharmacist (either from the same store or from a busy HIV-specialty pharmacy) to attend the second pilot training. Request feedback from the community pharmacist. i) Submit the curriculum for ACPE accreditation once the necessary changes have been made. j) Design marketing materials for the preceptorship (see Section 4 on Marketing Strategies for marketing tips).
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Figure 2: Summary of Developing HIV Community Pharmacy-Based Preceptorships Step 1: Identify a community pharmacy preceptorship site Characteristics of the preceptorship site: • Provides significant number of ARV medications • Holds a strong reputation for its services • Has a separate consultation room for patients
Step 2: Meet with the pharmacy store owner Discussion Points: • Purpose of the program • Operational issues • Staff time commitment and responsibilities • Patient flow on the training date
Step 3: If the pharmacy store owner agrees, draft the program details This process may involve the following steps: • Identify a regional ACPE provider • Set the program agenda • Come to an agreement with the clinic/hospital regarding operational issues • Provide the faculty with learning objectives • Develop an evaluation tool • Prepare handout materials • Pilot test your training • Submit the curriculum for ACPE accreditation • Market the training program
Common training topics for Community Pharmacy-based preceptorships include:
• Addressing HIV Drug Errors in the Retail Pharmacy Setting • Interactions between Common OTC Products and HIV Medications • Putting Theory into Practice: Medication Counseling with HIV Patients
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Adapting Existing Preceptorships/Mini-Residency Although it is ideal to have preceptorship events in the clinic/hospital or in a well-known community pharmacy store, Workgroup members realize that often AETCs/LPSs do not have a HIV-specialty pharmacist in their clinic/hospital or a local community pharmacy capable of conducting pharmacy trainings. In such cases, consider adapting existing medical or nursing preceptorships for community pharmacists. Possible scenarios for adapting preceptorships can be found below. Scenario 1: For AETCs/LPSs without a HIV-specialty pharmacist working in an HIV clinic or hospital setting in their geographic region In this situation, consider these options: 1. Collaborate with another AETC/LPS where such a pharmacist position exists. Request a collaborative partnership so community pharmacists can be referred to this site for training, following the steps outlined in the ‘HIV Clinic/Hospital-based Preceptorships’ section.
2. Connect with an HIV clinic that has existing medical/ nursing preceptorships. Ask representatives at the site(s) if they are open to having community pharmacists attend an adapted version of the medical/nursing program.
Upon agreement: a) Contact the regional AETC’s primary clinical pharmacy faculty and request a meeting with the medical preceptorship site’s faculty to: 1) Review and adapt the medical program to meet the identified needs of community pharmacists, as viewed by the medical and pharmacy faculty. 2) Determine training logistics, including ACPE accreditation requirements. 3) Determine faculty composition. Two options are: a) only medical and nursing staff will conduct the trainings (exclude pharmacist co-faculty) or b) an external pharmacy faculty will be allowed to come on-site to co-teach the program with the medical staff.
b) Pilot test the training program, following the steps outlined in the HIV Clinic/Hospital-based Preceptorships section.
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Scenario 2: For AETCs/LPS lacking a suitable community pharmacy in their geographic region In this situation, consider these options: 1. Contact another AETC/LPS with a community pharmacy in place. Request a collaborative partnership, enabling community pharmacists to be trained at another AETC/LPS site. Follow the steps outlined in the HIV Community Pharmacy-based Preceptorships section.
NOTE: Make sure the chosen community pharmacy has the following characteristics: a) provides a significant number ARV medications to HIV-infected patients b) is well known for its services, which includes: • staff’s dedication to client well-being, • willingness to communicate regularly with medical providers and • commitment to addressing adherence issues with clients within the community setting c) has a separate consultation room to engage patients in adherence discussions
2. Connect with a community pharmacy from another region, which has at least one of the above criteria in place, to discuss the possibility of setting up a capacity-building technical assistance (TA) scenario. In this scenario, the AETC/LPS will help the community pharmacy to establish itself as their HIV training partner.
Upon agreement: a) Contact the regional AETC’s primary clinical pharmacy faculty and request a meeting with the community pharmacy to: 1) Review the pharmacy’s current capacity to deliver expert HIV 2) Determine if the pharmacy has the capacity to become a suitable HIV training site with AETC/LPS support 3) Determine pharmacy site’s training needs if technical assistance is warranted 4) Develop and implement a TA workplan focused on a community pharmacy preceptorship program that has been adapted to the site’s new capacities b) Pilot test the preceptorship as outlined in HIV Community Pharmacy-based Preceptorships section.
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Frequently Asked Questions about Level 3 Preceptorships 1. What should I do if the site’s pharmacy does not have a separate consultation room? If the site’s pharmacy does not have a separate consultation room, perhaps the training can be held at your AETC/LPS, at a nearby HIV clinic, or an HIV/AIDS community-based organization (CBO). Your AETC/LPS might be able to facilitate any required negotiations to enable the collaborative partnership to occur. Transportation of pharmacy customers to the training site would need to be addressed, as well as the comfort level of the site’s identified pharmacist faculty in delivering private adherence counseling sessions to patients. 2. What are my options if there are no HIV-specialty pharmacists in my clinic/hospital? Ideally, the best option is to have a HIV-specialty pharmacist at the clinic/hospital training site. However, for some AETCs/LPSs, this may not be possible. In such cases, collaborate with another AETC/LPS where such a pharmacist position exists. Another option is to connect with an HIV clinic that has existing medical/ nursing preceptorships that can be adapted for community pharmacists. Please refer to the Adapting Existing Preceptorships section for more detailed information. 3. I need a cross program consultation. Who can I contact in the AETC network? The following AETC pharmacists can be contacted for cross program consultation: Name AETC/LPS Contact Information Orrick, Joanne Florida/Caribbean AETC [email protected] Thompson, Michael Florida/Caribbean AETC [email protected] Lee, Jean Midwest ATEC [email protected] Max, Blake Midwest ATEC [email protected] Miller ,Christopher NY/NJ AETC [email protected] Faragon, John NY/NJ AETC [email protected] DiCenzo, Robert NY/NJ AETC [email protected] Cantenzaro, Linda NY/NJ AETC [email protected] Humberto, Jiminez NY/NJ AETC [email protected] Kanmaz, Jiminez NY/NJ AETC [email protected] Conry, John NY/NJ AETC [email protected] Rosen, David NY/NJ AETC [email protected] Sharma, Roopali NY/NJ AETC (718) 488-1004 Ballard, Craig Pacific AETC [email protected] Balano, Kirsten Pacific AETC [email protected] Bradford, Colwell Pacific AETC [email protected]
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4. Can a preceptorship be adapted to address the unique issues involved in the pharmaceutical management of HIV-positive pregnant women and children? Program Coordinators can design a "Family-Centered" HIV preceptorship for pharmacists who are involved in the on-going management of pregnant women, infants, children and adolescents either in community practice or clinical care settings. The focus of the preceptorship should be on the role of the pharmacist within an HIV family-centered care team and it should be situated in a pediatric HIV clinic where pregnant women and children are routinely being co-managed by a medical provider and an HIV-specialty pharmacist. To help develop a Family-Centered HIV preceptorship program, follow the steps outlined in HIV Clinic/Hospital-based Preceptorships. Please refer to Appendix G for a sample Family-Centered HIV preceptorship program agenda.
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Developing Level 4 Pharmacy Trainings
Level 4 training programs consist of group case discussions. Real cases, without personal identifiers, are presented by the training participants to the faculty. Discussion follows the presentation. The following is a suggested step-by-step method for designing a pharmacist-specific Level 4 training experience that meets the requirements of the AETC program: 1) Contact various HIV clinics and request the names of two or three pharmacies that their patients commonly go to.
2) Contact each pharmacy and invite their staff for a case discussion program. To generate interest, be sure to mention that the program is free and that expert HIV faculty will be available to their staff. If possible, consider providing dinner and ACPE credits.
NOTE: Initially, the AETC may need to provide the cases for discussion, to give examples of how to use case-based discussion for education.
3) Schedule regular case discussions (i.e., every 2-3 months) with the pharmacy and identify a key pharmacist in the store.
4) Contact the key pharmacist 1-2 weeks prior to your next case discussion to remind them to identify cases for discussion. As the relationship develops, you could invite the HIV clinic(s) providers to attend. This will help foster relationships between clinic and pharmacy.
NOTE: Trainers are encouraged to bring articles and/or guidelines that support the case discussion topics.
Common Level 4 Case Discussion topics include: • HIV regimen changes • Avoiding drug errors • Adherence counseling issues • Over-the-counter (OTC) product interactions with ARVs • How to handle physician communication problems
Please refer to Appendix C for a summary of common topics for all levels of pharmacy trainings.
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Pharmacist’s Café When pharmacists gather for trainings, it is often helpful to begin with an ice breaker for the training participants. One example of an icebreaker is the Pharmacist’s Café, which is an open discussion forum to share ideas on issues that matter most to the pharmacists. This format is based on training techniques from a group called The World Café. This group has a website that describes the research and process principles regarding the use of conversations and questions and to utilize the collective intelligence of a group to create shared purpose. This methodology is most effective for getting participants talking and sharing prior to a Level 2 skills-building training.
For more informatin on The World Café, visit: www.theworldcafe.com
Format for Pharmacist’s Café Tools for how to use this technique can be found on the website above. Below is an example of this technique. Room Set Up and Preparation: Learners should be grouped at round tables or other seating structure conducive for conversations. Index cards and pens/pencils should be available to the learners. Poster paper will also be used to summarize themes from the exercise. The AETC facilitator or faculty should set the tone to be conversational, like those that happen in coffee houses or around the water coolers at work. Here are the steps that follow: 1) Each group should identify a Table Host 2) The Table Host will pose a question and take note of key points shared by the participants Possible questions are:
• How are pharmacists most helpful to people infected with HIV?
• How are pharmacists helpful to the primary care team that cares for people living with HIV (i.e., physicians, nurses, case managers, etc.)?
• What opportunities are there for pharmacists to be recognized as valued members of every HIV-infected patient’s care team?
• How can we continue these conversations? 3) Other group members should join the conversation and each member should be heard from. Note: As mentioned above, offer all members some index cards on which they can take notes. 4) After 10 minutes, Table Host will remain and others will travel to another table.
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5) Table Host will welcome new guests, summarize ideas from the first group and pose the next question. 6) New members will share their ideas, which will be recorded by the Table Host. 7) Table Host will share the notes with the larger group. Once the larger group has reconvened, the AETC facilitator or faculty will use the poster paper to summarize comments from the Table Hosts. These posters can be saved during the course of the training. Learners should be encouraged to add any additional comments, themes or drawings to the posters during breaks.
Needs Assessment Surveys Workgroup members have been developing pharmacy training programs for several years. These experienced trainers recommend beginning your program planning with a needs assessment survey to learn the needs of your audience. As a result, this Workgroup also started by creating a needs assessment survey specifically to determine the educational needs of community pharmacists (please see Appendix D). Users are encouraged to adapt the sample needs assessment survey.
Program Agendas A program agenda provides a snapshot of the training event and serves as a marketing point, drawing participants to the event. Responses received from the needs assessment surveys shape the development of a program agenda. To maximize participant attendance, program agendas should include preferred topics and a convenient time, as indicated by the survey respondents. Workgroup members have shared some of their successful training program agendas (see Appendixes E-H). Users are encouraged to adapt and customize the sample program agendas to regional planning and training efforts.
List of agendas in Appendix E-H: a) One-day program: 1) Clinical Pharmacy Practicum Target Audience: clinical pharmacists 2) HIV Pharmacy Practicum in the Community Setting Target Audience: registered community pharmacists 3) Family-Centered HIV Pharmacy Practicum Target Audience: community pharmacists b) One and one-half day program: 1) HIV Update for Pharmacists Target Audience: community and clinical pharmacists
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Overview There are two important factors that contribute to effective outreach and promotion of pharmacist training programs on HIV:
1. Availability of low-cost continuing pharmaceutical education (CPE) credits for the training program (See the next section on Continuing Education Credit for detailed information on offering CPE credits). 2. Involvement of key stakeholders such as individual pharmacists, community pharmacies, local/state pharmacy associations and consumer groups, when appropriate.
Listed below are tips for outreach, marketing and promotion of pharmacist training activities on HIV. These marketing tips have also been outlined in Appendix I.
How to Identify Pharmacies: • Contact the State Board of Pharmacy or State Pharmacy Association (Appendix J lists the State Pharmacy Associations) for a list of community pharmacies and their address. • There may be a cost associated with obtaining a list of community pharmacies; however, this may be a worthwhile investment to market the pharmacy programs. • Perform Internet searches (e.g., based on geographical data and zip codes). • Ask Medicaid, wholesalers or pharmaceutical representatives where patients fill prescriptions. • The phone book or the internet may be utilized to identify pharmacy wholesalers or pharmaceutical representatives.
• How to identify specific pharmacies dispensing antiretrovirals: • Obtain a list from the AIDS Drug Assistance Program (ADAP). • ADAP also provides data on the number of prescriptions filled by specific pharmacies. • Contact Ryan White funded medical practices. • A list of funded programs is available at: http://hab.hrsa.gov/programs/granteecontacts.htm
How to Reach Pharmacists: • Contact the American Association of Colleges of Pharmacy (AACP) to reach both faculty and pharmacy students. Student organizations may be helpful to identify graduating students. For the list of accredited schools of pharmacy, refer to Appendix K. • Contact local, state, and /or national pharmacy associations. • Target pharmacists in the local area; contact the state’s professional pharmacy association to obtain a roster of local chapter affiliates and contacts. These groups may be willing to include the promotional materials with their newsletters and/or promote the HIV training.
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• Contact the State Board of Pharmacy for a list of pharmacists and their contact information. Requesting a list of practitioners in specific training areas may require more effort. • Drawback to using this mailing list: It may include every registered pharmacist in the state and may not segregate community pharmacists from hospital-based pharmacists. • Target pharmacists participating in regional trainings /conferences.
Visit the American Society of Health-System Pharmacists web site for links to ASHP state affiliate chapters, pharmacy associations and organizations, pharmacy schools, nontraditional pharmacy programs, pharmacy residency sites, pharmacy technician training programs and other health-related sites: http://www.ashp.org/Import/ABOUTUS/WhoWeAre/StateAffiliates/Resources/Other ASHPResources.aspx
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Definition of Continuing Pharmacy Education Accreditation Council for Pharmacy Education’s (ACPE) newly revised definition effective August 1, 2007: Continuing education for the profession of pharmacy is a structured educational activity designed or intended to support the continuing development of pharmacists and/or pharmacy technicians to maintain and enhance their competence. Continuing pharmacy education (CPE) should promote problem-solving and critical thinking and be applicable to the practice of pharmacy.
Continuing Education for Pharmacists Pharmacists should develop and maintain proficiency in five core areas: • Delivering patient-centered care, • Working as part of interdisciplinary teams, • Practicing evidence-based medicine, • Focusing on quality improvement, and • Using information technology ACPE-accredited providers have to assure that continuing education activities comply with the definition and that activity content is applicable to the practice of pharmacy.
To maintain pharmacy licensure, all state boards of pharmacy require pharmacists to participate in accredited or approved continuing education activities. Additionally, an increasing number of state boards of pharmacy require pharmacy technicians to participate in continuing education activities in order to re-register or reapply for their licensure.
ACPE-approved continuing pharmacy education activities: For the complete list of pharmacy education programs offered by ACPE-accredited providers, visit their website at: http://www.acpe-accredit.org/pharmacists/programs.asp
Providing Continuing Education for Pharmacists To provide CPEs for pharmacists and pharmacy technicians in HIV education, it is helpful to partner with the local or state pharmacy associations. Many of these associations obtain CE credits from ACPE providers or from the State Board of Pharmacy. Sometimes local chapters of state associations are seeking topics, speakers and sponsorship of educational programs for their membership. State pharmacy associations typically have annual or semi-annual conferences/meetings/seminars that are planned at least 6 months in advance. Contact these groups early to discuss adding HIV training for their membership. Also, CE application packets may be obtained from the ACPE providers. At times there may be an early submission deadline (i.e., 45 or 60 days notice).
ACPE providers: For the complete list of ACPE-accredited providers, visit: http://www.acpe-accredit.org/pharmacists/providers.asp
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Conclusion Pharmacists play a significant role in the care and treatment of HIV-infected patients. With rapidly changing information in the field of HIV, successful pharmacy training programs should address these changes as well as the core competencies needed by pharmacists.
AETC Training Levels provide the framework for developing training programs for pharmacists and other healthcare providers. As outlined in this Guide, there are several methods for developing pharmacy training programs. Creating a needs assessment survey is an effective starting point. By providing several program development strategies, marketing tips and other helpful resources in one comprehensive document, this Guide can be used as a tool when developing effective AETC pharmacy training programs.
References
Accreditation Council for Pharmacy Education. Accreditation Standards for Continuing Pharmacy Education. Retrieved on June 09, 2008 from http://www.acpe- accredit.org/pdf/CPE_Standards_Final_092107.pdf
Accreditation Council for Pharmacy Education. Revised ACPE Definition of Continuing Education for the Profession of Pharmacy. Retrieved on June 09, 2008 from http://www.acpe- accredit.org/pdf/CE_Definition_Pharmacy_Final_CoverMemo2007.pdf
AIDS Education and Training Centers, National Resource Center. AETC Training Principles. Retrieved on August 04, 2008 from http://www.aidsetc.org/aidsetc?page=tr-29-00
Hardy, Helene (2005). Adherence to antiretroviral therapy: the emerging role of HIV pharmacotherapy specialists. Journal of Pharmacy Practice,18(4)247-263.
New York State Department of Health. Pharmacists: partners in health care for HIV-infected patients. New York (NY): New York State Department of Health; 2006 Jan. 28. Retrieved on August 03, 2008 from http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=10974&nbr=5754
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Abbreviations
The following abbreviations have been used in this Guide: AETC AIDS Education and Training Centers ACPE Accreditation Council for Pharmacy Education ADAP AIDS Drugs Assistance Program ARV Antiretroviral CBO Community-Based Organization CE Continuing Education CPE Continuing Pharmacy Education HIPAA Health Insurance Portability and Accountability Act LPS Local Performance Site NP Nurse Practitioner OTC Over The Counter PA Physician’s Assistant TA Technical Assistance
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List of Helpful Resources
• AIDS Education and Training Center (AETC) Web link: www.aidsetc.org • Academy of Managed Care Pharmacy (AMCP) Web link: www.amcp.org • Accreditation Council for Pharmacy Education (ACPE) Web link: http://www.acpe-accredit.org • American Association of Colleges of Pharmacy (AACP) Web link: www.aacp.org • American College of Apothecaries Web link: www.americancollegeofapothecaries.com • American College of Clinical Pharmacy (ACCP) Web link: http://www.accp.com • American Pharmacists Association (APhA) Web link: http://www.pharmacist.com • American Society of Consultant Pharmacists (ASCP) Web link: http://www.ascp.com • American Society of Health-System Pharmacists (ASHP) Web link: http://www.ashp.org • National Association of Boards of Pharmacy (NABP) Web link: http://www.nabp.net • National Community Pharmacists Association (NCPA) Web link: http://www.ncpanet.org • National Alliance of State Pharmacy Associations (NASPA) Web link: http://www.ncspae.org/
• National HIV/AIDS Clinicians’ Consultation Center (NCCC) Web link: http://www.nccc.ucsf.edu/
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APPENDIX A: ANTIRETROVIRAL DRUG INTERACTIONS WORKSHOP
OBJECTIVE: To review HIV antiretroviral and related opportunistic infection medication drug interactions.
GOALS: During this session, pharmacists will be able to: 1) Review a patient’s drug profile and identify potential drug interactions. 2) List the expected outcome/consequences of the interaction. 3) Formulate a counseling strategy and pharmaceutical care plan for handling the drug interaction
INSTRUCTIONS: The following activity uses case scenarios to review antiretroviral drug interactions. You are a pharmacist performing a dispensing shift at your local community or hospital outpatient pharmacy.
You will be broken up into small groups and provided with easel paper and markers. Please read your case and then discuss with your group. References on drug interactions will be provided. On your paper, create a chart with the following headings: 1. Drug Interaction 2. Expected Outcome of Drug Interaction 3. Pharmaceutical Care Plan 4. Patient Counseling Points
Complete the chart with the pertinent fields from your case. At the end of the allotted time, we will review your findings and care plans in the larger group.
There are seven cases that have been provided in this workshop.
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ARV Drug Interactions Workshop: CASE 1 Dr’s Office 12345 Medication Lane San Francisco, CA 94143 (415) 911-4111
Patient’s Name ___Homer Simpson______
Date: ______6/20/08______
Rx:
Clarithromycin 500mg PO BID #60, 5 refills Ethambutol 400mg PO QD #90, 5 refills Rifabutin 300mg, PO QD #30, 5 refills Methadone 10mg PO BID #120, 0 refills
Signature:______Dr. Doe______
Conversation at the pharmacy counter: “Hi! I’m here to refill my prescriptions. I think there are 7 of them. I also have these new ones (hands you the prescription) from Dr. Doe.”
When you ask him how he has been lately he says…
“I’ve been doing just ‘ok’. Dr. Doe keeps giving me all these medications. My back has been killing me – more than it has been in a long time. Especially over the last month. Maybe I should ask Dr. Payne if I can try a new medicine.”
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ARV Drug Interactions Workshop: CASE 1 (cont’d) Patient Homer J. Simpson Address 128 Donut Lane, Gender Male Insurance Cover-all insurance
PATIENT PROFILE Drug Name COMBIVIR 300mg/150mg TABS Orignal Rx 3/18/08 Sig Take one tablet by mouth twice daily Last Filled 5/20/08 Quantity 60 Physician Dr. Doe Refills left 3
Drug Name INVIRASE 500mg TABS Original Rx 3/18/08 Sig Take two tablets by mouth twice Last Filled 5/20/08 daily Quantity 120 Physician Dr. Doe Refills left 3
Drug Name NORVIR 100mg TABS Original Rx 3/18/08 Sig Take 1 capsule by mouth twice daily Last Filled 5/20/08 Quantity 60 Physician Dr. Doe Refills left 3
Drug Name Buspirone 15mg TABS Original Rx 2/20/08 Sig Take 1 tablet by mouth daily Last Filled 5/20/08 Quantity 30 Physician Dr. Psych Refills left 2
Drug Name Methadone 10mg TABS Original Rx 5/20/08 Sig Take 2 tablets by mouth twice daily Last Filled 5/20/08 Quantity 120 Physician Dr. Payne Refills left 0
Drug Name Stavudine 30mg TABS Original Rx 5/20/08 Sig Take 1 capsule by mouth twice daily Last Filled 5/20/08 Quantity 60 Physician Dr. Newhouse Refills left 4
Drug Name EPIVIR 150mg TABS Original Rx 5/20/08 Sig Take 1 tablet by mouth twice daily Last Filled 5/20/08 Quantity 60 Physician Dr. Newhouse Refills left 4
Drug Name Digoxin 0.125mg TABS Original Rx 3/20/08 Sig Take 1 tablet by mouth twice daily Last Filled 5/20/08 Quantity 60 Physician Dr. Hart Refills left 5
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ARV Drug Interactions Workshop: CASE 2 Dr’s Office 12345 Medication Lane San Francisco, CA 94143 (415) 911-4111
Patient’s Name ___Marge Simpson______
Date: ______6/20/08______
Rx:
Rifampin 300mg ii PO daily #60, 5 refills Isoniazid 300mg PO daily #30, 5 refills Pyrazinamide 500mg ii PO daily #60, 1 refill Ethambutol 400mg iii PO QD #90, 1 refills Epivir HBV 100mg PO daily, #30, 5 refills
Signature:______Dr. I. Diseases______
Conversation at the pharmacy counter: “I can’t believe I got TB and hepatitis from my trip to Asia! Here are my prescriptions. I think I also need refills on my other meds too.
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ARV Drug Interactions Workshop: CASE 2 (cont’d) Patient Marge Simpson Address 128 Donut Lane, Gender Female Insurance Lotsa insurance
PATIENT PROFILE Drug Name COMBIVIR 300mg/150mg TABS Orignal Rx 2/18/08 Sig Take one tablet by mouth twice daily Last Filled 5/20/08 Quantity 60 Physician Dr. Doe Refills left 1
Drug Name KALETRA 200/50mg TABS Original Rx 2/18/08 Sig Take two tablets by mouth twice Last Filled 5/20/08 daily Quantity 120 Physician Dr. Doe Refills left 1
Drug Name ADVAIR DISCUS 100/50mg Original Rx 1/18/08 Sig 1 inhalation twice daily Last Filled 5/20/08 Quantity 1 Physician Dr. General Refills left 0
Drug Name Phenytoin 300 CAPS Original Rx 1/20/08 Sig Take 1 capsule by mouth daily Last Filled 5/20/08 Quantity 30 Physician Dr. General Refills left 1
Drug Name CRESTOR 5mg TABS Original Rx 5/20/08 Sig Take 1 tablets by mouth daily Last Filled 5/20/08 Quantity 30 Physician Dr. General Refills left 2
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ARV Drug Interactions Workshop: CASE 3 Dr’s Office 12345 Medication Lane San Francisco, CA 94143 (415) 911-4111
Patient’s Name ___Moe Beers______
Date: ______6/20/08______
Rx:
Migranal nasal spray 4mg/mL: Instill 1 spray in each nostril. Repeat in 15 min.
Signature:______Dr. General______
Conversation at the pharmacy counter: “Ugh. I thought I was supposed to be starting to feel better now! That’s the whole reason I agreed to starting antivirals is to give me more energy. But I’m feeling awful! I’ve got this terrible headache, and my body and muscles really ache! I hope this migraine medicine does the trick. I never thought I had migraines before, but maybe it will at least get rid of my headache. Maybe some of these supplements will help too.”
Brings to the counter for purchase: a pack of gum, cigarettes a bottle of SAM-E and St. John’s Wort.
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ARV Drug Interactions Workshop: CASE 3 (cont’d) Patient Moe Beers Address 911 Drinking Lane, Gender Male Insurance Kindasorta insurance
PATIENT PROFILE Drug Name EPZICOM 300mg/600mg TABS Orignal Rx 5/01/08 Sig Take one tablet by mouth daily Last Filled 5/01/08 Quantity 30 Physician Dr. Infectious Refills left 0
Drug Name EPZICOM 300mg/600mg TABS Orignal Rx 6/01/08 Sig Take one tablet by mouth daily Last Filled 6/01/08 Quantity 30 Physician Dr. Internal Refills left 5
Drug Name LEXIVA 700mg TABS Original Rx 5/01/08 Sig Take one tablet by mouth twice daily Last Filled 5/01/08 Quantity 60 Physician Dr. Infectious Refills left 0
Drug Name Famciclovir 500mg TABS Original Rx 6/01/08 Sig Take one tablet by mouth twice daily Last Filled 6/01/08 Quantity 60 Physician Dr. Internal Refills left 5
Drug Name Simvastatin 40mg TABS Original Rx 6/01/08 Sig Take one tablet at bedtime Last Filled 6/01/08 Quantity 30 Physician Dr. General Refills left 5
Drug Name WELLBUTRIN XL 300 TABS Original Rx 1/20/08 Sig Take 1 tablet by mouth daily Last Filled 6/01/08 Quantity 30 Physician Dr. General Refills left 1
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ARV Drug Interactions Workshop: CASE 4 Dr’s Office 12345 Medication Lane San Francisco, CA 94143 (415) 911-4111
Patient’s Name ___Lisa Simpson______
Date: ______6/20/08______
Rx: Mevacor 10mg po at bedtime #30; 5 refills
Signature:______Dr. Cardio______
Conversation at the pharmacy counter: “Sigh. Isn’t San Francisco so grey in the summer? And now Dr. Cardio says I might have clogged arteries! It just figures that I have a broken heart. I thought I was doing so well, starting my meds and all. But I’ve been feeling so blah lately and I don’t have any energy. Do I have to wait long for this prescription? I just want to go home, go back to bed, and stay there forever.”
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ARV Drug Interactions Workshop: CASE 4 (cont’d) Patient Lisa Simpson Address 8220 Jazzy Lane Gender Female Insurance Smartypants Insurance
PATIENT PROFILE Drug Name EPZICOM 300mg/600mg TABS Orignal Rx 2/01/08 Sig Take one tablet by mouth daily Last Filled 6/01/08 Quantity 30 Physician Dr. Viral Refills left 2
Drug Name PREZISTA 600mg TABS Original Rx 2/01/08 Sig Take one tablet by mouth twice daily Last Filled 6/01/08 Quantity 60 Physician Dr. Viral Refills left 2
Drug Name NORVIR 100mg CAPS Original Rx 2/01/08 Sig Take one capsule by mouth twice Last Filled 6/01/08 daily Quantity 60 Physician Dr. Viral Refills left 2
Drug Name ISENTRESS 400mg TABS Original Rx 2/01/08 Sig Take one tablet by mouth twice daily Last Filled 6/01/08 Quantity 60 Physician Dr. Viral Refills left 2
Drug Name Lorazepam 1mg TABS Original Rx 4/20/08 Sig Take ½ - 1 tablet by mouth at Last Filled 6/01/08 bedtime as needed for sleep Quantity 30 Physician Dr. Psyche Refills left 1
Drug Name Paroxetine 20mg TABS Original Rx 12/20/08 Sig Take 1 tablet by mouth daily Last Filled 6/01/08 Quantity 30 Physician Dr. Psyche Refills left 6
Drug Name ORTHO CYCLEN 7/7/7 TABS Original Rx 12/20/08 Sig Take 1 tablet by mouth daily Last Filled 6/01/08 Quantity 84 Physician Dr. Baby Refills left 1
Drug Name Vitamin C 500mg TABS Original Rx 12/20/08 Sig Take 1 tablet by mouth daily Last Filled 6/01/08 Quantity 30 Physician Dr. Baby Refills left 1
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ARV Drug Interactions Workshop: CASE 5 Dr’s Office 12345 Medication Lane San Francisco, CA 94143 (415) 911-4111
Patient’s Name ___Sideshow Bob______
Date: ______6/20/08______
Rx:
Viagra 100mg Sig: Take ½ - 1 tablet 30 minutes prior to sex. #30 0 Refills
Signature:______Dr. Internal______
Conversation at the pharmacy counter: “I am just loving life! I need this prescription and refills on my Reyataz and Truvada, please.”
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ARV Drug Interactions Workshop: CASE 5 (cont’d) Patient Sideshow Bob Address 1092 Bigtop Lane Gender Male Insurance CircusCircus Insurance
PATIENT PROFILE Drug Name TRUVADA 300mg/200mg TABS Orignal Rx 1/01/08 Sig Take one tablet by mouth daily Last Filled 3/01/08 Quantity 30 Physician Dr. NT Viral Refills left 2
Drug Name Didanosine 400mg CAPS Original Rx 1/01/08 Sig Take one capsule by mouth daily Last Filled 3/01/08 Quantity 30 Physician Dr. NT Viral Refills left 2
Drug Name NORVIR 100mg CAPS Original Rx 1/01/08 Sig Take one capsule by mouth daily Last Filled 3/01/08 Quantity 30 Physician Dr. NT Viral Refills left 2
Drug Name REYATAZ 300mg CAPS Original Rx 1/01/08 Sig Take one capsule by mouth daily Last Filled 3/01/08 Quantity 30 Physician Dr. NT Viral Refills left 2
Drug Name COMBIVENT INH Original Rx 1/20/08 Sig 2 inhalations four times daily Last Filled 2/01/08 Quantity 1 Physician Dr. Internal Refills left 3
Drug Name Albuterol MDI Original Rx 1/20/08 Sig 1-2 inhalations every 4-6 hours as Last Filled 6/01/08 needed for shortness of breath Quantity 1 Physician Dr. Internal Refills left 0
Drug Name Esomeprazole 40mg CAPS Original Rx 4/01/08 Sig Take 1 capsule by mouth daily Last Filled 6/01/08 Quantity 30 Physician Dr. Internal Refills left 3
Drug Name CARDIZEM CD 120mg CAPS Original Rx 4/01/08 Sig Take one capsule by mouth daily Last Filled 6/01/08 Quantity 30 Physician Dr. Internal Refills left 1
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ARV Drug Interactions Workshop: CASE 6 Dr’s Office 12345 Medication Lane San Francisco, CA 94143 (415) 911-4111
Patient’s Name ___ Guy Comicbook ______
Date: ______6/20/08______
Rx:
Loratidine 10mg i PO QD #30 5 refills Sudafed 30mg i PO QID PRN #100 0 refills
Signature:______Dr. House______
Conversation at the pharmacy counter: “I need refills on my Septra. I’m already behind by a week. My doctor said it’s going to prevent me from getting sick – I don’t want to get that sick again. Here, I’ll buy this can of grapefruit juice to wash my meds down with. And, by the way, I know it’s a little early, but can I also pick up my other meds? Not the methadone – I know I need a special prescription for that one. I have an appointment coming up with Dr. Payne and Dr. Specialist on June 30th.”
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ARV Drug Interactions Workshop: CASE 6 (cont’d) Patient Guy Comicbook Address 28346 Fantasy Island Street Gender Male Insurance Trekkie Insurance
PATIENT PROFILE Drug Name TRUVADA 300mg/200mg TABS Orignal Rx 5/30/08 Sig Take one tablet by mouth daily Last Filled 5/30/08 Quantity 30 Physician Dr. Specialist Refills left 3
Drug Name VIRAMUNE 200mg TABS Original Rx 5/30/08 Sig Take one tablet by mouth daily x 21 Last Filled 5/30/08 days then increase to one tablet twice daily Quantity 60 Physician Dr. Specialist Refills left 3
Drug Name Methadone 10mg TABS Original Rx 5/30/08 Sig Take 3 tablets orally three times daily Last Filled 5/30/08 Quantity 270 Physician Dr. Payne Refills left 0
Drug Name BACTRIM DS 800/160mg TABS Original Rx 5/26/08 Sig Take 2 tablets by mouth three times Last Filled 5/26/08 daily Quantity 126 Physician Dr. Specialist Refills left 0
Drug Name Azithromycin 600 mg TABS Original Rx 5/30/08 Sig Take two tablets by mouth once weekly Last Filled 5/30/08 Quantity 8 Physician Dr. Specialist Refills left 3
Drug Name VFEND 200 mg TABS Original Rx 5/26/08 Sig Take one tablets by mouth twice daily Last Filled 5/26/08 Quantity 60 Physician Dr. Specialist Refills left 2
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ARV Drug Interactions Workshop: CASE 7 Dr’s Office 12345 Medication Lane San Francisco, CA 94143 (415) 911-4111
Patient’s Name ___ Joe Crabapple______
Date: ______6/20/08______
Rx:
Atripla i po at bedtime, #30 5 refills Selzentry 300mg i po twice daily #30
Signature:______Dr. Virology______
Conversation at the pharmacy counter: “Time to start these meds, huh? I guess things could be worse – I’m feeling pretty good, so I think I’m up to it.”
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ARV Drug Interactions Workshop: CASE 7 (cont’d) Patient Joe Crabapple Address 6253 Schoolhouse Street Gender Male Insurance University Insurance
PATIENT PROFILE Drug Name Risperdal 1mg TABS Orignal Rx 2/30/08 Sig Take one tablet by mouth twice daily Last Filled 5/30/08 Quantity 60 Physician Dr. Hed Case Refills left 1
Drug Name Doxycycline 100mg CAPS Original Rx 3/30/08 Sig Take one capsule by mouth twice Last Filled 3/30/08 daily until gone Quantity 20 Physician Dr. General Refills left 0
Drug Name Itraconazole 200mg CAPS Original Rx 3/30/08 Sig Take one capsule by mouth daily x Last Filled 5/30/08 12 weeks for toenails Quantity 30 Physician Dr. General Refills left 0
Drug Name CIALIS 10mg TABS Original Rx 3/30/08 Sig Take one tablet by mouth 30 Last Filled 3/30/08 minutes prior to sex Quantity 30 Physician Dr. General Refills left 0
Drug Name Atorvastatin 20 mg TABS Original Rx 3/30/08 Sig Take one tablet by mouth at bedtime Last Filled 5/30/08 Quantity 30 Physician Dr. Hearty Refills left 3
Drug Name Lorazepam 1mg TABS Original Rx 4/20/08 Sig Take ½ - 1 tablet by mouth at Last Filled 6/01/08 bedtime as needed for sleep Quantity 30 Physician Dr. Hed Case Refills left 1
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Appendix B: HIV Pharmacology Workshop Exercise
Exercise: Have posters around the room with the topic in the title section. Each table then has colored cards (approximately 10) with names of antiretroviral medicines (generic and brand names). The cards then need to be placed on the appropriate poster. If place near top of poster, the group is “Sure” the medicine belongs to that poster. Can place the card near the bottom of poster if “less sure” it belongs there. If brand name is already on the poster, do not also place the generic name there (and visa-versa). Groups can discuss with each other and use the references available in their packet (ARV tables from DHHS guidelines, ARV drug information sheet with pictures).
• Co-formulated (combination) Products (>1 medicine in one pill) • Once daily dosing FDA approved • Avoid in Pregnancy (or avoid component if co-formulated) • Renal Dose Adjustments Recommended (or component if co-formlated) • Significant interactions with Proton-Pump Inhibitors • Should be taken on Empty Stomach • Rash and/or Allergic Reaction is Common & suggests special education • Activity against Hepatitis B (or component if co-formulated) • FDA approved after January 2005 • Must Be Dispensed with Ritonavir
1. Co-formulated (combination) Products (>1 medicine in one pill) • Combivir (zidovudine/lamivudine) • Kaletra (lopinavir/ritonavir) • Trizivir • Atripla (abacavir/zidovudine/lamivudine) (efavirenz/tenofovir/emtricatabine) • Truvada (tenofovir/emtricitabine) • Epzicom (abacavir/lamivudine)
Teaching Points: • Some patients prefer lower bottle burden than pill burden. • Can affect co-pays (decrease cost). • Can increase confusion about names. • Need to recall individual components to educate/consider interactions and side- effect issues.
2. Once daily dosing FDA approved • Atripla • Atazanavir/ritonavir (Reyataz/Norvir) (efavirenz/tenofovir/emtricitabine) • Emtricitabine (Emtriva) • Epzicom (abacavir/lamivudine) • Tenofovir/emtricitabine (Truvada) • Lamivudine (Epivir) • Didanosine (Videx) • Viread (tenofovir) • Efavirenz (Sustiva)
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Naïve patients: • Kaletra (lopinavir/ritonavir) • Fosamprenavir/ritonavir (Lexiva/Norvir) • Reyataz (atazanavir)
Teaching Points: • Can effectively combine once daily dosing of antiretrovirals. • Some ARV are used once daily, but not FDA-approved (not on this list, would be added to chart during exercise). • Some once daily regimens are FDA-approved for use in ARV naïve pts, but not ARV experienced. • Review pharmacokinetic issues: Boosting of ritonavir – what does that really mean? “Forgivability” of regimens – what is the significance of missing a dose in a once a day regimen vs. twice a day regimen? • Adherence rates differ between once daily vs. twice daily vs. three times daily regimens. (In all chronic disease conditions, including HTN & DM)
3. Avoid in Pregnancy (or avoid component if co-formulated) • Efavirenz (Sustiva) • Viracept (nelfinavir) • Stavudine/didanosine (Zerit/Videx) • Atripla (efavirenz/tenofovir/emtricitabine)
Teaching Points: • Efavirenz isteratogenic– especially if used early in pregnancy (Pregnancy Category D) • Women desiring pregnancy, and/or not using effective birth control, should avoid efavirenz. • Stavudine and didanosine is on this list due to increased risk of pancreatitis and lactic acidosis when used in pregnancy. • Pharmacokinetics of ARV can be affected by pregnancy, leading to some dosing adjustments or increased side-effects. • Can use most of our ARV during pregnancy
4. Renal Dose Adjustments Recommended (or component if co-formulated) • Viread (tenofovir) • Emtricitabine (Emtriva) • Lamivudine (Epivir) • Stavudine (Zerit) • Truvada (tenofovir/emtricitabine) • Trizivir • Zidovudine (Retrovir) (abacavir/lamivudine/zidovudine) • Combivir (zidovudine/lamivudine) • Epzicom (abacavir/lamivudine) • Videx (didanosine) • Atripla (efavirenz/tenofovir/emtricitabine)
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Teaching Points: • No Protease Inhibitors on this list • Dose adjustment due to renal dysfunction is different that having medications cause renal dysfunction. • Tenofovir is only one on this list that is associated with causing renal dysfunction. • Coformulated products often need to be separated for appropriate dose adjustment. • Often medication errors are found when the dose is not adjusted for renal dysfunction. • Especially after renal function improves, if the dose is not adjusted accordingly, this could lead to subtherapeutic concentrations and resistance. • Atazanavir should not be administered to treatment experienced patients on hemodialysis and treatment naïve patients need to be on boosted atazanavir. No adjustments required for patients not on hemodialysis.
5. Significant interactions with Proton-Pump Inhibitors (PPIs) • Atazanavir (Reyataz) • Atazanavir/ritonavir (Reyataz/Norvir)
Teaching Points: • Atazanavir requires an acidic environment for absorption and PPIs will decrease absorption, even with boosted atazanavir. • A good drug history important, including over-the-counter medications, due to availability of PPIs and H-2 antagonists OTC • See FDA-approved package insert for atazanavir for updated recommended dosing for treatment experienced and treatment naïve patients receiving PPIs or H2 antagonists.
6. Should be taken on Empty Stomach • Videx (didanosine) • Efavirenz (Sustiva) • Indinavir (Crixivan) • Atripla (efavirenz/tenofovir/emtricitabine)
Teaching Points: • Indinavir (rarely given anymore) was given Q 8 hrs on empty stomach for adequate absorption, – until started using with boosted RTV. • Didanosine, even in enteric-coated formulation, still has an empty stomach requirement, unless dosed with tenofovir. When given with tenofovir, the dose is reduced to 250mg once daily and maybe given with food. • Need to double check auxiliary labels from pharmacy, as they do not always take into account co-administered meds. • The reason efavirenz is recommended on empty stomach is to avoid INCREASED absorption, which would lead to increased possible side-effects, not decreased efficacy. So if patients can tolerate taking with food and improves adherence, the patient can do so.
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7. Rash and/or Allergic Reaction is Common & suggests special education • Abacavir (Ziagen) • Epzicom (abacavir/lamivudine) • Trizivir (abacavir/zidovudine/lamivudine) • Nevirapine (viramune)
Teaching Points: • HLA-B*5701 test is available which could help predict patients likely to have abacavir hypersensitivity (ABC-HSR) reaction. • Discuss warning card dispensed with abacavir and abacavir-containing products. Patients should actually be advised NOT to stop their medications on their own. May often suggest for patients who have symptoms reported on the card to continue medication for several days to determine if truly ABC-HSR or just early side-effects from the new ARV regimen. • Early symptoms of ABC-HSR are not fatal. Restarting after stopping has had some life-threatening reactions. • Nevirapine dose should be once daily for first 2 weeks, then every 12 hours to reduce incidence of rash. • If a nevirapine rash develops without other symptoms (flu-like, abdominal pain), may be able to continue the medication. Rash often resolves within several days to weeks. • Severe rash and hepatitis is seen more often when nevirapine is used in men with CD4 > 400 and women with CD4 > 250. Should monitor Liver Function Tests (LFTs) every 2 weeks for first 8 weeks in all patients started on nevirapine. • Many other ARV can also cause rash, but do not necessarily need special education: Etravirine Fosamprenavir Efavirenz Darunavir Tipranavir Nelfinavir
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8. Activity against Hepatitis B (or component if co-formulated) • Tenofovir (Viread) • Lamivudine (Epivir) • Emtricitabine (Emtriva) • Truvada (tenofovir/emtricitabine) • Atripla (efavirenz/tenofovir/emtricitabine) • Trizivir (abacavir/lamivudine/zidovudine) • Epzicom (abacavir/lamivudine)
Teaching Points: • Tenofovir, lamivudine and emtriciatabine which are available in several co-formulated products, have activity against both HIV and Hepatitis B virus. • When treating co-infected individuals, both infections need to be treated concomitantly. (i.e., don’t treat one without treating the other). • There is a warning not to stop these medications suddenly as a Hepatitis B flare up may occur.
9. FDA approved after January 2005 • Atripla (efavirenz/tenofovir/emtricitabine) • Raltegravir (Isentress) • Darunavir (Prezista) • Maraviroc (Selzentry) • Tipranavir (Aptivus) • Etravirine (Intelence)
Teaching Points: • Some of the medications that are newly approved are actually just new formulations of old medicines (i.e., Atripla). • Some are new medicines in current classes of antiretrovirals (i.e., darunavir and tipranavir are new protease inhibitors). Data suggests activity against PI resistant virus, especially for darunavir. • Like-sounding medications adds to the confusion of names (Intelence vs Isentress). • Most recently, there has been an approval for medicines that are novel targets against HIV, such as CCR5 receptor antagonist and integrase inhibitor.
10. Must Be Dispensed with Ritonavir • Darunavir (Prezista) • Tipranavir (Aptivus)
Other Protease Inhibitors often boosted, but NOT ALWAYS: • Atazanavir (Reyataz) • Fosamprenavir (Lexiva) • Saquinavir (Invirase) • Indinavir (Crixivan)
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Already Co-formulated with ritonavir, therefore does not need extra dispensing:
• Lopinavir (coformulated as Kaletra)
Teaching Points: • Many Protease Inhibitors are used in combination with ritonavir, but many have FDA-approved dosing without ritonavir. • The two above are the only protease inhibitors that have no approved dosing without ritonavir • Efficacy of boosted protease inhibitors and “forgivability” is improved compared to unboosted protease inhibitors. • BID dosing of ritonavir can make for dispensing errors, as two or more bottles of 100mg ritonavir are given to the patient.
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Appendix C: List of Common Training Topics for Pharmacists
Level 1 • New Antiretroviral Medication Updates • Managing Adverse Reactions to HIV Medications • Pharmacokinetics/Pharmacogenomics and Therapeutic Drug Monitoring • Medication Errors in HIV • Medicare Part D and access to HIV Medications Level 2 • Use of New Antiretroviral Medications • Adherence Counseling • Identifying and Managing Drug-Drug Interactions • Managing and Counseling HIV Adverse Drug Reactions • Providing Culturally Competent HIV Care • Role of the Community Pharmacist in the HIV Care Team • HIV 101: When to Start Antiretroviral Therapy and What to Start With Level 3 For clinic/hospital-based preceptorships: • HIV Pharmacotherapy Update and Drug Interactions • Co-Management Approach to HIV Care • HIV Medical Update For community pharmacy-based preceptorships: • Addressing HIV Drug Errors in the Retail Pharmacy Setting • Interactions between Common OTC Products and HIV Medications • Putting Theory into Practice: Medication Counseling with HIV Patients Level 4 • HIV regimen changes • Avoiding drug errors • Adherence counseling issues • Over-the-counter (OTC) product interactions with ARVs • How to handle physician communication problems
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Appendix D: Needs Assessment Survey for Community Pharmacists and Pharmacy Staff
Purpose: The AIDS Education and Training Centers (AETCs) are a network of 11 regional centers that conduct targeted, multi-disciplinary education and training programs for healthcare providers treating persons with HIV/AIDS.
The AETC within your region is interested in learning more about the educational needs of community pharmacists and pharmacy staff related to HIV/AIDS care and treatment. This needs assessment survey will be used to help the AETCs identify topics of interest and the best ways to meet your educational needs. Your responses will be kept confidential.
State: ______Zip Code: ______
1. Are you familiar with your regional AIDS Education and Training Center? Yes No
2. Please indicate what type of pharmacy you work for (check all that apply):
O Independent O Mail order O Part of a small chain O HIV Specialty Pharmacy O Part of a large chain O Located in hospital/clinic
3. Please indicate your primary functional role. O Pharmacy Manager/Director O Pharmacy Technician O Registered Pharmacist O Pharmacy/Store Clerk
4. On average, how many HIV/AIDS-related prescriptions do you fill monthly? O 0-10 O 100-200 O 10-50 O >200 O 50-100 O Not applicable/don’t dispense
5. Please rate your knowledge/skills and desire for additional training in the following areas.
Novice/ Somewhat Expert I would like additional Beginner Knowledgeable training in this area Antiretrovirals and Drugs for Prevention and Treatment of Opportunistic Infections O O O O Yes O No
Complications of ARVs O O O O Yes O No
Pharmacy-specific educational resources O O O O Yes O No
HIV Medication Assistance Programs O O O O Yes O No
HIV Prevention/Pharmacist’s Role O O O O Yes O No
Managing side affects of HIV medications O O O O Yes O No
Pediatric Drug Formulations O O O O Yes O No
Prescribing Errors O O O O Yes O No
Prescription Reimbursements O O O O Yes O No
Relevant HIV drug interactions O O O O Yes O No
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Review of adult ARV treatment guidelines O O O O Yes O No
Treatment Updates and Drugs in Development O O O O Yes O No
Updates on HIV Resistance O O O O Yes O No
Other (specify):______
6. Please rate the following information dissemination and training formats according to your preference. Really Neutral Dislike Prefer O O O Conferences or Seminars O O O CD-ROM programs O O O Interactive online studies O O O Preceptorships O O O Printed materials (brochures, journals, newsletters, pocket guides, etc) O O O Video/Audio Teleconferences O O O Web courses (live) O O O Other (specify):______
7. Please indicate how much time your staff can devote to receiving HIV/AIDS education (check all that apply).
Training days per month: O ½ day O 1 day O 2 days O 3 days O >3 days
Hours per training session: O 1 hr. O 2 hrs. O 4 hrs. O 8 hrs. O >8 hrs.
8. What barriers exist for you and your staff in attending/obtaining training and education? (Check all that apply)
O Time O Language O Travel O Limited Computer Technology O Cost O Patient/Client Scheduling O Staff Coverage O Other (specify):______
9. What resources do you utilize most frequently when you are faced with an unfamiliar HIV/AIDS prescription dose? (Check all that apply)
O Computer automatically flags and provides O Online drug information resource a reference resource O DHHS Updated Treatment Guidelines O Look-up in a paper reference manual O National or Regional AETC Warmline/Hotline O Contact colleagues outside of your pharmacy O Other (specify):______O Ask colleague in your pharmacy
10. What barriers do you and your staff encounter in providing adequate or optimal consultation to HIV patients/clients? (Check all that apply)
O Lack of time to interact with clients O Inadequate private/semi-private space O Not in my job description O Staff do not have knowledge of HIV drug information O No reimbursement/fee paid to pharmacist for O Patient/client not receptive these efforts O Language barriers O Inadequate staffing O Lack of internet access O Other (specify): ______
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11. Do you provide the following to patients:
Verification of prescription drug coverage eligibility Yes No Assistance in applying for or updating prescription drug coverage eligibility Yes No Counseling on formulary options for non-covered medications Yes No Working with prescribers to develop alternate treatment options Yes No Assist and coordinate manufacturer drug assistance programs for patients without coverage Yes No Provision of emergency prescriptions at no charge Yes No
12. Does your pharmacy have mechanisms in place for patients to receive HIV medications that are not covered or not affordable based on their insurance plan? Yes No
If yes, please describe: ______
13. The provision of culturally competent care by health professionals has been recognized by the Surgeon General as an important component of effective health management of HIV patients. How does your pharmacy / staff deliver culturally competent care within the scope of pharmacy practice? (Check all that apply) Provide written materials and signage in the clients’ preferred language Provide services that are client centered (compatible with clients' cultural beliefs and practices) Promote diverse staff and leadership that are representative of the demographic characteristics of the service area in your organization Conduct a needs-assessment to plan for culturally and linguistically appropriate services within your organization None of the above Other, please specify: ______
14. The AETC’s mission is to target “Big 6” populations (pharmacists, physicians, physician assistants, nurses, nurse practitioners, dentists).
Have you ever attended an AETC training? Yes No If yes, was it useful in your care of patients? Yes No
AIDS Education and Training Centers
Thank you for your time and interest in completing this needs assessment survey.
Return this survey to: ______
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Appendix E: HIV Clinical Pharmacy Practicum (Program Agenda)
Tuesdays Tuesdays Wednesdays 7:30am – 1:45pm 7:30am – 1:45pm 7:15am – 1:30pm Hackensack Univ. Medical Ctr Jersey Shore Univ. Medical Ctr St. Michael’s Medical Ctr Hackensack, NJ Neptune, NJ Newark, NJ
Purpose: The program offers registered pharmacists an opportunity to directly observe how HIV patients receive both assessment and HIV clinical treatment by a multi-disciplinary management team of doctors, clinical pharmacists and nurses in an out-patient clinical care setting. Objectives: Upon completion of this program, participants should be able to: • Identify pertinent drug-drug interactions observed with highly active antiretroviral therapy (HAART). • List management strategies for dealing with adverse effects of HAART. • Interpret and understand ART resistance testing and its impact on selection of a HAART regimen. • Determine how to approach therapeutic dilemmas, e.g. unavailability of medications, incorrect drug doses, etc. • Recognize the role of a pharmacist in a multi-disciplinary approach to the management of HIV patients. • Understand a wide array of challenging issues in the lives of various patients living with HIV infection
Agenda 15 minutes Registration and Pre-Test Completion 60 minutes Lecture: HIV Pharmacotherapy Update and Drug Interactions 200 minutes Patient Care Observation: Co-Management Approach to HIV Care 40 minutes Lecture: HIV Medical Update 15 minutes Post-Test Completion and Evaluation
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Appendix F: HIV Pharmacy Practicum in the
Community Pharmacy Setting (Program Agenda)
08HX1I 2007-2008
Purpose: This customized one-on-one training is designed to educate registered pharmacists on community pharmacy issues relevant to the management of HIV-positive patients in the community through a combination of didactic lectures and patient observation at a community pharmacy.
Objectives: Upon completion of this program, participants should be able to: • Identify potential over-the-counter product interactions observed with highly active antiretroviral therapy (HAART) and other common HIV prescription medications. • Manage potential HIV drug errors which may adversely affect patient care • Foster patient-provider relationships which enhance HIV medication adherence • Incorporate learned theories into effective HIV community pharmacy practice
Agenda: This program is 5.5 hours in length and is individually arranged for dates and times at each participating retail pharmacy site
15 min Registration and Pre-Test Completion
60 min Addressing HIV Drug Errors in the Community Pharmacy Setting
60 min Interactions between Common OTC Products and HIV Medications
180 min Putting Theory into Practice: Medication Counseling with HIV Patients
15 min Post-Test Completion and Evaluation
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Appendix G: Family-Centered HIV Pharmacy Practicum (Program Agenda)
Purpose This program is designed to offer registered pharmacists an opportunity to directly observe the multidisciplinary management of pregnant women, infants, children, and adolescents with HIV. The focus will be on the critical role of the community pharmacist in the co-management of these patients with their HIV family-centered care team at a Ryan White Part D-funded pediatric clinic.
Learning Objectives Upon completion of the program the pharmacist should be able to: y Discuss the appropriate use of antiretroviral therapy (ART) by HIV-positive pregnant women and their newborn infants to prevent perinatal transmission of HIV. y Discuss the approved indications for initiating ART in infants, children, and adolescents with HIV infection, along with the preferred ART regimens in each age group. y Discuss the prevention and treatment of opportunistic infections commonly associated with HIV infection in pediatric patients, including Candidiasis, Pneumocystis jeroveci pneumonia, Mycobacterium avium complex. y Understand the age-appropriate dose and dosing requirements, along with the adverse effects and drug interactions commonly associated with the antiretroviral medications approved for pediatric use. y Understand the importance of antiretroviral drug adherence and the factors that affect adherence, including family and school dynamics, patient and caregiver education, dosage form and palatability, and regimen complexity. Agenda 8:30 AM - 9:00 AM Registration and Pre-Test 9:00 AM -11:00 AM Management of Family-Centered HIV/AIDS: A Review of HIV Pathophysiology and the Use of Antiretroviral Medications in Pregnant Women and Children 11:00 AM -11:45 AM Compounding, Dispensing, Counseling, and Caring: The Community Pharmacist as a Critical Component of the Multidisciplinary Care of Pediatric HIV Patients 11:45 AM -12:30 PM Lunch Break 12:30 PM -1:00 PM Treating the Child and the Family: An Overview of Issues Related to Medication Adherence 1:00 PM - 4:00 PM Patient Observation in the Family-Centered HIV Clinic 4:00 PM - 4:30 PM Post-Test and Program Evaluation
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Appendix H: HIV Update for Pharmacists (Program Agenda)
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Appendix I: Quick Tips on How to Reach Community Pharmacists
Do you find it challenging to contact community pharmacists? Below are some helpful ideas.
How to Identify Pharmacies: • Contact the State Board of Pharmacy for a list of pharmacy addresses • Perform Internet searches (e.g., based on geographical data and zip codes) • Ask Medicaid, wholesalers or drug representatives where patients fill prescriptions • Look in the phone book or the internet for wholesalers’/drug representatives’ contact information • How to identify pharmacies dispensing HIV medications: • Obtain a list from the AIDS Drug Assistance Program (ADAP) o ADAP also provides data on the number of prescriptions filled by specific pharmacies • Contact Ryan White funded medical practices
How to Reach Pharmacists: • Contact pharmacy schools, get involved with student organizations • Contact local, state, and /or national pharmacy associations • Contact the State Board of Pharmacy for a list of pharmacists and their contact information • Target pharmacists participating in regional trainings /conferences • Target pharmacy chains and independent stores in the community
Modes of Intervention: • Surveys (including Needs Assessment surveys): telephone/ e-mail/ postal mail • Advantage (e-mail and postal mail): pharmacists can complete the survey at their convenience • Disadvantage (e-mail and postal mail): low response rate • Encourage participants to fill out surveys at conferences and other events • Interview individual pharmacists: in-person or via telephone • Offer incentives for completing the survey: • Offer CE certificate • Wave registration fee for a training/ conference • Offer chance to win a raffle ticket, gift card
Developed by members of the Meeting the Resource Needs of Community Pharmacists Workgroup, a national AETC Workgroup coordinated by the AETC National Resource Center (NRC)
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Appendix J: List of State Pharmacy Association
Alabama Pharmacy Assn. Georgia Pharmacy Association Maine Pharmacy Association 1211 Carmichael Way 50 Lenox Pointe, NE PO Box 1450 Montgomery, AL 36106-3672 Atlanta, GA 30324 Scarborough, ME 04074 Voice: 334-271-4222 Voice: 404-231-5074 Voice: 207-396-5340 Fax: 334-271-5423 Fax: 404-237-8435 Fax: 207-396-5326 http://www.aparx.org http://www.gpha.org http://www.mparx.com Alaska Pharmaceutical Assn. Hawaii Pharmacists Association Maryland Pharmacists Assn. 203 West 15th Avenue, #100 PO Box 1510 650 W. Lombard Street Anchorage, AK 99510-1188 Honolulu, HI 96701 Baltimore, MD 21201-1513 Voice: 907-563-8880 Voice: 808-330-7738 Voice: 410-727-0746 Fax: 907-563-7880 Fax: 808-488-8601 Fax: 410-727-2253 http://www.alaskapharmacy.org http://www.hipharm.org/ http://marylandpharmacist.org Arizona Pharmacy Association Idaho State Pharmacy Assn. Massachusetts Pharmacists Assn. 1845 E. Southern Avenue P.O. Box 140117 500 West Cummings Park Tempe, AZ 85282-5831 Boise, Idaho 83714 Woburn, Massachusetts 01801-6585 Voice: 480-838-3385 phone: 208-424-1107 Voice: 781-933-1107 Fax: 480-838-3557 fax: 208-376-3131 Fax: 781-933-1109 http://www.azpharmacy.org http://www.idahopharmacy.org www.masspharmacists.org Arkansas Pharmacists Assn. Illinois Pharmacists Association Michigan Pharmacists Assn. 417 South Victory 204 W. Cook Street 815 N. Washington Ave. Little Rock, AR 72201 Springfield, IL 62704-2526 Lansing, MI 48906-5198 Voice: 501-372-5250 Voice: 217-522-7300 Voice: 517-484-1466 Fax: 501-372-0546 Fax: 217-522-7349 Fax: 517-484-4893 http://www.arpharmacists.org http://www.ipha.org www.michiganpharmacists.org California Pharmacists Assn. Indiana Pharmacists Alliance Minnesota Pharmacists Assn. 4030 Lennane Drive 729 N. Pennsylvania St. 1935 W. County Rd. B2, Ste. 165 Sacramento, CA 95834 Indianapolis, IN 46204-1128 Roseville, MN 55113 Voice: 916-444-7811 Voice: 317-634-4968 Voice: 651-697-1771 Fax: 916-444-7929 Fax: 317-632-1219 Fax: 651-697-1776 http://www.cpha.com/ http://www.indianapharmacists.org http://www.mpha.org Colorado Pharmacists Society Iowa Pharmacy Association Mississippi Pharmacists Assn. 6825 E Tennessee Ave Ste 440 8515 Douglas Avenue, Ste. 16 341 Edgewood Terrace Dr. Denver, CO 80224-1662 Des Moines, IA 50322 Jackson, MS 39206-6299 Voice: 303- 756-3069 Voice: 515-270-0713 Voice: 601-981-0416 Fax: 303-756-3649 Fax: 515-270-2979 Fax: 601-981-0451 http:// www.copharm.org http://www.iarx.org http://www.mspharm.org Connecticut Pharmacists Assn. Kansas Pharmacists Association Missouri Pharmacy Association 35 Cold Spring Road, Ste. 125 1020 SW Fairlawn Rd. 211 E. Capitol Ave. Rocky Hill, CT 06067 Topeka, KS 66604-2275 Jefferson City, MO 65101-3001 Voice: 860-563-4619 Voice: 785-228-2327 Voice: 573-636-7522 Fax: 860-257-8241 Fax: 785-228-9147 Fax: 573-636-7485 http://www.ctpharmacists.org http://www.kansaspharmacy.org http://www.morx.com Delaware Pharmacists Society Kentucky Pharmacists Assn. Montana Pharmacy Association 27 North Main Street 1228 U.S. 127 South PO Box 1569 Smyrna, DE 19977 Frankfort, KY 40515 Helena, MT 59624-1569 Voice: 302-659-3088 Voice: 502-227-2303 Voice: 406-449-3843 Fax: 302-659-3089 Fax: 502-227-2258 Fax: 406-442-8018 http://www.depharmacy.net http://www.kphanet.org http://www.rxmt.org Florida Pharmacy Association Louisiana Pharmacists Assn. Nebraska Pharmacists Assn. 610 North Adams Street 450 Laurel St., Ste. 1400 6221 South 58th St., Ste. A Tallahassee, FL 32301 Baton Rouge, LA 70801 Lincoln, NE 68516 Voice: 850-222-2400 Voice: 225-346-6883 Voice: 402-420-1500 Fax: 850-561-6758 Fax: 225-344-1132 Fax: 402-420-1406 http://www.pharmview.com www.louisianapharmacists.com http://www.npharm.org
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Nevada Pharmacist Association Oklahoma Pharmacists Assn. Utah Pharmacists Assn. PO Box 35668 45 NE 52nd St., PO Box 18731 1125 S. Blackhawk Blvd. Las Vegas, NV 89133 Oklahoma City, OK 73154 Mount Pleasant, UT 84647 Phone: 702-683-1955 Voice: 405-528-3338 Voice: 435-462-5323 Fax: 702-657-2089 Fax: 405-528-1417 Fax: 435-462-5325 www.nevadapharmacistassoc.com http://www.opha.com http://www.upha.com New Hampshire Pharmacists Oregon State Pharmacists Assn. Vermont Pharmacists Assn. Assn. 29702-B SW Town Center Loop West PO Box 790 26 S. Main Street, PMB #188 Wilsonville, OR 97070-6481 Richmond, VT 05477-0790 Concord, NH 03301 Voice: 503-582-9055 Voice: 802-434-3001 Voice: 603-229-0292 Fax: 503-582-9046 Fax: 802-434-4803 Fax: 603-224-7769 http://www.oregonpharmacy.org http://www.vtpharmacists.org http://www.nhpharmacists.org Pennsylvania Pharmacists Assn. Virginia Pharmacists Association New Jersey Pharmacists Assn. 508 North 3rd Street 2530 Professional Road 760 Alexander Road, PO Box 1 Harrisburg, PA 17101-1199 Richmond, VA 23235 Princeton, NJ 08543-0001 Voice: 717-234-6151 Voice: 800-527-8742 Voice: 609-275-4246 Fax: 717-236-1618 Fax: 804-285-4227 Fax: 609-275-4066 http://www.papharmacists.com http://www.vapharmacy.org http://www.njpharma.org Puerto Rico, Colegio de Washington D.C. Pharmaceutical New Mexico Pharmacists Assn. Farmaceuticos de Association 2716 San Pedro NE, Suite C PO Box 360206 908 Caddington Ave Albuquerque, New Mexico 87110 San Juan, PR 00936-0206 Silver Spring, MD 20901-1109 Voice: 505-265-8729 Voice: 787-753-7157 Phone: 301-593-3292 Fax: 505- 255-8476 Fax: 787-759-9793 Fax: 301-593-7215 http://www.nm-pharmacy.com www.colegiofarmaceuticos.com Washington State Pharmacists New York, Pharmacists Society of Rhode Island Pharmacists Assn. Association the State of 1643 Warwick Avenue 1501 Taylor Ave., SW 210 Washington Ave. Extension Warwick, RI 02889 Renton, WA 98055-3139 Albany, NY 12203 Voice: 401-737-2600 Voice: 425-228-7171 Voice: 518-869-6595 Fax: 401-737-0959 Fax: 425-277-3897 Fax: 518-464-0618 http://www.ripharmacists.org http://www.wsparx.org/ http://www.pssny.org South Carolina Pharmacy Assn. West Virginia Pharmacists North Carolina Association of 1350 Browning Road Association Pharmacists Columbia, SC 29210-6903 2016 1/2 Kanawha Boulevard E. 109 Church Street Voice: 803-354-9977 Charleston, WV 25311-2204 Chapel Hill, NC 27516 Fax: 803-354-9207 Voice: 304-344-5302 Voice: 919-967-2237 http://www.scrx.org Fax: 304-344-5316 Fax: 919-968-9430 http://www.ncpharmacists.org South Dakota Pharmacists Assn. Wisconsin, Pharmacy Society of PO Box 518 701 Heartland Trail North Dakota Pharmacists Assn. Pierre, SD 57501 Madison, WI 53717 1641 Capitol Way Voice: 605-224-2338 Voice: 608-827-9200 Bismarck, ND 58501-2195 Fax: 605-224-1280 Fax: 608-827-9292 Voice: 701-258-4968 http://www.sdpha.org http://www.pswi.org/ Fax: 701-258-9312 http://www.nodakpharmacy.net Tennessee Pharmacists Assn. Wyoming Pharmacy Assn. 500 Church Street, Suite 650 PO Box 228 Ohio Pharmacists Association Nashville, TN 37219 Byron, WY 82412-0228 2155 Riverside Drive Voice: 615-256-3023 Voice: 307-272-3361 Columbus, Ohio 43221-4052 Fax: (615) 255-3528 Fax: 307-548-6259 Voice: 614-586-1497 http://www.tnpharm.org http://www.wpha.net/ Fax: 614-586-1545 http://www.ohiopharmacists.org Texas Pharmacy Association P.O. Box 14709 Austin, Texas 78761-4709 Voice: 512-836-8350 Fax: 512-836-0308 http://www.texaspharmacy.org
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Appendix K: List of Pharmacy Schools
Thomas J. Long School of Pharmacy CONNECTICUT ALABAMA & Health Sciences at the University University of Connecticut School of Auburn University Harrison School of the Pacific Pharmacy of Pharmacy 3601 Pacific Avenue 69 N. Eagleville Road, Unit 3092 2316 Walker Building Stockton, CA 95211 Storrs, CT 06269-3092 Auburn University, AL 36849-5501 Tel: (209) 946-2561 Tel: (860) 486-2129 Tel: (334) 844-8348 FAX: (209) 946-2410 FAX: (860) 486-1553 FAX: (334) 844-8353 www.pacific.edu/pharmacy/index.html http://pharmacy.uconn.edu www.pharmacy.auburn.edu
Touro University – California College DISTRICT OF COLUMBIA Samford University McWhorter of Pharmacy Howard University College of Pharmacy, School of Pharmacy 1310 Johnson Lane Nursing, and Allied Health Sciences 800 Lakeshore Drive Mare Island School of Pharmacy Birmingham, AL 35229 Vallejo, CA 94592 Sixth & “W” Streets, NW Tel: (205) 726-2820 Tel: (707) 638-5221 Annex 2, Room 203 FAX: (205) 726-2759 FAX: (707) 638-5266 Washington, DC 20059 http://www.samford.edu/schools/phar http://www.tumi.edu/cop.html Tel: (202) 806-5431 macy.html FAX: (202) 234-1375
University of California, San Diego www.howard.edu ARIZONA Skaggs School of Pharmacy and Midwestern University College of Pharmaceutical Sciences FLORIDA Pharmacy-Glendale 9500 Gilman Drive, MC 0657 Florida Agricultural and Mechanical 19555 N. 59th Avenue La Jolla, CA 92093-0657 University College of Pharmacy and Glendale , AZ 85308 Tel: (858) 534-1366 Pharmaceutical Sciences Tel: (623) 572-3500 FAX: (858) 534-8248 New Pharmacy Building , Room 333 FAX: (623) 752-3510 www.ucsd.edu 1415 S. Martin Luther King, Jr. Blvd. www.midwestern.edu/Pages/CPG.html Tallahassee, FL 32307
University of California, San Tel: (850) 599-3301 University of Arizona College of Francisco School of Pharmacy FAX: (850) 599-3347 Pharmacy 521 Parnassus Ave. Rm C-156 www.famu.edu 1295 N. Martin Street Box 0622 P.O. Box 210202 San Francisco, CA 94143-0622 Nova Southeastern University Tucson, AZ 85721 Tel: (415) 476-1225 College of Pharmacy Tel: (520) 626-1427 FAX: (415) 476-6632 3200 S. University Drive FAX: (520) 626-4063 http://pharmacy.ucsf.edu Ft. Lauderdale, FL 33328 www.pharmacy.arizona.edu Tel: (954) 262-1304 University of Southern California FAX: (954) 262-3995 ARKANSAS School of Pharmacy http://pharmacy.nova.edu/home.htm University of Arkansas for Medical 1985 Zonal Avenue
Sciences College of Pharmacy Los Angeles, CA 90089-9121 Palm Beach Atlantic University Lloyd 4301 West Markham Street Tel: (323) 442-1369 L. Gregory School of Pharmacy Slot 522 FAX: (323) 442-1681 900 South Olive Avenue Little Rock, AR 72205 www.usc.edu/schools/pharmacy West Palm Beach, FL 33401 Tel: (501) 686-5557 Western University of Health Tel: (561) 803-2731 FAX: (501) 686-8315 Sciences College of Pharmacy FAX: (561) 803-2703 www.uams.edu/cop 309 E. Second Street www.pba.edu
Pomona , CA 91766-1854 CALIFORNIA Tel: (909) 469-5581 University of Florida College of Loma Linda University School of FAX: (909) 469-5539 Pharmacy Pharmacy www.westernu.edu Box 100484 West Hall 1316 J. Hillis Miller Health Center 11262 Campus Street COLORADO Gainesville, FL 32610 Loma Linda, CA 92350 University of Colorado at Denver and Tel: (352) 273-6312 Tel: (909) 558-7442 Health Sciences Center School of FAX: (352) 273-6306 FAX: (909) 558-7973 Pharmacy www.cop.ufl.edu www.llu.edu C-238, 4200 E. Ninth Avenue Denver, CO 80262 Tel: (303) 315-5055 FAX: (303) 315-6281 www.uchsc.edu/sp/sp/
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GEORGIA University of Illinois at Chicago KENTUCKY Mercer University College of College of Pharmacy University of Kentucky College of Pharmacy and Health Sciences 833 South Wood Street Pharmacy 3001 Mercer University Drive M/C 874 725 Rose Street, Suite 327 Atlanta, GA 30341-4155 Chicago , IL 60612 Lexington , KY 40536-0082 Tel: (678) 547-6304 Tel: (312) 996-7240 Tel: (859) 323-7601 FAX: (678) 547-6315 FAX: (312) 996-3272 FAX: (859) 257-2128 www.mercer.edu/pharmacy www.uic.edu/pharmacy/ www.uky.edu/Pharmacy
South University School of Pharmacy INDIANA LOUISIANA 709 Mall Boulevard Butler University College of University of Louisiana at Monroe Savannah, GA 31406-4811 Pharmacy and Health Sciences College of Pharmacy Tel: (912) 201-8120 4600 Sunset Avenue 700 University Avenue FAX: (912) 201-8154 Indianapolis, IN 46208 Monroe, LA 71209-0400 www.southuniversity.edu Tel: (317) 940-9735 Tel: (318) 342-1600 FAX: (317) 940-6172 FAX: (318) 342-1606 University of Georgia College of http://www.butler.edu/academics/aca_ www.ulm.edu Pharmacy pharmacy.asp 250 W. Green Street Xavier University of Louisiana Athens, GA 30602-2351 Purdue University School of College of Pharmacy Tel: (706) 542-1914 Pharmacy and Pharmaceutical #1 Drexel Drive FAX: (706) 542-5269 Sciences New Orleans, LA 70125 www.rx.uga.edu 575 Stadium Mall Drive Tel: (504)520-7421 West Lafayette, IN 47907 FAX: (504) 520-7930 HAWAII Tel: (765) 494-1368 www.xula.edu/pharmacy University of Hawaii at Hilo College FAX: (765) 494-7880 of Pharmacy http://www.pharmacy.purdue.edu/ MARYLAND 60 Nowelo Street, Suite 101 University of Maryland School of Hilo, HI 96720 IOWA Pharmacy Tel: (808) 443-5900 Drake University College of 20 North Pine Street FAX: (808) 933-0861 Pharmacy and Health Sciences Baltimore, MD 21201-1180 http://pharmacy.uhh.hawaii.edu 2507 University Avenue Tel: (410) 706-7651 Cline Hall Suite 106 FAX: (410) 706-4012 IDAHO Des Moines, IA 50311 www.pharmacy.umaryland.edu Idaho State University College of Tel: (515) 271-1814 Pharmacy FAX: (515) 271-4171 MASSACHUSETTS PO Box 8288 www.pharmacy.drake.edu Massachusetts College of Pharmacy 970 South 5th Avenue and Health Sciences School of Pocatello, ID 83209 University of Iowa College of Pharmacy-Worcester Tel: (208) 282-2175 Pharmacy 19 Foster Street FAX: (208) 282-4482 115 South Grand Avenue Suite 400 http://pharmacy.isu.edu/live/ Iowa City, IA 52242 Worcester, MA 01608 Tel: (319) 335-8794 Tel: (508) 890-8855*1911 ILLINOIS FAX: (319) 353-5594 FAX: (508) 890-8515 Midwestern University Chicago http://pharmacy.uiowa.edu/ http://www.mcphs.edu/ College of Pharmacy 555 - 31st Street KANSAS Massachusetts College of Pharmacy Downers Grove , IL 60515 University of Kansas School of and Health Sciences School of Tel: (630) 971-6417 Pharmacy Pharmacy-Boston FAX: (630) 971-6097 1251 Wescoe Hall Drive 179 Longwood Avenue www.midwestern.edu/Pages/CCP.html Room 2056 Malott Hall Boston, MA 02115 Lawrence, KS 66045-7582 Tel: (617) 732-2781 Southern Illinois University Tel: (785) 864-3591 FAX: (617) 735-1082 Edwardsville School of Pharmacy FAX: (785) 864-5265 http://www.mcphs.edu/ Campus Box 2000 www.pharm.ukans.edu/dean/index.htm Edwardsville, IL 62026-2000 Northeastern University Bouvé Tel: (618) 650-5150 College of Health Sciences FAX: (618) 650-5152 School of Pharmacy http://www.siue.edu/PHARMACY/ 360 Huntington Avenue Boston , MA 02115 Tel: (617) 373-3380 FAX: (617) 373-7655 www.bouve.neu.edu/pharmacy
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MICHIGAN MISSISSIPPI NEBRASKA Ferris State University College of University of Mississippi School of Creighton University Medical Pharmacy Pharmacy Center School of Pharmacy and 220 Ferris Drive Post Office Box 1848 Health Professions Big Rapids, MI 49307 University, MS 38677 2500 California Plaza Tel: (231) 591-2254 Tel: 662-915-7265 Omaha, NE 68178 FAX: (231) 591-3829 FAX: 662-915-5118 Tel: 402-280-2950 www.pharmacy.ferris.edu www.olemiss.edu/depts/pharm_school FAX: 402-280-5738 http://spahp2.creighton.edu/admission/ University of Michigan College of MONTANA pharmacy Pharmacy University of Montana College of 428 Church Street Health Professions and Biomedical University of Nebraska Medical Ann Arbor, MI 48109-1065 Sciences Skaggs School of Pharmacy Center School of Pharmacy and Tel: 734-764-7144 340 Skaggs Building Health Professions FAX: 734-763-2022 Missoula, MT 59812-1512 986000 Nebraska Medical Center www.umich.edu/~pharmacy/ Tel: 406-243-4621 Omaha, NE 68198-6000 Accreditation History FAX: 406-243-4209 Tel: 402-559-4333 www.health.umt.edu/ FAX: 402-559-5060 Wayne State University Eugene www.unmc.edu/pharmacy Applebaum College of Pharmacy NORTH CAROLINA and Health Sciences Campbell University School of NEW JERSEY 259 Mack Avenue Pharmacy Suite 2620 PO Box 1090 Rutgers, the State University of New Detroit, MI 48201 205 Day Dorm Road Room 101 Jersey Ernest Mario School of Tel: 313-577-1574 Buies Creek , NC 27506 Pharmacy FAX: 313-577-0457 Tel: 910-893-1686 William Levine Hall Web Site: www.cphs.wayne.edu FAX: 910-893-1943 160 Frelinghuysen Road Accreditation History www.campbell.edu/pharmacy/ Piscataway, NJ 08854-8020 Tel: 732-445-2675 MINNESOTA University of North Carolina At FAX: 732-445-5767 University of Minnesota College of Chapel Hill School of Pharmacy http://pharmacy.rutgers.edu/ Pharmacy 100C Beard Hall, CB #7360 308 Harvard Street SE Chapel Hill, NC 27599-7360 NEW MEXICO 5-130 Weaver-Densford Hall Tel: 919-966-1122 University of New Mexico College of Minneapolis, MN 55455-0343 FAX: 919-966-6919 Pharmacy Tel: 612-624-1900 www.pharmacy.unc.edu MSCO9-5360 FAX: 612-624-2974 1 University of New Mexico www.pharmacy.umn.edu/ Wingate University School of Albuquerque, NM 87131-5691 Pharmacy Tel: 505-272-0906 MISSOURI 316 N. Main St FAX: 505-272-6749 St. Louis College of Campus Box 3087 http://hsc.unm.edu/pharmacy Pharmacy College of Pharmacy Wingate, NC 28174 4588 Parkview Place Tel: 704-233-8015 NEVADA St. Louis, MO 63110 FAX: 704-233-8332 University of Southern Tel: 314-446-8341 E-Mail: [email protected] Nevada College of Pharmacy FAX: 314-446-8304 Web Site: www.wingate.edu 11 Sunset Way Web Site: www.stlcop.edu/ Henderson, NV 89014 NORTH DAKOTA Tel: 702-990-4433 ex. 2017 University of Missouri-Kansas North Dakota State University FAX: 702-990-4435 City School of Pharmacy College of Pharmacy, Nursing and www.usn.edu 5100 Rockhill Road Allied Sciences Kansas City, MO 64110-2499 123 Sudro Hall NEW YORK Tel: 816-235-1609 Fargo, ND 58105-5055 Albany College of Pharmacy and FAX: 816-235-5190 Tel: 701-231-7609 Health Sciences www.umkc.edu/pharmacy FAX: 701-231-7606 106 New Scotland Avenue www.ndsu.edu/pharmacy Albany, NY 12208 Tel: 518-445-7212 FAX: 518-445-7294 www.acp.edu
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Long Island University Arnold and University of Cincinnati James L. Marie Schwartz College of Pharmacy Winkle College of Pharmacy PENNSYLVANIA and Health Sciences 3225 Eden Ave Duquesne University Mylan School 75 DeKalb Avenue Health Professions Bldg, Room 136 of Pharmacy At University Plaza Cincinnati, OH 45267-0004 306 Bayer Learning Center Brooklyn, NY 11201 Tel: 513-558-3326 Pittsburgh, PA 15282-1504 Tel: 718-488-1004 FAX: 513-558-4372 Tel: 412-396-6377 FAX: 718-488-0628 www.pharmacy.uc.edu FAX: 412-396-1810 www.liu.edu www.pharmacy.duq.edu University of Findlay School of St. John Fisher College Wegmans Pharmacy Lake Erie College of Osteopathic School of Pharmacy 1000 N. Main Street Medicine School of Pharmacy 3690 East Avenue Findlay , OH 45840 1858 West Grandview Blvd. Rochester, NY 14618 Tel: 419-434-5327 Eris, PA 16509 www.sjfc.edu/pharmacy FAX: 419-434-4390 Tel: 814-866-8409 www.findlay.edu/academics/colleges/co FAX: 814-866-8450 St. John's University College of hp/academicprograms/ www.lecom.edu/pharmacy/ Pharmacy and Allied Health Science 8000 Utopia Parkway University of Toledo College of Temple University School of Jamaica, NY 11439 Pharmacy Pharmacy Tel: 718-990-6411 2801 West Bancroft Street 3307 North Broad Street FAX: 718-990-1871 Toledo, OH 43606-3390 Philadelphia, PA 19140 www.new.stjohns.edu/academics/gradua Tel: 419-530-1931 Tel: 215-707-4990 te/pharmacy FAX: 419-530-1907 FAX: 215-707-3678 www.utpharmacy.org www.temple.edu/pharmacy University at Buffalo The State University of New York School of OKLAHOMA Thomas Jefferson University Pharmacy & Pharmaceutical Southwestern Oklahoma State Jefferson College of Health Sciences University School of Pharmacy Professions Jefferson School of 126 Cooke Hall 100 Campus Dr. Pharmacy Amherst, NY 14260-1200 Weatherford, OK 73096 130 S. 9th Street Tel: 716-645-2823 Tel: 580-774-3760 Ste. 1520 FAX: 716-645-3688 FAX: 580-774-7020 Philadelphia, PA 19107 www.pharmacy.buffalo.edu www.swosu.edu/pharmacy Tel: 215-503-9082 FAX: 215-503-9052 OHIO University of Oklahoma College of www.jefferson.edu Northeastern Ohio Pharmacy Universities College of Pharmacy 1110 N. Stonewall-Room 133 University of Pittsburgh School of 4209 State Rt. 44 PO Box 26901 Pharmacy Rootstown, OH 44272-0095 Oklahoma City, OK 73190 1104 Salk Hall Tel: 330-325-6461 Tel: 405-271-6485 3501 Terrace Street FAX: 330-325-5930 FAX: 405-271-3830 Pittsburgh, PA 15261 www.neoucom.edu/audience/gradschoo www.oupharmacy.com Tel: 412-624-2400 l/pharmacy/pharmacy FAX: 412-648-1086 OREGON www.pharmacy.pitt.edu/ Ohio Northern University College of Oregon State University College of Pharmacy Pharmacy University of the Sciences in 525 S. Main St. 203 Pharmacy Building Philadelphia Philadelphia College of Ada, OH 45810 Corvallis, OR 97331-3507 Pharmacy Tel: 419-772-2277 Tel: 541-737-3424 600 South 43rd Street FAX: 419-772-2720 FAX: 541-737-3999 Philadelphia, PA 19104-4495 www.onu.edu/Pharmacy www.pharmacy.oregonstate.edu Tel: 215-596-8805 FAX: 215-596-8977 Ohio State University College of Pacific University School of www.usip.edu Pharmacy Pharmacy 500 West 12th Avenue 222 S.E. 8th Ave Wilkes University Nesbitt College of Columbus, OH 43210 Suite 451 Pharmacy & Nursing School of Tel: 614-292-5711 Hillsboro, OR 97123 Pharmacy FAX: 614-292-3113 Tel: 503-352-7271 84 West South St www.pharmacy.ohio-state.edu FAX: 503-352-7270 Wilkes-Barre, PA 18766 www.pacific.edu/pharmd Tel: 570-408-4280 FAX: 570-408-7828 www.wilkes.edu/pharm/default.asp
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PUERTO RICO SOUTH DAKOTA University of Incarnate Word Feik University of Puerto Rico Medical South Dakota State School of Pharmacy Sciences Campus School of University College of Pharmacy 4301 Broadway, CPO #99 Pharmacy 1 Administration Lane San Antonio, TX 78209 P.O. Box 365067 Box 2202 C Tel: 210-883-1000 San Juan , PR 00936-5067 Brookings , SD 57007-009 FAX: 210-822-1516 Tel: 787-758-2525*5427 Tel: 605-688-6197 www.uiw.edu/pharmacy/ FAX: 787-751-5680 FAX: 605-688-6232 www.upr.clu.edu/ www.3.sdstate.edu/academics/collegeof University of Texas at Austin College pharmacy/index.cfm of Pharmacy, The RHODE ISLAND 1 University Station A 1900 University of Rhode Island College of TENNESSEE PHR 2.112 Pharmacy East Tennessee State Austin, TX 78712-0120 41 Lower College Road University College of Pharmacy Tel: 512-471-1737 Kingston, RI 02881 P.O. Box 70414 FAX: 512-471-8783 Ronald P. Jordan, RPh 807 University Parkway www.utexas.edu/pharmacy/ Tel: 401-874-2761 Johnson City, TN 37614 FAX: 401-874-2181 Larry D. Calhoun, PharmD UTAH www.uri.edu/pharm www.etsu.edu/pharmacy/ University of Utah College of Pharmacy SOUTH CAROLINA University of Tennessee College of 30 South 2000 East Medical University of South Carolina Pharmacy Room 201 College of Pharmacy 847 Monroe Avenue Salt Lake City, UT 84112-5820 280 Calhoun Street Suite 226 Tel: 801-581-6731 P.O. Box 250141, Qf108 Memphis, TN 38163 FAX: 801-581-3716 Charleston, SC 29425 Tel: 901-448-6036 www.pharmacy.utah.edu Arnold W. Karig, PhD FAX: 901-448-7053 MUSC Campus Dean www.pharmacy.utmem.edu VIRGINIA Tel: 843-792-8450 Hampton University School of FAX: 843-792-9081 TEXAS Pharmacy E-Mail: [email protected] Texas A& M University Health Hampton, VA 23668 www.musc.edu/pharmacy/ Science Center Irma Lerma Rangel Tel: 757-727-5071 College of Pharmacy FAX: 757-727-5840 South Carolina College of Pharmacy MSC 131 www.hamptonu.edu 280 Calhoun Street 1010 West Avenue B P.O. Box 250141 Kingsville, TX 78363-8202 Shenandoah University Bernard J. Charleston, SC 29425 Tel: 361-593-4723 Dunn School of Pharmacy Joseph DiPiro, PharmD FAX: 361-593-4233 1460 University Drive Executive Dean www.pharmacy.tamhsc.edu Winchester, VA 22601 Tel: 843-792-8450 Tel: 540-665-1282 FAX: 843-792-9081 Texas Southern University College of FAX: 540665-1283 E-Mail: [email protected] Pharmacy and Health Sciences www.su.edu/academic/pharmacy.asp sccp.sc.edu 3100 Cleburne Street Houston, TX 77004 University of Appalachia College of University of South Carolina College Tel: 713-313-4277 Pharmacy of Pharmacy FAX: 713-313-1091 1060 Dragon Road 700 Sumter St www.tsu.edu Oakwood, VA 24631 Coker Life Science Room 109 Tel: 276-498-4190 Columbia, SC 29208 Texas Tech University Health FAX: 276-498-4193 Randall C. Rowen, Pharm.D. Sciences Center School of Pharmacy www.uacp.org/ Campus Dean 1300 South Coulter Tel: 803-777-4151 Amarillo, TX 79106 Virginia Commonwealth University FAX: 803-777-2775 Tel: 806-354-5463 at the Medical College of Virginia E-mail: [email protected] FAX: 806-356-4613 Campus School of Pharmacy www.pharm.sc.edu www.ttuhsc.edu/sop/ 410 North 12th Street MCV Box 980581 University of Houston College of Richmond, VA 23298-0581 Pharmacy Tel: 804-828-3006 141 Sciences & Research Bldg 2 FAX: 804-827-0002 4800 Calhoun www.pharmacy.vcu.edu Houston, TX 77204-5000 Tel: 713-743-1253 FAX: 713-743-5678 www.uh.edu/pharmacy/
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WASHINGTON WISCONSIN West Virginia University School of University of Washington School of University of Wisconsin- Pharmacy Pharmacy Madison School of Pharmacy P.O. Box 9500 H364 Health Sciences 777 Highland Ave. 1136 Health Science North Box 357631 Madison, WI 53705-2222 Morgantown, WV 26506-9500 Seattle, WA 98195-7631 Tel: 608-262-1414 Tel: 304-293-5101 Tel: 206-543-2030 FAX: 608-262-3397 FAX: 304-293-5483 FAX: 206-685-9297 www.wisc.edu/pharmacy/ www.hsc.wvu.edu/sop www.dept.washington.edu/pha WEST VIRGINIA WYOMING Washington State University College University of Charleston School of University of Wyoming School of of Pharmacy Pharmacy Pharmacy P.O. Box 646510 2300 MacWorld Ave.S.E. 1000 E. University Ave. 105 Wegner Hall Charleston, WV 25304 Dept 3375 Pullman, WA 99164-6510 Tel: 304-357-4858 Laramie, WY 82071 Tel: 509-335-4750- FAX: 304-357-4868 Tel: 307-766-6120 FAX: 509-335-2530 www.pharmacy.ucwv.edu/ FAX: 307-766-2953 www.pharmcay.wsu.edu www.uwyo.edu/pharmacy/
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