MSHP 2013 Annual Conference April 25-26, 2013 Mayo Civic Center “Rounding the Bases for Safe and Healthy Patients” Agenda/Speakers/CE Hours/ACPE Numbers/Objectives Thursday, April 25th Time Total Hours 8:00 – 9:30 1.5 hr. Speaker/Presentation Title Christopher Jerry, “The Emily Jerry Story from Tragedy to Triumph” 0134-0000-13-058-L05-P; 0134-0000-13-058-L05-T Pharmacist Learning Objectives: 1. Discuss the events surrounding the medical error that resulted in Emily Jerry’s death and a criminal prosecution. 2. Describe the “lessons learned” from Emily’s tragic death. 3. Describe ISMP recommended “safe practices that upon implementation will immediately help reduce the probability of these types of medication errors from occurring. 4. Identify and discuss the qualities of a safety culture that enhance harm prevention. Technician Objectives: 1. Discuss the events surrounding the medical error that resulted in Emily Jerry’s death and a criminal prosecution. 2. Describe the “lessons learned” from Emily’s tragic death as they apply to the pharmacy technician compounding error that occurred. 3. Describe ISMP recommended “safe practices that upon implementation will immediately help reduce the probability of these types of medication errors from occurring. 4. Identify and discuss the qualities of a safety culture that enhance harm prevention. 10:00 – 11:00 1 hr. Kay Perrotta, PharmD, MBA, BCPS - “Insights into Diagnosis and Treatment of Angioedemia Hereditary and Other Types” 0134-0000-13-059-L01-P; 0134-0000-13-059-L01-T Pharmacist Learning Objectives: 1. Describe the different types of angioedema. 2. Define the differences in etiology of the different types of angioedema. 3. Identify the effective treatments for allergic, idiopathic and hereditary angioedema. 4. Explain how and why the newer agents work in patients with hereditary angioedema. 5. Dispute the use of the newer C1 esterase inhibitors in the use of allergic angioedema with symptoms of urticaria. Technician Program Learning Objectives: 1. 2. 3. 4. Describe the different types of angioedema. Define the differences in etiology of the different types of angioedema. Challenge the use of C1 esterase inhibitors in all types of angioedema. Identify the disadvantages of using C1 esterase for non-hereditary angioedema patients. 1 Thursday, April 25th (Continued) Time Total Hours 10:00 – 11:00 1 hr. Speaker/Presentation Title Rebecca Fahrenbruch, PharmD, BCOP & Jeremy Whalen, PharmD, BCOP “Oncology Medication Update” 0134-0000-13-060-L01-P; 0134-0000-13-060-L01-T Pharmacist Learning Objectives: 1. Review new oncology medication and their indication of use 2. Discuss potential toxicities and monitoring recommendations for the new oncology agents 3. Review Chronic Myelogenous Leukemia (CML) 4. Compare and contrast new Chronic Myelogenous Leukemia (CML) agents 5. Describe compounding practice of these agents 6. Inform regarding cost information and dosage forms of these agents Technician Program Learning Objectives: 1. Identify mechanism of action and indication for newly approved oncology medications 2. Discuss potential toxicities and monitoring recommendations for the new oncology agents 3. Describe compounding practice of these agents 4. Inform regarding cost information and dosage forms of these agents 10:00 – 11:00 1 hr Cody Wiberg, PharmD, M.S., R.Ph. – “Pharmacy Laws: Hot Topics” 0134-0000-13-061-L03-P; 0134-0000-13-061-L03-T Pharmacist Learning Objectives: 1. Describe pending state and federal legislation that, if enacted, will have an impact on the profession of pharmacy and the distribution of drugs 2. Define current laws and rules related to compounding and manufacturing 3. List issues that are likely to be the subject of new rules or statutes within the next two years. 4. Identify recently implemented rule changes involving the registration of pharmacy technicians. Technician Program Learning Objectives: 1. Describe pending state and federal legislation that, if enacted, will have an impact on the profession of pharmacy and the distribution of drugs 2. Define current laws and rules related to compounding and manufacturing, including the roles that technicians may have in compounding 3. List issues that are likely to be the subject of new rules or statutes within the next two years. 4. Identify the impact that recently implemented rule changes will have on initial and renewal registrations of pharmacy technicians. 11:00 – 12:30 1.5 hr. “Pearls – Session I” 0134-0000-13-062-L01-P; 0134-0000-13-062-L01-T Kathryn Schultz, PharmD, FASHP - “Interns Call the Shots at Bethesda Hospital” Pharmacist Objectives: 1. Discuss the role of pharmacy interns in a health care worker immunization campaign at one Minnesota hospital Technician Objectives: 1. Discuss the role of pharmacy interns in a health care worker immunization campaign at one Minnesota hospital. 2 Thursday, April 25th (Continued) Time Total Hours 11:00 – 12:30 1.5 hr. Speaker/Presentation Title Katherine Miller, PharmD – “Implementation of a Clinical Scoring Tool to Assist with Patient Prioritization” Pharmacist Objectives: 1. Implementation of a clinical scoring tool has provided an opportunity for pharmacists to prioritize their patients based on specific clinical characteristics. T or F (Answer: True) Technician Objectives: 1. Implementation of a clinical scoring tool has provided an opportunity for pharmacists to prioritize their patients based on specific clinical characteristics. T or F (Answer: True) Rebecca Fahrenbruch, PharmD, BCOP – “Pegfilgrastim (Neulasta) Bone Pain: Prevention with Loratadine or Dose Reduction” Pharmacist Objectives: 1. Discuss the proposed mechanism and dosing of Loratadine used to prevent bone pain and the recent data to support avoiding dose reduction of Pegfilgrastim for bone pain. Technician Objectives: 1. Discuss the proposed mechanism and dosing of Loratadine used to prevent bone pain and the recent data to support avoiding dose reduction of Pegfilgrastim for bone pain Kristen McCullough, PharmD, BCPS, BOP – “Old Men, New Tricks: Advances in Docetaxel-Refractory Prostate Cancer” Pharmacist Objectives: 1. Describe the mechanism of action of cabazitaxel, abiraterone, and enzalutamide 2. Compare and contrast expected outcomes of response and toxicity to each agent 3. Outline appropriate patient counseling points for each agent 4. Apply clinical data to justify selection of therapy in docetaxel-refractory prostate cancer Technician Objectives: 1. Define castration-resistant prostate cancer as it applies to docetaxel failure 2. Describe the primary adverse drug reaction to cabazitaxel, abiraterone and enzalutamide 3. Identify two unique preparation requirements for cabazitaxel Amber Alstadt, PharmD, – “Acute Pain Management in Patients Taking Opioid Antagonists” Pharmacist Objectives: 1. Describe the pharmacokinetic and pharmacodynamic properties of opioid antagonists. 2. Identify when to stop and restart opioid antagonist therapy when opioids may be needed perioperatively. 3. Compare and contrast opioid alternatives for acute pain management in patients taking opioid antagonists. 4. Construct a systematic approach to designing a patient-specific pain management plan for patients taking opioid antagonists. 3 Thursday, April 25th (Continued) Time Total Hours 11:00 – 12:30 1.5 hr. Speaker/Presentation Title Amber Alstadt, (Continued) Technician Objectives: 1. Identify the name and dosage of available opioid antagonists. 2. Describe why opioids will not be effective for pain management in patients taking opioid antagonists. 3. Identify the name and dosage ranges of opioid alternative pain medications. 4. Identify when to stop and restart opioid antagonist therapy when opioids may be needed perioperatively. Erin Frazee, PharmD, BCPS – “Dexmedetomidine: Is it the next thing on tap for alcohol withdrawal?” Pharmacist Objectives: 1. Contrast the pharmacologic mechanism of action and adverse effects of benzodiazepines and dexmedetomidine as they pertain to use in alcohol withdrawl 2. Evaluate the scientific caliber of existing literature for dexmedetomidine in alcohol withdrawl syndrome 3. Identify the place in therapy for dexmedetomidine for alcohol withdrawl syndrome Technician Objectives: 1. List at least three symptoms associated with alcohol withdrawl 2. Explain one possible risk/adverse effect of rapidly escalating benzodiazepine (i.e. lorazepam, midazolam) doses in the context of alcohol withdrawl treatment. 3. Identify whether or not dexmedetomidine is appropriate for all patients with alcohol withdrawl syndrome Rebecca Palermo, PharmD, BCPS – “Pharmacoligic Approach to Beta-Blocker Overdose” Pharmacist Objectives: 1. Define the pharmacology of the beta1-adrenergic receptor 2. Outline beta-blocker characteristics which help guide pharmacologic management 3. Compare and contrast the options for pharmacologic management of betablocker overdose 4. Discuss the use and dosing of high dose insulin and dextrose for management of beta-blocker overdose Technician Objectives: 1. Outline the adverse effects and possible outcomes of beta-blocker overdose 2. Describe the options for pharmacologic management of beta-blocker overdose 3. Discuss the importance of stat preparation and administration of pharmacologic agents for management of beta-blocker overdose 11:00 – 12:30 1.5 hr. Gary Carlson, B.S. Pharm. – “NECC Meningitis Outbreak and Its Sequalla” 0134-0000-13-063-L04-P; 0134-0000-13-063-L04-T Pharmacist Objectives: 1. Describe the NECC meningitis outbreak and its sequella. 2. Describe the known causes of the outbreak 3. Apply current Minnesota and Federal Law to sterile compounding. 4. Explain proposed changes at the Federal and State level. 5. Describe the probable impact on Health System pharmacy 4 Thursday, April 25th (Continued) Time 11:00 – 12:30 Total Hours 1.5 hr. Speaker/Presentation Title Gary Carlson, (Continued) Technician Objectives: 1. Describe the NECC meningitis outbreak and its sequella 2. Describe the known causes of the outbreak 3. Apply current Minnesota and Federal Law to sterile compounding. 4. Explain proposed changes at the Federal and State level. 5. Describe the probable impact on Health System pharmacy 14:00 – 15:00 1hr. “PPMI Roundtable” Moderator: Lance Oyen, PharmD, BCPS, FCCP, FCCM Roundtable Panel: Krista Huot, PharmD (MSHP-Arrowhead) Paul Glynn, PharmD, BCPS, CGP (MSHP-Central) Jan Puttbrese, PharmD, (MSHP-Heartland & Northwestern) Gary Sigmeth, BS (MSHP-Southern) 0134-0000-13-064-L04-P; 0134-0000-13-064-L04-T Pharmacist Objectives: 1. Highlight PPMI recommendations incorporated into pharmacy workflow at various practice settings. 2. To deliver key practice model solutions from many practice settings to audience. 3. To offer panelists from a variety of practices for audience questions and answers 4. To discuss barriers and experiences in implementing practices or models Technician Objectives: 1. Highlight PPMI recommendations incorporated into pharmacy workflow at various practice settings. 2. To deliver key practice model solutions from many practice settings to audience. 3. To offer panelists from a variety of practices for audience questions and answers 4. To discuss barriers and experiences in implementing practices or models 15:30-16:30 1 hr. Ben Anderson, PharmD, MPH – “Review of Meaningful Use Stage I and II Initiatives” 0134-0000-13-065-L04-P; 0134-0000-13-065-L04-T Pharmacist Objectives: 1. Interpret the requirements for patient engagement, quality measures, health information exchange, standards and Electronic Health Record (EHR) usability for Meaningful Use Stage I 2. Differentiate Meaningful Use Stage II requirement changes from Stage I requirements 3. Describe the role of pharmacy informatics in conformance with the Meaningful Use standards 4. Distinguish the role of Clinical quality measures with the framework of Meaningful Use Technician Objectives: 1. Interpret the definition of Meaningful Use as it relates to a certified EHR 2. Explain the differences between Core Criteria and Menu Set Criteria 3. Describe the role of pharmacy technician as it relates to meeting Clinical Quality Measures. 5 Thursday, April 25th (Continued) Time Total Hours 15:30-16:30 No Credit “Student Speed Networking Session” Matt Kresl, PharmD, BCPS & Paul Wittmer, RPh, BS, MBA 15:30-16:30 1 hr. “Pearls – Session II” Speaker/Presentation Title 0134-0000-13-066-L01-P; 0134-0000-13-066-L01-T Melissa Carlson, PharmD, BCPS – “Adverse Drug Event Tracking: Implementation of an Electronic Trigger Notification Process in the EMR” Pharmacist Objectives: 1. Describe the implementation of a new, electronic process for trigger identification, patient chart review, and documentation. Technician Objectives: 1. Describe the implementation of a new, electronic process for trigger identification, patient chart review, and documentation. Kati Shihadeh, PharmD, – “Required Indications for Antimicrobials” Pharmacist Objectives: 1. To identify benefits of capturing required indications for antimicrobials during physician order entry. Technician Objectives: 1. To identify benefits of capturing required indications for antimicrobials during physician order entry. Emily Herstine, PharmD – “Appropriate Treatment for Candida glabrata” Pharmacist Objectives: 1. Identify appropriate empiric therapy for Candida glabrata. 2. Describe current resistance patterns of Candida glabrata. 3. Describe appropriate step-down therapy for Candida glabrata. Technician Objectives: 1. Differentiate echinocandin antifungals from azole antifungals. Natasha Thoner, PharmD – “Intrapartum Antiretroviral Therapy” Pharmacist Objectives: 1. Explain the importance of starting antiretroviral therapy prior to pregnancy or early during pregnancy. 2. State the zidovudine dosing for intrapartum women with a HIV RNA > 400 copies/mL. 3. Evaluate the primary literature behind the new guideline recommendations Technician Objectives: 1. Explain the importance of starting antiretroviral therapy prior to pregnancy or early during pregnancy. 2. Evaluate the primary literature behind the new guideline recommendations. 3. Distinguish between pregnant patients with a HIV RNA > and < 400 copies/mL. 6 Thursday, April 25th (Continued) Time Total Hours 15:30-16:30 1 hr. Speaker/Presentation Title “Pearls – Session II” (Continued) Matthew Lillyblad, PharmD – “Optimizing Antithrombotic Therapy in Patients with Concomitant Atrial Fibrillation and Coronary Artery Disease” Pharmacist Objectives: 1. Describe the risk of stroke and recurrent ischemic events in patients with atrial fibrillation and coronary artery disease. 2. Compare the bleeding risks of single, dual, and triple antithrombotic therapy. 3. Explain the 2012 CHEST Guidelines for single, dual, and triple antithrombotic therapy for patients with atrial fibrillation and coronary artery disease at various risks for stroke and recurrent ischemic events. Technician Objectives: 1. List commonly used antithrombotic agents for atrial fibrillation and coronary artery disease 2. Explain why combining antithrombotic agents increases the risk of bleeding 3. Identify patients on single, dual, and triple antithrombotic therapy who may need an adjustment in their antithrombotic regimen. 17:00-18:00 1 hr. “Outstanding Resident Research Project Award” Moderators: Anna Benson, PharmD, BCPS & Jessica Swearingen, BS, PharmD 0134-0000-13-067-L01-P; 0134-0000-13-067-L01-T David Gurda, PharmD, PGY-1 Pharmacy Practice Resident - United Hospital (Allina Health) “A Comparison of Lidocaine, Buffered Lidocaine, and Bacteriostatic Normal Saline for Local Anesthesia Prior to Peripheral Intravenous Catheterization” Jordan Haag, PharmD, PGY-2 Pharmacotherapy Specialty Resident – Mayo Clinic “Drug Related Problems in the Emergency Department: Prospective Validation and Refinement of a Real-Time Electronic Surveillance and Notification System” Daniel Wojenski, PharmD, BCPS, PGY-2 Hematology/Oncology Resident – Mayo Clinic “Comparison of Toxicity, Efficacy, and Dose Modifications in Obese and Non-Obese Patients Receiving Modified FOLFOX6 for Metastatic Colorectal Cancer” Pharmacist Objectives: 1. Describe study methodology and/or interventions utilized to attain predefined outcomes. 2. Interpret data or information collected to summarize project results. 3. Utilize study results to demonstrate the impact of residency research on advancing pharmacy practice and attaining health-system and/or pharmacy department goals. 4. Identify study limitations, steps for implementing research into practice and implications for future research. 5. Describe how the study results will impact patient care. Technician Objectives: 1. Describe the relationship between outcomes studied and influence on technician work. 2. Summarize how the project results may impact pharmacy practice. 3. Demonstrate how residency research can advance pharmacy practice. 4. If applicable, identify future research opportunities related to advancing technician practice. 7 Total Hours: Friday, April 26th Time 11.5 hours (7 obtainable hours) – April 25th Thursday Total Hours Speaker/Presentation Title KEYNOTE SESSION 08:30 - 09:30 1 hr. Kim McCoy, MPH, MS; Todd Lemke, PharmD, CDE; Molly Ekstrand, RPh, AE-C, CDE “Covering the Health System Bases for Patient Safety” 0134-0000-13-068-L05-P; 0134-0000-13-068-L05-T Pharmacist Learning Objectives: 1. Describe how pharmacy services can help to optimize patient safety and reduce costs through care coordination across settings and disciplines 2. Identify opportunities to integrate pharmacists and medication management into patient care 3. Demonstrate how pharmacists can make the most of ongoing Minnesota initiatives to increase access to clinical pharmacy services 4. Challenge pharmacists and other providers to apply a population health approach to patient safety and quality of care 5. Issue a call to action to pharmacists to strengthen medication management through advocacy, innovation and implementation of evidence-based practices Technician Program Learning Objectives: 1. Describe how pharmacy services can help to optimize patient safety and reduce costs through care coordination across settings and disciplines 2. Identify opportunities to integrate pharmacists and medication management into patient care 3. Demonstrate how pharmacists can make the most of ongoing Minnesota initiatives to increase access to clinical pharmacy services 4. Challenge pharmacists and other providers to apply a population health approach to patient safety and quality of care 5. Issue a call to action to pharmacists to strengthen medication management through advocacy, innovation and implementation of evidence-based practices 9:45 -10:45 1 hr. Bradley A. Boucher, PharmD, FCCP, FCCM, BCPS - “Achieving Hemostasis in Operating Room the Critical Care Setting: What the Pharmacist Needs to Know” 0204-0000-13-416-L01-P ****”Program accredited through ASHP Advantage” **** Attendees must complete a continuing Pharmacy Education Request online and may print their official ASHP statements of continuing pharmacy education credit at the ASHP eLearning site (http://elearning.ashp.org) immediately following this activity. Learning Objectives: 1. Discuss the clinical and economic impact of surgical complications that result in bleeding and transfusion. 2. Demonstrate knowledge of local and systemic hemostatic agents, including clinical, safety, economic, and regulatory factors. 3. Describe the role of the health-system pharmacist in the use of hemostatic agents to manage surgical bleeding. 9:45 -10:45 No Credit “Pharmacy Practice Act (Roundtable)” 8 Moderator: Shane Madsen, PharmD, BCPS Friday, April 26th (continued) Time 9:45–10:45 Total Hours 1 hr. Speaker/Presentation Title Christina Glasgow, PharmD, BCPS – “Medication Considerations for Pharmacists Caring for Post Bariatric Surgery Patients” Sampaguita Wright, PharmD – “Tips for Pharmacists Caring for Patients with Ventricular Assist Devices” 0134-0000-13-070-L04-P; 0134-0000-13-070-L04-T Pharmacist Learning Objectives: (Christina Glasgow) 1. Differentiate the bariatric surgeries available in the United States. 2. Describe the potential impact of each bariatric procedure on medication absorption and therapeutic outcomes. 3. Identify strategies for overcoming decreased medication absorption and improving therapeutic outcomes. (Sampaguita Wright) 1. Describe the physiology of left ventricular assist devices (LVADs) and discuss how these devices benefit patients with advanced heart failure. 2. Evaluate overall treatment goals for patients with LVADs. 3. Discuss medications and medication classes commonly prescribed to patients with LVADs. 4. Discuss potential complications that may occur after LVAD implantation. 5. Determine appropriate medication changes and schedule follow-up labs for a patient with an LVAD, based on patient characteristics and hemodynamics. Technician Learning Objectives: (Christina Glasgow) 1. Describe the different types of bariatric surgeries available in the United States 2. Explain why different medication formulations are necessary for post bariatric surgery patients 3. Identify ways to modify different medication formulations to improve medication absorption. (Sampaguita Wright) 1. Identify LVADs currently available for bridge to transplant (BTT) and destination therapy (DT) in the United States 2. Describe common medications prescribed to patients with LVADs. 3. List potential complications that may occur after LVAD implantation. 10:45-11:45 1hr Julie Cunningham, PharmD, BCPP – “Opioid Discontinuation: The Art of Tapering Opioids” 0134-0000-13-071-L01-P, 0134-0000-13-071-L01-T Pharmacist Learning Objectives: 1. Discuss current literature evidence for safe tapering of opioids in patients with chronic use. 2. Review opioid withdrawal symptoms and factors that may contribute to the intensity of symptoms. 3. Describe relevant pharmacokinetic information that impacts the development of opioid tapers. 4. Discuss concurrent medications, disease states that may require opioid taper adjustments. 9 5. Review case examples and develop plans to taper opioids. Friday, April 26th (continued) Time 10:45-11:45 Total Hours 1hr Speaker/Presentation Title Julie Cunningham (Continued) Technician Learning Objectives: 1. Review opioid withdrawal symptoms 2. Describe relevant medication issues that impact the rate of opioid taper. 3. Discuss concurrent medications, disease states that may require opioid taper adjustments. 4. Review case examples and develop plans to taper opioids. 10:45-11:45 1 hr. Michael Botorff, PharmD, FCCP, FNLA, CLS – “Essential Guidelines for Hospital Pharmacists in Acute Coronary Syndrome” 0468-000-13-002-L01-P ****Program accredited through Medical Learning Institute**** Learning Objectives: 1. Discuss current updates on treatment guidelines for ACS. 2. Review recent advances in treatment, technology/techniques to improve ventricular function and relieve symptoms. 3. Describe the value and need for adherence to treatment guidelines and provide evidence-based solutions to treatment with current therapies. 4. Examine through different cas scenarios the current treatment options/techniques utilized to address ACS. 10:45-11:45 1hr. James M. Hoffman, PharmD, M.S., BCPS - “Preparing Your Practice for Biosimilars” 0204-0000-13-415-L01-P ****Program accredited through ASHP Advantage**** Attendees must complete a Continuing Pharmacy Education Request online and may print their official ASHP statements of continuing pharmacy education credit at the ASHP eLearning site (http://elearning.ashp.org) immediately following this activity. Learning Objectives: 1. Review the intricate scientific process used to produce biopharmaceutical agents and compare it with the process used to create traditional chemical drug products. 2. Examine potential approaches to monitoring and identifying unique adverse events that could emerge with biosimilars. 3. Review key information that will be needed to evaluate biosimilars for formulary consideration. 4. Develop a plan for the introduction of biosimilars into routine health-system practice, including an approach to transitions of care. 12:00 – 12:15 No Credit Kathryn Schultz, PharmD, FASHP – “Navigating the ASHP Summer Meeting” 10 Friday, April 26th (continued) Time Total Hours Speaker/Presentation Title KEYNOTE SESSION: 12:15-13:15 1 hr. Paul W. Abramowitz, PharmD, FASHP, Chief Executive Officer of American Society of Health-System Pharmacists (ASHP) – “Transforming Patient Care: Paramount Issues and Opportunities in Pharmacy Practice” 0134-0000-13-069-L04-P; 0134-0000-13-069-L04-T Pharmacist Learning Objectives: 1. Discuss future pharmacy practice models, and new methods of care delivery to improve care outcomes. 2. Identify strategies to redesign the medication use system in and across sites of care. 3. Explain future workforce, education, training, credentialing and privileging requirements necessary for pharmacists, technicians to provide optimal care, and accreditation for pharmacy practice sites. 4. Describe the importance and process for pharmacists to obtain provider status as a non-physician provider under Section 1861 of the Social Security Act and detail Pharmacy’s advocacy efforts. 5. Discuss the Accountable Care Organization Model and how pharmacists should participate. 6. Identify opportunities and ways pharmacists can educate the public, patients, and public payers in order to further advance the profession. 7. Summarize the vital role pharmacists play as primary care providers, describe their contribution to the advancement of complete and integrated care, and outline the tools needed to achieve this outcome. Technician Learning Objectives: 1. Discuss future pharmacy practice models, and new methods of care delivery to improve care outcomes. 2. Identify strategies to redesign the medication use system in and across sites of care. 3. Explain future workforce, education, training, credentialing and privileging requirements necessary for pharmacists, technicians to provide optimal care, and accreditation for pharmacy practice sites. Total Hours: 7 hours (4 obtainable hours) – April 26, 2013 GRAND TOTAL: 18.5 Program Hours (11 obtainable hours) – April 25-26, 2013 11