A study on diabetic patients by the University at Buffalo School of Pharmacy and Pharmaceutical Sciences identified cost savings with improvements in a key indicator of glucose control in diabetes patients, the hemoglobin A1C measurement. The A1C provides a three-month average of the amount of excess glucose in the blood. Higher A1Cs indicate that a patient is at higher risk for developing long-term complications associated with diabetes, such as kidney disease or vision problems.

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Published last spring in the Journal of the American Pharmacists Association, the UB study of 50 patients with Type 2 diabetes demonstrated that in just six months clinical pharmacists, in collaboration with primary care providers, were able to significantly reduce patients’ A1C levels.

In the UB study, patients’ A1C levels were reduced by an average of 1.1 percent, from an average of 8.5 percent to 7.4 percent, one year after being enrolled in the program, while also improving the overall metabolic profile.

“Our results show that enhancing the patient’s access to care through collaborative physician-pharmacist relationships can yield lower blood glucose levels, improve the overall metabolic profile and reduce costs to the payer,” says Erin Slazak, PharmD, UB clinical assistant professor of pharmacy practice and board certified pharmacotherapy specialist.

These clinical improvements occurred while monthly costs per patient went down by approximately $212, around $2,500 per year, even though there were nominal increases in the cost of medications prescribed.

The key to success?

“Patients had unlimited access to pharmacists throughout the year,” says Slazak.

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Patients referred to the UB program had been identified by their primary care providers as having difficulty controlling their blood sugar. Slazak notes that it was not uncommon to see patients with glucose levels as high as 400 mg/dl (normal levels are below 100 mg/dl).

The UB pharmacists spent an initial one-hour appointment with each patient, where they worked up detailed health records covering dietary information and all medications and disease conditions, and then reviewed them with each patient.

After that, patients could call or make appointments with pharmacists at will.

“We did extensive education with patients about how to manage their conditions,” says Slazak. “In many cases, we were instrumental in getting them to start insulin. There is a lot of resistance to that, and not just because it’s an injection.”

For patients in the initial stages of administering insulin, she says it was common to be contacted once every few days. The pharmacists then made suggestions to physicians about changes in medications, dosages or lifestyle that might be beneficial to their patients.

That kind of individualized attention is far from the norm for diabetic patients.

“Nationwide, the standard of care is that the primary care provider manages diabetes alone,” says Slazak. “Pharmacists typically do not have direct involvement.”

That is partly because some states, including New York, have not yet approved collaborative practice agreements between physicians and pharmacists. In the Buffalo study, for example, physicians were required to review pharmacists’ recommendations and approve all interventions first. Completion of the review process and approval occurred in only half of the cases, potentially limiting the overall benefit to the patient.

“We know there’s a long-term clinical and economic benefit to pharmacists working directly with patients and we think that can continue to grow,” says Scott V. Monte, PharmD, UB clinical assistant professor of pharmacy practice and director of Diabetes and Cardiovascular Research, CPL Associates, LLC, in Buffalo. “Pharmacists can help achieve better outcomes if given the chance.”

The study was conducted through MedSense™, part of the Pharmacotherapy Research Initiative, a collaborative effort between Lifetime Health Medical Group and UB, to study how pharmacists impact patient care. MedSense™ is one of many program sites that are part of the UB Pharmacotherapy Research Initiative in the School of Pharmacy and Pharmaceutical Sciences, which was established to study how pharmacy medication management can improve the health of patients while cutting costs through patient-centered pharmacotherapy.

In addition to Slazak and Monte, other co-authors on the paper include Nicole Paolini Albanese, PharmD, UB clinical assistant professor; Martin Adelman, PhD, chief information officer at CPL Associates, LLC; Gauri Rao, a student in the UB School of Pharmacy and Pharmaceutical Sciences, and Joseph A. Paladino, PharmD, UB professor of pharmacy and director of outcomes research at CPL Associates, LLC.

The program is jointly funded by Lifetime Health Medical Group and the UB School of Pharmacy and Pharmaceutical Sciences.

Pharmacists Improve Care of Diabetics While Cutting Costs, Research Shows is a post from: Pharmacy in jobs, news, schools

The Massachusetts College of Pharmacy and Health Sciences has banned students, faculty, and staff from covering their faces on its three campuses in an effort to ensure public safety, a college spokesman said yesterday.

Pharmacy school bars covering of the face is a post from: Pharmacy in jobs, news, schools

But there were dozens of other events both big and small that helped weave the local fabric of 2009. Gov. Deval Patrick spent a day here visiting with business, government and arts representatives. The Provincetown Cemetery filled up, leading to a discussion on how to expand the burial grounds. A new ladder truck was delivered, replacing the one destroyed in an accident last year. The Bradford pear trees that line the sidewalk to Town Hall were saved. And off-leash beach rights were restored to dog owners.

Here is a look at some of the stories that had a significant impact on life in Provincetown over the past year.

Reworking a school system
After years of avoiding the subject, town residents and a new school superintendent convinced the school committee to directly address restructuring the school district. As the student population continued to decrease, residents overwhelmingly voted at the April Annual Town Meeting to establish a regional school district planning committee to explore the possibility of merging Provincetown’s schools with the Nauset Regional School District. The three-person committee’s report is supposed to be presented at the 2009 ATM.
However, it took until Oct. 13 for the committee to hold its first meeting, a delay that concerned both selectmen and Town Moderator Irene Rabinowitz, who appointed the committee. As a result, selectmen voted unanimously in July to send a letter to the school committee urging action. Since then, school committee chair Peter Grosso stepped forward to be the district’s representative on the committee and two residents, Alex Brown and Barbara Rushmore, volunteered to serve.

Shortly after that, in November, the new school superintendent, Dr. Beth Singer, proposed that the school committee hold its own talks about the future of the school district. After a lengthy and often emotional discussion, committee members agreed to organize a series of workshops open to the public that begin planning for the future of a different school district.

In tourism
The 2009 tourism season in Provincetown was a mixed bag but there were some sighs of relief that it wasn’t worse in this uncertain economy.
Booking rates for vacation rental homes on Cape Cod and the Islands were down 5.7 percent over the 2008 season, according to WeNeedaVacation.com, an Internet vacation booking site. A cold and wet June and half of July discouraged visitors but great weather through the rest of the summer and into the fall helped increase those numbers.

Still, the tourists who did arrive kept a strong grip on their wallets, cutting back on shopping across the board from artwork to fudge, based on reports from several local business owners, And many visitors who normally would have booked a week’s stay in town reduced that to four or five nights; there were often last-minute weekend vacancies available.

Retail stores reported revenue declines between 20 and 30 percent. But based on anecdotal evidence, it seems that the number of daytrippers was about even with last year. At the town’s municipal parking lots, the number of drivers was almost flat compared with the same April through August period in 2008.

“The overall picture was not great,” Provincetown Chamber of Commerce Executive Director Candy Collins-Boden said, referring to visitor spending. “But Provincetown could have done worse.”

Town Hall restoration
The last phase of the $6.54 million repair and restoration of the 123-year-old building began on Aug. 25, after voters approved funding at both the April Annual Town Meeting and the June Special Town Meeting. Phase 2, which will renovate and restore the interior of the historic building, as well as replace outdated electrical and heating systems, will take approximately one and a half years to complete.

Park project
Ambitious planning on the part of town leaders ran into resistance from some residents over a proposal to turn the municipal parking lot into a waterfront park, transportation gateway and visitors center. As part of that proposal, public parking would be moved to a proposed parking structure to be built on the site of the Duarte’s parking lot at the corner of Bradford and Standish streets. The idea of adding a 700-car, multi-level parking facility on the Duarte’s property — assuming the town was successful in purchasing it — worried some residents but selectmen said no design would be finalized without a series of public forums. In the meantime, the town is waiting to hear if its application for $25 million in federal stimulus money to pay for the project will be approved, a decision that is expected in February.

As the market turns
Although the takeover of the former Grand Union grocery store on Shank Painter Road by Stop & Shop actually took place on Dec. 12, 2008, the impact of the renovation of the town’s only grocery store was fully felt in 2009. The produce was fresher, there were more items available and a new, expanded pharmacy was built this past year. There were some complaints that it was taking longer to fill drug prescriptions over the summer months, however, prompting selectmen to write a letter of concern to the new managers.

Pharmacy no more
The reason there was a crush at the Stop & Shop pharmacy was largely due to the new market buying the prescription business of long-time Adams Pharmacy, which took the word “pharmacy” off of its sign. Adams, in business in Provincetown since 1875, sold that part of its business to Stop & Shop in March.

Art barn
Another change in a long-time fixture in Provincetown was the sale of the barn that housed the legendary Hawthorne School of Art and gave birth to Provincetown’s reputation as an international art colony. It was sold by its long-time owner Olga Opsahl-Gee, who with her late husband, Peter Gee, operated the art school since 1994. The new owner, Joshua Prager, has not revealed what he plans to do with the barn, although he said he would use it as a residence part of the year and have arts programming there the rest of the time.

Pru Sowers can be reached at psowers@provincetownbanner.com

School talks & market turnovers among top Provincetown stories in 2009 is a post from: Pharmacy in jobs, news, schools

In an email press release sent Monday afternoon, Coupeville Town Marshal David Penrod described the robber as approximately 5-feet, 6-inches tall, weighing 150 pounds. He was wearing a dark colored hooded jacket or sweatshirt, dark colored jeans, a black mask, and brandished a silver handgun.

Deputies with the Coupeville Marshal’s Office were on scene within one minute, closely followed by the Island County Sheriff’s Office. Deputies conducted an extensive search of the immediate area, but were unable to locate the suspect.

Coupeville deputies, Island County Sheriff’s deputies and State Patrol troopers’ vehicles flashed their lights along Main Street, Highway 20 and Broadway Avenue in an effort to set up a perimeter around the pharmacy.

“You’ve got to plug up the holes you know you have,” said Lt. Evan Tingstad with the Island County Sheriff’s Office.

Coupeville schools were locked down for more than an hour while deputies checked the areas surrounding them.

There were eight people in the store at the time of the robbery, including a pharmacist, two pharmacy assistants, two technicians and three college students who were helping with store inventory, general manager Adam Lind said. No one was injured during the robbery.

“The crew is a little shaken up,” he said.

The man cleared out the pharmacy’s supply of OxyContin, a highly addictive prescription pain medication.

“He took everything we had on the shelf in every strength,” Lind said.

Investigators dusted for finger prints and lifted a shoe print the robber left after he vaulted over the front counter on his way out, Lind said.

The pharmacy remained open after the robbery and continued to filled prescription requests by customers who seemed unaware of the morning heist.

Law enforcement officials are continuing to investigate the incident and review the store’s video surveillance system.

“The suspect is still at large and the investigation is being conducted by the Island County Sheriff’s Office with the assistance of the Coupeville Marshal’s Office,” Marshal Penrod wrote in the press release.

A Skagit County Sheriff’s Office search dog and handler were initially called in to help with the search effort. The unit was called off because officials couldn’t find anything to give the animals a scent trail, according to Island County Sheriff Mark Brown.

During the lock down, Coupeville Elementary School kids were kept in classrooms and the windows were blacked out. The exterior doors were locked at the high school and middle school. The district lifted the lock down at 11:45 a.m.

Anyone with information regarding the crime should contact Detective Sgt. Mike Beech of the Island County Sheriff’s Office, 678-4422, or call 911. Anonymous tips may be left with the Island County Tip Line at 679-7319.

More details about the lockdown and the reported robbery to follow.

UPDATE: Marshal gives description of Coupeville pharmacy armed robber is a post from: Pharmacy in jobs, news, schools

“It’s not my decision,” Thorp said in a meeting with News & Record editorial writers last March.

Thorp said he would be happy to help UNCG gather information toward its goal.

“The question whether UNCG is the right place for a second school of pharmacy and whether the state needs one — those are things that need to be decided by President Bowles and Chancellor Brady,” he said later, referring to UNCG leader Linda Brady and UNC system President Erskine Bowles.

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What that precisely meant was unclear. But it did not appear to be a ringing endorsement.

When pressed about opinions on his campus, Thorp was equally nimble, if uninformative. “Well, you know universities are places where there are lots of opinions,” he said. “There is certainly some skepticism about it but there are some other people who think it makes sense.”

In any event, he said, it wasn’t their decision to make, either.

(He was a lot more forthcoming about Tar Heel basketball.)

But being opposed to a new pharmacy school “isn’t part of the UNC culture,” Thorp said, reassuringly.

That was then.

That was before UNC-CH began pursuing its own plans for a satellite pharmacy school at UNC-Asheville. This would not be a full-fledged school like the one envisioned for Greensboro, where as many as 100 students would enroll. But it would involve up to 40 students and would compete for funding at a time when state money is hard to come by.

As of now, there are three schools of pharmacy in North Carolina: the lone public one in Chapel Hill and private ones at Campbell and Wingate universities.

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A major premise in its long-range plans to establish a school, say UNCG officials, is the acute shortage of pharmacists in the state. Their proposal cites a 2008 report by the Pharmacy Manpower Project that ranked North Carolina and Wisconsin as the two states with the most serious shortages of pharmacists.

Some UNC-CH officials counter that the shortage isn’t as great now as it was thought to be before because of the recession.

Why then, the need for another program in Asheville?

And recessions do eventually end. The pharmacy school is a much longer-term proposition.

UNC-CH’s timing also is, well, suspicious. UNCG’s plan has been on the table for months. The Chapel Hill plan was either a well-kept secret or a late development.

Brady said Thursday that she learned of the Chapel Hill proposal at the end of September. “My sense is it had not been in the works very long,” she said.

There may be no calling dibs in these matters, but shouldn’t Chapel Hill at least have touched bases with UNCG as a professional courtesy?

“People have different approaches,” Brady said.

Even so, she added, “I personally don’t view the Chapel Hill concept as a competitor. It’s very different from what we’re proposing here.”

UNCG would offer the professional-level and graduate degrees, including doctorates, and include a significant research component.

She said UNCG’s provost, David Perrin, interim UNC-CH vice chancellor and provost Bruce Carney and the UNC system’s vice president for academic affairs, Alan Mabe, will meet within the next two weeks to discuss the two proposals.

“I don’t think it’s helpful for us to be competitors,” she said. “Sometimes that’s the case, but it would be good for the two institutions to sit down and talk about the two plans and the state’s needs.”

No offense to Asheville, but the arguments for a school here are compelling: the economic impact; backing from the Moses Cone Health System and influential local foundations; the impact on downtown, if it should be built there; synergy in research with the N.C. A&T/UNCG Joint School of Nanoscience and Nanoengineering.

“Our argument is not only an educational argument,” Brady said. “It’s an economic development argument.”

The Asheville initiative definitely would cost considerably less up front. But UNCG expects a return of as much as $28 for every dollar invested, including between $5 million and $6 million a year in sponsored research and $6.5 million in annual tuition revenue.

For her part, UNCG’s Brady was clearly expecting statesmanship to trump turf concerns.

“The first chancellor to call me following my appointment here was Holden Thorp,” she said.

Can UNCG and UNC-CH meet in middle on pharmacy schools? by Allen Johnson is a post from: Pharmacy in jobs, news, schools

It goes something like this, “Now that I’m out of a job, I might as well go back to school,” according to Jay Walls, a representative of the University of North Texas graduate school.

The turnout Wednesday for the Graduate & Professional School Fair held on the campus of Abilene Christian University bore out that thinking.

A steady flow of prospects began circulating through the exhibit room shortly after the fair started. Walls wasn’t surprised.

“Enrollment has gone up because of the economy,” he said. “Schools tend to do better when the economy is down.”

Wednesday’s fair was sponsored by the West Central Texas Career Consortium, which consists of eight local colleges and universities and Dyess Air Force Base.

Ben Klein, who is on schedule to receive a master’s degree in clinical psychology from ACU in May, credited the economy with forcing him to make some decisions. Klein browsed the tables set up by about 25 institutions, picking up literature and learning about their doctoral programs.

“If more jobs were out there and more money was out there, I might just stop with my master’s,” Klein said.

But because of limited well-paying positions for clinical psychologists with only a master’s degree, Klein decided to check out doctoral programs.

And, he is looking into possibly joining the military as a means of paying for the degree. At least two branches of the service — Army and Air Force — offer scholarships for doctoral degrees with a military commitment after graduation, Klein said.

Deciding to go directly into a doctoral program, rather than working first, and getting the military to pay for it is a direct result of a slumping economy, Klein said.

Jace Jones, who was manning a table for the University of North Texas School of Public Health, faced the same situation as Klein. He has a master’s degree in health policy and management, but a doctorate is needed for higher-paying jobs.

So, Jones decided to increase his value by working on a doctorate. He would have started work with the master’s degree if good jobs had been available.

“There just weren’t that many out there,” he said.

On the flip side, the recruiting is picking up.

“It’s been kind of good for graduate schools,” he said.

Another man with an easy job Wednesday was Make Nall, who represented the Texas Tech University School of Pharmacy in Abilene.

The school has enrolled 40 students each year since opening, with a current enrollment of 120. Next year’s 40 will bring the school to its maximum enrollment. Even without a bad economy, the pharmacy schools gets more applicants than it can handle, Nall said.

Last year, between 600 and 700 people applied. But the economic downturn has brought some unusual applicants such as a chiropractor and a few physicians. The physicians are applying from rural areas, Nall said, because small clinics are hiring more physician’s assistants than doctors. Physicians leaving those clinics are enrolling in pharmacy schools because the entry level pay for a pharmacist can be as high as $140,000 a year, Nall said.

Another recruiter not having any trouble Wednesday was Mark Cortez, field representative for Walden University, an accredited online institution of higher learning. The flexibility offered by an online education draws working people and other nontraditional students, Cortez said. The poor economy just adds to the mix.

“It’s been big,” Cortez said. “People have been having a hard time finding a job.”

Pharmacy, Without a job, it’s back to school is a post from: Pharmacy in jobs, news, schools

The health-care industry added an additional 29,000 jobs in October, nearly the same amount it grew in September. In total, since the start of the recession, the industry has added 597,000 jobs, according to the BLS.

The biggest month-to-month jump came in the category of health care and social assistance, which added approximately 3,400 positions.

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And like in September, there was growth across all health-care sectors, including in hospitals, ambulatory-care settings and in doctors’ offices.

Pharmacy – Looking for a Job? Health Care Is Still a Good Bet is a post from: Pharmacy in jobs, news, schools

Try telling Mac Wilhoit there’s nothing new under the sun. He knows better.

The 61-year-old independent pharmacist has reinvented his North Knoxville business several times, and he’s not through.

Since 1989 Wilhoit has offered his thousands of customers free deliveries, drug screenings and counseling. Now an innovative medication alert service is free to customers, all from the humble building on Washington Pike.

The small pharmacy stocks no groceries, cosmetics or beer at the store’s front end. Instead, medication counseling takes up that space. Prescription medicines are the bulk of the business, and Wilhoit and his staff greet his return “patients” by first name, accompanied by a pat on the back.

For years Wilhoit has responded with a flat “no” to national drugstore chain buyout offers. And Mac’s Pharmacy recently added another store – this time with his son managing. Wilhoit recently bought Edgemoor Pharmacy in Claxton, renamed it Mac’s Pharmacy and celebrated a reopening in October.

In an economy where business takeovers are the norm and chain stores are in every neighborhood, Mac’s Pharmacy is bucking the trend. Wilhoit believes he joins thousands of small businesses leading the nation’s economic recovery. Mac’s Pharmacy is part of a national group of 3,500 independently owned stores. The Leader Pharmacies network helps independent stores leverage competitive medication pricing.

“I’ve had lots of offers from chains, and I have nothing against them. It’s just not for me,” says Wilhoit, who has handed down the same philosophy to his son Mike.

Mike Wilhoit, 27, worked briefly for a chain drugstore following graduation from the University of Tennessee but soon returned to the family business.

“I know this other more personal side of pharmaceutical care,” said Mike Wilhoit. “It’s what my dad has always offered. And it’s what I’ve always wanted since I was a boy, wearing my own little white coat when I would visit the store.”

The store’s customer offerings range from a wellness program of free children’s multivitamins to a computer-generated dosage alert notification.

“We’re the same since 1989, only different,” Wilhoit said.

“We began by taking care of our patients, and we’re keeping that up by changing it up and offering more. It’s another way to differentiate ourselves and make Mac’s something extra,” he said.

Recently the pharmacy piloted “Medicine on Time,” a service that offers a monthly color-coded calendar card containing maintenance medications. Wilhoit says the new system does the hard work, helping elderly patients keep their freedom longer.

Prescriptions are filled as usual and inserted into a daily dosage punch-out card. The program is offered on a free trial basis.

“This is done in nursing homes, but not usually by local pharmacies,” he says. “And when home health nurses administer medications, it is more expensive for the patient.”

Mac’s also recently created “My Dose Alert,” a free automatic notification that alerts customers by phone, text message or e-mail when it’s time to take their medications.

“Research tells us that one out of every two patients do not take their medicine as prescribed, on time,” Mike Wilhoit says. “More than 80 percent cite forgetfulness as the main reason. That means the majority of people simply need a friendly reminder, and that’s what we’re offering the entire community for free if they buy their medication here.”

The high-tech and high-touch approach appeals to UT pharmacy school interns, says Wilhoit.

About a dozen students intern annually at Mac’s Pharmacy, a relationship that is growing, Wilhoit says.

“UT’s pharmacy school is still new, so we know more students will intern. And we show the students the other side – what an independent pharmacy looks like, and they love it. They see our technology, the robotics systems that fill prescriptions, and that technology allows them to get closely involved with our patients.”

Wilhoit says independent pharmacies are competitive in price, even cheaper, but it’s not their primary focus. Wilhoit’s answer to one-stop shopping is health care for his customers.

“That’s simply why I’m here. We even call insurance companies and physicians for our patients when they are having trouble with a prescription. We get on the phone for them. This is why I remain an independent pharmacy. I’m at liberty to create my own job satisfaction and give back to the community,” Wilhoit says.

“I don’t want people to come to Mac’s for price, or leave because of price.”

Mary Leidig is a freelance contributor to the News Sentinel.

PHOTOS BY MICHAEL PATRICK/NEWS SENTINEL

Mac’s Pharmacy stays independent by focusing on customers’ needs is a post from: Pharmacy in jobs, news, schools