North Carolina Pharmacist Spring 2012

North Carolina

Pharmacist

Former Executive Director Fred Eckel turns a page in his career

Vol. 92, Number 2 Advancing Pharmacy. Improving Health. Spring 2012

Save the date!

August 3-5, 2012

Host Hotel Information: The Marina Inn at Grande Dunes will honor our group rates several days before and after the meeting so bring family and friends for a week-long vacation!

1-866-437-4113 • marinainnatgrandedunes.com/ncap • Group Code: NC Assoc. of PharmacistsMake your hotel reservations now before the cut-off date of July 3rd

Make your beach plans now for the NCAP Community Care Practice Forum Meeting

in collaboration with NC Mutual Drugat Myrtle Beach!

Meeting topics include:• CPR for Health Care Professionals• APhA Diabetes Certificate Program• Immunization Certificate Program• Legislative Update• Anxiety and Stress Management• Pharmacist’s Role in Diabetes Management• Increasing Front End Sales with Natural Products• Immunization Update• Innovative Practice Models in North Carolina

North Carolina Pharmacist, Spring 2012 3

Official Journal of the North Carolina

Association of Pharmacists109 Church Street • Chapel Hill, NC 27516

800.852.7343 or 919.967.2237fax 919.968.9430

www.ncpharmacists.org

JOURNAL STAFF

EDITORSally J. Slusher

ASSOCIATE EDITORChristopher R. Gauthier

EDITORIAL ASSISTANTSLinda Goswick

Teressa Horner Reavis

BOARD OF DIRECTORS

PRESIDENTJennifer Askew Buxton

PRESIDENT-ELECTMary Parker

PAST PRESIDENTCecil Davis

TREASURERDennis Williams

BOARD MEMBERSMichelle Ames

Ashley BranhamJennifer BurchValerie Clinard

Stephen DedrickJennifer GommerKira Brice HarrisLeAnne Kennedy

Beth Mills

North Carolina Pharmacist (ISSN 0528-1725) is the

official journal of the North Carolina Association

of Pharmacists. An electronic version is published

quarterly at 109 Church St., Chapel Hill, NC 27516.

The journal is provided to NCAP members through

allocation of annual dues. Subscription rate to non-

members is $40.00. annually. Opinions expressed in

North Carolina Pharmacist are not necessarily official

positions or policies of the Association. Publication of

an advertisement does not represent an endorsement.

Nothing in this publication may be reproduced in any

manner, either whole or in part, without specific writ-

ten permission of the publisher.

• From the Executive Director .......................................... 4

• From the President ................................................. 5

• Gauthier Delivers NCAP’s Message in DC .................... 6

• NCAP Hosts Golf Tournament for Endowment .............. 7

• S246 Talking Points........................................................ 8

• Fred Eckel Turns a Page in His Career ........................ 10

• Eckel Honored at APhA Reception ............................... 11

• Chronic Care Practice

Forum Meeting Highlights .................................. 12

• New Practitioner Network:

Optimizing the Use of

Mobile Technology in Your Workplace ..................... 14

• Safety Solutions:

Pharmacy Technicians:

Identifying and Reporting Medication Errors ............ 16

• NC Makes RxImpact .................................................... 18

• Award Nominations Sought .......................................... 21

• Pharmacy Time Capsules ............................................ 24

Volume 92, Number 2 Spring 2012

Inside

Mark your calendar for the

NCAP Annual ConventionOct. 28-30, 2012

Raleigh Convention Center

4 North Carolina Pharmacist, Spring 2012

From the Executive Director

Advocacy. Advocacy is defined as follows: the act of pleading for, supporting, or recommending; active espousal: He was known for his advocacy of states’ rights (thank you Merriam Webster). That’s a pretty powerful word. It’s also a word that many of us don’t pay much attention to in this profession.

I’m not surprised really. I’ve been a pharmacist for eigh-teen years, and I was not an advocate for my profession for the entire first half of my career. Pharmacists are a humble bunch. Honestly, ever since Norman Rockwell depicted us in oil, we’ve been that way. We are quiet (professionally, that is), unas-suming, and happy to help; the smile of our patients is thanks enough. I could go on, but you get the picture. We, as a profes-sion, are happy to let others take the limelight in the patient care arena. Tooting our own horns somehow seems tawdry and beneath our level of professionalism.

I write this while in Washington, DC for the second time in a week. Last week, NCAP President-elect Mary Parker and I were at the Pharmacists Mutual Leadership Conference and now I’m at the NCPA Legislative Conference. Maybe it’s the view of the Capitol building out my window (man, that’s a big dome!) or the energy of the people attending, but I keep going back to the word advocacy and how it applies to pharmacy.

So, how does advocacy apply to pharmacy? Well, after taking part in these conferences, I think that we still haven’t defined its role for us. Shocked? Did you think that I was going to let you all in on a little secret? Did you think that I had the answer right here? Sorry to disappoint you, but look at this as an opportunity.

See, we are new to this advocacy thing, and it is com-pletely out of character for us. We aren’t used to talking about ourselves. I think that the profession has to get over the percep-tion that promoting yourself or pleading for what you want pro-fessionally is somehow narcissistic. I’ve been doing association work for over twelve years now, and I still get uncomfortable testifying in front of the General Assembly. I still get tongue tied when talking about my profession to Congress. Why? I’m

certainly not awestruck by the positions held by the electorate. It’s not that I don’t know what I want as a professional. It’s also not that I’m unfamiliar with the issues. It’s the fact that I have to TELL someone something good about me. I have to pat myself on the back and show my worth to others. We’re uncomfortable with that. OK, we all know some colleagues who have ABSO-LUTELY no problem talking themselves up, but they certainly are not in the majority.

So, I practice it. I continually put myself into situations that FORCE me to advocate for my profession and myself. We had to learn to become good pharmacists. It took practice. The same holds true for advocacy. We need to become a good advocate. We need to practice advocacy constantly until it is no longer uncomfortable to us.

This is what I ask you to do. I ask you to practice advo-cacy. Allow yourself the opportunity to talk up your profession. When the opportunity arises, and believe me I’ll let you know, take hold of the moment and advocate for yourself. Plead for what you want, support the views of your profession, recom-mend action on behalf of your profession. Allow your voices to be heard. We can do this professionally, and with practice we can become the powerful force that our profession needs us to be. We can finally define the role of advocacy in North Carolina pharmacy and begin to move the profession where we all know it needs to go.

Will there be bumps along the way? Yup. Will it be diffi-cult? Yup. Will you want to curse me for taking you out of your comfort zone? Probably. It’s OK; I’m a big boy. I can take it. But, at the end of the day, we will make ourselves relevant as a profession. That, my friends, will make the struggle more than worth it! All the best,

Christopher R. Gauthier, RPh

Practicing Advocacy


North Carolina Association of Pharmacists109 Church StreetChapel Hill, NC 27516phone: 919.967.2237 • fax: 919.968.9430

Advancing Pharmacy. Improving Health.

Dear NCAP Members:

In my last message, I encouraged you to make a New Year’s Resolution to give back to your profession. If you have not made that commitment just yet, I’d like to offer you an example of one way that you can meet this challenge: be a mentor. In fact, even if you have already made that commitment to give, either through NCAP or another venue, I would argue that you should still be a mentor.

When I’m precepting students, I always remind them that they need to be both a mentor and a mentee. I tell them that it’s part of their professional obligation. I remind them that, although they may not feel

particularly seasoned or skilled, they have plenty of advice and guidance to offer others. John Crosby, a men-torship expert and Executive Director of Uncommon Individual Foundation says, “mentoring is a brain to pick, an ear to listen, and a push in the right direction.” I tell students that any of us can do these things, no matter how seasoned or skilled. This is also true for each of us as practicing pharmacists and pharmacy profession-als. Although we may not feel like we have too much to offer to a colleague, a student, or another healthcare professional, we most certainly do.

Mentoring does not always mean providing insight or advice. It can also mean leading by example. Being involved in professional associations, advocating for the profession, or providing excellent patient

care in the presence of a mentee can be just as impactful. So take a colleague, resident, or student along the next time you attend an association meeting or go above and beyond to care for a patient. These experiences do make a difference in the lives of others, and these mentees will go on to touch even more lives and to advance the profession even further as a result.

At times, we may feel that we have become so seasoned or skilled that we no longer require mentors in our own careers. I would argue that this will never be the case for any of us. Crosby also states that “success-ful people turn everyone who can help them into sometime mentors.” This is true no matter what phase of our careers we are in. Not only do we need a mentor, each of us needs many mentors. These people are giving you their advice or pushing you in certain directions because they are seeing your situation through their own lens. Getting information from a variety of sources may open your eyes to possibilities you hadn’t thought of or lead you to an improved plan or outcome, but no one mentor has all the right answers.

Although I can honestly say that the guidance and advice I have received from mentors over the years is priceless, I also believe that I have learned and grown just as much by being a mentor myself. In fact, I can think of specific relationships where I started as the mentor and turned into the mentee, or vice versa. Mentor-ship is certainly not a one-way street, and the more time you spend on this thoroughfare, the richer and more rewarding your career can become.

In fact, mentoring can also offer you a way to make your own voice heard even louder. Because you are active and engaged in the advancement of the profession, coach and mentor others to do the same. Teach them about the issues facing pharmacy and help them learn to advocate for themselves and for the profession as well. The more pharmacists believe that the future of pharmacy is our responsibility, the louder our voice becomes.

Please consider spending a little time giving back to our profession in 2012 by being a mentor. If you need any help figuring out how, you may contact me personally anytime.

Sincerely,

Jennifer Buxton, PharmD President


NCAP Executive Director Christopher Gauthier attended the National Association of Community Pharmacists Legislative and Government Affairs Conference in Washington, DC May 7-9, 2012. Many issues regarding pharmacy practice were brought forth, and the many Senators and Congressmen in attendance left much more informed about the state of the profession and the concerns of North Carolina pharmacists.

The following bills were highlighted during the conference and discussed during the subsequent personal visits with law-makers:

HR 1971/ S 1058Pharmacy Competition and Consumer Choice ActThis bill would require Medicare Part D plans to disclose their source for generic drug reimbursement (MACs) and to update MACs weekly. It would also reform Part D auditing processes by prohibiting plans from requiring pharmacies to keep more stringent records than federal or state require-ments. It would also provide a greater choice of pharmacies for con-sumers by not allowing mandates or incentives from plans to use PBM owned pharmacies, thereby increasing PBM transparency.

HR 4215Medicare Pharmacy Transparency and Fair Auditing ActSimilar to HR 1971, but more focused on Part D plans. It would also require Part D plans to disclose and update MACs weekly and reform auditing processes as in HR 1971. It would also prohibit extrapolation in auditing and limit the ability of the PBM to recoup funds for clerical errors unless there is proof of intent to commit fraud.

HR 1946Preserving our Hometown Independent PharmaciesThis legislation promotes competition by providing indepen-dent pharmacies similar leverage as large chains to negotiate third-party contracts. It would also allow independents to form negotiating entities that are no larger than 25% of the pharmacy business.

HR 1936Medicare Access to Diabetic Supplies ActThis bill would insure that Medicare beneficiaries could continue to obtain diabetes testing supplies and counseling services from community pharmacies by exempting them from the DME com-petitive bidding process. It preserves patients’ access to home delivery of their supplies.

The President’s 2013 budget was also discussed at length with lawmakers. As it stands now, the budget would seek to move Tricare patients to mail order by incentivizing copy increases over the next five years. Mail order copays would remain $0 for a 90 day supply, and retail starts at $5 for a 30 day supply at local community pharmacies. Plus the proposed bud-get would no longer allow local pharmacies to fill non-formulary drugs on Tricare at all. Gauthier conveyed our displeasure with this line of thinking, offering that North Carolina Pharmacists are uniquely positioned to help lower total health care costs

with services such as Medication Therapy Management, Medi-cation Reconcilia-tion, and promoting Adherence. To move these prescriptions to mail order would not only be detrimental to the total cost of health care, but dangerous for patients.

Other issues that were touched upon during personal meet-ings with the North Carolina Congres-sional Delegation in-cluded drug shortages, supply chain secu-rity, 340B reform, the increase in pharmacy

crime, and the impact of the ESI Medco merger on Community Pharmacy.

We also asked lawmakers to support the RxTech Act (Phar-maceutical Enhancement Code). This legislation would set national standards for distributors of pharmaceuticals and would provide lot level tracking of all prescription medications. It was made clear to lawmakers that pharmacists can’t be burdened to track and trace at the unit level because of the cost impact on small businesses.

In general, lawmakers were attentive to the concerns of North Carolina pharmacists and asked numerous questions to make sure they understood the message.

Will this translate on the voting floor? Only time will tell. v

Gauthier Delivers NCAP’s Message in DC

NC Senator Kay Hagan speaks with NCAP Executive Director Chris Gauthier during the recent NACP Legislative and Government Affairs Conference in DC.


Save the Date!

Join the North Carolina Association of Pharmacists for a golf outing on September 12 at the beautiful River Ridge Country Club in Raleigh. Proceeds from this tournament will benefit the NCAP Endowment Fund.

• Shotgun start at 9:00 am

• 18 holes and prizes followed by a barbecue lunch!

• Cost: $65

• More information and registration available soon

The Endowment Fund provides income to aid in achieving charitable, scientific, literary and educational goals.

It’s tee time!


North Carolina Association of Pharmacists 109 Church Street • Chapel Hill, NC 27516 • 919-967-2237 • www.ncpharmacists.org

North Carolina Association of Pharmacists Supports S246 to protect the public’s health by increasing access to vaccines through the expanded role of immunizing pharmacists.

Immunizations...SERVING A PUBLIC NEED

S246, Expand Pharmacists’ Immunizing Authority would: Improve public health by expanding access to vaccines. Require immunizing pharmacists to work with primary care providers to ensure patient safety. Immunizing pharmacists could provide vaccine services only through a strong relationship with a North Carolina-based physician. Require reporting of immunizations to primary care providers to protect patients. Enable adult patients who don’t have a primary care provider or health plan to receive vaccines through immunizing pharmacists. Establish a convenient place for adults to receive Tdap (tetanus, diphtheria, pertussis) vaccine to prevent whooping cough, which has reemerged as a public health threat in North Carolina. Enable immunizing pharmacists to administer all CDC recommended vaccines to adults, pursuant to a specific prescription order, a standing order, or protocol. Require immunizing pharmacists to use the North Carolina Immunization Registry (NCIR). Currently, the only North Carolina physician practices required to use the NCIR are those that participate in the Vaccines for Children program.

S246, Expand Pharmacists’ Immunizing Authority would NOT: Allow pharmacists to administer any vaccine to young children. Fragment the medical home. The provisions of S246 mandate that an immunizing pharmacist MUST have a strong relationship with a North Carolina-based physician to administer vaccines.

Please make S246 North Carolina law. Vote FOR S246, Expand Pharmacists’ Immunizing Authority.

Pharmacists Protecting the Public Health

NCAP has developed the following talking points for you to use when contacting your legislators to discuss the reasons for passing S246. Please call or write your North Carolina representatives today! If you need assistance contact NCAP.


NC Association of Pharmacists (NCAP) Supports S246, Expand Pharmacists’ Immunizing Authority

Christopher Gauthier, RPh • [email protected] • 919-967-2237 Evelyn Hawthorne • [email protected] • 919-523-9096

Pharmacists Protecting the Public HealthIn 1994, the U.S. Secretary for Health and Human Services reached out to the American Pharmacists Association (APhA) to en-list pharmacists to increase immunization rates -- a primary public health goal. APhA responded and developed a rigorous training program for pharmacists to serve as vaccinators – this program is recognized by the Centers for Disease Control and Prevention (CDC). Today, this program has grown and has been adopted by schools and colleges of pharmacy across the U.S., enabling more than 140,000 pharmacists to be trained as immunizers. Pharmacists in all 50 states are now public health partners by increasing access to flu vaccine. Most states allow pharmacists to administer other vaccines, too.

Pharmacists were called upon during the 2008-2009 H1N1 flu pandemic to provide vaccine to prevent transmission of this deadly influenza strain. During the H1N1 pandemic, North Carolina pharmacists provided flu vaccine to adolescents for the first time – a big success for public health.

NCAP seeks to enable qualified and trained immunizing pharmacists to administer all other CDC recommended vaccines to adults, by prescription, by standing order or by protocol.

Please make S246 North Carolina law. Vote FOR S246, Expand Pharmacists’ Immunizing Authority.

U.S. and N.C. Vaccination Rates are Unacceptable; Fall Short of National Norms• In 2010, influenza and pneumococcal immunization rates for adults 65 and older in the United States were 66.6% and 59.7%, respectively. • Annually, nearly 90,000 Americans die of infections that can be prevented by vaccination, such as influenza, pneumococcal disease, and hepatitis B, according to the CDC Advisory Committee on Immunization Practices (ACIP).• In 2010, the CDC reported that vaccination rate for Tdap, the medicine that prevents whooping cough, among other things, was only 8.2 per cent for persons of ages 19-64. Whooping cough outbreaks have been reported across the country – including North Carolina – and are at epidemic proportions in several states, including California and Washington.

CDC RECCOMENDS MORE VACCINES, BUT NC HAS A SHORTAGE OF PRIMARY CARE PHYSICIANS

Pharmacists are Highly Qualified Immunizers • In a paper published in Journal of Adolescent Health in 2006, the Society for Adolescent Medicine supports compliance with ACIP’s adolescent vaccination schedules and the use of qualified pharmacies as alternative vaccination sites – particularly for young persons without access to comprehensive preventive care. • A Harvard Medical School study, Non-traditional settings for influenza vaccination of adults: cost and cost effectiveness, published by Pharmacoeconomics in 2008, found that pharmacies provide safe, convenient, and cost-effective locations for vaccination, includ-ing access for those without a medical home. • A survey published by Medical Care in 2001 reported that the availability of pharmacist-provided immunization services improve immunization demand and vaccination rates by ALL health care providers. These results confirm a study published by Dr. John Gra-benstein of the University of North Carolina at Chapel Hill in 1994. • A study published in Vaccine in 2004 found among patients aged 18-64, states allowing pharmacist administration of influenza vac-cines had a 5% increase in vaccination rates.• Findings published in Journal of the American Pharmacists Association in 1999 concluded that pharmacists are the health care professionals who are the most accessible to the public. Pharmacists are repeatedly listed among America’s most trusted health care professionals. They have received extensive training and education about medications – including vaccines. Pharmacists can identify specific people who need vaccines on the basis of their medication history or knowledge of patient-specific disease-based risk factors. Pharmacists can offer a useful bridge between patients and primary care providers by identifying an individual patient’s needs and facilitating referrals to health care providers when appropriate.

For more information contact:


By Abisoye Abisogun, PharmD

As I looked around the basement of the North Carolina Association of Phar-macists building, I marveled at all the old apothecary instruments and multiple awards and plaques. There I was, a new pharmacist completing my residency at UNC, when I was given the opportunity to spend time with and interview one of the leaders of our profession. A man who was moving mountains and advocating for pharmacy before I was even born. A man with so much experience and so many accomplishments, a two-inch binder is needed to hold his CV. He has held several elected positions in professional organiza-tions ranging from delegate, secretary, vice-president, president and executive director. He has served as faculty advisor, editor-in-chief, and sat on a vast range of committees. His name? Frederick Mon-roe Eckel, the immediate past Executive Director of NCAP.

Of course, this was not my first time meeting or speaking to Mr. Eckel, but it was my first opportunity to really get into his mind and hear his story firsthand. “Are you ready to get started?” I asked. His response, “I’m always ready.” We laughed at the exchange and the interview began.

One of the first questions I asked Mr. Eckel was how he got into pharmacy. He said “It was by happenstance. It was not a planned activity.” He started working behind the soda fountain in an indepen-dent pharmacy in the ninth grade. He worked there throughout high school and eventually assisted in delivering patients’ medications and preforming cashier du-ties. After high school, he began studying elementary education at Pennsylvania State University but, unfortunately, he became ill and had to drop out. As he was recovering from his illness, he returned to the pharmacy to work part-time. During a Saturday evening shift, one of the pharma-cists asked him what he was going to do with his life. The pharmacist shed some

light into the field and that began Mr. Eckel’s journey into pharmacy. He was admitted to the Philadelphia College of Pharmacy and Science that September.

While at PCP, he made the dean’s list. This was quite a contrast to what his high school guidance counselor thought of him; he told his father not to waste his money sending him to college because he was not smart enough!

As his Bachelor of Science studies came close to an end, Mr. Eckel started thinking of what he wanted to do in phar-macy. He did not like the idea of work-ing nights and weekends. In the 1960’s, hospital pharmacy and medical representa-tives were the only other options available that did not require weekend work. How-ever, his path was changed by the guid-ance of one of his mentors at PCP, Herbert Flack. Mr. Flack suggested he try a new program at The Ohio State University and earn a Master of Science in Hospital Phar-macy. He joined the program thinking he would get his master’s degree and come back to work at Abington Hospital in his hometown of Abington, PA. However, the program inspired a major directional change. Students had to complete a thesis and Mr. Eckel’s thesis, “An Analysis of Pharmaceutical Services in Nursing Homes of Franklin County, Ohio,” would lead him to greater heights professionally. It was the first study that looked at the needs and opportunities for pharmacists to contribute to advancing care and drug therapy in nursing homes.

His thesis gave him the opportunity to make presentations around the country on pharmacists’ services in nursing homes. While in Ohio he completed a residency in hospital pharmacy, served as an instructor at the university, as a pharmacy consultant and as the assistant director of pharmacy.

His thesis also led him to North Caro-lina where he became the program director for a project on developing and improving pharmacy services in hospitals, nursing homes and assisted living facilities. The

project was funded by the Z. Smith Reyn-olds Foundation, Duke Endowment, and the Burroughs Wellcome Foundation. “I left Ohio thinking my wife and I would be in North Carolina for two years, but things opened up. There were many opportuni-ties so we stayed” he said. It’s been 46 years and he’s still counting.

In North Carolina, he contributed significantly to the initial development of hospital pharmacists and helped bring the clinical movement to the state. He also started his tenure at the University of North Carolina School of Pharmacy (now the UNC Eshelman School of Pharmacy). He implemented an undergraduate course in hospital pharmacy practice and taught a couple of graduate courses and a required course in orientation to student pharmacists. He was very active in the school and the North Carolina Society of Hospital Phar-macy. He developed the master’s program at UNC and also opened it to international students. “I made a personal commitment that the program would have at least one in-ternational student each year to help benefit a foreign country and help current students from America appreciate the diversity in the world.” His contacts with the Christian Pharmacist Fellowship International and this program allowed him to travel and speak on every continent (except for Ant-arctica) and every state in the union.

He came to NCAP in 2001 as presi-dent-elect of and shortly after, became the interim Executive Director. He was even-tually appointed to the Executive Director role. Again, he thought it would just be short-term but after resigning on April 1, 2012, eleven years had passed.

When commenting on what challenges the organization faced during his early years as executive director, he said, “One of the big questions then was ‘what should pharmacists do for patients and how should they be paid for doing it?’ The debate was whether professional services were a byproduct of dispensing services, or should pharmacies be paid separately

Reflections from a visionary

Fred Eckel Turns a Page in His Career


Eckel Honored at APhA Reception NCAP hosted a reception at this year’s American Pharmacists Association An-nual Meeting in New Orleans, LA on March 10th. Friends and colleagues from across the country gathered to meet NCAP’s new Executive Director, Christopher Gauthier, and celebrate the career of former Executive Director Fred Eckel who retired this year from the Association. UNC Dean Bob Blouin, Chris Gauthier and NCAP President Jennifer Buxton paid tribute to Fred for his many years of service to pharmacy.

for providing professional cognitive services? Helping pharmacists become providers was an important activity that many NCAP members wanted. Being an organization that was focused on the entire profession, (due to the merger of four state pharmacy associations that created NCAP) he had to balance between the various priorities important to different member-ship groups.”

Another major challenge he faced early on was to manage the association’s finances. His highest priority was to build a strong financial base to secure the future of the association. He sacrificed salary and organized the Building Remodeling Fund and with the help of the Pharmacy Network Foundation, $500,000 was raised and ownership of the building was trans-ferred to the NCAP Endowment.

According to Mr. Eckel, highlights of his career include being able to achieve and sustain contributions to the profes-sion by spending most of his career in one place, contributing to the early develop-ment of hospital pharmacists in the state, starting early continuing education pro-grams that helped transform the practice of pharmacy, and the expertise he brought into the classroom that helped prepare a number of current leaders in pharmacy.

The only thing he loves more than pharmacy is faith and family. “Keep your priorities in order; Faith, Family, Career,” he said. He is married to Mar-garet Ann Jolliff, his wife since 1963 and has two children, Sarah Ann Eckel Myatt and Stephen Frederick Eckel, as well as five grandchildren, James, Hannah, Josh, David, and Peter. Both children followed in their father’s footsteps and are licensed pharmacists in North Carolina, having graduated from UNC. He said “What re-ally makes a career worthwhile is the leg-acy you can leave, and seeing my children contributing to the profession that I love has helped make my life worthwhile.”

“I don’t know if I will ever really retire,” he said. He is currently working one day a week with Community Care of North Carolina (CCNC) on the Special Provisions project, creating opportunities for community pharmacists to work closer with physician practices. A pharmacy coalition is working to get legislative

funding for new positions in CCNC to implement these practices. He will also be teaching a couple of courses at UNC in the fall, is still editor-in-chief of Pharmacy Times and will be doing volunteer work with NCAP.

Those who influenced him and helped him grow professionally include profes-sors Bob Abrahm, Ken Avis and Dean Linwood Tice at PCP; Cliff Latiolais, his preceptor in his graduate program; and Warren Weaver. He credits Mr. Flack for getting him into hospital pharmacy.

“Healthcare delivery is a team effort. Pharmacists in all practice settings need to be integrated into that team. Too many pharmacists practice in isolation. My future dream is that they will be integrated into a virtual team and actively recognized as an essential ingredient in the healthcare process. Independent pharmacists need

to become interdependent pharmacists. I hope I live long enough to see that hap-pen,” he said.

“My future will be in heaven with my Lord. But in the meantime, I will continue what I’ve always been doing: mentoring people, advancing the profession, and educating young minds.”

Right before the conclusion of our interview, I asked him what advice he would give a new practitioner like me. He said “A successful life is one in which you give rather than take. Pharmacy can be good to you if you focus on meeting pa-tients’ needs rather than your own needs. Rewards follow practice. They should not dictate practice.”

Something tells me we have not heard the last of Fred Eckel as he continues to work in the field of his greatest passion, pharmacy. v

Ron Small of Wake Forest Baptist Health, UNC Eshelman School of Pharmacy Dean Bob Blouin and Fred Eckel.


NCAP’s Chronic Care Practice Forum meeting was held March 21-23 at the Ballantyne Hotel and Lodge in Charlotte, NC. Some attendees kicked the meeting off with a round of golf and everyone enjoyed quality CE programming and network-ing opportunties. Author and inspirational speaker Maggie Callanan delivered the keynote address. Callanan is a hospice nurse and world-renowned speaker on topics relating to the care of the dying, as well as coping strategies for hospice staff and volunteers. She delivered practical, no-nonsense answers to difficult questions using humor, wisdom, and compassion. Mark your calendars- the 2013 Chronic Care meeting is scheduled for March 20-22 at the Ballantyne.

ExhibitorsAbbott Laboratories, Inc.Avanir PharmaceuticalsBoehringer-IngelheimCardinal HealthDey Pharma - Mylan SpecialtyGeriMedGeriScriptRxHCCLilly USAMaggie Callanan, Book SigningMcKessonMedCall, LLCMHANCDONANovartis PharmaceutcialsNovo NordiskSmith Drug CompanySoutheastern Continuing Medical Education Consultants, LLC

Special “thanks” to our Meeting Sponsors and Exhibitors

Platinum SponsorsAbbott Laboratories, Inc.Avanir PharmaceuticalsCardinal HealthGeriMedNovo Nordisk

2012 Chronic Care Practice Forum Meeting

Charlotte Mathany (right) presented the Chronic Care Pharmacist of the Year award to Ted Hancock for his outstanding contributions to the profession.

Judy Turnage (left) presented the Dale Jones Memorial Award for Excellence in Geriatrics to Cheryl Kendrick.


Q&A withCheryl D. Kendrick, PharmD

Where and when did you receive your pharmacy degree? I received a BS Pharmacy degree from UNC Chapel Hill in 1982, and a PharmD from UNC Chapel Hill in 1998.

Where do you currently work?PharMerica and Wesley Long Greensboro Campus of Cone Health Hospital.

Describe the facility where you work.I am currently a floater long-term care consultant pharmacist and hold licenses in NC, SC, VA, AR, TN, GA, TX, FL and MS.

What type of significant projects have you been involved in recently?Reduction of use of sliding scale insulin in long-term care facilities, both through teaching modules and consulting on site. Providing electronic interim medication regimen reviews for short stay residents and significant change of condition to long-term care facilities.

What kind of advice would you provide to someone new to your specialty area?Develop a relationship with the medical team in your area and communicate. Be willing to assist the medical team with dosing decisions to improve patient out-comes.

Why did you become involved in NCAP?My father was a pharmacist and stressed the importance of becoming involved at the state level.

What is the value of NCAP for you?It enhances a broad spectrum of knowledge of current clinical, legislative, and practical information. It also fosters networking between peers and mentors in our profession.

What is the value of NCAP for the profes-sion?Education, legislative awareness, phar-macy advocacy and networking.

NCAP has partnered with the Connecticut Pharmacy Association to offer The Phar-macist Refresher Course, an online course designed for pharmacists who wish to return to community pharmacy practice after an absence from practice for three or more years. The course consists of three modules, all of which have been approved for ACPE

credits. The first two modules are online and composed of weekly study segments that allow course participants to work at their own pace, on their own time. The third module consists of a three-week, 90-hour live experience in a community pharmacy. Only those who participate in all three modules will earn a Pharmacist Re-fresher Course Certificate from Charter Oak State College. Those taking modules One and/or Two for personal enrich-ment will earn ACPE credits through CPA. This course will give home study law credit to any pharmacist wanting to learn about quality assurance strategies and North Carolina’s pharmacy laws.The QA/Law Course can be used to prepare for reciprocity into North Carolina, or for those who want an update on Pharmacy Law and Qual-ity Assurance. Students must follow a two-week course schedule. Online discussion boards and instructor monitoring and interaction keep you on track throughout the course. The course is offered the first two full weeks of every month. This course is accredited by ACPE for 15 hours of home study law education.

For more information visit www.ncpharmacists.org

Online Offerings:

Pharmacist Refresher

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Member Spotlight


New Practitioner Network

By Kimberly Nealy, PharmD, BCPS and Jason Chou, PharmD, MS

After working in pharmacy for the past twelve years in North Carolina, I have experienced retail, independent, acute and long-term care, and academia. One similarity between these diverse settings is the need for a variety of high quality and quickly accessible professional resources. Although employers invest in many references (both hard copy and electronic), often something is lacking. I can remember working as a technician and having pharmacists bring in personal copies of books each day to supplement company-provided resources.

With the popularity of smart phones and tablet PCs, the ability to expand and individualize your personal mobile library seems infinite. It may be difficult to determine which applications (apps) to download onto your mobile device either due to a lack of time or a limited understanding of the technology. Devices which are capable of downloading applications or software include iPhones, iPads, iPods, Android phones and tablets, Blackberrys, Palms, Pocket PCs and other personal digital assistants (PDAs). The table below provides some commonly used apps that may be useful in any pharmacy setting.

In addition to downloading specific applications, there are many ways to maximize the usage of your mobile device in the work-place. Consider searching for your favorite medical journal (e.g., New England Journal of Medicine, The Lancet, The British Medical Journal, etc.), professional pharmacy organization, or workplace tools (e.g., scientific calculator). You can also find hundreds of medical apps on www.skyscape.com at various costs.

One of the greatest benefits of mobile technology is the ability to access frequently updated information. Most devices will either automatically update your applications or provide you with a prompt to select updates. However, if your device requires you to manu-ally search for updates it is important to do so periodically. New apps are created on a daily basis so browsing through your app store or market every few weeks to months will help keep you informed on new additions.

Finally, often times you will discover invaluable tools while casually browsing or networking with other professionals. Consider visiting the North Carolina Association of Pharmacists Facebook page to share your favorite helpful mobile apps! v

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Mobile App Description Compatible Device(s)* Cost** Comments

Lexi-Comp DrugInformation iOS,Android,&Blackberry $$$ -Purchaseindividualoracombinationofproducts includingmonographs,interactionscreening,toxicity information,compatibilities,pillidentificationand manymore

Micromedex DrugInformation iOS,Android,&Blackberry Free- -Monographsbydrugordrugclass $$$ -Additionalfeaturesavailablewithyoursubscriptionto thefullonlineMicromedex($$$)

ePocrates DrugInformation iOS,Android,&Blackberry Free- -Monographs,interactionchecker,pillidentification, $$$ tablesandpocketguides

Up-To-Date MedicalInformation iOS(Androidcomingsoon) Free -Hostsarticlesonvariouspeerreviewedclinicaltopics w/Sub writtenbyfieldexperts -Freemobileappwithindividualsubscription($$$) -Freemobilewebbrowsingwithgroupsubscription

Medscape MedicalInformation iOS,Android,&Blackberry Free -Monographs(includingOTCandherbal),interaction screening,disease&procedureinformation andmedicalnews -AlsoaccessesMedline

Redi-Reader GuidelineReader iOS Free -DownloadclinicalguidelinesbytheADA,IDSA,CDC, ATSandmore

Sanfordguide InfectiousDiseases iOS&Android $$ -Infectiousdiseaseregimens,spectrumofactivity, calculatorsandmore

Pharmacist’sLetter PharmacyJournal iOS Free -Getmonthlyissues,patienthandouts,drug&dosage w/Sub charts,treatmentguidelinesandCEfree withyoursubscriptiontothePharmacist’sLetter($$$)

RxShortages Drugshortageinformation iOS&Android Free -IncludesASHPandFDAshortageinformation

GoogleTranslator Languagetranslation iOS&Android Free -Translatesbetweenmanylanguages

TripIt Travelplanning iOS,Android,&Blackberry Free -Organizestravelinformationsuchasflights,car rentals,hotelreservations,andmore

DragonDictation Voicetotexttranslation iOS Free -Quicklydictatesspokenwordintotext

*iOS(operatingsystemforiPad,iPod,oriPhone),Android(operatingsystemonmanysmartphones&tabletPCs)**$=$1-25,$$=$26-100,$$$>$100,Freew/Sub=freewithsubscription

New Practitioner Spotlight: Drew Kessell PharmD, MBA, MSDrew Kessell is a native of North Carolina and began his academic training at Davidson College. After complet-

ing the prerequisites for pharmacy school, he enrolled at Campbell University and graduated in 2007 with a Doctor of Pharmacy degree and a Master of Business Administration degree. Wishing to continue his didactic management and leadership training while expanding his clinical experiences, he completed a two-year residency program at Riv-erside Methodist Hospital in Columbus, Ohio. In conjunction with completion of his residency, Drew also completed a Master of Science in Health-Systems Pharmacy Administration from the Ohio State University.

Currently, he is the Clinical Director of Pharmacy at FirstHealth Moore Regional Hospital in Pinehurst, NC. In this capacity he has responsibility for oversight of the clinical pharmacy programs at Moore Regional. In addition, he

serves as a preceptor for IPPE and APPE students from several schools of pharmacy in North and South Carolina. His responsibilities grew to include Residency Program Director for Moore Regional’s new PGY-1 pharmacy residency program.

Drew is an active member of professional organizations at the local and state levels. He is President of the Moore County Pharma-cists Association, a member of the NCAP New Practitioner Network (NPN) and serves as and at-large member of the NPN Executive Committee. He believes with the ever-changing healthcare environment that the time for pharmacists to get involve, especially new practitioners, is now. “Involvement with NCAP and NPN provides numerous opportunities to advance the profession of pharmacy and increase the public’s perception of the powerful benefit pharmacists, in all practice settings, have on patient care,” he said. v


Safety Solutions

By Ashley Coats James

Pharmacy technicians have a unique opportunity in patient safety to identify opportunities to intervene in medication safety events, and collaborate with the pharmacist and other team mem-bers to effect change. This is an opportunity regardless of the technician’s practice site – community, acute or chronic care.The modern pharmacy technician

The modern pharmacy technician is recognized as a key member of the pharmacy team. As frontline personnel, pharmacy technicians are in a position to closely interact with patients, ac-cess documented patient information when required, and offer an additional line of defense in patient safety. Pharmacy technicians are capable of filling a gap in safety event detection, prevention, and reporting among specially trained health care workers. Even though the modern pharmacy technician is in a position to favor-ably impact the medication safety process, they are not actively engaged in the detection, prevention, and reporting of medication errors. Quality Assurance

Many initial reports of medication errors come from the individuals directly involved in the event or involved in the ac-tions leading up to an event. Pharmacy technicians commonly encounter breakdowns in the system that increase the possibility of making a mistake. • Poor handwriting of prescribing physicians• Improper and mistaken use of abbreviations• Environmental, physical, and emotional stressors• Inadequate training

The modern pharmacy technician has the skills and train-ing to identify situations that could improve patient safety. As an integral part of the pharmacy team, pharmacy technicians can approach situations in collaboration with a pharmacist to solve problems and pursue reporting through the appropriate systems. Addressing barriers to the participation of pharmacy technicians in the medication safety process will strengthen the ability of the pharmacy to deliver quality patient care. • Not being incorporated in quality planning• Inadequate pharmacist-technician communication/relationships• Lack of medication safety education and trainingA new approach

Pharmacy technicians can make important contributions to medication error prevention, detection, and reporting by (1) being prepared to identify potentially unsafe conditions or processes and (2) being trained and authorized to report these conditions to the pharmacy’s Quality Assurance program.

A strong culture of safety encourages the pharmacy techni-cian (and others!) to be proactive about bringing ideas to the attention of the team about potential system breakdowns, but also system processes that seem to be working well. For example, reporting “near miss” incidents can identify important workflow steps that prevent the error from reaching the patient or from causing harm.

Implementation of new action plans can lead to systemic improvements in patient care and safety throughout pharmacy practice.

The new safety roles can be summarized as:Pharmacist: • engage technicians in reporting errors and developing corrective actions• encourage conversation about the quality of the pharmacy sys-tem, the work environment, and the culture of safety• use safety huddles as an opportunity to discuss safety events with co-workersManager: • promote the confidential reporting system• provide medication safety training• provide patient communication training • expect technicians to attend and participate in safety meetings• enhance pharmacist-technician relationships with team building exercisesTechnician: • identify continuing education programs or safety training to increase safety awareness• understand the pharmacy’s quality assurance program• offer suggestions to improve problematic systems• use effective communication with patients about medication safety

Pharmacy technicians play an integral role in support-ing pharmacy practitioners in a variety of settings. Through the development of advanced knowledge and skills in medication safety training, the pharmacy technician can contribute to quality improvements in patient care. The value of an expanded phar-macy technician role and their impact on enhancing patient safety should not be overlooked. v

About the Author…Ashely Coats James is a PharmD Candidate, 2012, at UNC Eshelman School of Pharmacy. She authored this story while completing a Medica-tion Safety Rotation at SecondStory Health in Carrboro, NC.

Pharmacy Technicians: Identifying and Reporting Medication Errors


By Jennifer L. Clark, PharmD Candidate, Class of 2013, Campbell University College of Pharmacy and Health Sciences

In its fourth year, the National Asso-ciation of Chain Drug Stores (NACDS) hosted approximately 300 pharmacists, pharmacy students, and pharmacy ex-ecutives to RxImpact Pharmacy Day on Capitol Hill. The two-day event kicked off on March 21 with RxImpact U Acad-emy, where students learned about current pharmacy issues and etiquette to prepare them for meetings with their legislators the following day. The main issues they discussed with their legislators were the Medication Therapy Management Benefits Act (HR 891) or the Medication Therapy Management Empowerment Act (S 274), and the Pharmacy Competition and Con-sumer Choice Act of 2011 (HR 1971/S 1058). HR 891 and S 274 open MTM services to Medicare Part D beneficiaries who have one chronic disease state. In addition, both the House and Senate MTM bills allow the patients the opportunity to choose where they obtain their MTM services. These bills provide a payment structure to pharmacies which are in-corporated in performance measures for Medicare Part D plans based on time and resources used, and appropriate medica-tion use. HR 1971 and S1058 protect neighborhood pharmacies and lower costs for patients. These bills help in providing transparency into the Pharmacy Benefit Manager’s (PBM) activities by requiring PBM’s to conduct fair and unobtrusive audits of pharmacies.

After the participants were well versed on the pharmacy topics of the day, teams from all over the US met with legislators from their respective regions on March 22. Of the two North Carolina teams, North Carolina Team 02 was comprised of students from all three pharmacy schools with Jennifer Clark (team leader) repre-senting Campbell University; Shawn Grif-fin, Kimberly Niver and Michel Simon representing the University of North Caro-lina; and Jana Sigmon and Mark “Charlie” Yates representing Wingate University. This all-student team had the amazing opportunity to meet with Congressman Larry Kissell (NC 08), Congressman Mike McIntyre (NC 07), Congresswoman Renee

NC student representatives (l to r): Mark “Charlie” Yates (Wingate), Jana Sigmon (Wingate),Kimberly Niver (UNC), Shawn Griffin (UNC), Jennifer Clark (Campbell), Michel Simon (UNC).

Ellmers (NC 02), Congressman David Price (NC 04), and Senator Richard Burr.

Team leader Jennifer Clark said “Being selected as team leader was an unbeliev-ably rewarding experience. It was great having all three NC pharmacy schools come together for a common cause. I felt that we were very successful working together as a team to deliver our message of support for vital pharmacy legislature. Having the opportunity to participate in

RxImpact has allowed me to be on the forefront of the advancement of pharmacy. Pharmacists are constantly plagued with the public’s misconception that all we do is fill bottles with pills. This was a great opportunity to inform legislators that we hold doctoral degrees and we are commu-nity health care providers. This was also a great way for us to realize that if we don’t push for the advancement of pharmacy

then no one will.” v

NC Makes RxImpact


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Award Nominations SoughtNew Rx Champions Award Added

It is a privilege for the North Carolina Association of Pharma-cists to recognize excellence within the profession. NCAP will present the following awards at the Convention, October 28-30 in Raleigh, NC The Board of Directors invites NCAP members to nominate deserving members for these awards. Nomina-tions must be in writing (visit the NCAP website or call NCAP). Submit nominations to the NCAP Awards Committee, c/o Linda Goswick, 109 Church Street, Chapel Hill, NC 27516, fax 919-968-9430 or e-mail [email protected]. New in 2012: Cardinal Health Foundation Rx Champions AwardThis award recognizes a pharmacist for his/her work within the pharmacy community to raise awareness of the serious public health problem of prescription drug abuse. Bowl of Hygeia Award Criteria for this award are: (1) Licensed to practice pharmacy in NC; (2) Has not previously received the Award; (3) Is not cur-rently serving nor has served within the immediate past two years on the awards committee or as an officer of the Association in other than an ex officio capacity; (4) Has compiled an outstand-ing record of community service, which, apart from his/her spe-cific identification as a pharmacist, reflects well on the profession. Don Blanton Award Presented to the pharmacist who has contributed most to the advancement of pharmacy in North Carolina during the past year. This award was established by Charles Blanton in memory of his father, Don Blanton, who served the North Carolina Pharmaceuti-

cal Association as President 1957-58. Excellence in Innovation AwardPresented to a pharmacist practicing in North Carolina who has demonstrated Innovative Pharmacy Practice resulting in im-proved patient care. Distinguished Young Pharmacist AwardCriteria for this award are: (1) Entry degree in pharmacy received less than 10 years ago (2002 or later graduation date); (2) Licensed to practice pharmacy in NC; (3) Actively practices retail, institutional, managed care or consulting pharmacy; (4) Participates in national pharmacy associations, professional programs, state association activities and/or community service. Please send nominations for this award to Kira Brice Harris, Chair of the New Practitioner Network [email protected].


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June 16, 2012: Technician Review Seminar, Raleigh

June 17, 2012: Technician Review Seminar, Greensboro

July 20, 2012: Residency Conference, Washington Duke Inn, Durham, NC

July 28, 2012: Technician Review Seminar, Asheville

July 29, 2012: Technician Review Seminar, Charlotte

August 3-5, 2012: Community Care Practice Forum Meeting, Myrtle Beach, SC

October 28-30, 2012: NCAP Annual Convention, Raleigh Convention Center, Raleigh, NC

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1987—Twenty-five years ago:• Petition requesting recognition of Nutrition Support Pharmacy Practice as a specialty was submitted to the Board of Pharmaceu-tical Specialties.1962—Fifty years ago:• New England College of Pharmacy affiliated with Northeastern University• The Indian Hospital at Crow Agency, Montana began filing outpatient prescriptions directly from the patient’s medical re-cord. This was eventually adopted throughout the Indian Health Service. 1937—Seventy-five years ago:• National Cancer Institute was established to conduct and sup-port research relating to the cause, diagnosis, and treatment of cancer.1912—One hundred years ago:• Public Health and Marine Hospital Service was renamed the Public Health Service (PHS) and the mission was expanded to include communicable diseases field investigations, navigable stream pollution, and information dissemination.• APhA House of Delegates was established as a forum for all branches of the profession to have a voice.One of a series contributed by the American Institute of the History of Pharmacy, a unique non-profit society dedicated to assuring that the contributions of your profession endure as a part of America’s history. Membership offers the satisfaction of helping continue this work on be-half of pharmacy, and brings five or more historical publications to your door each year. To learn more, check out: www.aihp.org

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North Carolina Pharmacist Spring 2012

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