Pharmacy Track

To view PPTicon-web  PowerPoint presentations click here.

To learn more about individual breakout sessions click on the title name (updated 3-25-16):

Tuesday, March 29, 2016
Drug Enforcement Administration Regulations Update
Technologies to Reduce Diversion, Fraud and Abuse: Electronic Prescribing and Drug Deactivation
Drugs to Watch: Tramadol, Hydrocodone and Naloxone
 
Wednesday, March 30, 2016
To Fill or Not to Fill, That Is the Question
Looking Beyond Red Flags
Pharmacy Burglary, Robbery and Diversion

Overview
The number of opioid prescriptions dispensed annually by retail pharmacies grew by 48 percent from 2000 to 2009, when the total reached 257 million, according to the Office of National Drug Control Policy (ONDCP). Pharmacy professionals can play a pivotal role in combating Rx drug abuse — including educating patients about proper usage and storage of their medications, identifying potential misuse and diversion of controlled substances, and collaborating with physicians in spotting and resolving concerns. As pharmacists rise to meet those opportunities, they also must respond to liability concerns due to heightened scrutiny from law enforcement agencies and security threats due to greater criminal activity. The Pharmacy Track will explore the responsibilities and challenges of pharmacy professionals and identify the industry’s best practices in responding to these challenges. Topics will include corresponding responsibility, diversion prevention, electronic prescribing systems, drug deactivation, pharmacy-based naloxone, and pharmacy burglaries and robberies, as well as an update on federal regulations.
Drug Enforcement Administration Regulations Update
Tuesday, March 29, 2016 | 4:15 pm to 5:30 pm
CE certified ACPE | GA POST | GA Bar
Presenter Demetra Ashley
Associate Deputy Assistant Administrator, United States Drug Enforcement Administration
Moderator Chad C. Corum, PharmD
Co-Owner and Pharmacist, Corum Family Pharmacy, and Member, Operation UNITE Board of Directors
Session Description Painkiller prescriptions in 2012 totaled 259 million — enough for every American adult to have a bottle of pills, according to the Centers for Disease Control and Prevention (CDC). While the responsibility for the proper prescribing is upon the prescriber, an additional responsibility rests with the pharmacist who dispenses the Rx. A pharmacist is required to exercise sound professional judgment when making a determination about the legitimacy of a controlled substance Rx, which is not always easy. In this session, the presenter will examine methods for the pharmacist to use in determining whether any given Rx is valid or invalid. Discussions of what to do in the gray areas, what liabilities exist for filling an invalid Rx, and what penalties await violators of the law will also be included.
Learning Objectives 1. Define the legal standard for dispensing medications pursuant to a valid Rx.
2. Identify regulations that establish practitioners’ legal requirements under 21 USC.
3. List the factors the pharmacist should consider prior to dispensing.
4. Provide accurate and appropriate counsel as part of the treatment team.
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Technologies to Reduce Diversion, Fraud and Abuse: Electronic Prescribing and Drug Deactivation
Tuesday, March 29, 2016 | 5:45 pm to 7:00 pm
CE certified AMA | ANCC | ACPE | ADA | AAFP
Presenters Sean P. Kelly, MD
Emergency Physician, Beth Israel Deaconess Medical Center
 
Arthur F. Ream III
Chief Information Security Officer and Director of Information Technology Applications, Cambridge Health Alliance
 
Hooshang Shanehsaz, RPh
Director of Pharmacy, Cardinal Health, and Vice President, Delaware Board of Pharmacy
Moderator Jinhee J. Lee, PharmD
Public Health Advisor, Division of Pharmocologic Therapies, Substance Abuse and Mental Health Services Administration, and Member, Rx & Heroin Summit National Advisory Board
Session Description Technology is evolving to aid pharmacists in their fight against the Rx drug abuse epidemic. To reduce drug diversion, fraud and “doctor shopping,” e-prescribing of controlled substances (EPCS) creates a secure, electronic transmission from the prescriber to the pharmacy. As result, paper prescriptions and physicians’ U.S. Drug Enforcement Administration (DEA) numbers are never in patients’ hands, prescriber patterns are more transparent, and wait times are shorter for all patients. Presenters will explain how EPCS reduces drug diversion and fraud, outline DEA requirements for EPCS, and describe how Cambridge Health Alliance successfully implemented EPCS to improve patient safety and satisfaction.

To limit opportunities for diversion, the Office of National Drug Control Policy has emphasized proper medication disposal. The state of Delaware, in conjunction with the Prescription Drug Action Committee and the Delaware Pharmacist Society, completed a pilot program with an at-home drug deactivation system. The goal was to educate patients to deactivate and dispose of unneeded medications. At six pharmacies across the state, patients were given the at-home deactivation product with an opioid Rx and asked to complete an online survey. The presenter will discuss program results and patient responses.

Learning Objectives 1. Explain how electronic prescribing of controlled substances reduces drug diversion and fraud and improves patient satisfaction.
2. Outline DEA requirements for electronic prescribing of controlled substances.
3. Describe the results of Delaware’s pilot program with the Deterra Drug Deactivation System.
4. Provide accurate and appropriate counsel as part of the treatment team.
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Drugs to Watch: Tramadol, Hydrocodone and Naloxone
Tuesday, March 29, 2016 | 7:15 pm to 8:30 pm
CE certified AMA | ANCC | ACPE | AAFP
Presenters Traci Green, PhD, MSC
Deputy Director, Boston Medical Center Injury Prevention Center
 
Roneet Lev, MD
Director of Operations, Scripps Mercy Hospital Emergency Department, and Chair, San Diego County (CA) Rx Drug Abuse Medical Task Force
 
Nathan Painter, PharmD
Associate Clinical Professor, University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Science
Moderator Anne L. Burns, RPh
Vice President, Professional Affairs, American Pharmacists Association, and Member, Rx & Heroin Summit National Advisory Board
Session Description In 2014, the U.S. Food and Drug Administration (FDA) changed tramadol from a Schedule V to Schedule IV controlled substance and hydrocodone from Schedule III to Schedule II. The status of naloxone is changing also, with 24 state laws granting prescribers immunity from criminal prosecution for prescribing, dispensing or distributing naloxone to a layperson as of July 2015, according to LawAtlas. This session will consider the implications of these developments.

Since the FDA changed the schedules of tramadol and hydrocodone, has the number of prescriptions or deaths related to these medications changed? Two presenters — a doctor of medicine and doctor of pharmacy — will answer for California by using prescription drug monitoring program (PDMP) data to compare prescribing patterns before and after the schedule change. They also will explain that tramadol is dangerously misunderstood by both patients and physicians when it is assumed to be non-opioid (false), non-addicting (false), less potent (false) and safer (the jury is out).

What do pharmacists think about integrating naloxone and other overdose prevention strategies into their practices? A researcher will answer based on one state’s experience and the results of a nationally representative survey of pharmacists’ perspectives regarding pharmacy-based naloxone and related safe opioid use interventions for pharmacies. She first will explain why Rhode Island initiated pharmacy-based naloxone in 2013 and review the results, and she then will present findings and implications of the nationally representative survey conducted in partnership with the American Pharmacists Association from September to October 2015.

Learning Objectives 1. Analyze the impact of tramadol and hydrocodone schedule changes on the number of prescriptions and deaths related to these medications in California.
2. Describe reasons physicians and patients need a better education about tramadol and its potential dangers.
3. Evaluate pharmacists’ perspectives on pharmacy-based naloxone based on a nationally representative survey.
4. Provide accurate and appropriate counsel as part of the treatment team.
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To Fill or Not to Fill, That Is the Question
Wednesday, March 30, 2016 | 11:15 am to 12:30 pm
CE certified ACPE
Presenters Edward McGinley, MBA, RPh, DPh
President, National Association of Boards of Pharmacy
 
Mike Menkhaus, RPh
EPRN Project Manager, Kroger
 
Karen M. Ryle, RPh, MS
Associate Chief of Pharmacy for Ambulatory Care, Massachusetts General Hospital
Moderator Chad C. Corum, PharmD
Co-Owner and Pharmacist, Corum Family Pharmacy, and Member, Operation UNITE Board of Directors
Session Description In the nation’s war against Rx drug abuse, pharmacists are considered the last line of defense before a medication is released to a patient who may have intent to abuse, misuse or divert. This session will equip pharmacists to make informed decisions when considering whether to fill or not to fill a Rx for a controlled substance.

The first presenter will outline a variety of decision-making tools for pharmacists. Attendees will be able to identify red flags, distinguish between prescriptions being issued for a legitimate medical purpose from those that are not, and calculate the Morphine Milligram Equivalent (MME) from various dosages of other opioid narcotics. Case studies will illustrate interactions when the U.S. Drug Enforcement Administration (DEA) has held pharmacists accountable for not meeting their corresponding responsibilities. The presentation also will cover the importance of dispensing nasal naloxone and advising patients about medication disposal.

The next presentation will discuss the importance of prescription drug monitoring programs (PDMPs) to pharmacists, warning signs of drug abuse or diversion, and the personal commitment of pharmacists to make a difference in combatting the Rx drug abuse epidemic. The presenters will explain how Ohio PDMP and Kroger leveraged a SAMHSA grant to integrate PDMP data into the workflow of a pharmacy system with great success — increasing Kroger pharmacists’ requests for patient reports from less than 10 percent of controlled substance prescriptions to nearly 100 percent. The efficiencies and other benefits of in-workflow access will be compared to traditional website access to data, as well as utilization rates and better healthcare outcomes for patients.

Learning Objectives 1. Identify warning signs that a Rx will be abused or diverted.
2. Explain a project that integrates PDMP data into the workflow of a pharmacy system.
3. Compare in-workflow access to PDMP data with traditional website access to PDMP data.
4. Provide accurate and appropriate counsel as part of the treatment team.
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Looking Beyond Red Flags
Wednesday, March 30, 2016 | 2:00 pm to 3:15 pm
CE certified ACPE
Presenters Marc Fleming, PhD, MPH, RPh
Assistant Professor, Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy
 
Nicholas Hagemeier, PharmD, PhD
Assistant Professor of Pharmacy Practice, East Tennessee State University Gatton College of Pharmacy
 
Kimberly Vernachio, PharmD
President, Vernachio Managed Care Consulting
Moderator J. Kevin Massey, MS
Business and Program Development Specialist, Weitzman Institute, Community Health Center, Inc., and Member, Rx & Heroin Summit National Advisory Board
Session Description Pharmacists who check PDMP data may find themselves asking, “Now what?” This session will consider how to evaluate Rx legitimacy and go beyond merely refusing to dispense to playing a key role in mitigating opioid addiction — generating better outcomes and saving lives.

The first presentation will look beyond red flags to inform Rx legitimacy judgments and subsequent prescribing and dispensing decisions. The presenter will describe the outcomes of two research projects that examined prescribers’ and pharmacists’ perceptions of Rx legitimacy and Rx drug abuse communication behaviors. Attendees will gain insight into the process of evaluating Rx legitimacy and learn how subjectivity inherent in these judgments influences prescribing and dispensing behaviors and patient care. The presenter also will identify evidence­based, practice-friendly interventions to engage community pharmacists in community-based prevention of Rx drug abuse and its consequences.

The second presentation will examine the gaps, challenges and opportunities to empower pharmacists and improve outcomes in relation to drug coverage of opioids and benzodiazepines. The presenters advocate for early identification, supportive benefit structures and intervention training. Topics will include defining steps to take when PDMP data indicates a problem; identifying excessive narcotic use and intervention opportunities; fraud, waste and abuse issues associated with benzodiazepines; and the decision to cover benzodiazepines given the Medicare Part D benefit structure.

Learning Objectives 1. Identify prescribers’ and pharmacists’ perceptions of Rx legitimacy and Rx drug abuse communication behaviors.
2. Express the gaps and challenges related to drug coverage of opioids and benzodiazepines.
3. Explain the benefit of early identification, supportive benefit structures and intervention training to empowering community pharmacists to mitigate opioid addiction.
4. Provide accurate and appropriate counsel as part of the treatment team.
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Pharmacy Burglary, Robbery and Diversion
Wednesday, March 30, 2016 | 3:30 pm to 4:45 pm
CE certified ACPE | GA POST
Presenters Cheri Atwood
Director of Compliance, Mississippi Board of Pharmacy
 
John Harless
Lieutenant, Mississippi Bureau of Narcotics
 
Tara O’Connor Shelley, PhD
Associate Professor, Center for the Study of Crime and Justice, Colorado State University
Moderator Chad C. Corum, PharmD
Co-Owner and Pharmacist, Corum Family Pharmacy, and Member, Operation UNITE Board of Directors
Session Description The illicit value of Rx drugs creates a powerful incentive for pharmaceutical diversion, particularly in the form of robbery and burglary of retail pharmacies. This session will explore these problems and identify solutions.

The first presenter will examine the offender’s perspective on pharmacy robbery and burglary. Using interview data collected from a sample of offenders convicted of these crimes, she will share insights into their motivations and methods. She will identify preventative measures to enhance the security of pharmacies, as well as the safety of customers and staff. The presentation also will cover pathways to addiction and the illicit market for Rx drugs.

Next, representatives of the Mississippi Board of Pharmacy and the Mississippi Bureau of Narcotics — which have joined forces to educate pharmacists and the public in Mississippi about trends in Rx drug diversion to the black market — will present strategies to reduce pharmacy burglaries and robberies. The unique presentation will meld statutory and regulatory policy into a coherent plan to reduce diversion. Their approach may serve as a model for law enforcement, regulatory inspectors and pharmacies across the nation.

Learning Objectives 1. Explain the trends in diverting pharmaceuticals, particularly in the form of pharmacy robbery and burglary.
2. Identify preventative measures to enhance security of pharmacies and the safety of their staff and customers.
3. Outline strategies to reduce pharmacy burglaries and robberies.
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The content and scheduled time of these breakout sessions are subject to change.