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  What’s The Word? Defining Community Pharmacy Interventions

  Elizabeth Laughlin, BSPS; Danielle C. Mayer, PharmD, BCACP; and Sarah Lynch, PharmD, BCACP

  Primary Objective: Determine whether student pharmacists & licensed pharmacists are consistently able to categorize interventions

  Secondary Objective: Evaluate trends in themes for situations that are not easily categorized

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  The Incidence and Severity of Drug Interactions Before and After Switching Antiretroviral Therapy to Bictegravir/Emtricitabine/Tenofovir alafenamide in Treatment Experienced Patients

  Ciara Walshe, PharmD Candidate and Jason J. Schafer, PharmD, MPH, BCPS-AQ ID, BCIDP, AAHIVP

  Objective

  • The primary outcome was to measure the proportion of patients experiencing DIs before and after the ART switch.
  • The secondary outcome was to measure changes in DI scores before and after the ART switch.

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  Clinical Interventions Documented by APPE Students: Results from a Pilot Study

  Elizabeth Laughlin, BSPS; Danielle Mayer, PharmD, BCACP; and Sarah Lynch, PharmD, BCACP

  Primary Objective: Evaluate the types of drug therapy problems identified by student pharmacists and the results of these interventions.

  Secondary Objective: Evaluate trends in trends of what type of interventions are identified and how they are defined.

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  Connecting Health Plan Care Managers with a Network of Enhanced Services Community Pharmacies: A Pennsylvania Case Study

  Nicholas Leon, PharmD; Stephanie McGrath, PharmD; Kim Coley, PharmD; David Pope, PharmD; Elizabeth Grassmyer; Melissa A. McGivney, PharmD; and Patricia Epple

  PPCN pharmacies have been able to successfully collaborate, bi-directionally, with health plan care managers to improve patient health and enable appropriate utilization of healthcare resources

  To build off of our early success, additional systems and tracking capabilities are being explored related to the following:

  • Bi-directional tracking of referrals
  • Care managers to pharmacists
  • Pharmacists to care managers
  • Delivery drivers as community health workers
  • Drug class specific interventions (ex. a focus on opioids)
  • Disease state specific interventions (ex. a focus on asthma or type 2 diabetes)
  • Formal interventions focused on dialing patients back into the services/resources offered by health plans

  PPCN is actively discussing collaborations with multiple health plans, public health entities, and healthcare consultant companies

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  A Community Pharmacy Elective Course Utilizing a Service Development Project to Foster Innovation and Creative Thinking

  Danielle Mayer, PharmD, BCACP

  Course Description

  Innovations in Community Pharmacy Practice is a 2-credit hour course offered to pharmacy students in the spring of the third professional year.

  Teaching methods

  • Group discussions
  • Case study activity
  • Self-reflection
  • Group project

  The focus of this course is the evolving role of the community pharmacist in delivering direct patient care services. Students learn the basics of creating a business plan and utilize these principles to create their own business plan for a new or enhanced service that could be implemented at a community pharmacy site. This is a hands-on, project- based course, designed to foster innovation, entrepreneurship, and critical-thinking in the context of community pharmacy practice.

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  A Real World Assessment of the Efficacy and Safety of Switching from TDF to TAF in Treatment Experienced Patients with HIV Infection

  Jaclyn O'Connor, PharmD Candidate; Kaitlin N. Sassa, PharmD; and Jason J. Schafer, PharmD, MPH, BCPS AQ-ID, BCIDP, AAHIVP

  Objective

  • The primary objective of this study was to determine if patients maintain viral suppression after switching from TDF to TAF
  • The secondary objective was to assess changes in renal function and serum cholesterol levels

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  Patients living with HIV infection are less likely to receive the correct statin intensity for cardiovascular disease risk reduction

  Jason J. Schafer, PharmD, MPH; Roshni Emmons, PharmD, BCPS; Nick V. Hastain, PharmD; and Todd Miano, PharmD, PhD

  • Patients living with HIV (PLWH) are at high risk for atherosclerotic cardiovascular disease (ASCVD)
  • Eligible PLWH should receive statins for ASCVD risk reduction according to current guidelines
  • Studies suggest that statins are underprescribed in PLWH, but comparisons to uninfected patients and assessments of statin intensity have not occurred

  Objective

  To determine the influence of HIV infection on appropriate statin prescribing for ASCVD risk reduction

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  Relationships among Patient Diabetes Self-Care Behaviors, Depression and Self-Reported Medication Adherence in African Americans with Diabetes

  Shu Xiao, PhD, PharmD Candidate; Monica Woloshin, BS, PharmD Candidate; Robin Casten, PhD; Barry Rovner, MD; and Ginah Nightingale, PharmD, BCOP

  Objectives

  To determine the extent to which self-care behaviors and self-reported medication adherence are related to depression in older African Americans with diabetes who presented to the ED.

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  Exploring the Prevalence and Characteristics Associated with Weight Gain and Metabolic Changes in PLWH who are Virologically Suppressed on Antiretroviral Therapy and Switch to Integrase Inhibitor Containing Regimens

  Matty Zimmerman; Joseph DeSimone Jr., MD; and Jason J. Schafer, PharmD, MPH, BCPS-AQ ID, BCIDP, AAHIVP

  Objectives

  • To determine the prevalence, extent and characteristics of weight gain among virologically suppressed PLWH whose ART has been switched to an INSTI-containing regimen
  • To examine the presence of metabolic changes in PLWH who have been switched to INSTI-containing ART

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  Weight Gain in Patients with HIV Infection who are Virologically Suppressed on Antiretroviral Therapy and Switch to Integrase Inhibitor Containing Regimens

  Matty Zimmerman and Jason Schafer, PharmD, MPH, BCPS, BCIDP, AAHIVP

  Objective

  To determine the prevalence and extent of weight gain among virologically suppressed PLWH whose antiretroviral therapy (ART) has been switched to an integrase inhibitor (INSTI) containing regimen.

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  Impact of an Academic Pharmacy Elective on Student Interest in a Career in Academia

  Gina Bellottie, PHarmD, BCACP; Lindsay Fitzpatrick, BS, PharmD; and Elena Umland, PharmD

  Objective

  To determine the impact of an academic pharmacy elective on student interest in pursuing academic careers.

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  A Novel Diabetes Elective Course for Pharmacy Students

  Amy M. Egras, PharmD, BCPS, BC-ADM

  Course Description & Objectives

  The Diabetes Immersion elective is a 2-credit hour course offered to pharmacy students in their 3rd year of pharmacy school.

  1. Demonstrate empathy regarding the impact of diabetes on everyday life.
  2. Demonstrate the ability to monitor blood glucose, count carbohydrates, inject “insulin”, and adjust insulin dose based on daily experiences.
  3. Discuss the impact of mental health and sociobehavioral/cultural aspects on diabetes.
  4. Develop and provide diabetes education to the community.

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  Are patients living with HIV infection at risk for not receiving statin medications for cardiovascular disease risk reduction?

  Nick Hastain, PharmD Candidate; Roshni S. Patel, PharmD, BCPS; and Jason J. Schafer, PharmD, MPH, BCPS, AAHIVP

  Objective

  To determine the prevalence of appropriate statin prescribing for ASCVD risk reduction in PLWH

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  The Next Generation: A Novel Diabetes Elective Course for Pharmacy Students

  Catherine Hedigan; Mirna Rezkalla; Matthew Ta; and Amy M. Egras, PharmD, BCPS, BC-ADM

  Background

  • 30.3 million people or nearly 10% of the United States are diagnosed with diabetes
  • Patients with uncontrolled diabetes often have many clinicians, including pharmacists, to help control their diabetes
  • Clinicians that can empathize with patients have shown to improve patient satisfaction and outcomes2
  • The Diabetes Immersion elective at Thomas Jefferson University College of Pharmacy is offered to third-year pharmacy students to provide additional knowledge about diabetes through hands-on learning and guest lecturers
  • The class emphasizes a well-rounded understanding of diabetes touching on topics that may not otherwise be covered in required courses due to time constraints

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  Hotspotting Without A Patient

  Mirna Rezkalla, BS, PharmD Candidate; Nicole Lenegan, BSN, RN; and Elena Umland, PharmD

  Introduction

  • Interprofessional (IP) teamwork is the foundation for successful patient care outcomes. Numerous issues can arise from poor teamwork stemming from the lack of acknowledgment and appreciation of the roles of each healthcare provider.
  • Throughout our training in school, students often become focused on their own profession and develop biases or perceptions of the other members of other healthcare disciplines.
  • The Hotspotting program provides students the opportunity to eliminate biases and clarify perceptions.

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  The incidence and severity of drug interactions before and after antiretroviral therapy simplification in treatment experienced patients with HIV Infection

  Aleena Santana, PharmD Candidate; Nick Hastain, PharmD Candidate; and Jason J. Schafer, PharmD, MPH, BCPS, AAHIVP

  Purpose

  • The primary objective of this study was to assess changes in the incidence and severity of drug interactions before and after ART simplification in treatment experienced patients.
  • Describe ART medication class changes and analyze predictors for achieving drug interaction score reductions.

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  Improving Medication use for Project HOME Residents in an Urban Setting

  Toni Campanella, PharmD Candidate; Ashley Maister, PharmD Candidate; and Roshni S. Patel, PharmD, BCPS

  Partners:

  Project HOME is a non-profit organization in Philadelphia that provides housing, employment opportunities, medical care, and education to those who are homeless or at risk of becoming homeless, including those with a history of serious mental health or substance misuse disorders.

  Jefferson College of Pharmacy students are dedicated to transforming the health and well-being of the community. By engaging in innovative opportunities, students are well-positioned to deliver patient-centered care.

  APhA-ASP serves as the collective voice of student pharmacists to provide opportunities for professional growth, to improve patient care, and to envision and advance the future of pharmacy.

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  The Bug-Bag: Consolidating Medications to Cut Costs

  James Harrigan, PharmD, MS3; Erin Bange, MD; Jessica Caro, MD; Sarah Yeager, PharmD; and David Manoff, MD

  Background

  Founded in 1991, JeffHOPE is an organization of student run medical clinics providing care to the homeless and underserved populations of Philadelphia. JeffHOPE currently operates at 5 different sites

  • Eliza Shirley

  Population served: Women and children

  Serves as a transitional shelter and aims to help newly homeless women and children find more stable housing

  • Sunday Breakfast

  Population served: Men older than 18

  Serves as a transitional shelter offering housing for 30 days for homeless men

  • ACTS

  Population served: Women and children

  Provides long term housing for women and children who are homeless. The shelter is also located next to a recovery house for drugs and alcohol whose participants are also seen in clinic.

  • Our Brothers’ Place

  Population served: Men older than 18

  Serves as a long term men’s homeless shelter. Most residents stay in the shelter for 60-90 days before finding more permanent housing.

  • Prevention Point

  Population served: Men, women, and children

  Mobile clinic conducted along with a needle exchange program using a harm reduction model of care.

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  Employing Pharmacy Students to Improve the Medication Use Process for Underserved Patients with a History of Mental Health or Substance Use Disorders

  Ashley Maister, PharmD Candidate; Toni Campanella, PharmD Candidate; and Roshni S. Patel, PharmD, BCPS

  Project HOME is a non-profit organization in Philadelphia that provides housing, employment opportunities, medical care, and education for chronically homeless individuals with serious mental health conditions.

  One nurse oversees the medication use process at three of Project HOME’s residences; however, non-clinical staff are responsible for carrying out the medication use process.

  The purpose of this project was to identify how the Jefferson College of Pharmacy’s APhA-ASP chapter could assist Project HOME with their medication-related needs and improve the medication use process.

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  The Effect of Undergraduate Exposure and Experience on Choosing to Pursue a Pharmacy Degree

  Erica M. McGovern, MS; Andrew Stacy, BS; Elena Schmidt, PhD, MA; and Elena Umland, PharmD

  BACKGROUND

  • Shortage of pharmacists identified by Department of Health and Human Services in 20001
  • Despite investment of significant recruitment resources to achieve optimum enrollment, fewer applications are being submitted for consideration to pharmacy school, and the number of students pursuing pharmacy school continues to decline2
  • American Association of Colleges of Pharmacy (AACP) Recruitment Admissions Task Force speculates that qualified candidates may be pursuing other healthcare professions due to lack of awareness of and limited exposure to the expanding role of the pharmacist2
  • Limited studies have been conducted to evaluate the primary factors motivating students to pursue a career in pharmacy

  Poster presented at: AACP Annual Meeting at Nashville, Tennessee, United States.

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  Methemoglobinemia in Acetaminophen Overdose and Glucose-6-phosphate Dehydrogenase Deficiency

  Maelen Ignacio, PharmD; Colin Craft, MD; Fern M. Martin, MD; and Cara McDaniel, PharmD, BCPS

  Background:

  • Methemoglobin (MetHb) is formed when the iron moiety of hemoglobin (Hgb) is oxidized from ferrous (Fe²⁺) to ferric (Fe³⁺) state à impaired O₂ delivery to tissues
  • Acetaminophen Metabolism:

  ~90% is metabolized in liver via sulfation and glucuronidation

  remainder is metabolized via CYP450 to a toxic oxidizing agent, N-acetyl-p-benzoquinone imine (NAPQI), which is detoxified via glutathione¹

  • Acute Acetaminophen Overdose:

  saturates sulfation and glucuronidation pathways

  depletes glutathione stores

  leads to excess NAPQI à oxidative stress à methemoglobinemia¹

  • MetHb Reduction Pathway:

  cytochrome b5 reductase removes 95% to 99% of endogenous MetHb

  nicotinamide adenine dinucleotide phosphate (NADPH

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  Daptomycin Non-Susceptible MRSA Bacteremia: A Case Report

  Jaclyn Cusumano, PharmD; Anna Marie Morlino, PharmD; and Andrew Moyer, PharmD

  Background

  Staphylococcus aureus^{1, 2, 3}

  • One of the most common pathogens causing community-acquired and nosocomial infections
  • Has rapidly developed resistance to many antibiotics:

  Daptomycin ²

  • Bactericidal cyclic lipopeptide antibiotic
  • Possesses negative charge which attracts calcium to form cationic complex
  • Interacts with negatively charged phospholipid heads on bacterial cell membranes, leading to membrane depolarization and cell death

  Daptomycin non-susceptible (DNS) S. aureus ^{2, 4, 5}

  • Extremely rare - About 60 clinical cases reported
  • Defined by an MIC greater than 1 mcg/mL
  • Potential mechanisms include:

  – Changes in cell membrane and cell wall structure alter daptomycin’s permeability²

  • Overexpression and dysregulation of dltA transcription increases D-alanylated teichoic acid content in the cell wall
  • mprF mutation leads to partially neutral charge of cell membrane

  – Vancomycin intermediate S. aureus (VISA) and vancomycin resistant S. aureus (VRSA) may predispose patients to develop DNS S. aureus²

  • Have seen increased resistance with lower doses^{4, 5}

  – 4 to 6 mg/kg/day has higher rates of DNS S. aureus

  – Experts recommend doses ≥ 8mg/kg/day especially for bacteremia