May/June 2019 Newsletter
In this issue:

  • Tony's Tenets: Final Tenet - Be Dedicated to Your Craft
  • Inaugural Address from Incoming President Alex Oschman
  • Board Update
  • Research and Education Foundation Update
  • Spotlight on 2019 Best Practice Award Winner
  • Spotlight on 2019 Best Resident Project Award Winner
  • Reflections on MSHP's History: Where Did We Come From?
  • Membership Survey
  • Pharmacist Continuing Education Opportunities
  • The Use of Magnesium in Major Depressive Disorder Management
  • Overview of Long-Acting Injectable Antipsychotics
  • Best Practice Spotlight: Inpatient Hypoglycemia Monitoring
  • Special Feature: Transitions of Care
  • Involving Pharmacy Learners in Transitions of Care Pharmacy Services
  • Transitions of Care: An Introductory Pharmacy Practice Experience
  • Featured Clinical Topic – Critical Care, Emergency Medicine, and Pulmonology
  • Dupilumab (Dupixent) Use in Asthma
  • Fluid Resuscitation in Critically Ill Patients
  • Affiliate Chapter News and Events
  • Upcoming Newsletter Info
Tony’s Tenets: Final Tenet -
Be Dedicated to Your Craft
The price of success is hard work, dedication to the job at hand, and the determination that whether we win or lose, we have applied the best of ourselves to the task at hand.
                                                       -Vince Lombardi

If you believe in yourself and have dedication and pride - and never quit, you'll be a winner. The price of victory is high but so are the rewards.
                                                                                                      -Bear Bryant

Inaugural Address from Incoming President Alex Oschman
As spring wraps up, a new board will be taking over for MSHP for the upcoming year. My start with MSHP began when I was a pharmacy resident, where GKCSHP participation allowed me to meet new people as a new pharmacist who had just moved to Kansas City.  When I moved back to accept a position as a NICU Clinical Specialist at Children’s Mercy, I got involved with GKCSHP as the newsletter editor for a couple of years. I then became the membership chair for GKCSHP and then membership committee chair for MSHP.  My years of involvement focusing on membership helped me to learn about the strengths and challenges of our society.  Through my involvement, I have also met numerous members who, with their extensive knowledge and experience, will help the board and myself be successful over the next 12 months in leading MSHP. 

Board Update
Elaine Ogden, PharmD, BCPS, BC-ADM
MSHP Secretary/Kansas City VA Medical Center

March Updates
  • The board was very busy in March with the normal monthly meeting and a live meeting in Collinsville
  • Discussed award winners for the Spring meeting
  • Coordinated activities and information for Legislative Day
  • Reviewed potential topics and discussion points for Legislative Day
  • Finalized the Spring meeting program/script
  • Completed internal audit – no discrepancies!!!!
  • Reviewed last year’s membership survey for ideas for the strategic planning meeting in June

April Updates
  • The board was tired from March 😊, but recapped Spring meeting – successes and areas for improvement
  • Recapped Legislative Day
  • Discussion regarding enhancing social media presences with new members to the communications committee
  • Education and Programing committee meeting with MPA for fall joint meeting
  • New Practitioner workgroup has finished recording the technician CE
Research & Education Foundation Update
Spotlight on 2019 Best Practice Award Winner

At the MSHP/ICHP Spring Meeting, the R&E Foundation presented Journey McCarty, Pharm.D. with the MSHP Best Practice Award for her project entitled “Implementing a Pharmacist Driven 72-hour Antimicrobial Time Out”. The University of Missouri Health Care System implemented a pharmacist driven 72 hour antimicrobial time out in patients receiving vancomycin, ertapenem, meropenem, micafungin, or posaconazole. The primary outcome was days of therapy per 1000 patient days. Secondary outcomes included number and type of interventions, number and percentage of interventions accepted by physicians, time reported by pharmacist to complete antibiotic time out, and percentage of Antibiotic Time Out alerts completed.

Spotlight on 2019 Best Resident Project Award Winner

Dr. Haleigh Stolte, a PGY1 resident at the North Kansas City Hospital, was awarded the Best Resident Project at the ICHP/MSHP Spring Meeting for her project entitled “CAM I aCUTely Change Your Mind: A Pharmacist Driven Approach to Reducing Delirium”. Based upon the new Guidelines for Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU (PADIS), management of ICU delirium should initially focus on reduction of modifiable risk factors for delirium. Medications such as benzodiazepines, opioids, H2 receptor antagonists, corticosteroids, anticholinergics, and NSAIDS have been associated with delirium. 

Reflections on MSHP's History:
Where Did We Come From?
Author: Bert McClary

A child sometimes asks a parent, “Mommy, where did I come from?” I rarely get asked directly, “Where did MSHP come from?” but members do express an interest when they hear facts about the early days of MSHP. I’m not one of the parents—we have three founding fathers—I’m more like one of the uncles and aunts who were there watching and helping, but I’ll try to get you interested in our history with a few anecdotes during the next year. We will be celebrating 50 years of activity in the spring of 2020.

MSHP Membership Survey
In an effort to identify member needs, evaluate programs and measure member satisfaction with MSHP, we are conducting our annual survey and would love your input.

We will use your input at the upcoming strategic planning session at the end of June 2019. 

Your input is anonymous, but once you complete the survey and provide us your contact information, you will be entered into a  drawing for a $50 Amazon gift card.

Deadline for the drawing will be Friday, June 21st.
Pharmacist Continuing Education
The Use of Magnesium in Major Depressive Disorder Management

Authors: Arianne MacGillivray, PharmD and Ijeoma Onyema,
PharmD PGY-1 Pharmacy Practice Residents

Mentor: Anthony Lucido PharmD, BCPS
PGY-1 Pharmacy Practice Residency Director
SSM Health DePaul Hospital – Bridgeton, MO

Program Number: 2019-05-09
Approval Dates: June 5, 2019 – December 4, 2019
Approved Contact Hours: One (1) CE(s) per LIVE session.

Overview of Long-Acting Injectable Antipsychotics

Authors: Andrea Prince, PharmD and Michelle Ndiulor, PharmD
PGY-2 Ambulatory Care Pharmacy Residents

Mentor: Joshua Holland, PharmD, BCPP
Psychiatry Pharmacy Specialist
CoxHealth – Springfield, MO

Program Number: 2019-05-08
Approval Dates: June 5, 2019 – December 4, 2019
Approved Contact Hours: One (1) CE(s) per LIVE session.

Best Practice Spotlight:
Inpatient Hypoglycemia Monitoring
According to a report released by the Center for Disease Control and Prevention, over 100 million adults in the United States currently live with diabetes or prediabetes. 1 Notably, various antidiabetic agents, such as insulin and secretagogues, are commonly associated with hypoglycemic events in the inpatient setting. Controlling both hyperglycemia and hypoglycemia is important in hospitalized patients and is associated with increased cost, length of stay, morbidity, and mortality. 2 Association of hypoglycemia with mortality has resulted in changes in clinical guidelines which make recommendations regarding glycemic control. 3  

Special Feature:
Transitions of Care
Involving Pharmacy Learners in Transitions of Care Pharmacy Services

Since the inception of the Hospital Readmission Reduction Program (HRRP) by the Centers for Medicare and Medicaid Services (CMS) in 2011, implementation and expansion of pharmacy – led transitions of care (TOC) services has become a focus for many institutions and clinics. 1 The positive impact of pharmacy – led TOC services has been well documented in the literature through landmark trials such as the Medications at Transitions and Clinical Handoffs (MATCH) study and Project Re – Engineered Discharge (ProjectRED). 2,3 Examples of pharmacy – led TOC services include medication history collection, medication reconciliation, comprehensive medication review, disease state education and medication counseling. One barrier to implementation of successful pharmacy – led TOC services is staffing resources. 4  
Transitions of Care: An Introductory Pharmacy Practice Experience

Transitions of care (TOC) is a process designed to maintain the safety and care of patients when transferring between different health care settings or different health care professionals within the same setting. However, transitioning patients can be complex, resulting in medication errors. In the United States, medication errors and adverse drug events contribute to almost 700,000 emergency department visits and over 100,000 hospitalizations. Factors often attributed to causing adverse drug events include breakdowns in communication, accountability, incomplete medication reconciliation and insufficient patient and caregiver education. 1 All of these elements contribute to hospital readmissions, stressing the importance of an effective TOC process. Pharmacists can play a fundamental role in this process by providing interventions such as medication reconciliation, patient counseling and follow-up telephone calls. In fact, various institutions that have piloted the use of pharmacists on their TOC team found improvement in outcomes such as a decrease in the number of return emergency department visits and a reduction in medication discrepancies. 2-4
Featured Clinical Topic:
Critical Care, Emergency Medicine, and Pulmonology
Dupilumab (Dupixent) Use in Asthma
According to the Center for Disease Control, more than 26 million Americans suffer from asthma, accounting for approximately 8% of children and 8% of adults. Within this population, 5 to 10% of patients have severe asthma that does not respond to conventional therapy with a short-acting beta-agonist and inhaled corticosteroids. Patients with refractory asthma experience an increased rate of exacerbations, hospital visits, and medical costs.

Fluid Resuscitation in Critically Ill Patients
The Surviving Sepsis Campaign (SSG) 2016 makes several recommendations about fluid resuscitation. The current SSG recommendations state that at least 30 mL/kg of IV crystalloid should be given to patients within the first 3 hours of admission, with a target MAP of 65 mmHg. 1  Reassessment of these patients should include the evaluation of several hemodynamic parameters, including heart rate, blood pressure or the use of other dynamic parameters. 2  After initial resuscitation, SSG recommends that crystalloids should be used for subsequent intravascular volume replacement 1 (strong recommendation) and that albumin should be added when patients require large amounts of crystalloids (weak recommendation).

Affiliate Chapter News & Events
Greater Kansas City Society of Health-System Pharmacists (GKCSHP)

Watch your emails for information on upcoming events! A resident welcome happy hour and membership event are being planned for August, and Residency Research Day at St. Luke’s Hospital in Kansas City is being planned for September!
GKCSHP is on Instagram! Follow us @gkcshp!

President: Lauren Mishler, PharmD, BCPS, BCACP
Mid-Missouri Society of Health-System Pharmacists (MMSHP)

Upcoming Events:
June 20, 2019: Andexxa
Time: 6:00 PM Networking/Announcements, 6:30 PM Presentation
Location: Chris McD's

In March we had a great turnout for community service event at Columbia’s Ronald McDonald House. Student and pharmacist members were able to provide a delicious brunch to the families.

In collaboration with the MU Health System residency programs, there were two continuing education opportunities this spring! Thank you to Journey McCartney, Rosalyn Reese and Ali Stringberg for their clinical pearls in April and Ryan Buttig and Chris Clayton for theirs in May. Everyone did an excellent job!

We also initiated our new officers in May!
  • Emily Wiederanders, PharmD, BCPS is assuming the role of President
  • Sandy McGraw, PharmD will embark on the role of President-Elect
  • Jordan Anderson, PharmD, BCPS, BCPPS is transitioning from Past-President to Treasurer

President: Emily Wiederanders , PharmD
Saint Louis Society of Health-System Pharmacists (STLSHP)

Thank you to everyone who participated in April’s Night at the Ballpark! It was a huge success.

Congratulations to our new STLSHP officers!
  • President-elect: Gabrielle Gibson
  • Treasurer: Besu Teshome     

Upcoming Events:
June 12, 2019: Treatment Options for Adults with HAP/VAP and Complicated Skin and Skin Structure Infections
Sponsored by: Cumberland Pharmaceuticals
Time: 6:30PM
Location: Bonefish Grill - Brentwood, MO

President: Carmen Smith , PharmD, BCPS
Southeast Missouri Society of Health-System Pharmacists (SEMSHP)

  • Thank you to all those who attended our CE event on June 1st and for Danica Balbach and Erica Prost, both PGY-1 residents at Southeast Hospital, for providing it!
  • Stay tuned for future via email and on our Facebook page!

To join SEMSHP:

President:   Julie Haase , PharmD, BCPS, BCCCP
Upcoming Newsletter Info
July/August 2019 Newsletter

Featured Clinical Topic:  

Submit to: Laura Challen
Upcoming Featured Clinical Topics
Sept/Oct: Oncology
Nov/Dec: Infectious Disease/Vaccines 
Newsletter Submission Guidelines
  • Pharmacists, pharmacy technicians, and pharmacy students in Missouri are eligible to submit content for publication in the MSHP Newsletter. Student submissions need to include pharmacist oversight.
  • Submit content to the current Newsletter Committee Chair on or before the established deadlines.
  • CE and Featured Clinical Topics must be approved by the Newsletter Committee Chair in advance of article submission, to prevent duplicates. Duplicate articles submitted without advanced approval may not be published.
  • Recommended length of submissions for committee, affiliate, college/schools of pharmacy, and student chapter reports is half to one page in length.
  • Recommended length of submissions for featured clinical topics is 1 to 2 pages, without references.
  • Recommended length of CE articles is individualized, based on the amount of CE provided.
  • Recommended length of submission for other categories is 1 to 2 pages.
Newsletter Submission Deadlines
  • July/Aug. 2019: July 8th
  • Sept./Oct. 2019: September 9th
  • Nov./Dec. 2019: November 11th
Is there a Pharmacy Best Practice happening at your institution? Would you like to share your successes with MSHP Membership? We'd love to highlight your institution in a future MSHP Newsletter!

Please contact the MSHP Newsletter Chair, Laura Challen
Interested in becoming a MSHP member or need to renew? It's easy! Click the above button or visit the MSHP website:

Membership Dues:
Pharmacist: $110
Joint Pharmacist: (Married Couple) $155
Technician: $35
Associate Member: $110
Recent Graduate (within 24 months): $45
Student: $25
Retired Pharmacist: $35
MSHP Board of Directors
2018-2019 Board of Directors
President: Tony Huke
President-Elect: Alex Oschman
Immediate Past President: Jeremy Hampton
Secretary: Elaine Ogden

2019-2020 Board of Directors Effective July 1st
President: Alex Oschman
President-Elect: Davina Dell-Steinbeck
Immediate Past President: Tony Huke
Secretary: Barb Kasper
Treasurer: Christina Stafford
MSHP Committee Chairs
2018-2019 Committee Chairs
Vendor Relations Board Liaison -  Evanna Shopoff
Membership Committee -  Ashley Evans
Communications Committee -  Elaine Ogden
Public Policy Committee -  Sarah Cox
Newsletter Committee -  Sarah Cook
Education and Programming -  Elizabeth Englin
Website Committee -  Kathryn Burnett

2019-2020 Committee Chairs
Vendor Relations Board Liaison -  Evanna Shopoff
Membership Committee -  Erin Hennessey
Communications Committee -  Barb Kasper
Public Policy Committee -  Sarah Cox
Newsletter Committee -  Laura Challen
Education and Programming -  Elizabeth Englin
Website Committee -  Lori Rio
If you have any questions, comments, or wish to submit an article to for MSHP Newsletter, please contact the Newsletter Committee Chair:
 Laura Challen or another Newsletter Committee member.

2018-2019 MSHP Newsletter Committee Members
Laura Challen, PharmD, MBA, BCPS, BCACP (Chair starting July 1st)
Sarah Cook, PharmD, BCPS (Chair)
Barb Kasper, PharmD, BCACP
Rebecca Nolen , PharmD, BCPS, AAHIVP
Hannah Pope, PharmD, BCPS
Emily Shor, PharmD
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