Register Now for 3rd Annual OASIS

Time is running out to reserve your spot at the 2023 Outpatient Antimicrobial Stewardship Innovations Symposium (OASIS) Aug. 17 in Grand Rapids. This 3.5-hour educational meeting, sponsored by the Michigan Society of Health-System Pharmacists and the Ferris State University College of Pharmacy, will have both in-person and virtual options for attendees.

Click the buttons below to find out more.

Register Now for the MSHP Annual Meeting!

Registration is now open for the Michigan Society of Health-System Pharmacists (MSHP) Annual Meeting, which will be held Friday, Oct. 27, at the Crowne Plaza Lansing West, 925 S. Creyts Road in Lansing.

Held each fall, the MSHP Annual Meeting offers up to six hours of live continuing education credit. Programming is geared toward health-system pharmacists, residents, pharmacy technicians and student pharmacists. The MSHP Annual Meeting focuses on clinical, leadership management and residency topics as well as other general areas of pharmacy practice.

In addition to continuing education programs, the event offers the annual MSHP Town Hall Meeting to install new MSHP Board of Directors members into office officially, recognize volunteers and award recipients, a clinical skills competition for students and an exhibit hall to provide attendees with a chance to exchange ideas and learn about new products and services.

Submit Your MSHP and MPA Award Nominations Today!

Nominate one of your colleagues for a prestigious award to recognize their professional accomplishments!

Choose from a variety of awards, including eight Michigan Pharmacists Association (MPA) awards, four Michigan Society of Health-System Pharmacists (MSHP) awards, two Michigan Society of Pharmacy Technicians (MSPT) awards, three Michigan Pharmacy PAC awards, three local association awards, the Michigan Society of Community Pharmacists (MSCP) Pharmacist of the Year Award or the Consultant and Specialty Pharmacists of Michigan (CSPM) Pharmacist of the Year Award.

MSHP nominations are due Sept. 1. 

All other award nominations are due Oct. 1. Learn more and submit your award nominations by clicking below.

Be a Presenter at the 2024 Annual Convention & Exposition

The Michigan Pharmacists Association (MPA) is currently accepting Session Proposal Submissions for the 2024 Annual Convention & Exposition (ACE).

Taking place Feb. 23-25, 2024 at the Renaissance Center in Detroit, MPA’s ACE is the premier educational experience for pharmacists, residents, pharmacy technicians, students and pharmaceutical partners throughout Michigan.

Below is an abbreviated list of initial topics MPA membership has noted are areas of interest for session proposals.

• Changing landscape of type 2 diabetes
• Value-based healthcare models vs fee-for-service
• Dementia/Alzheimer’s disease
• ADHD
• Disease state management
• Heart failure 
• Site of care for health systems
• Balance between in-patient and out-patient
• Medication specific courses
• Manufacturing and marketing practices
• Drug diversion detection
• PBMS and DIR fees for independent pharmacies
• Current drug shortages
• Biologics
• Consequences of the opioid crisis
• Medical marijuana  

Should you have any questions or additional needs, please reach out to MPA Director of Education and Events, Lisa N. Powers, CAE, CTA at lpowers@michiganpharmacists.org.

MPA looks forward to receiving your submission soon!

Become a Leader: Volunteer for MSHP

The Michigan Society of Health-System Pharmacists (MSHP) relies on volunteers to help the organization meet its professional goals. Volunteers can serve as committee members, officers or members of the MSHP Board of Directors, or serve as delegates to the American Society of Health-System Pharmacists (ASHP) House of Delegates. Please note that you must be an MSHP/Michigan Pharmacists Association (MPA) member to volunteer for the following committees or groups. Volunteers are appointed by the MSHP president-elect in November and December for the following calendar year. Learn more and submit an application by filling out this form.

Form submissions are due Friday, Sept. 15, 2023.

Save the Date for MSHP Committee Day in January

Thursday, Jan. 11, 2024

Volunteer Opportunities

→MSHP Board of Directors

→Regional Societies

→Michigan Delegates to the ASHP House of Delegates

→MSHP Committees

• Ambulatory Care Committee
• Antimicrobial Stewardship Committee
• Educational Affairs Committee
• Membership Committee
• Organizational Affairs Committee
• Publications Committee
• Residency Committee
• Transitions of Care Committee

- ANTIMICROBIAL STEWARDSHIP -

Michigan Test and Treat in the Legislature

By Brianna VanHouten, Pharm.D. candidate, Ferris State University College of Pharmacy; Shelbye Herbin, Pharm.D., BCPS, BCIDP, PRIME associate director, scientific affairs; and Michael Klepser, Pharm.D., FCCP, FIDP, Pharmacy Practice, Ferris State University College of Pharmacy, Collaboration to Harmonize Antimicrobial Registry Measures (CHARM)

Historically, pharmacists’ role on the health care team has been focused around filling prescriptions, answering questions about drug therapies and counseling patients about their medications. In April 2020, the United States Department of Health and Human Services recognized the accessibility of pharmacists and their ability to aid in the COVID-19 pandemic by granting pharmacists the authority to order and administer COVID-19 tests.¹ This was the first time such authority was given to pharmacists at the federal level.

Although pharmacists in Michigan have been able to order Clinical Laboratory Improvement Amendments-waived (CLIA) tests in Michigan and provide followed care under a collaborative practice agreement (CPA), a new piece of legislation looks to broaden these activities. Senate Bill 219 was recently signed into law by Gov. Gretchen Whitmer.

Under this bill, trained pharmacists will be given the authority to:

• Independently order and administer qualified immunizations for ages 3 and up that meet the following requirements: recommended by the Centers for Disease Control’s advisory council and approved/authorized for use or emergency use by the FDA.
• Independently order and administer qualified laboratory tests that meet the following requirements: classified as a waived test by the FDA; uses a specimen collected by a nasal/throat swab or a finger prick; used for testing of COVID-19, influenza, or a respiratory infection.
• Order and dispense antiviral treatment for COVID-19 and influenza based off laboratory tests provided at the pharmacy level.²

SB 219 recognizes the qualifications of pharmacists and allows them the ability to autonomously engage in these clinical activities without the need for a CPA. Although the bill provides limited independent authority to test and treat, it does not restrict the pharmacist’s ability to order and use other CLIA-waived tests, collect other permissible specimen types, or order/dispense medications for other conditions under CPAs or pursuant of federal authorization.

This bill will improve access to care for the patients in Michigan, especially for those 30% to 40% who do not identify a primary care provider.⁴ The CDC estimates that from Oct. 1, 2022, to April 30, 2023, there have been more than 12 million visits with health care providers due to influenza alone.³ As concern grows about the upcoming respiratory illness season with influenza, COVID and other viruses, this bill allows all pharmacists the opportunity to offer timely and accessible care.

Although the bill is a tremendous opportunity for pharmacy, it leaves the question of payment to be answered. Data revealed that patient populations, especially younger adults, not only preferred receiving tests in community pharmacies, but were also willing to pay $50 or more out-of-pocket for these services. Another survey of adults, mostly over 50, showed they were willing to receive tests at community pharmacies and were willing to pay an amount equal to or greater than their office visit co-pay.⁵ Although a uniform reimbursement model does not currently exist, for test and treat programs, patients will pay cash or use their health savings accounts for these services until a model for reimbursement is established. This scenario is similar to how payment for vaccinations evolved.

Change is often slow; however, SB 219 is game changing and finally provides recognition of the education and training of pharmacists.

References

1. Guidance for Licensed Pharmacists. COVID-19 Testing, and Immunity under the PREP Act. 2020
2. House Substitute for Senate Bill No. 219. SB.0219. 2023.
3. 2022-2023 U.S. flu season: Preliminary in-season burden estimates. Centers for Disease Control and Prevention. https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm. Published May 26, 2023. Accessed 7 July 2023.
4. Michael E. Klepser, Donald G. Klepser, Allison M. Dering-Anderson, Jacqueline A. Morse, Jaclyn K. Smith, Stephanie A. Klepser, Effectiveness of a pharmacist-physician collaborative program to manage influenza-like illness, Journal of the American Pharmacists Association, Volume 56, Issue 1, 2016, Pages 14-21, ISSN 1544-3191, https://doi.org/10.1016/j.japh.2015.11.008.
5. koski RR, Klepser N, Koski M, Klepser M, Klepser D. Community pharmacist-provided test and treat programs for acute infectious conditions. J Am Coll Clin Pharm. 2023;1‐11. doi:10.1002/jac5.1793

- MEMBER SPOTLIGHT -

Miranda Maitland



Pharm.D., BCPS, assistant director of pharmacy, MyMichigan Medical Center Sault; president, Northern Michigan Society of Health-System Pharmacists

Member Since: 2015

Describe Your Role/Day in the Life: What I love about my job is that every day is different and presents unique challenges that require me to be flexible. In my role, I serve as a leader in the pharmacy department. I am a pharmacy representative for hospital administration, clinical leaders and medical staff. I assist in overseeing the day-to-day operations of the pharmacy along with many quality, safety and financial projects. My passion is being a clinical resource to the pharmacy and medical team, as well as staffing and being able to serve our community through helping patients.

Why You’re an MSHP/MPA Member: I am a MSHP/MPA member because of the network of engaged pharmacists and the opportunity to form meaningful connections. There are many ever-changing practices in the health care environment and being a leader in the pharmacy department often requires myself to make decisions on these practices. I am grateful to have formed relationships with pharmacists that are subject matter experts that I can always reach out to.

Recent Accomplishments: I recently became a board-certified pharmacotherapy specialist and am excited to continue to refine my clinical skills and knowledge.

How MSHP/MPA Has Helped You Achieve Any Accomplishments: Being a new practitioner in a leadership role presents unique challenges. I am grateful that MPA has many different opportunities to get involved in committees and leadership roles. Serving as the president of the Northern Michigan Society of Health-System Pharmacists has allowed me to practice my leadership skills and gain confidence with my role.

- RESIDENT'S CORNER -

Pharmacist-to-Order MRSA Nasal PCR

By Julia Nahle, Pharm.D., PGY-1 pharmacy resident,

Trinity Health St. Joseph Mercy Ann Arbor

Vancomycin is frequently started inpatient as initial empiric antibiotic therapy, especially in patients with a septic clinical presentation. Vancomycin is often managed by inpatient clinical pharmacists, as it requires close monitoring and pharmacokinetic dose adjustments to ensure appropriate efficacy and to avoid toxicities.¹

One of the most common inpatient infectious diseases is pneumonia. MRSA nasal screening has a high specificity and negative predictive value for ruling out MRSA pneumonia.² The Infectious Diseases Society of America (IDSA) recommends obtaining respiratory cultures or a nasal PCR to allow for de-escalation or confirmation of need for continued therapy in patients with appropriate risk factors who are on vancomycin.³ It can be a challenge to obtain quality respiratory cultures, so patients may continue to receive potentially unnecessary empiric therapy when a nasal PCR is not ordered.

Close monitoring of vancomycin by pharmacists focusing on stewardship recommendations, in addition to pharmacist order and follow-up on MRSA nasal PCRs, has been shown to improve patient care.^4-8 As of Jan. 16, 2023, Trinity Health Ann Arbor has authorized pharmacists to order MRSA PCR nasal swabs per protocol in patients with vancomycin orders for pneumonia or sepsis from a suspected respiratory source.

To assess the clinical implications of Trinity’s new policy, a Medication Use Evaluation (MUE) looked at patients admitted to Trinity Health Ann Arbor between January and March 2023. Patients were included if they had a MRSA PCR ordered and performed. Patients who passed away within 24 hours of the MRSA PCR result, or who got a MRSA PCR after a full course of vancomycin ended were excluded.

A total of 132 PCRs were used to guide inpatient antimicrobial treatment. The most common indication was pneumonia (90). Of the 132 inpatient PCRs, 113 patients were on vancomycin at the time of PCR. There were 103 negative PCRs; of those, 79 patients had vancomycin discontinued within 24 hours. Pneumonia or sepsis with a primary respiratory source was the primary suspected infection in 71 of the 103 negative MRSA PCRs. A pharmacist made a documented recommendation to discontinue vancomycin in 26 of these 71 patients. Of the 71 patients with suspected pneumonia, vancomycin was discontinued within 24 hours in 55 patients (77%).

Vancomycin was continued with a negative MRSA PCR in 24 of 100 patients (24%). Four patients had vancomycin continued by the primary team (average of 41 hours). In all four patients, pharmacists had a documented recommendation for vancomycin discontinuation. Fifteen of the 24 patients were followed by ID, who recommended continuing vancomycin. Another five patients were continued on vancomycin by the primary team for infections other than pneumonia.

The results of the MUE showed that use of MRSA nasal PCRs have resulted in prompt discontinuation of vancomycin in most patients with a suspected respiratory infection or pneumonia. The evaluation further outlined the importance of pharmacists ordering and following up on MRSA PCRs to optimize antimicrobial stewardship. Overall, the implementation of a pharmacist-driven MRSA nasal PCR protocol has had a positive impact on Trinity Health Ann Arbor’s antimicrobial stewardship efforts.

References

1. Rybak MJ, Le J, Lodise TP, et al. Therapeutic monitoring of vancomycin for serious methicillin-resistant staphylococcus aureus infections: a revised consensus guideline and review by the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists. American Journal of Health-System Pharmacy. 2020;77(11):835-864.
2. Parente DM, Cunha CB, Mylonakis E., Timbrook TT. The clinical utility of methicillin-resistant staphylococcus aureus (MRSA) nasal screening to rule out MRSA pneumonia: a diagnostic meta-analysis with antimicrobial stewardship implications. Clinical Infectious Diseases. 2018;67(1):1-7.
3. Metlay JP, Waterer GW, Long AC, et al. Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019;200(7):e45-e67.
4. Pham SN, Sturm AC, Jacoby JS, Egwuatu NE, Dumkow LE. Impact of a pharmacist-driven MRSA nasal PCR protocol on pneumonia therapy. Hosp Pharm. 2021;56(4):221-227.
5. Willis C., Allen B., Tucker C., Rottman K., Epps K. Impact of a pharmacist-driven methicillin-resistant Staphylococcus aureus surveillance protocol. American Journal of Health-System Pharmacy. 2017;74(21):1765-1773.
6. Cho L., Gilbert GE, Zipperlen C., Danaher K., Glatt AE. Impact of methicillin‐resistant Staphylococcus aureus polymerase chain reaction nasal swabs on vancomycin utilization in patients admitted to the intensive care unit with respiratory infections. Pharmacy Practice and Res. 2022;52(1):26-33.
7. Dunaway S., Orwig KW, Arbogast ZQ, Myers ZL, Sizemore JA, Giancola SE. Evaluation of a pharmacy-driven methicillin-resistant Staphylococcus aureus surveillance protocol in pneumonia. Int J Clin Pharm. 2018;40(3):526-532.
8. Baby N., Faust AC, Smith T., Sheperd LA, Knoll L., Goodman EL. Nasal methicillin-resistant staphylococcus aureus (MRSA) PCR testing reduces the duration of MRSA-targeted therapy in patients with suspected MRSA pneumonia. Antimicrob Agents Chemother. 2017;61(4):e02432-16.

- EDUCATIONAL AFFAIRS -

Looking Ahead to the MSHP Annual Meeting Oct. 27

By Kimberly Vo, Pharm.D., PGY2 pharmacy resident, Corewell Health West

This year, the Michigan Society of Health-System Pharmacists (MSHP) Annual Conference will be held in person on Friday, Oct. 27, at the Crowne Plaza Lansing West in Lansing. Live continuing education (CE) credits will be offered for a total of six hours.

The keynote speaker in the morning will be Jacinda Abdul-Mutakabbir, Pharm.D., MPH, AAHIVP, assistant professor of clinical pharmacy at the University of California-San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences. Abdul-Mutakabbir is also a founding member of PharmGradWishlist, a pharmacist campaign that aims to support emerging racially and ethnically minoritized pharmacist trainees.

In additional to educational programming, a continental breakfast, lunch and refreshments will be provided. MSHP Annual will conclude with a panel discussion on implementing social determinants of health (SDoH) in pharmacy education and training.



Learn more and register today.

- REGIONAL UPDATE -

Northern Michigan Society of Health-System

Pharmacists Regional Society Update

By Miranda Maitland, Pharm.D., BCPS, assistant director of pharmacy, MyMichigan Medical Center Sault, NMSHP president

The Northern Michigan Society of Health Systems Pharmacists (NMSHP) had its first meeting of the year in May. The meeting consisted of two hours of live continuing education (CE) for pharmacists and pharmacy technicians. NMSHP is extremely thankful for Nathan Richards, Courtney Vanhouzen, Tony Huizenga, Brianna Brian, Carley Dubbert and Genevieve Bates for presenting their residency research projects.

NMSHP will be planning another live CE opportunity in October. Our hope is to have both an in person and virtual attendance option.

For more information on upcoming meetings, please contact NMSHP president Miranda Maitland at mirandapmaitland@gmail.com.

- STUDENT FOCUS -

Caring for Aging Immigrants



By Chloe Romero and Kavya Sundar, 2025 Pharm.D. candidates,

University of Michigan College of Pharmacy

As health care professionals, applying social determinants of health (SDoH) is as important as providing treatments or medications to impact patient outcomes. For pharmacists, SDoH often means bridging gaps in health care to improve outcomes in medication use. One important example of health disparities affecting patient care is the elderly immigrant population, who often face both a language barrier and complex medication regimens. With Michigan attracting more immigrants, pharmacists face barriers to having meaningful interactions with elderly immigrants.

Michigan is a diverse state, with many patients who have not had the opportunity to learn even the basics of English. This becomes a struggle, especially for the elderly. Comorbidities are on the rise among elderly patients and many of these patients are prescribed several medications. With the high number of medications these patients are prescribed, they are more susceptible to medication errors, especially if they have limited health literacy. Low health literacy is associated with poor outcomes, especially when the elderly experience poor medication adherence. 

The geriatric population is a unique population when it comes to understanding their medication regimen. They can be unaware of their schedule or simply forget to take their medications. Many strides have been made to create resources that help with this particular issue, such as pill boxes and medication alarms, but there are still barriers to overcome. Unfortunately, patients are often reluctant to show they don’t understand medical information and the miscommunication could easily lead to a life-threatening event.

How do we combat these barriers as pharmacists? There are several solutions and medley of them will likely need to be used. Practicing mindful listening and using layman language in simulated patient interactions can be one method to improve communication with patients. There could also be sessions on how to use a translator and when to use a translation service. 

Additionally, trustworthy communication needs to be established. Most patients know enough to say hello, but their understanding of how to use a medication may still be impacted by their skill level in English. With the elderly, that means providing clear and efficient language that is easier for them to understand. For example, rather than stating “Do not take this medication on a full stomach,” you can direct the patient “to take the pill on empty stomach two hours before breakfast.” Pharmacies should also be required to have instructions on obtaining a translator, as each setting and employer will have different methods of obtaining translation services.

Once communication has been established, it is up to us to utilize our education to benefit the patients. Nowadays, pharmacies have certain metrics that are constantly being monitored by computers and phones. Living in the United States, private health care has used these metrics to make spending time helping patients with complex issues (such as the elderly and immigrants) much more challenging. As such, we need to advocate for the monetary benefits of addressing these issues to CEOs and those in finance. While we may not get paid for our services directly by insurance, it would save the health care system a lot of money if patients stopped taking interacting medications together, for example.

Coming from a family of immigrants, it can be quite difficult for non-native, older generation English speakers to get the adequate treatment necessary. The hope is that one day, we do not have to see a 10-year-old child trying to translate medical information for their grandparents. Health care can be an inclusive sector, embracing and adapting for anyone who needs it.

OFFICERS

PRESIDENT | Michelle Dehoorne | (313) 343-6381 | Ascension, Detroit

PRESIDENT-ELECT | Kyle Schmidt | (616) 685-6675 | Mercy Health St. Mary's, Grand Rapids

IMMEDIATE PAST PRESIDENT | Shawna Kraft | (734) 232-6667 | Michigan Medicine, Ann Arbor

TREASURER | Marc Guzzardo | (810) 606-6095 | Ascension, Detroit

EXECUTIVE VICE PRESIDENT | Edward Szandzik | (313) 587-6279 | Detroit

DIRECTORS

Stacy Brousseau | (269) 341-7407 | Bronson Methodist Hospital, Kalamazoo

Diana Kostoff | (313) 725-7925 | Henry Ford, Detroit

Nada Farhat | nmhammou@med.umich.edu | Michigan Medicine, Ann Arbor

Julie Schmidt | (269) 341-7999 | Bronson Methodist Hospital, Kalamazoo

REGIONAL SOCIETY REPRESENTATIVES 

CENTRAL | Tim Ekola | (734) 845-3418 | VA Ann Arbor Healthcare System

NORTHERN | Miranda Maitland | mirandapmaitland@gmail.com | My Michigan Medical Center, Sault Ste. Marie

SOUTHEASTERN | Jessica Jones | (313) 982-5737 | Beaumont Health, Detroit

WESTERN | Shelby Kelsh | shelbyKelsh@ferris.edu | Ferris State University, Big Rapids

MANAGING EDITOR | Ryan Weiss | (517) 377-0232 | Michigan Pharmacists Association, Lansing