- MEMBERSHIP -

In honor of Pharmacy Week in Michigan, the MSHP Board of Directors is pleased to offer a $10 discount on dues renewals to all MSHP members through the end of October. Use the promo code mshp2025 when renewing to receive this special offer.

MPA is currently running a special during American Pharmacists Month for active pharmacists to join or renew their annual membership for $299. Those who apply the promo code and are active pharmacists will receive an additional $10 off their dues for 2026.

MSHP thanks you for your membership and involvement with MPA!

- AMBULATORY CARE -

MSHP Ambulatory Care Survival Guide: Updates for 2025

By Jodie Elder, Pharm.D., professor of pharmacy practice, Ferris State University College of Pharmacy; ambulatory pharmacist, University of Michigan Health-West

In 2021, the MSHP Ambulatory Care Pharmacy Practice Committee (ACPPC) published the first edition of the Ambulatory Care Survival Guide, a foundational resource created to support ambulatory pharmacists practicing in Michigan. Designed for both new and experienced practitioners, the guide is updated annually and provides state-specific information on credentialing and privileging, collaborative practice agreements, billing practices, quality metrics and dashboard development.

Over the past two years, the ACPPC has expanded the guide to include a new section addressing health-related social needs (HRSN). Defined by Centers for Medicare and Medicaid Services as “the social and economic needs that individuals experience that affect their ability to maintain their health and well-being,” HRSN applies to five core domains: housing instability, food insecurity, transportation barriers, utility needs and interpersonal safety.¹ Pharmacists, as some of the most accessible members of the health care team, are often in a unique position to identify these needs and connect patients with appropriate support before other providers are aware.

The new HSRN section highlights strategies for pharmacists to identify and triage these needs to optimize medication management. To support this work, ACPPC members developed a table of community resources available to address food insecurity, transportation, housing instability and financial strain.

The revised edition of the Survival Guide also updated billing information with detailed descriptions of billing codes and requirements. Members can access the guide by logging into their account on the MPA website. Please take advantage of this resource and provide feedback for the committee via email to JodieElder@ferris.edu.

References:

1. U.S. Department of Health and Human Services. 2023. Call to Action: Addressing Health-Related Social Needs in Communities Across the Nation. P.1-15.Available at https://aspe.hhs.gov/sites/default/files/documents/3e2f6140d0087435cc6832bf8cf32618/hhs-call-to-action-health-related-social-needs.pdf. Accessed Aug. 26, 2025.

- RESIDENT'S CORNER -

HIV Antiretroviral Postexposure Prophylaxis (PEP) Updates

By Giang Anderson, Pharm.D., Yuli Zheng, Pharm.D., Hailey Flood, Pharm.D., Alexander Stockwell, Pharm.D., PGY1 residents at Trinity Health Muskegon

HIV infections in the United States have declined substantially over the past 30 years due to advancements in preventative care and medicine.¹ One key preventative care option is the use of antiretroviral agents after possible and confirmed HIV exposures. Exposures can be non-occupational (nPEP), or occupational (oPEP). Exposures for oPEP involve incidents such as accidental needlestick injuries among health care workers or first responders, while nPEP incidents can range from sexual exposure to IV drug use.¹

PEP should be initiated as soon as possible, ideally within 24 hours, but no later than 72 hours following exposure. Prophylaxis is recommended when the source is known to be HIV-positive. If the source’s HIV status is unknown, the decision to begin PEP should be made on a case-by-case basis, considering the risk of transmission. If the source is later confirmed to be HIV-negative, PEP should be discontinued immediately.¹ The standard duration of PEP therapy is 28 days, but the 2025 guideline introduces a new preferred regimen and follow-up protocols.

Guideline medication regimen update

Medication recommendations have been updated from the last guidelines published in 2016 prioritizing better safety, tolerability and lower pill burden. Biktarvy (bictegravir/emtricitabine/tenofovir alafenamide) once daily is now the preferred therapy recommended by the updated PEP guidelines. An alternative option includes dolutegravir combined with either tenofovir alafenamide or tenofovir disoproxil fumarate, plus emtricitabine or lamivudine.¹ Regardless of the regimen selected, the recommended duration of PEP remains 28 days.

Biktarvy dosing

Biktarvy contains bictegravir 50 mg, emtricitabine 200 mg and tenofovir alafenamide 25 mg, and is administered once daily with or without food. Do not use if creatinine clearance is less than 30 mL/min, or if creatinine clearance is less than 15 mL/min and the patient is not receiving hemodialysis. For hepatic impairment, standard dosing is appropriate for Child-Pugh class A or B. Use is not recommended in Child-Pugh class C. Biktarvy is considered safe for use in pregnancy.

For pediatric patients that weigh less than 25 kg, the dosing is the same as above, but for those that weigh between 14-25 kg, the recommended dose is reduced to bictegravir 30 mg, emtricitabine 120 mg and tenofovir alafenamide 15 mg.² Most common side effects include diarrhea, nausea and headache. Furthermore, bictegravir increases serum creatinine without affecting glomerular filtration rate. Additionally, Biktarvy can potentially exacerbate HBV infection upon initiation or discontinuation of treatment. In patients with HBV co-infection or reactivation, hepatic function should be monitored closely to detect and manage potential liver-related complications. Patients should not discontinue Biktarvy abruptly without provider guidance as it may result in disease progression.²  

Laboratory testing and nPEP follow-up updates

In the 2016 guideline, HIV Ag/Ab testing was recommended at baseline, four-to-six weeks post- exposure, and again at three months.³ In the 2025 guideline update, HIV Ag/Ab testing recommendations remain unchanged; however, it may be deferred if nPEP was initiated within 24 hours after exposure and adherence is confirmed. Additionally, HIV diagnostic nucleic acid test (NAT), is now recommended at the same interval.¹ The addition of NAT can be beneficial for clinicians to identify acute HIV infection in patients more reliably. This may be valuable in patients who received vaccines or neutralizing antibodies in prevention trials where the antibody results may not be reliable.⁴

For individuals who are receiving long-acting injectable pre-exposure prophylaxis (PrEP) antiretroviral therapy within the past year, the 2025 guideline recommends both HIV nucleic acid test (NAT) and Ag/Ab HIV test at the initial visit.¹ The previous guideline update in 2016 did not include information for testing patients on long-acting injectable PrEP.

The 2016 guideline stated that in patients who were fully adherent to their daily PrEP regimen, nPEP following potential HIV exposure was not indicated. However, nPEP may be indicated for those patients who were not fully adherent to PrEP.³

Transitioning to PrEP after PEP

Individuals starting nPEP should be informed that PrEP offers ongoing protection against HIV for those at continued risk after completing nPEP. Health care providers should assess patients for PrEP eligibility and, when appropriate, develop a clear transition plan from nPEP to PrEP. If PrEP is initiated before the final HIV test at 12 weeks post-exposure, patients must be counseled on the potential for false-negative results and the importance of continued HIV monitoring.¹ For those with anticipated ongoing exposure, an immediate transition to PrEP accompanied by HIV testing at the end of the nPEP regimen can help maintain protection during the interim period before the final HIV test. 

Update on the flow diagram figures in the new guideline

The updated guidelines introduce a detailed and user-friendly approach to initiating nPEP. The three distinct flow diagrams are tailored to specific possible exposure scenarios including: sexual exposure, injection drug exposure and other exposure.¹ This is an improvement over the 2016 guideline, which had one general flow diagram.

These flow diagrams and new guideline updates can be accessed at Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV — CDC Recommendations, United States, 2025 | MMWR (starting at figure 2).

References

1. Tanner MR, O'Shea JG, Byrd KM, Johnston M, Dumitru GG, Le JN, Lale A, Byrd KK, Cholli P, Kamitani E, Zhu W, Hoover KW, Kourtis AP. Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV - CDC Recommendations, United States, 2025. MMWR Recomm Rep. 2025 May 8;74(1):1-56. doi: 10.15585/mmwr.rr7401a1. PMID: 40331832; PMCID: PMC12064164.
2. BIKTARVY (bictegravir, emtricitabine, and tenofovir alafenamide) tablets, for oral use. Prescribing Information. Foster City, CA: Gilead Sciences, Inc.; 2025.
3. Dominguez, Kenneth L. et al. (2016). Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV—United States, 2016.
4. National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (U.S.). Division of HIV/AIDS Prevention. "Technical update for HIV nucleic acid tests approved for diagnostic purposes," 2023

- STUDENT FOCUS -

Artificial Intelligence in Pharmacy:

Empowering Our Profession to Lead Responsibly

By Shatila Zaman and Jihun Park,

University of Michigan College of Pharmacy class of 2027

Artificial intelligence is quickly transforming health care by offering powerful tools that enhance clinical decision-making, optimize treatment selection and streamline clinical workflows. As the stewards of medication therapy management and safety, pharmacists are uniquely equipped to lead the integration of AI technologies into the health care industry in ways that uphold patient care and improve outcomes.

AI refers to a compendium of computational systems that have the capacity to mimic human cognition.¹ In health care, AI applications include machine learning, natural language processing and predictive modeling. They analyze large, complex datasets to identify patterns that support clinical decision-making. These innovations are currently being applied in fields such as drug discovery, disease surveillance, diagnostics and workflow automation.¹ Within pharmacy, AI has enabled not only the implementation of medication adherence tools, robotic dispensing, intelligent clinical surveillance systems and inventory management strategies, but also the rapid generation of evidence-based recommendations obtained from peer-reviewed literature and national guidelines.^1,2,3

A systematic review conducted by Ranchon and colleagues (2022) highlighted the development of AI-powered tools that have been specifically designed to support clinical pharmacy services.⁴ These applications included methodologies for identifying medication orders that require pharmacist intervention, optimizing product dispensing workflows and supporting therapeutic education. Furthermore, most tools incorporated machine learning techniques, often leveraging data from electronic medical records to enhance the precision and efficiency of pharmacy services. While these tools are still in the early stages of incorporation, they reflect the growing interest in aligning AI innovations with the unique responsibilities that pharmacists have in both the hospital and community settings.⁴

These AI tools show great promise; however, their integration into pharmacy practice should be thoughtfully governed to protect patient safety, transparency and clinical reliability. Pharmacists must be able to interpret model outputs, critically assess performance, as well as maintain accountability in clinical decision-making. The American Society of Health-System Pharmacists emphasizes that pharmacists play a foundational role in AI governance in that AI tools are ethically utilized, appropriately validated and deployed with patient safety as the primary goal.⁵ This responsibility also includes addressing bias, protecting patient privacy, and advocating for equitable access and transparency.⁵

To help pharmacists build competence in these areas, ASHP has launched the Artificial Intelligence Pharmacy Certificate Program. This ACPE-accredited continuing education program offers 18.75 hours of content that is focused on foundational knowledge and practical applications of AI across diverse pharmacy practice settings.⁶ The curriculum addresses key topics such as supervised and unsupervised learning, predictive versus generative models and model drift, as well as ethical considerations like privacy and algorithmic bias. Real-world scenarios walk learners through the evaluation and use of AI in diverse pharmacy settings, including health systems, ambulatory care and telepharmacy. Pharmacists are also introduced to administrative topics, including how to build an AI business case, measure return on investment and lead multidisciplinary governance teams.⁶

This certificate aims to embolden pharmacists to both apply AI effectively, and to take an active role in its development, integration and oversight. It reinforces the pharmacist’s role as a critical evaluator of digital tools, thus balancing innovation with the standards of evidence-based medicine, equity and safety that define our profession.

AI holds considerable potential to improve patient outcomes, decrease preventable harm and support pharmacist-driven innovation in health care delivery. However, our profession must continue to build the infrastructure and expertise needed to ensure that these tools are adequately updated with reliable sources and are responsibly utilized.⁵ Educational opportunities such as the ASHP certificate are an important step towards preparing pharmacists to progress the optimal use and application of AI in health care.

As AI continues to advance, it will inevitably become an integral component of pharmacy practice.⁵ The challenge ahead lies not just in adopting these technologies, but in shaping them – driven by a commitment to ethical integrity, clinical excellence and the ongoing improvement of patient care.

References:

1. Alowais SA, Alghamdi SS, Alsuhebany N, et al. Revolutionizing healthcare: the role of artificial intelligence in clinical practice. BMC Medical Education. 2023;23(1). doi:10.1186/s12909-023-04698-z
2. Raza MA, Aziz S, Noreen M, et al. Artificial intelligence (AI) in Pharmacy: An Overview of Innovations. INNOVATIONS in Pharmacy. 2022;13(2):13. doi:10.24926/iip.v13i2.4839
3. Roosan D, Padua P, Khan R, et al. Effectiveness of ChatGPT in clinical pharmacy and the role of artificial intelligence in medication therapy management. Journal of American Pharmacist Association. 2024;64(2). https://doi.org/10.1016/j.japh.2023.11.023.
4. Ranchon F, Chanoine S, Lambert-Lacroix S, Bosson JL, Moreau-Gaudry A, Bedouch P. Development of artificial intelligence powered apps and tools for clinical pharmacy services: A systematic review. International Journal of Medical Informatics. 2022;172:104983. doi:10.1016/j.ijmedinf.2022.104983
5. American Society of Health-System Pharmacists. ASHP Statement on Artificial Intelligence in Pharmacy. Published January 2024. Accessed June 28, 2025. https://www.ashp.org/-/media/assets/policy-guidelines/docs/statements/artificial-intelligence-in-pharmacy.pdf
6. Artificial Intelligence (AI) in pharmacy certificate. Knowledge Connection. https://elearning.ashp.org/products/12581/artificial-intelligence-ai-in-pharmacy-certificate.

- REGIONAL UPDATE -

Western Michigan Society of Health-System Pharmacists

By Jessica Prociv, Pharm.D., WMSHP president

The Western Michigan Society of Health-System Pharmacists (WMSHP) had a great summer. We had a very productive board retreat in June to wrap up the year and start planning for the next.

August was our annual West Michigan Whitecaps baseball game. We had a strong turnout from our members, 49 in total, with plenty of networking opportunities despite the heat. Special thanks to board member Nate Kanous for planning it again.

WMSHP members attend the West Michigan Whitecaps game in August.

Kyle Brillantes, our resident at large, did a great job this past year with networking among residents. We welcomed our new resident at large, Matt Hickson, who is completing his PGY-1 residency at Corewell West.

Matt will be in charge of planning a monthly meeting, networking and some other projects during the year.

Our first meeting back for the fall was Sept. 11 for in-person CE at Corewell. Dr. Maja Gibbons presented on supportive care for oncology patients.

Fall is always busy with monthly CE and opportunities for student members to work on their interview skills and CV writing abilities. Our residency showcase was held Oct. 2. We are hosting two mock interviews, an in-person event on Oct. 30 at Ferris’s Grand Rapids campus and a virtual event on Nov. 6.

For further information on the mock interviews, please email pontefb@ferris.edu. Registration for the monthly meeting and residency showcase is available on our website: https://wmshp.net/events.

Volunteer for MSHP Committees Today

If you are interested in serving on a 2026 MPA or MSHP committee, please fill out the member engagement form.

MPA committee members are required to attend the following committee days:

• Wednesday, Jan. 21, 2026 (in-person, MPA headquarters)
• Wednesday, May 13, 2026 (virtual)

MSHP committee members are required to attend the following committee days:

• Thursday, Jan. 8 (in-person, MPA headquarters)
• May 2026, date TBD (in-person, MPA headquarters)

2025 MSHP Annual Meeting – Register Now!

The MSHP Annual Meeting is approaching fast, taking place Oct. 24.

Join the Michigan Society of Health-System Pharmacists (MSHP) for its 2025 Annual Meeting at the Hilton DoubleTree in Dearborn! The MSHP Annual Meeting offers continuing education for pharmacists, pharmacy residents, student pharmacists and pharmacy technicians, along with a chance for exhibitors and sponsors to showcase products and network with MSHP members.

CE Speaking Opportunities at Non-Pharmacy Organizations

The MSHP Publications Committee was charged in 2024 with identifying opportunities for pharmacists to present at non-pharmacy organization meetings. After surveying MSHP membership in April, the committee compiled a list of organizations. Click the button below if you're interested in presenting.

OFFICERS

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

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

IMMEDIATE PAST PRESIDENT | Kyle Schmidt | 616-685-6675 | Mercy Health St. Mary's, Grand Rapids

TREASURER | Michelle Dehoorne | 313-343-6381 | Ascension, Detroit

EXECUTIVE VICE PRESIDENT | Gary Blake | 248-840-2382 | Henry Ford Health | Troy

DIRECTORS

Tara McAlpine | tara.mcalpine@trinity-health.org | Trinity Health Michigan

Ben Pontefract | bpontefract@gmail.com | Ferris State University, Big Rapids

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

Amber Lanae Martirosov | 313-916-3494 | Wayne State University, Detroit

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 | Lama Hsaiky | lama.hsaiky@corewellhealth.org | Corewell Health, Dearborn

WESTERN | Jessica Prociv | jessie_olds28@yahoo.com | Bronson Methodist Hospital, Kalamazoo

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

The MSHP Monitor is a publication of the Michigan Society of Health-System Pharmacists, published as a service to its members.

Michigan Society of Health-System Pharmacists - An Affiliated Chapter of the American Society of Health-System Pharmacists and a Practice Section of the Michigan Pharmacists Association