Confronting a crisis, VCU School of Pharmacy shifts curriculum on opioids
By Karolina Blaziak
Communications Associate, VCU School of Pharmacy
With thousands of Virginians affected by the opioid crisis, the VCU School of Pharmacy has added to its curriculum material about how pharmacists can respond.
An article about these curriculum changes has been accepted by the American Journal of Pharmaceutical Education. The article, “Preparing pharmacy students to manage the opioid crisis,” also discusses the background of opioid prescriptions and pain management, and the rise of opioid misuse to an epidemic in the United States.
Opioid overdoses have killed more Virginians each year than car crashes or guns, with more than 4,000 deaths between 2012 and 2017, according to the Virginia Department of Health. That has made overdoses the No. 1 cause of unnatural death in the state.
In 2016, Virginia’s health commissioner declared opioid addiction a public-health emergency. The commissioner issued a standing order authorizing pharmacists via a statewide standing order to dispense naloxone to any person requesting the drug.
To prepare pharmacy students for this responsibility, a number of activities were added to the pharmacy curriculum. In the fall 2017 semester the VCU School of Pharmacy offered a new laboratory activity in opioid-overdose management to its third-year pharmacy students.
With the statewide reach of the problem there has been “a new change in culture and awareness about opioid overdoses,” said Krista Donohoe, Pharm.D., an associate professor in the Department of Pharmacotherapy and Outcomes Science at the VCU School of Pharmacy.
The laboratory course taught 130 VCU pharmacy students what to do in the event of a patient overdose, along with a discussion of the Prescription Drug Monitoring Program, and how to do opioid calculations. The instructors — Donohoe and fellow VCU School of Pharmacy Pharmacotherapy and Outcomes Science faculty members Laura Morgan, Pharm.D., and Kacie Powers, Pharm.D. — wanted to prepare the pharmacy students to counsel patients and their families on opioid overdoses using naloxone.
Pharmacists can play a critical role in combating the opioid crisis. They have regular contact with patients and track their prescriptions through a database called the Prescription Drug Monitoring Program that lists medications prescribed and how frequently they are being dispensed.
The pharmacy students practiced with different prescription-monitoring database scenarios to learn how to identify red flags for opioid misuse.
For example, if a patient’s records show multiple visits to doctors or pharmacies, the pharmacist should recognize this as a possible red flag, and contact the prescriber to warn about potential opioid misuse, said Morgan, an associate professor in the VCU School of Pharmacy’s Department of Pharmacotherapy & Outcomes Science who served on a statewide Task Force on Prescription Drug and Heroin Abuse for then-Gov. Terry McAuliffe.
Students also practiced calculations needed to safely switch patients from one opioid to another such as from oral administration to intravenous.
In a survey conducted at the end of the course, students gave the curriculum changes high marks and said the class gave them the knowledge and confidence needed to care for their patients in the community.
“We’re going to continue it. Definitely,” Donohoe said.
Additional listed authors for the journal article are Thuy T. Tran, Pharm.D.; Ph.D. candidate Fawaz M. Alotaibi, Pharm.D.; and Archana Raghavan, Pharm.D.
For more information: Greg Weatherford, VCU School of Pharmacy director of communications
Press inquiries or questions about communications and media:
Director of communications, VCU School of Pharmacy
(804) 828-6470 (office) | (804) 937-4722 (mobile)
Advice to class of ’17: “You have the tools to succeed!”
“Wherever you go, you will be part of the School of Pharmacy family.” With those words, Dean Joseph T. DiPiro congratulated Pharm.D. and graduate degree candidates assembled for the 2017 Hooding and Diploma Ceremony.
He noted that the Class of ’17 can boast high achievers, accomplished leaders, students who have maintained high levels of professionalism and graduates who are going on to great careers in many domains of pharmacy. “It is a privilege,” he said, “to be in a profession where your career will result in bettering people’s lives.”
Graduation speaker Marcia Buck of the school’s U.Va. Division, who is president of the American Society of Consultant Pharmacists, admitted that looking to the future can be overwhelming and even scary. “You have the tools to succeed,” she assured graduates.
Her suggestions for success included looking for and accepting mentors and serving as a preceptor if the opportunity presents itself.
Buck has been precepting VCU pharmacy students for 25 years. In her experience, she said, “It is one of the best pharmacy schools in the world!”
About two-thirds of the Pharm.D. graduates will be practicing pharmacists across the country. That includes Sana Noori, who has been working with Walgreens and Bon Secours in the Richmond area since her second year of pharmacy school. “I’ve decided to stay on with both,” she said. “With Walgreens, I’ll be a community pharmacist. And with Bon Secours, I’ll be a staff inpatient hospital pharmacist. … I want to keep my skills sharp with both aspects of pharmacy.”
The remaining Pharm.D. students matched with residencies, received fellowships or will pursue graduate education. Elizabeth Young is headed for a PGY1 residency at Purdue University College of Veterinary Medicine.
“I have known for a while that I wanted to pursue a career in veterinary pharmacy,” she said. “I grew up on a farm, my father is a small-animal veterinarian and, as an undergraduate at Virginia Tech, I obtained a pharmacy technician position at the Veterinary Teaching Hospital, which really solidified my choice.”
She was able to take an elective veterinary course at VCU which, she noted, not all pharmacy schools offer. She also had the opportunity to complete a rotation with North Carolina State University’s College of Veterinary Medicine through VCU SOP’s Office of Experiential Education. Her ultimate goal is to work for a veterinary teaching hospital pharmacy — “hopefully … Virginia Tech.”
Graduate degree-holders will go on to serve as postdocs, teach or work in the pharmaceutical industry. Hebing Liu, for example, will join several VCU School of Pharmacy alumni who have gone on to work for the U.S. Food and Drug Administration.
$2.4 million R01 grant renewal awarded pharmacy-engineering research team
VCU School of Pharmacy professor Michael Hindle and VCU School of Engineering professor Worth Longest have received a $2.4 million, four-year renewal of a National Institutes of Health grant originally awarded in 2011.
The original and current R01 grants were provided by the National Heart, Lung and Blood Institute. As co-principal investigators, Hindle and Longest have been using computational fluid dynamics simulations and realistic in vitro airway models to find ways to improve aerosol drug delivery during various forms of non-invasive ventilation (respiratory support provided via a mask or nasal prongs).
Administering aerosols to the lungs via the nose is convenient for patients receiving non-invasive ventilation. But as the aerosol is delivered to its destination in the lungs, medication can be lost and wasted, drug effects can be reduced and side effects potentially can be increased. Longest and Hindle have developed a new small particle, excipient enhanced growth aerosol device that demonstrates more efficiency in reaching the lungs, reduction of variability in dose effects among subjects and better targeting of small airways.
The renewal grant will allow researchers to translate this novel high-efficiency aerosol delivery technology and test it for the first time with human subjects. (Respiratory Care editor Dean Hess referenced the need to move Hindle and Longest’s experimental and computational findings into clinical studies on page 889 of “Aerosol Therapy During Noninvasive Ventilation or High-Flow Nasal Cannula.”)
The interdisciplinary study will be performed completely within VCU by Hindle and Longest along with the School of Medicine’s Aamer Syed, Chris DeWilde and Anna Priday, VCU Johnson Center for Critical Care and Pulmonary Research; Jamal Zweit and Sundaresan Gobalakrishnan, Center for Molecular Imaging; and Mel Fratkin and Jianqiao Luo, Department of Radiology.
Longest and Hindle have collaborated on a number of research projects over the years to improve aerosol inhaler mouthpiece technology, develop novel aerosol inhaler concepts and investigate aerosol deposition in realistic oropharyngeal models. Initial seed funding for this project was supported by the Innovation Gateway at VCU and an Interdisciplinary Research Grant from the Schools of Dentistry, Pharmacy and Engineering.
Last year, Hindle was named the first recipient of the School of Pharmacy’s Peter R. Byron Distinguished Professorship. The professorship was established by Byron, the former department chairman who laid the foundation for the Department of Pharmaceutics’ Aerosol Research Group.
Hindle earned his Ph.D. in pharmaceutical sciences from the University of Bradford in England. He completed a postdoctoral fellowship in pharmaceutics at VCU School of Pharmacy before joining the Department of Pharmaceutics faculty in 1997. Learn more about his research.
In memoriam: Norman L. Hilliard (B.S. ’53)
MCV School of Pharmacy alumnus and Richmond native Norman L. Hilliard, 88, died Nov. 19, 2016.
Survivors include daughter Catherine Miles and son-in-law Caleb Miles; daughter Norma Anderson; grandsons Caleb H. Miles, Taylor Miles and Andy Anderson; and sister Frances Hilliard Pritchard. He was predeceased by his wife of 65 years, Lola West Hilliard, who died in 2013.
Norman and Lola Hilliard were familiar figures on the MCV Campus; in fact, that’s where they originally met.
Daughter Norma Anderson says her mom, a nurse, was affiliated with MCV Hospitals in the late 1940s when Norman Hilliard “saw her walking around and thought she was kind of cute!” The two soon wed, and Lola Hilliard is the one who suggested that her husband attend pharmacy school.
“She put him through school, spurred him on,” says Anderson. Hilliard, active in both Kappa Psi and Rho Chi fraternities as a student, graduated in 1953. His career included retail pharmacy practice and serving as a pharmacy officer in the U.S. Air Force, where he attained the rank of captain. Later, he returned to his alma mater to teach and also directed its continuing education program.
Anderson has fond memories of visiting her father’s office at the School of Pharmacy, sitting in on one of his lectures, dining at the Skull and Bones and playing with other alums’ kids at VPhA conventions in Virginia Beach. She also recalls her dad working behind the counter at Lafayette Pharmacy in Richmond’s Beverly Hills Shopping Center.
In the late 1960s, Hilliard went back to school, earning his M.Ed. at VCU in ‘70. That degree led to a career in continuing studies on the university level. In the 1980s, both daughters completed degrees at VCU, as well: Catherine in occupational therapy and Norma in communication arts and design.
Retirement didn’t lessen Hilliard’s involvement with the university or the school. “Both Norman and his wife were very supportive of me when I became the dean in 1996,” recalls Victor Yanchick, who retired in 2014. “It was obvious to me that he had a love for the School of Pharmacy and its long history of excellence.”
In 2008, Hilliard attended the School of Pharmacy’s 50th Anniversary Graduate Alumni Reunion along with fellow emeriti faculty Marvin Boots, John Ruggiero, Bill Soine, Harold Smith and Jim Stubbins. Asked at the time if she or her husband had any current news to share, Lola Hilliard laughed. “No, we’re just growing old!” she said. But it was clear the two weren’t slowing down.
Hilliard enjoyed playing golf regularly, his membership in the Lions Club and dinners with a rogue spin-off group, the ROLEOs (Retired Old Lions Eating Out). And together, the Hilliards attended many of his School of Pharmacy reunions as well as Galen Society Dinners for leadership donors.
As Yanchick noted, Hilliard was nothing if not a proud alumnus. In an article he wrote for the Scarab alumni magazine in 1972, Hilliard discussed the importance of interprofessionalism and expanding the School of Pharmacy’s clinical component to bring pharmacists into line with the rest of the health-care team.
“Considerable study and effort on the part of the faculty and administration has resulted in the current program,” he wrote, “which we believe to be one of the finest in the country.”
A celebration of Norman Lynwood Hilliard’s life will begin at 1:30 p.m. Dec. 4 at Trinity United Methodist Church, 903 Forest Ave. in Richmond. A reception will follow. In lieu of flowers, the family requests that donations be made to the VCU School of Pharmacy, 410 N. 12th St., P.O. Box 980591, Richmond, VA 23219; Trinity United Methodist Church, 903 Forest Ave., Richmond, VA 23229; or Hospice Community Care, 10128 W. Broad St., Suite J, Glen Allen, VA 23060.
Dealing with ageism and stereotypes
VCU School of Pharmacy faculty, alumni and students have provided the Dr. Rx column for Richmond’s Fifty Plus magazine since December 2009. We now share those columns on the SOP website, as well, for those who might not have seen the most recent issue.
Serving as Dr. Rx for June 2016 was Meredith Crumb, who received her Pharm.D. degree and Certificate in Aging Studies in May. This summer, she begins a residency with the Veterans Affairs Tennessee Valley Healthcare System in Nashville. She earned her bachelor’s degree in environmental sciences from the University of Virginia.
Q. I feel as though we Boomers are aging pretty well … eating better, exercising more, taking fewer medications … but still we hear so much about age-related bias. Any advice?
A. Ageism is the practice of stereotyping and discriminating based on age, most commonly against older adults and the aging process. This term was coined by Robert Butler, a geriatrician, who recognized age stereotyping as an issue as early as 1968.
Age stereotypes represent widely shared beliefs about the defining characteristics of groups of individuals based simply on how old they are. While the most commonly recognized form of age stereotype is that of older adults, age stereotypes exist for any age group. Teens, for example, may be stereotyped as immature or reckless, while the elderly might be considered slow or out of touch.
As you progress through life, you integrate your own experiences of aging into personal stereotypes. The social category of “older person” encompasses multiple stereotypes.
Stereotypes can be positive or negative. Unfortunately, the number of negative stereotypes tend to exceed the positive. Age stereotypes can range from beliefs about physical characteristics and personality traits to social status and behavioral tendencies. While these stereotypes are based in shared beliefs, they can vary because of different personal experiences and development.
Self-stereotyping occurs when you identify with a group – such as an age group – to the point that you unconsciously take on behaviors associated with stereotypes of that group. For example, whether you are an older person or a younger person, claiming to have a “senior moment” when forgetting something perpetuates one of the negative stereotypes associated with aging. Often we are simply distracted and are not giving our full attention to the task at hand; there’s no need to blame a stereotypical characteristic to explain the inability to recall information.
Studies have found that self-perceptions about aging can have long-term effects on health. This means that people who hold negative views of aging may experience more significant declines in their own health, over time, than those who hold positive beliefs about aging.
So start changing your negative self-stereotyping, embrace your individuality and focus on the positive aspects of aging. Stereotypes don’t have to bring you down!
Media and marketers often exploit age stereotypes, perpetuating ageism. Marketing messages can induce fear in younger populations about the aging process with the goal of persuading them to buy into “anti-aging” products and procedures.
There is some good news: While American culture tends to emphasize negative stereotypes regarding the aging process, there is evidence that the amount of age bias is actually decreasing. Since individual experiences and perspectives influence stereotyping, we can help fight age stereotypes and ageism by examining and challenging our own biases.
Pay attention and challenge the messages that society sends about the aging process. Does a particular stereotype align with your experience of the aging process? Share your experiences with others, and start the conversation to combat ageism.
AACP recognizes VCU School of Pharmacy for transformative community service
The American Association of Colleges of Pharmacy has selected VCU School of Pharmacy to receive the 2014-15 Lawrence C. Weaver Transformative Community Service Award for its significant commitment to addressing unmet community needs through education, practice and research.
Representatives from the VCU School of Pharmacy will be honored for the school’s Pharmacist Collaborative Care and Outreach in the Community (PCOC) program during AACP’s Annual Meeting, Pharmacy Education 2015, at the Gaylord National Resort & Convention Center in National Harbor, Md., in July.
“The PCOC program comprises exemplary initiatives that include academic-community partnerships with independent senior living facilities and underserved clinics, large-scale community outreach programs, and programs to train the next generation of health professionals,” said VCU School of Pharmacy Dean Joseph T. DiPiro. “The common theme that unifies PCOC initiatives is the focus on underserved populations, including the uninsured, older adults, homeless individuals and those in rural areas.”
Since it began in 2001, the PCOC program has grown to include seven formal community partnerships. During that time, 17 full-time faculty members, more than 600 students and 37 residents have provided more than 33,000 patient care encounters in the Greater Richmond area.
“The community transformation efforts of VCU have been lauded both within and outside of pharmacy, most recently with the C. Peter Magrath Award from the Association of Public and Land-grant Universities,” said Lucinda L. Maine, executive vice president and CEO of AACP. “We are truly fortunate to be able to shine a light on their excellent work.”
In addition to direct patient care, faculty, Pharm.D. and graduate students and residents have conducted more than 50 research projects related to community outreach, producing 57 posters and 14 publications.
The Weaver Award, consisting of a commemorative sculpture and financial stipend, highlights community service as an important element of the academic mission and recognizes institutions that serve as examples of social responsiveness on the part of the academic health professions community. Previous recipients are the schools and colleges of pharmacy at the University of Oklahoma, the University of Minnesota, the University of Mississippi, the University of Washington, the University of Missouri-Kansas City and the University of Southern California.
Founded in 1900, AACP is the national organization representing the interests of pharmacy education. It serves 134 accredited colleges and schools with pharmacy degree programs, including more than 6,600 faculty, 64,800 students enrolled in professional programs and 4,900 individuals pursuing graduate study.
Dixon to receive New Investigator Award
VCU School of Pharmacy assistant professor Dave Dixon has been named a 2015 recipient of the American Association of Colleges of Pharmacy’s New Investigator Award. His $10,000-funded research proposal is titled “Nighttime Dosing of Amlodipine Versus Lisinopril in Non-Dipping African Americans.”
Dixon is one of 15 pharmacy faculty nationwide who will receive start-up funding to complete their research, which will be presented at AACP’s Annual Meeting in July 2016 in Anaheim, Calif. He is the first VCU recipient since the award was initiated in 2011. Co-investigators in the study are Evan Sisson, associate professor, and Michael Kelly, PGY-1 ambulatory care resident.
In reference to the study, Dixon notes that blood pressure normally follows a diurnal pattern, higher first thing in the morning and lower at night. The absence of a nighttime dip in blood pressure increases risk for cardiovascular morbidity and mortality.
“Non-dipping” is more prevalent in African-Americans, which might explain why they are at greater risk for target organ damage. The study’s primary objective is to evaluate the efficacy of nighttime administration of two blood pressure medications, Lisinopril versus Amlodipine, in non-dipping African-Americans.
Dixon, who joined the SOP faculty in 2012, focuses primarily on lipid disorders, hypertension and heart failure. He is a fellow of the National Lipid Association, a diplomate of the Accreditation Council for Clinical Lipidology and an associate of the American College of Cardiology. He is also on the Southeast Lipid Association board of directors and serves on the editorial board of the Journal of Clinical Lipidology and iForumRx.org.
Dixon, along with Sisson and Veronica Shuford, director of educational innovation and assessment, received the 2014 AACP Innovations in Teaching Award for “Use of Video-Recorded Clinic Visits to Improve Student Pharmacists’ Clinical Interviewing Skills.” He also was named a VCU School of Pharmacy Outstanding Preceptor in 2013.
Dixon earned his Pharm.D. degree at Campbell University and completed a primary care residency at Charles George VA Medical Center in Asheville, N.C.
Pharmacy gala honors deans in transition
More than 350 VCU School of Pharmacy alumni, faculty, residents, students, preceptors, friends and family convened May 29 at Richmond’s Jefferson Hotel to mark the passing of an era. The VCU Pharmacy Gala celebrated Victor A. Yanchick’s 18 years of leadership as dean and Joseph T. DiPiro’s appointment as new dean.
Following a cocktail reception and dinner, VCU President Michael Rao announced that the Victor A. Yanchick Professorship in Geriatric Pharmacy had been established in the dean’s name. Rao commended Yanchick on his “profound legacy … that will be our building block for years to come.”
Rao also congratulated the School of Pharmacy on having been fortunate enough to attract DiPiro, who most recently served as executive dean and professor for the South Carolina College of Pharmacy at the University of South Carolina and the Medical University of South Carolina.
Sheldon Retchin, senior vice president for health sciences and CEO for the VCU Health System, said he’d never seen the Grand Ballroom so packed. ““It’s rare that you have deans travel this far!” he joked.
Robert Blouin, dean of the University of North Carolina Eshelman School of Pharmacy, was on hand, as well as Lynn Crismon and James Doluisio, current and emeritus deans of the University of Texas at Austin College of Pharmacy. VCU School of Dentistry Dean David Sarrett and the School of Nursing’s retired dean, Nancy Langston, and current dean, Jean Giddens, also were in attendance.
Noting that Yanchick had been a dean or associate dean for more than 45 years elicited a “Wow!” from the audience. During his tenure at VCU, Retchin added, “Vic has been complemented by Donna, his lovely wife. We are the beneficiaries of that relationship.”
As of July 1, DiPiro will be VCU School of Pharmacy’s eighth dean since the school’s inception in 1898. Officially introduced as incoming dean, DiPiro addressed Yanchick: “It is my privilege to follow you,” he said. “[My wife] Cecily and I wish you and Donna all the best in the years ahead.”
Lucinda Maine, executive vice president and CEO for the American Association of Colleges of Pharmacy, called the gala “a night full of institutional awe.” Yanchick was one of her first AACP officers and later served as AACP president, while DiPiro was editor of the AACP-produced American Journal of Pharmaceutical Education for 12 years.
Other highlights included tributes to Yanchick by two of the deans (Doluisio and Langston), three pharmacy alumni (John Beckner, Preston Hale and Janet Silvester), a current colleague (Jeffrey Delafuente, SOP associate dean for academic affairs) and Yanchick’s son Jeffrey. Ellen Carfagno, SOP director of development, served as emcee for the gala, and the Hon. Harvey Morgan, also an alumnus, offered the invocation.
Crismon, who counted Yanchick among his mentors, presented gifts from the University of Texas; School of Pharmacy alumnus Al Schalow read an original poem; and a painting by School of Dentistry alumnus W. Baxter Perkinson was presented by Ellen Byrne, senior associate dean with the School of Dentistry and an alumna of pharmacy, dentistry and medicine.
“I have been the world’s luckiest guy,” Yanchick remarked at evening’s end, adding that the support he has received over the years has left him with a sense of both humility and pride. As an example, he said, “I am so proud of this professorship in geriatric pharmacy. With our aging population, we have to take care of our elders in the best possible way.”
Thanking the audience for attending, Yanchick said, “I am so pleased Joe is going to be the next dean. You are in good hands now.”
The VCU Pharmacy Gala was made possible by donations from presenting sponsors MCV Foundation and the School of Pharmacy. Table sponsors were Bremo Pharmacy, Carthan F. Currin Jr., George Emerson, L. Preston and Barbara Hale, MCV Alumni Association, Pfizer Consumer Healthcare, U.Va. Health System, VCU Alumni Association, VCU Health System Pharmacy and Walgreens.
See more photos from the VCU Pharmacy Gala!