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Academy in Action 

Great Question!

Executives in the wider association world got an enlightening glimpse of AACP.

There’s an association for everything—pharmacy educators, home builders, grape growers, poodle breeders, you name it. Even though their focus differs, one association can learn a lot from another. That’s why ASAE: The Center for Association Leadership invited AACP Executive Vice President and CEO Lucinda L. Maine, Ph.D., R.Ph., to take a few questions from AACP member Amy Franks, Pharm.D., assistant professor of pharmacy practice at the University of Arkansas for Medical Sciences, then shared the responses in ASAE’s magazine. Here’s the dialogue that appeared in Associations Now, giving executives at nonprofit organizations from A to Z insights into AACP.

Amy Franks: What is the foremost challenge you see for AACP in the next five years?

Lucinda Maine: Both higher education and healthcare are in the midst of "disruptive innovation," and our members live at that intersection. AACP's challenge is to consider how to help our members prepare not just to survive but to thrive in the face of what may be very different business realities in the future. This makes the charge of the 2012-2013 Argus Commission [a group comprising the past five AACP presidents, who examine key professional issues] exciting and important. The commission's current charge is to assess the game-changers.

Franks: Given the current era of healthcare reform, how should we as academicians adapt our curricula to better prepare our students to enter the profession?

Maine: We must prepare graduates to be team-ready contributors to patient-centered care. We're not far from this focus today, and what is tremendous is that other players in healthcare now recognize that they really need the medication-use specialist (a.k.a. our graduates) on the team.

Franks: What excites you most about AACP's membership?

Maine: I'd have to say that it is their incredible level of engagement in the programs and meetings and services we provide. Even the person who conducted our member-needs analysis this past year remarked that he rarely encounters members of an organization as engaged and committed as AACP members. Reprinted with permission.

Copyright, ASAE: The Center for Association Leadership (November 2012), Washington, DC.

 

Translating Genetic Information Into Improved Care

The University of Florida delivers personalized medicine to heart patients.

Personalized medicine-a concept in which an understanding of a patient's genetic makeup is used to enhance treatment–is becoming reality at UF&Shands, the University of Florida Academic Health Center. Under a new standard of care, UF doctors will help ward off heart attacks or strokes after heart procedures by taking a person's genetic information into account before prescribing medications that prevent blood clots.

Patients at UF&Shands who undergo a procedure that involves passing a thin tube into the left side of the heart to diagnose or treat heart disease will now be routinely screened for biological signals in their blood. Physicians hope to discover clues about how patients might respond to a common anticlotting drug called clopidogrel, also sold as Plavix.

"In 2010, the Food and Drug Administration changed clopidogrel's label to warn clinicians that it may not work for high-risk heart patients with certain genetic traits. But there hasn't been a good way to get genetic information to doctors so they can use it during treatment," said Dr. Julie A. Johnson, director of the UF Clinical and Translational Science Institute's (CTSI) Personalized Medicine Program and the UF College of Pharmacy's Center for Pharmacogenomics. "Over the past year, we worked with stakeholders across our health system to tackle that challenge, and we are now able to deliver on the promise of personalized medicine."

Reducing Complications

The screening is no different than a typical blood draw for patients. One sample is sent to UF Pathology Laboratories to determine if any of the seven genetic variations that influence how the body responds to clopidogrel are present. Results are typically available within 24 hours and are added to the patient's electronic medical record. If the results suggest that clopidogrel is not the best treatment option, the electronic medical record system will alert the cardiologist and recommend that alternate drugs be prescribed.

"This helps us prescribe the right medication the first time and absolutely has the potential to reduce complications," said Dr. R. David Anderson, an associate professor of medicine at UF and director of interventional cardiology and the cardiac catheterization laboratory at UF&Shands. The new screening procedure is in line with the National Institutes of Health's (NIH) vision to use patients' genetic information to tailor their healthcare. The Genetic Information Nondiscrimination Act allows people to benefit from personalized medicine without fear of genetic discrimination by health insurance companies or employers.

A Blueprint for Better Health

This initial use of personalized medicine at UF&Shands will help the roughly 1,500 patients per year treated at the cardiac catheterization lab, 40 percent of whom are likely to be prescribed clopidogrel. Over time, UF&Shands will expand the new approach to more patients. "The model we've developed can provide a blueprint for other health systems that want to use evidence-based genetic information to improve patient care," said Dr. David R. Nelson, director of the UF CTSI. "This is a major step toward being able to translate more than a decade of groundbreaking genomic research into better health."

Stanford University adopted the UF&Shands model, and UF and Stanford researchers collaborated to develop a custom chip to collect and screen DNA samples for a total of 256 genetic variations that are suspected of influencing how the body responds to medications, including the seven relevant to clopidogrel. UF Pathology Laboratories is using the new gene chip as part of a related research study. Participants can have their additional 249 results stored in a secure database for future use in clinical care and research.

Funding for the UF CTSI Personalized Medicine Program and the collaboration with Stanford came from a grant of nearly $500,000 through the Clinical and Translational Science Awards program, led by NIH's National Center for Advancing Translational Sciences. A $350,000 grant from the NIH Pharmacogenomics Research Network provides additional support.

For now, NIH funding will cover the screening costs at UF&Shands. UF researchers will study the program as it rolls out to assess and optimize its cost-effectiveness and impact on patient care.

 

Genetic Testing in the Community Pharmacy

The Ohio Northern University (ONU) Raabe College of Pharmacy, along with Kroger Pharmacy, received a Community Pharmacy Foundation grant that focuses on looking at genetics relative to drug therapy. The clinical study includes testing patient genetic information relative to a specific metabolizing enzyme that is responsible for converting clopidogrel to its active form.

Using genetic testing in the community pharmacy setting, researchers will try to identify individuals for whom the drug is likely not working. These individuals can then be given an alternative medicine. The study is being performed in collaboration with Kroger Pharmacies at several sites, but primarily in Marion, Ohio. Lab work and analysis will occur at ONU. Dr. David R. Bright, assistant professor of pharmacy practice, is the principal investigator. Dr. David F. Kisor, professor of pharmacokinetics and chair of the Department of Pharmaceutical and Biomedical Sciences, and Dr. Jeffery Talbot, associate professor of pharmacology, are co-investigators.

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