Specialty Roundtable: Exploring Practice Settings within Psychiatric and Neurologic Pharmacy

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1 Specialty Roundtable: Exploring Practice Settings within Psychiatric and Neurologic Pharmacy Sunday, April 19, 3:15-4:30 p.m. Grand Ballroom E Academic Detailing Table 1: Sarah J. Popish, PharmD, BCPP Program Manager, Academic Detailing Program Office Veterans Affairs Central Office, Pharmacy Benefits Management Clinical Pharmacy Specialist-Mental Health VA Northern California Healthcare System Vallejo, CA Dr. Popish is currently a Program Manager for Veterans Affairs Central Office, Pharmacy Benefits Management, Academic Detailing Program office. After receiving her PharmD from the University of Colorado School of Pharmacy she went on to complete an Psychiatric Pharmacy Residency affiliated with Idaho State University College of Pharmacy and a two year Pharmacogenomics and Psychopharmacology Research Fellowship with Nova South Eastern University and Lake Erie College of Medicine. Dr. Popish has lectured extensively on various topics in clinical psychiatry, published several peer reviewed articles, and received numerous professional honors and awards, including the National Pharmacy Benefits Management innovative practice award. Academic Detailing Academic Detailing is evidence based outreach programing that seeks to use the marketing strategies of industry to promote evidence based guidelines and best practices. The Veterans Affairs Academic Detailing (AD) program office develops educational programing and trains healthcare professionals, primarily pharmacists, to deliver this programing. This starts with a thorough evaluation of the available literature to develop up-to-date, evidence-based recommendations that cover the comparative benefits, risks and cost-effectiveness of treatments for a given therapeutic area. These recommendations or key messages are then disseminated by Academic Detailers in an interactive educational outreach visit that utilizes social marketing to engage the provider and meet his or her specific educational needs. Academic detailing is based on relationship building and provides specific practice-change recommendations through key message-focused discussions with the clinician. Table 2: Tammie Lee Demler,BS, PharmD, MBA., BCPP Director of Pharmacy Services and Psychiatric Pharmacy Residency Training New York State Office of Mental Health at the Buffalo Psychiatric Center Adjunct Clinical Associate Professor of Pharmacy Practice Department of Pharmacy Practice University of Buffalo School of Pharmacy and Pharmaceutical Sciences Buffalo, New York Dr. Tammie Lee Demler is the Director of the ASHP accredited post Doctoral psychiatric pharmacy residency for the New York State Office of Mental Health and is the Director of pharmacy services for the Buffalo Psychiatric Center. facility within the New York State Office of Mental Health. Dr.Demler is past President of the Pharmacists Society of the State of New York and President of the Pharmacists Association of Western New York. She received her BS in pharmacy in 2002, Doctor of Pharmacy degree in 2002 and Masters of Business Administration in 2009 from the University of Buffalo. She is board certified (BCPP) in psychiatric pharmacy practice. Currently, Dr. Demler serves as Clinical Associate Professor of pharmacy practice at the University of Buffalo School of Pharmacy and Pharmaceutical Sciences, Clinical Assistant Professor at The University of

2 Florida, St. John Fisher College and D Youville College in Buffalo, NY. She received a gubernatorial appointment to the NYS Department of Motor Vehicles Medical Advisory Board and currently collaborates with the New York State Department of Health as an academic detailer/clinical pharmacist prescriber educator.having found her passion for media and community outreach, Dr. Demler has been host of WNY Tonight with Tammie Lee for the last decade, and in addition to being featured as an expert in numerous media interview she is also a contributing author for APA psychiatric news, US Pharmacist, ACCP Ambulatory Care Self Assessment Progam (ASCAP) and Carlat behavioral report. She most recently was promoted to community affairs radio reporter for Cumulus Broadcast Company (97 Rock, 103 the edge, 104 WHTT). Among her most notable awards, Dr. Demler was named the New York State Senate Woman of Distinction in 2004 for her professional contributions to the people of New York State and the Bowl of Hygeia for her national professional advocacy. Inpatient State Psychiatric Hospital The New York State Office of Mental Health (NYS OMH) is responsible for the operation of 17 psychiatric facilities, which serve mentally ill adults with each facility located withon one of five geographic regions. The Buffalo Psychiatric Center provides comprehensive mental health services to adults 18 and over who reside in Erie, Niagara, Cattaraugus and Chautauqua counties (total population served 1,350,731). BPC inpatient services has a bed capacity of 189 for 7 units and thousands of outpatients served by clinic staff and ACT team members. Primary Care Table 3: Glen L. Stimmel, PharmD Professor of Clinical Pharmacy, Psychiatry and the Behavioral Sciences University of Southern California School of Pharmacy and Keck School of Medicine Los Angeles, CA Dr. Stimmel is a founding member and Past President of CPNP and Board member of the CPNP Foundation, a founding member, elected fellow, and Past President of the American College of Clinical Pharmacy, and an original member and past Chair of the Board of Pharmaceutical Specialties Specialty Council on Psychiatric Pharmacy Practice. Dr. Stimmel has authored over 230 articles and textbook chapters in the areas of clinical psychopharmacology, pharmacoeconomics, and expanded scope of practice for pharmacists. He pioneered efforts in developing psychiatric pharmacy practice, education and residency programs, as well as investigating and securing prescriptive authority for pharmacists in California. LAC/USC Geriatrics Primary Care Clinic This clinic provides primary care to all seniors > 75 years old, seniors > 65 years old with complex medical problems, and any elder or dependent adult suspected of being a victim of abuse/neglect. The clinical team consists of attending geriatricians, a geriatrics fellow, 4-5 internal medicine residents, a clinical pharmacist (Dr. Stimmel), and an ambulatory care pharmacy resident. The team together makes all treatment decisions. Dr. Stimmel and the attending geriatrician consult with the internal medicine residents as they present their cases where drug therapy decisions are made. The most common disorders in this clinic include diabetes, hypertension, cardiovascular disease, incontinence, osteoporosis, routine health maintenance, depression, insomnia, and mild to moderate dementia. LAC/USC Rheumatology Clinic Depression Management Consult Service This specialty clinic provides care to patients with all rheumatoid disorders; the most common disorders are lupus and rheumatoid arthritis. The clinicians include 4-5 rheumatologist attending staff, 6 rheumatology fellows, Dr. Stimmel, and an ambulatory care pharmacy resident. Depression is commonly seen in this clinic (>20% of patients). Rheumatology attendings and fellows refer patients to Dr. Stimmel who have new depressive symptoms, and patients who are already taking antidepressants. New patient evaluations (typically ~45 patient visit) result in either a referral to psychiatry (~20%), no

3 Table 4: start of antidepressants since patient does not meet criteria for major depression (30%), or start/continue antidepressants with individual follow-up appointments with Dr. Stimmel (~50%). Prescriptive authority is not part of this practice since it was purposely set up to be a consultative service to enhance the rheumatology fellows expertise in identifying and treating depressive disorders with Dr. Stimmel. Carla Cobb, PharmD, BCPP Clinical Psychiatric Pharmacist RiverStone Health Billings, Montana Carla Cobb is a psychiatric pharmacy specialist at RiverStone Health and the Montana Family Medicine Residency in Billings, Montana where she has practiced for 16 years. She is a Clinical Professor in Pharmacy Practice at the University of Montana. Carla graduated from the University of Manitoba and received her Doctor of Pharmacy degree from the University of Texas. She completed a residency in psychiatric pharmacy at the University of Texas and San Antonio State Hospital. She is board certified in psychiatric pharmacy. She is a founding member of the College of Psychiatric and Neurologic Pharmacists and serves on the drug utilization review board for Montana Medicaid, the Montana Patient Centered Medical Home stakeholder council, and the Pharmacy Quality Alliance. Her practice and research is focused on the team approach of care for people with psychiatric disorders in the primary care setting, including the role of pharmacistprovided comprehensive medication management. In 2013 she was awarded the Bowl of Hygeia for outstanding community service. Pharmaceutical Industry Table 5: Primary Care Clinic RiverStone Health is a federally-qualified community health center that includes a primary care clinic, outpatient pharmacy, healthcare for the homeless, Medicaid case management, hospice, home health, family health, and public health services. The health clinic is a NCQA Level 1 recognized patient-centered medical home and serves as the outpatient clinic for the Montana Family Medicine Residency with a total of 24 residents. Students from the University of Montana School of Pharmacy also enjoy 8-week required ambulatory care or four-week psychiatry or medication management elective advanced practice experiences in the clinic. The clinic provides an integrated team approach to care with physicians, non-physician providers, residents, behavioral health (psychologist, therapist, addiction counselor), diabetes educator, dietician, care coodinators, and resource advocates, all part of the patient care team. Three part-time pharmacists, including one board certified psychiatric pharmacist, along with pharmacy students, provide clinic pharmacy services. Toya Bowles, PharmD, MS, BCPP Principal Medical Science Liaison, CNS Medical Affairs Janssen Scientific Affairs, L.L.C. Titusville, NJ via Miami, FL Dr. Toya Bowles is a CNS Principal Medical Science Liaison for Janssen. She has worked in the pharmaceutical industry, specifically in CNS, for the last 12 year. Prior, Dr. Bowles worked as a clinical psychiatric pharmacist. She received her BS Pharm and Pharm D from the University of Kansas, and a Psychopharmacology Fellowship and Masters of Science in pharmacy law, policy, and regulatory from the University of Florida. She is Board Certified in Psychiatric Pharmacy. Field Science Medical Science Liaisons (MSL) are generally experts in the field (PharmD, PhD, MD). CNS MSL s and have been specialty trained in psychiatric pharmacy with many years of clinical experience, and usually BCPP prior to working in industry. Generally, MSL s

4 provide detailed medical information, gather medical insights both regionally/nationally, and connect/liaise research and projects with the company. Though each pharmaceutical company operates differently, there are common regulatory processes all follow. Table 6: Judy L. Curtis, PharmD, BCPP, FASHP Director, Medical Science Liaisons, MidAtlantic Region Sunovion Pharmaceuticals Inc. Marlborough, Ma Dr. Judy Curtis is a board certified psychiatric pharmacist and recently joined Sunovion as a Director, Medical Science Liaison, MidAtlantic region. Previously, she was with Ortho- McNeil Janssen Scientific Affairs as a CNS Principal Scientific Affairs Liaison for nine years. Prior to industry, Dr. Curtis was an Associate Professor at the University of Maryland, School of Pharmacy in Baltimore, Maryland, Her primary clinical practice was with developmentally delayed adults with severe behavioral problems. She also developed and directed the Psychiatric Pharmacy Practice Residency program for the Mental Health Program at University of Maryland for 16 years. She was a consultant for the Department of Justice, Department of Health and Mental Hygiene and Developmental Disabilities Administration for the State of Maryland, Clifton T. Perkins Hospital Center (forensic facility), Washington County ARC and various other state agencies. She is a founding member of the College of Psychiatric and Neurologic Pharmacists and served as the association s secretary from Dr. Curtis frequently presented at national and regional meetings on various psychiatric topics. She has numerous publications and was the primary author for chapters in Applied Therapeutics and Pharmacotherapy. I work as part of the Medical Affairs division of Sunovion Pharmaceuticals Inc., as a Medical Science Liaison. My job is to disseminate clinical information about the company s product(s) to health care professionals and formulary decision makers and initiate and maintain relationships with researchers, academic leaders, key opinion and thought leaders. I also answer clinical questions regarding the product(s), including offlabel questions upon unsolicited request. I attend, represent and support the company s presence at professional meetings and participate in speaker training for the company s speaker s bureau. I am responsible for MSL activities in the MidAtlantic Region of the US. The views and opinions expressed here are mine and not those of Sunovion Pharmaceuticals. Substance Use Disorder Table 7: Christopher Stock, PharmD, BCPP Clinical Pharmacy Specialist, Substance Abuse Programs Pharmacy Research Program Manager Co-Director, CSP InterMountain NODES Center George E Wahlen VA Medical Center Salt Lake City, UT Chris Stock, PharmD, BCPP is a clinical pharmacy specialist for the substance abuse treatment programs at the George E Wahlen VA Medical Center in Salt Lake City and Adjunct Professor at the University of Utah. He completed his PharmD and a clinical pharmacy residency at the University of Utah and affiliated hospitals and clinics in He taught at Ferris State University in Michigan for several years before returned to Salt Lake City in He has 30 years of experience working in the substance abuse field with adolescent and adults. He ran the VA s outpatient detoxification clinic for alcohol and opioids for nearly 10 years and now is part of a multidisciplinary Recovery Clinic at the VA providing Medication Assisted Treatments including methadone, Suboxone and naltrexone for opioid dependent veterans. He is an active clinical investigator, has partnered with NIDA (the National Institutes on Drug Abuse) and the VA research office

5 for the past 20 years conducting studies on Medication Assisted Treatments for Opiate, Alcohol, Tobacco, Methamphetamine and Cocaine Addiction. He along with other VA and University of Utah colleagues recently published results of a trial treating symptoms of alcohol withdrawal with either gabapentin or chlordiazepoxide. Chris has authored and coauthored numerous publications, primarily regarding pharmacotherapy trials for substance use disorders. He has recently become the naloxone distribution and overdose prevention champion at this VA and in Utah. He is on several national committees related to naloxone distribution. He is co-chairing this facilities opioid safety initiative. He is a long standing member of the U of U s IRB committee. He bicycles, hikes, swims, loves to travel with his wife. Table 8: VA Inpatient and Clinics VA Substance Use disorder 15 bed residential program and weekly clinics, including tobacco cessation clinic and buprenorphine clinic. Educational groups, medication groups, overdose awareness and prevention group, naloxone distribution for overdose prevention VA Chairman overseeing VA/NIDA interagency research contract this clinical trial group (10 clinics) has conducted over a dozen RCTs of medications for substance use disorders ( tobacco, cocaine, methamphetamine, and opioid dependence in the past 15 years) Community outreach Legislative champion for increased naloxone access in Utah 2014 Working with the Utah Department of Health, several healthcare systems to implement Overdose Education and Naloxone Distribution throughout Utah. Bethany DiPaula, PharmD, BCPP Associate Professor, University of Maryland Director of Pharmacy, Springfield Hospital Center Clinical Pharmacist, Howard County Health Department Dr. DiPaula is a residency trained, board certified psychiatric pharmacist. She is an associate professor at the University of Maryland, Baltimore School of Pharmacy and the Residency Program Director for the PGY2 Psychiatric Pharmacy Residency Program Director. Dr. DiPaula has been active in developing physician-pharmacist collaborative practices. She created a buprenorphine/naloxone-maintenance program at the Howard County Health Department. She works collaboratively with the Health Department s physicians to assess and manage opioid dependent patients, many of which are indigent. She previously worked with opioid dependent patients in a pharmacist-physician collaborative care model at People s Community Health Center. Dr. DiPaula developed PGY2 psychiatric pharmacy residency rotations at both the Howard County Health Department and People s Community Health Center. She has also mentored addicted pharmacists while volunteering with the Pharmacist Education and Assistance Committee (PEAC). Within the mental health program, Dr. DiPaula has provided clinical pharmacy and administrative services at Maryland state psychiatric hospitals and has served as Director of Pharmacy. Dr. DiPaula has participated in national committees and programs relating to psychiatric and substance use disorders. Most recently, she has been serving as the chair of the 2014 College of Psychiatric and Neurologic Pharmacists (CPNP) Substance Abuse Task Force. Howard County Health Department, Columbia, Maryland I work within a physician-pharmacist collaborative practice at the Howard County Health Department in the Behavioral Health-Substance Abuse Bureau. This is a suburban health department which provides full substance abuse treatment programming as well as medication management for substance use and psychiatric disorders. Under Maryland State approved protocols, I provide medication management services for buprenorphine/naloxone maintained patients during individual and group appointments. I also assist with patient follow up, medication prior authorization, and diversion monitoring.