Ryan Marotta, Assistant Editor

In recognition of his dedication to improving his patients’ health through individualized care, George Bethel, RPh, has been named the 2017 winner of the Walmart Pharmacist Excellence in Patient Care Award.

A graduate of the University of Rhode Island College of Pharmacy, Bethel has worked as a pharmacist or pharmacy manager at Walmart pharmacies throughout Maine, including stores in Brunswick, Auburn, Rockland, Portland, and Windham. He considers the highlight of his career, however, to be his daily interactions with his patients.

“I chose the profession of pharmacy for its ability to have a positive impact on members of the community through one-on-one consultation,” Bethel told 

 “Individual patient care and interaction is the most rewarding aspect of my career.”

Bethel recalled a particularly noteworthy incident in which a patient asked him for help choosing a dietary supplement. During their conversation, Bethel discovered that the patient was seeking treatment for advanced prostate cancer and that the patient’s lack of insurance forced him to look for an OTC medication.

“I convinced the patient to seek assistance for insurance and return to his provider for medical treatment,” Bethel said. “We developed a great professional relationship after this, and I had the honor of serving him for an additional 8 years. One of my last conversations with the patient touched upon his gratitude for our initial contact and his emphasis on the importance of preventive screening.”

Reflecting on his career, Bethel emphasized the importance of gratitude in caring for patients and advised his fellow pharmacists to end each consultation with a sincere gesture of appreciation.

“Pharmacists provide an integral role in comprehensive health care. As a cornerstone of our profession, we offer useful and relevant information for our community, but we should never take for granted the trust our patients give us,” he said. “Taking time to consult with patients seeking professional advice is paramount for the future of pharmacy.”

Q: What do you think is the most important quality for a pharmacist to possess? 

Pharmacists need to have both an awareness for unique patient needs and the ability to refine pharmacy practice to meet those requirements. We serve diverse populations of patients within our communities, encountering a broad range of socioeconomic, educational, religious, and generational differences. Identifying specific patient needs allows us to offer the most effective level of service, and investing time with each patient enables us to provide a better level of care.

Q: What do you think is the most important issue in the field of pharmacy today? 

 It is essential that pharmacists be nationally recognized as health care providers. Provider status is warranted in response to the wide range of services that are now being offered by pharmacists, including medication therapy management, comprehensive medication reviews, immunizations, and collaborative practice. Each clinical service provides an additional level of support by supplementing traditional paths of health care management. On average, community pharmacists see individual patients at least once a month. Ongoing patient engagement builds trusting relationships and allows for greater opportunity to discuss concerns, answer questions, and establish regular intervals for follow-up consultation. As pharmacists continue to be a viable resource for health care services, obtaining provider status will allow our profession to better contribute toward a higher level of patient care.

Q: What advice would you give to aspiring pharmacists? 

 Since the start of my career, I have looked for ways to mentor pharmacy students by way of preceptor site hosting and summer intern programs. Working with these young professionals is a rewarding experience that affords an opportunity to give back to the profession. Our future pharmacists are a group of talented individuals determined to make positive impacts on the profession, and I am encouraged by their curiosity and zeal. My advice for future pharmacists is to maintain that same level of curiosity and enthusiasm throughout their career.

Articles

Walmart Pharmacist Excellence in Patient Care Award Winner: George Bethel, RPh

Learn about the new products and expanded indications approved by the FDA in June 2017.

The FDA approved Melinta Therapeutics’ delafloxacin (Baxdela) on June 19, 2017.

Baxdela is indicated to treat adults with acute bacterial skin and skin structure infections (ABSSSI) caused by susceptible bacteria. The drug, a fluoroquinolone that exhibits activity against both gram-positive and gram-negative pathogens, will be available as both a 450-mg tablet and a bioequivalent 300-mg IV dose.

Like other fluoroquinolones, Baxdela carries a risk of adverse events such as tendinitis, peripheral neuropathy, and central nervous system effects. Other side effects associated with the drug’s use include nausea, vomiting, diarrhea, and headache.

The FDA approved Neos Therapeutics’ methylphenidate extended-release orally disintegrating tablets (Cotempla XR-ODT) on June 19, 2017.

Cotempla XR-ODT is indicated for the treatment of attention-deficit/hyperactivity disorder (ADHD) in patients aged 6-17 years. It is the first orally disintegrating extended-release methylphenidate product to receive the FDA’s nod.

Adverse events associated with the drug’s use include decreased appetite, difficulty sleeping, nausea, vomiting, indigestion, stomach pain, weight loss, anxiety, dizziness, irritability, mood swings, increased heart rate, and increased blood pressure.

Neos plans to launch Cotempla XR-ODT in child-resistant blister packs during the fall of 2017.

The FDA approved Shire’s mixed salts of a single-entity amphetamine product (Mydayis) on June 20, 2017.

Mydayis, a product consisting of 3 different types of drug-releasing beads, is indicated for the once-daily treatment of ADHD in patients aged 13 years and older.

Adverse events reported by trial participants treated with the drug include difficulty sleeping, decreased appetite, dry mouth, increased heart rate, anxiety, nausea, irritability, and weight loss.

Shire plans to launch the Mydayis during the third quarter of 2017.

The FDA approved Genentech’s rituximab and hyaluronidase human (Rituxan Hycela) on June 22, 2017.

Rituxan Hycela is indicated for the treatment of follicular lymphoma (FL), diffuse large B-cell lymphoma (DLBCL), and chronic lymphocytic leukemia (CLL) in adults. The drug, a subcutaneous injection, includes the same monoclonal antibody as intravenous rituximab (Rituxan) in combination with hyaluronidase human, an enzyme that helps to deliver rituximab under the skin.

Adverse events associated with the use of Rituxan Hycela in patients with FL include infection, low white blood cell count, nausea, constipation, cough, and fatigue. Side effects reported by trial participants with DLBCL include infection, low white blood cell count, hair loss, nausea, and low red blood cell count. Adverse events observed in patients with CLL include infection, low white blood cell count, nausea, low platelet count, fever, vomiting, and injection site redness.

Melinta Therapeutics announces US FDA Approval of Baxdela for acute bacterial skin and skin structure infections [news release]. Melinta’s website. 

http://melinta.com/melinta-therapeutics-announces-u-s-fda-approval-baxdela-delafloxacin-acute-bacterial-skin-skin-structure-infections-absssi

Neos Therapeutics announces FDA approval of Cotempla XR-ODT (methylphenidate) extended-release orally disintegrating tablets for the treatment of ADHD in patients 6 to 17 years old [news release]. Neos’ website. 

http://investors.neostx.com/phoenix.zhtml?c=254075&p=RssLanding&cat=news&id=2281776

U.S. FDA Approves Mydayis (mixed salts of a single-entity amphetamine product) — A New Once-Daily Option for ADHD Symptom Control in Patients 13 Years and Older [news release]. Shire’s website. 

https://www.shire.com/newsroom/2017/june/w6x937

FDA Approves Rituxan Hycela (Rituximab and Hyaluronidase Human) for Subcutaneous Injection in Certain Blood Cancers [news release]. Genentech’s website. 

https://www.gene.com/media/press-releases/14670/2017-06-22/fda-approves-rituxan-hycela-rituximab-an

4 New FDA Approvals to Know from June 2017

Although moderate drinking is commonly thought to lower an individual’s risk of developing cardiovascular disease (CVD) compared with heavy drinking or abstinence, the results of a recent study suggest that these protective benefits may only extend to certain heart conditions.

, analyzed data on 1.93 million individuals with no history of CVD. After a median follow-up period of 6 years, the research team found that moderate drinking (defined as no more than 14 units of alcohol a week) was associated with reduced risks of unstable angina, myocardial infarction, unheralded coronary death, heart failure, ischaemic stroke, peripheral arterial disease, and abdominal aortic aneurysm compared with not drinking. However, moderate drinking was not linked to any reductions in chronic stable angina, sudden coronary death, transient ischaemic attack, or intracerebral and subarachnoid hemorrhage.

Based on their findings, the researchers advise health care providers to recommend that their patients lower their CVD risk through more effective ways than moderate drinking, such as exercising and quitting smoking.

“This has implications for patient counselling, public health communication, and disease prediction algorithms and suggests the necessity for a more nuanced approach to the role of alcohol consumption in the prevention of cardiovascular disease,” the study authors concluded.

Although moderate drinking is commonly thought to lower an individual’s risk of developing cardiovascular disease compared with heavy drinking or abstinence, the results of a recent study suggest that these protective benefits may only extend to certain heart conditions.

Moderate Drinking Less Effective at Preventing Heart Disease Than Previously Thought

The results of a recent study indicate that patients with severe mental illnesses (SMI), such as schizophrenia, bipolar disorder, and major depression, are significantly more likely to develop cardiovascular disease (CVD) than the general population.

, analyzed data on 3.2 million patients across 92 previous studies. Of the participants with SMI, 10% also had CVD. Based on their analysis, the researchers determined that patients with SMI faced a 53% higher risk of CVD than healthy participants and were 85% more likely to die from CVD than patients of a similar age without SMI.

Noting that factors such as antipsychotic use and higher body mass index could contribute to this increased risk, the study authors advise health care providers to screen patients with SMI for CVD while managing risk factors and recommended that they prescribe antipsychotics associated with fewer adverse events.

“These findings are a stark reminder that people with SMI are being left behind, at a time when the health of the general population as a whole appears to be benefitting from public health initiatives to reduce the burden of cardiovascular disease,” said Brendon Stubbs, PhD, in a press release. “People with SMI die much earlier than those without these disorders, yet the majority of these premature deaths may be preventable with care that prioritizes lifestyle changes, such as exercise, better nutrition, and stopping smoking, along with cautious prescribing of antipsychotics.”

The results of a recent study indicate that patients with severe mental illnesses, such as schizophrenia, bipolar disorder, and major depression, are significantly more likely to develop cardiovascular disease than the general population.

Mental Illness Linked to Heightened Cardiovascular Disease Risk

A recent study has found that women who consume a diet associated with chronic inflammation as adolescents or young adults may face a heightened risk of premenopausal breast cancer.

Cancer Epidemiology, Biomarkers & Prevention

, evaluated data on 45,204 women aged 33-52 years who completed food frequency questionnaires about their diet as teenagers and adults. The participants were then separated into 5 groups based on the inflammatory score of the adolescent diet, with a high score defined by a diet low in vegetables and high in soft drinks, refined sugars and carbohydrates, red and processed meats, and margarine.

During a 22-year follow-up period, 870 of the participants were diagnosed with premenopausal breast cancer and 490 were diagnosed with postmenopausal breast cancer. Based on their analysis, the researchers determined that women in the highest inflammatory score group were 35% more likely to develop premenopausal breast cancer than those in the lowest score group.

“About 12% of women in the United States develop breast cancer in their lifetimes,” said Karin B. Michels, ScD, PhD, in a press release. “However, each woman’s breast cancer risk is different based on numerous factors, including genetic predisposition, demographics, and lifestyle. Our study suggests that a habitual adolescent/early adulthood diet that promotes chronic inflammation may be another factor that impacts an individual woman’s risk.”

Poor Diet Linked to Premenopausal Breast Cancer Risk

Although current guidelines indicate that women at average risk do not need to be screened for cervical cancer after age 65, the results of a recent study suggest that women up to age 85 can benefit from these screenings.

, evaluated data on cervical cancer rates and the use of screening tests among women 65 years and older from the 2013 and 2015 National Health Interview Survey. The research team found that, after correcting for hysterectomy, incidence rates of cervical cancer among the participants increased up to age 70 and did not start declining until age 85. The study authors also noted that one-fifth of cervical cancer cases and one-third of cervical cancer deaths in 2013 occurred among women 65 years and older.

Additionally, the researchers discovered that while only 12% of women in their 40s had not been recently screened for cervical cancer, that percentage progressively increased as women approached their 50s and 60s and that nearly 850,000 women aged 61-65 years had not been screened within the previous 5 years.

“In the short term, efforts could be undertaken to clarify misperceptions about the risk of cervical cancer among older women and providers,” said lead author Mary C. White, ScD, in a press release. “Messages about a ‘stopping age’ need to emphasize the recommendation for an adequate screening history of previous negative tests before screening is discontinued, not just chronologic age.”