Vital Record » Pharmacy http://news.tamhsc.edu Your source for health news from the Texas A&M Health Science Center Thu, 18 Dec 2014 20:47:39 +0000 en-US hourly 1 ACPE names pharmacy dean chair-elect for international commission http://news.tamhsc.edu/?post=acpe-names-pharmacy-dean-chair-elect-for-international-commission http://news.tamhsc.edu/?post=acpe-names-pharmacy-dean-chair-elect-for-international-commission#comments Thu, 18 Dec 2014 20:47:39 +0000 http://news.tamhsc.edu/?post_type=post&p=22206 The Texas A&M Rangel College of Pharmacy dean was elected to serve as chair-elect for International Commission for the Accreditation Council for Pharmacy Education. In this role, he serves with site evaluation teams to improve and certify programs at colleges of pharmacy around the world and will represent the International Commission as chair beginning in February ]]>
Dean of the Texas A&M Rangel College of Pharmacy

Indra K. Reddy, Ph.D., professor and founding dean of the Texas A&M Rangel College of Pharmacy

Indra K. Reddy, Ph.D., professor and founding dean of the Texas A&M Health Science Center Irma Lerma Rangel College of Pharmacy, was named vice chair/chair-elect of the International Commission for the Accreditation Council for Pharmacy Education (ACPE) from Feb. 1, 2015, to Jan. 31, 2016.

Since 2013, Reddy has served as an international commissioner through the International Service Program, which extends through 2016. In this role, he serves with site evaluation teams to improve and certify programs at colleges of pharmacy around the world. Beginning in February 2016, Reddy will represent the International Commission as chair during ACPE board of directors’ meetings.

“I bring my experiences as founding dean of the Texas A&M Rangel College of Pharmacy to the floor to help advance the mission of ACPE’s International Services Program, to enhance the quality of pharmacy education, training and practice in global settings,” Reddy said. “I am delighted to serve as International Commissioner as it presents a tremendous opportunity to contribute to the advancement of pharmacy education and training and to the provision of optimal patient care.”

As commissioners, the team witnesses and participates in, firsthand, the quality enhancement of pharmacy education and practices throughout the world.

In June, ACPE granted pharmacy degree program certification to programs in India, Cyprus, and Saudi Arabia. Recently certified programs include, Jagadguru Sri Shivarathreeshwara University Colleges of Pharmacy in India, Near East University Faculty of Pharmacy in Northern Cyprus, and King Faisal University College of Clinical Pharmacy in Saudi Arabia.

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Texas A&M pharmacy students reach out to South Texas at Project SHINE http://news.tamhsc.edu/?post=texas-am-pharmacy-students-reach-out-to-south-texas-at-project-shine http://news.tamhsc.edu/?post=texas-am-pharmacy-students-reach-out-to-south-texas-at-project-shine#comments Thu, 18 Dec 2014 16:30:44 +0000 http://news.tamhsc.edu/?post_type=post&p=22187 Texas A&M pharmacy students, in collaboration with other health professionals, combat preventable diseases by providing free health screenings at Project SHINE (Service & Help through Interprofessional Networking Experience), targeting low-income, border communities in South Texas. The students received a grant from Blue Cross Blue Shield in the Healthy Kids, Healthy Families initiative to provide free flu shots for the community]]>
A pharmacy student performs a health screening at Project SHINE

David Guzman, second-year professional student pharmacist at Texas A&M Rangel College of Pharmacy, provides a blood glucose screening at Project SHINE at the Dr. Javier Saenz Middle School in Penitas, Texas, in November.

Families are sometimes faced with a difficult choice:  pay for food or visit a doctor’s office.  While many factors contribute to making this important decision, including inadequate health insurance coverage, lack of transportation or the inability to take time off from work, people put themselves at risk when they do not visit a physician regularly for routine checkups.

In fact, six of the seven leading causes of death in Texas were chronic diseases, including heart disease, high blood pressure and diabetes, according to the 2014 Health Status of Texas report. Together, these chronic diseases claimed the lives of more than 105,000 Texans.

In order to detect certain chronic diseases and combat the problem, patients need to have regular screenings in the early stages when intervention is most effective.

Professional student pharmacists at the Texas A&M Health Science Center Irma Lerma Rangel College of Pharmacy, in collaboration with other health professionals, including the Texas A&M College of Medicine, are working to combat preventable diseases by providing free screenings throughout the year in South Texas. The screenings, many of which are part of the student-driven Project SHINE (Service & Help through Interprofessional Networking Experience), target low-income, border communities, known as colonias, that are unincorporated subdivisions often lacking access to basic infrastructure and health care services.

“Project SHINE offers an invaluable service to residents of the colonias,” said David Guzman, second-year professional student pharmacist at Texas A&M Rangel College of Pharmacy. “I experienced the dire need firsthand as a child growing up in South Texas.”

Project SHINE was developed by students from the Texas A&M Rangel College of Pharmacy to provide preventative health care services to medically underserved areas in South Texas. The project not only provides preventative care, it is an interprofessional educational opportunity for medical, nursing, pharmacy and other health professions students. Students provided cholesterol, blood glucose and blood pressure screenings, as well as immunizations, along with patient counseling – all free of charge.

In November, the interprofessional team for Project SHINE saw more than 80 patients in South Texas at the Dr. Javier Saenz Middle School in Penitas. More than 60 patients received free flu shots supported by a grant from Healthy Kids, Healthy Families, an initiative designed to improve the health and wellness of at least 1 million children through community investments.

With each person who walked into the gym of the middle school on that Saturday, Guzman saw someone like his mother or grandmother, who were in need of medical care when he was a child.

Growing up in the underserved area of Brownsville, Texas, Guzman looked up to his mother, a single parent and schoolteacher. When Guzman was 12 years old, his mother became very ill. He traveled with her 30 minutes one way for frequent doctor appointments because there was no specialist in their area.

Guzman did not witness firsthand the interaction between his mother and her primary care physician, but he did see the interaction between her and the pharmacist who provided her with expert counseling and support throughout her health care journey. This experience influenced Guzman’s decision to pursue a career in pharmacy.

“My mother would ask questions and the pharmacist would guide and teach her,” he said. “For me, seeing my mother – the teacher – being taught by someone else really impacted me.”

Now as a pharmacy student, Guzman is learning to serve in the role of counselor to the patients he encounters through Project SHINE. In one particular patient, Guzman shared the danger of having high triglyceride values. It was during this consultation that Guzman realized how important health screenings were. “I thought, ‘what if that person hadn’t come in t0day,’ what might have happened to that patient?”

The student chapter of the American Pharmacists Association-Academy of Student Pharmacists (APhA-ASP) plans to have another Project SHINE health fair in the colonias area in the spring.

Guzman plans to practice pharmacy in the Rio Grande Valley after he graduates.

“Influencing a family just like that pharmacist did for my mother – and even my life – meant a lot to me,” he said. “I am proud to be part of a college that gives back to the community where I grew up and plan to live following graduation.”

Story written by Sheri Dunlap, junior journalism major at Texas A&M University-Kingsville

Healthy Kids, Healthy Families began as a three-year initiative designed to improve the health and wellness of at least 1 million children through community investments by Health Care Service Corporation and its Blue Cross and Blue Shield (BCBS) plans in Illinois, New Mexico, Oklahoma and Texas. This BCBS grant is an accomplishment of the school and APhA-ASP organization for Texas A&M Rangel College of Pharmacy. The APhA-ASP Project SHINE will reach more children and their families in underserved areas in South Texas with this grant.   

Group of students pose after a health fair in South Texas

Project SHINE was developed by students from the Texas A&M Rangel College of Pharmacy in collaboration with other health care professionals to provide preventative health care services to medically underserved areas in South Texas.

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Tiny drug ‘vehicles’ could attack cancer cells without damaging healthy cells http://news.tamhsc.edu/?post=tiny-drug-vehicles-could-attack-cancer-cells-without-damaging-healthy-cells http://news.tamhsc.edu/?post=tiny-drug-vehicles-could-attack-cancer-cells-without-damaging-healthy-cells#comments Tue, 02 Dec 2014 23:09:32 +0000 http://news.tamhsc.edu/?post_type=post&p=22088 Researcher at Texas A&M Rangel College of Pharmacy aims to create nanocarriers that directly target cancerous cells while bypassing healthy ones. The design of his nanocarrier can specifically target the cancer-specific enzyme, efficiently enter the cancerous cells and then release the drug inside. The researcher was recognized in a global award for his novel research]]>
Dr. Lin Zhu researches in his lab at the Texas A&M Rangel College of Pharmacy

Lin Zhu, Ph.D., assistant professor at the Texas A&M Rangel College of Pharmacy, works to improve drug effectiveness and minimize side effects of cancer therapy drugs.

Chemotherapy, the most widely accepted cancer treatment on the market, works by stopping or slowing the growth of cancer cells, which grow and divide rapidly. But, chemotherapy can harm healthy cells that divide quickly, causing a number of unwanted side effects. What if there was an anticancer drug that could attack – and kill – cancer cells without harming healthy cells and devoid of any side effects?

This is exactly what researchers at the Texas A&M Health Science Center Irma Lerma Rangel College of Pharmacy are testing, tiny drug vehicles, similar to “The Magic School Bus” in the popular children’s book series, that are capable of directly targeting cancerous cells in the body, bypassing healthy cells. The goal? Delivering the magic school bus – or cancer drug – directly into cancerous cells, killing them without damaging healthy cells.

Lin Zhu, Ph.D., assistant professor at the Texas A&M Rangel College of Pharmacy, is keen on improving drug effectiveness and minimizing side effects of cancer therapy drugs by using a particular enzyme that is unique to cancer cells and can be used as a target for cancer-specific delivery of anticancer drugs. The novel approach would allow scientists to program a drug nanocarrier (a tiny vehicle that exists on the nanometer scale and can significantly improve the physical, chemical and biological properties of the loaded drug molecules) that can specifically target the cancer-specific enzyme, efficiently enter the cancerous cells and then release the drug inside.

“The nanocarriers are like little missiles and the drug is not released until it enters the tumor,” Zhu said. “This allows high doses of toxic drugs to be given to only destroy the cancerous cells without negatively impacting healthy cells.”

To date, Zhu’s lab has overcome many challenges of current anticancer drugs, such as poor water solubility, insufficient tumor cell internalization, low tumor specificity, acquired drug resistance and severe side effects.

“Many drugs have poor water solubility and insufficient tumor cell internalization, causing low bioavailability, or a poor rate of absorption into cells,” Zhu said. “It is important to correct this, because even when you take a large amount of a drug, very little can be effectively utilized by the body.”

To increase the bioavailability, he is designing a drug-loaded nanocarrier, also known as nanomedicine, that can be directly engulfed by cancer cells. The drug is released internally and exhibits antitumor activity inside the cell. Another way he hopes to increase bioavailability is to modify the chemical structure of the drug in such a way to improve important properties such as solubility, without affecting its potency.

Even when the drug is dissolvable and enters the bloodstream, Zhu explained, you cannot be sure that the drug accumulates in the tumor. To remedy this, he looks for ways to impart the disease-specific properties to the medication. Zhu has designed nanocarriers with a protective shield and a tumor-sensitive linker between the nanocarrier’s core and shield. The tumor-specific enzyme, such as matrix metalloproteinase 2 (MMP2), acts like a pair of scissors, cutting away the linkers and exposing the unshielded nanocarriers to cancer cells. At the cellular level, the actions of the nanocarriers can be monitored and evaluated using florescent probes.

In addition to bioavailability and tumor specificity, Zhu researches ways to decrease drug resistance in cancer cells.

“After a patient uses a drug for a long time, the cancer cells develop resistance,” he said. This is similar to how bacteria react to antibiotics after prolonged use. He has two ways to increase the sensitivity to cancer drugs. Zhu mixes the drug into the nanomaterials, allowing it to be disguised in the carrier, and uses a combination of drugs within a nanocarrier to deliver a two-for-one punch into the cancerous cell.

The Controlled Release Society (CRS) recently recognized Zhu’s contributions to the field of drug delivery by awarding him the CRS T. Nagai Postdoctoral Research Achievement Award. This prestigious award recognized Zhu, who was a postdoctoral researcher, and his mentor, Vladimir P. Torchilin, Ph.D., distinguished professor at Northeastern University.

His research is a precursor to future medicines that will contribute to advancing patient care by improving specificity and reducing side effects.

Zhu has spent years researching targeted drug delivery. He has published more than 25 peer-reviewed articles in high impact journals, including Proceeding of the National Academy of Sciences of the United States of America, American Chemical Society (ACS) Nano, Angewandte Chemie, and Biomaterials; he has two patents, presented more than 14 presentations, and won several noteworthy awards in the fields of drug delivery and cancer research.

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Pharmacy researcher looks for ways to increase medication absorption http://news.tamhsc.edu/?post=pharmacy-researcher-looks-for-ways-to-increase-medication-absorption http://news.tamhsc.edu/?post=pharmacy-researcher-looks-for-ways-to-increase-medication-absorption#comments Tue, 18 Nov 2014 20:05:42 +0000 http://news.tamhsc.edu/?post_type=post&p=22013 Researcher with the Texas A&M Rangel College of Pharmacy looks for ways to extend the release of medication in the body in order to ease patient care and rehabilitation. The researcher has found ways by using natural materials to prolong the duration of action of medication in the body, making it more convenient for patients]]>

While taking a medication is oftentimes as simple as popping a bottle cap and filling a glass of water, many patients do not realize the complexity of the work that led to manufacturing that drug. Researchers spend lengthy periods of time designing formulations that can extend the efficacy of medicine or increase its impact on relief.

One such researcher, Mohammad Nutan, Ph.D., associate professor of pharmaceutical sciences at the Texas A&M Health Science Center Irma Lerma Rangel College of Pharmacy is interested in bioavailability, or the rate and extent at which a substance is absorbed in the body.

“When you take a tablet of medication, it lasts for maybe just a few hours,” Nutan said. “We have the ability to extend the medication with design, whether it is prolonging it in some way or having someone consume the medication by an alternative method—intramuscularly for example. If we developed a formula that could extend the release of the medication, it could ease this process for patients.” An example of such release is Allegra® medications. A consumer can purchase a 12-hour formula or a 24-hour formula, depending on the needs of the patient.

Nutan is looking for ways to ease patient care and rehabilitation; and so far, has found means of prolonging the duration of action of medication in the body, making it more convenient for patients. His current research focuses on improving absorption of fat soluble drugs obtained from natural sources, thus the advantage of extending drug release is combined with the benefits of using natural products.

“One thing we often do is look at the effects of different factors used in different formulations to increase bioavailability,” Nutan said. “How do these factors truly affect it? We occasionally use experimental design, prepare multiple formulations and see which model works.”

By using experimental design, Nutan uses less time and resources to complete his research, which allows him to gather more data to find the formulation with optimized properties.

“The design allows you to measure the effects of various factors, such as particle size of the drug and the amount of each ingredient used, on some important factors including extent of drug release and product stability,” Nutan said. “The formula with the best desirable characteristics can be predicted by using software and consequently such formulation can be prepared to verify the expected outcomes.”

Nutan is currently studying curcumin, which is a natural substance in turmeric that is helpful in treating certain cancers and used as an antioxidant. Using animal models, he looks at the relationship between the changes in the experiment and the outcome after discovering how much of the drug is released at certain specific time points throughout the process.

More than just advancing discoveries himself, Nutan also encourages his research students to test things on their own. He allows them to propose what they’d like to research and he supports them as they learn.

“The first thing they learn – and I learned – is that not every experience works on the first try,” he said. “In fact, more times than not, you get to start all over. But that is the beauty of research – finding solutions where you least expected them.”

Nutan hopes his work in the area of medical absorption will offer patients solutions that will ease, and sometimes expedite, their health and rehabilitation journey.

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Allergic to penicillin? You probably aren’t http://news.tamhsc.edu/?post=allergic-to-penicillin-you-probably-arent http://news.tamhsc.edu/?post=allergic-to-penicillin-you-probably-arent#comments Tue, 18 Nov 2014 17:05:12 +0000 http://news.tamhsc.edu/?post_type=post&p=22015 Penicillin is often the first line of defense for a number of common illnesses, including ear and sinus infections, strep throat, chest infections and urinary tract infections. But when a patient is allergic to the ‘superdrug,’ physicians are left with few antibiotic options that are oftentimes less effective, more expensive and can cause greater side effects, putting you at more risk for drug resistance]]>

Penicillin is often the first line of defense for a number of common illnesses, including ear and sinus infections, strep throat, chest infections and urinary tract infections. But when a patient is allergic to the ‘superdrug,’ physicians are left with few antibiotic options that are oftentimes less effective, more expensive and can cause greater side effects, putting you at more risk for drug resistance.

However, new research suggests that a majority of people who think there are allergic to penicillin are actually not. In fact, in one study, 94 percent of people who believed they were allergic to penicillin tested negative during an allergy test for the drug.

All too often, people have a bad experience with penicillin as a child, such as a skin rash following dosage of penicillin, but were never actually tested to see if they were truly allergic.Differences between penicillin side effects and allergic reactions

“People tend to confuse side effects with allergies,” said Andrea M. Luce, Pharm.D., assistant professor at the Texas A&M Health Science Center Irma Lerma Rangel College of Pharmacy. “People will experience a side effect and think it’s an allergy. It’s vital to know the difference between a side effect and a true allergic reaction to the medication.”

The most common side effects include: stomach pain, nausea or vomiting. In a true allergy to penicillin, patients have an anaphylactic reaction, including swelling of the airways, hives and shortness of breath.

“Recently, a patient expressed that they were allergic to penicillin and we asked what happens when they take it,” Luce said. “The patient said they get light headed, which happens as a side effect rather than an allergy.”

Unsure whether you are truly allergic to penicillin or just had a bad childhood experience with the medication? Penicillin skin testing is the most reliable method for evaluating your sensitivity to the drug.

Why does it matter? Penicillin-based antibiotics are often much less expensive and reduce your risk for drug resistance. If you repeatedly administer highly powerful, non-penicillin antibiotics for infections, they can easily become less effective over time.

It’s important to discuss your allergies with your pharmacist or health care provider who can help you determine the difference between side effects and true allergies and whether you are a candidate for penicillin allergy testing.

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Texas A&M Rangel College of Pharmacy offers specialized rotation in drug addiction http://news.tamhsc.edu/?post=texas-am-pharmacy-offers-specialized-rotation-in-drug-addiction-2 http://news.tamhsc.edu/?post=texas-am-pharmacy-offers-specialized-rotation-in-drug-addiction-2#comments Fri, 31 Oct 2014 19:23:58 +0000 http://news.tamhsc.edu/?post_type=post&p=21896 The Texas A&M Rangel College of Pharmacy will offer an elective to students in substance abuse Advance Pharmacy Practice Experiential (APPE) rotations at the South Texas Substance Abuse Recovery Services (STSARS) in Corpus Christi as an option for professional student pharmacists who are interested in treating addictions]]>

Drug abuse is a problem that is faced by millions of Americans every day. According to a survey conducted by the National Institute on Drug Abuse in 2011, an estimated 22.5 million Americans 12 or older—or 8.7 percent of the population—had used an illicit drug or abused a psychotherapeutic medication in one month. That number was up from 8.3 percent in 2002.

Texas A&M Health Science Center Irma Lerma Rangel College of Pharmacy faculty and staff understands the importance of professional student pharmacists learning about addiction so they can put that knowledge into practice by serving as a resource for patients and their family members facing such situations.

Bree Watzak, Pharm.D., assistant professor of pharmacy practice, takes students to a week-long program on alcoholism and other drug dependencies at the University of Utah School of Medicine each summer. The experience challenges students both emotionally and professionally, as they are able to see how addiction truly works by sitting in on 12-step programs and group therapy sessions of addicts, learning that addiction is not purely a choice of an individual, it becomes a disease.

The program allowed students to see addiction from the perspective of others, while expanding their knowledge of the disease, using innovative strategies and methods. Each student participant was made aware of the signs of drug addiction and that ultimately, anyone from any background could suffer from the disease.

As an option for professional student pharmacists who are interested in treating addictions, the Texas A&M Rangel College of Pharmacy will offer an elective to students in substance abuse Advance Pharmacy Practice Experiential (APPE) rotations at the South Texas Substance Abuse Recovery Services (STSARS) in Corpus Christi.

Students who take this course as an APPE elective will gain an appreciation of the disease model of drug addiction. This six-week experience will serve as the culmination of an experience that will give students a glimpse of the other side of drug addiction, the illicit use of both prescription and street drugs. This is a unique pharmacy program offered to very few professional students and will allow for a niche in their education and pharmacy practice opportunities.

“My colleagues and I wanted to get the students from the Texas A&M Rangel College of Pharmacy involved in learning about substance abuse,” said Ron Garza, R.Ph., pharmacist at DeLeon’s Pharmacy and a preceptor for the college. “That way, when they get out in their own practice, they’ll understand the behavior of true addicts. They will be able to know what to do if they run into someone with these behaviors, because it is a very critical area and they can be involved in intervention techniques.”

Though many families experience addicts in their lives, they only understand the physical and emotional aspects of drug dependency, never the chemical side. The program allowed professional student pharmacists to see how a single chemical can change someone and their personality.

Students will learn that overcoming an addiction is something that has to be done progressively. With the newfound knowledge, students can fight side-by-side with those facing a daily battle with addiction.

“I was truly inspired and impressed by students who are interested in substance abuse and addiction,” Garza said. “I attended a program at the University of Utah School of Medicine and was moved by them and the fact that they seemed to have a spiritual experience. We have to keep students like these going, as they are getting into something magnificent. They will be great citizens and professional pharmacists.”

Students who are interested in preventing addiction, identifying those who are addicted, and reaching out to families of drug abuse and offer support can receive hands-on training through this program. More than anything, professional student pharmacists will be able to assist people who are suffering with addiction and help them to become loving friends and family members again.

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Pharmacy students impact lives, one patient at a time http://news.tamhsc.edu/?post=pharmacy-students-impact-lives-one-patient-at-a-time http://news.tamhsc.edu/?post=pharmacy-students-impact-lives-one-patient-at-a-time#comments Tue, 30 Sep 2014 14:38:08 +0000 https://news.tamhsc.edu/?post_type=post&p=21445 The Texas A&M Rangel College of Pharmacy received a $5,000 grant to enhance service learning projects from the Coastal Bend Community Foundation for professional student pharmacists on Sept. 10 at the Del Mar Economic Development Center in Corpus Christi. ]]>
Bryan Donald, third-year professional student pharmacist at the Texas A&M Health Science Center Irma Lerma Rangel College of Pharmacy, volunteers at a service learning event.

Bryan Donald, third-year professional student pharmacist at the Texas A&M Health Science Center Irma Lerma Rangel College of Pharmacy, volunteers at a service learning event.

A patient sat down to their have blood pressure, cholesterol and blood sugar levels checked at the Kleberg County Health Fair in the spring. After checking the levels, a professional student pharmacist asked how the patient was feeling. The patient answered, “Well, I do have a headache and I am kind of tired, but I think I am just stressed from working all day.”

Turns out, the patient had high blood pressure and was unaware of the problem.

“That’s my favorite part of community outreach,” said Bryan Donald, third-year professional student pharmacist at the Texas A&M Health Science Center Irma Lerma Rangel College of Pharmacy. “When a patient does not even know something is wrong and we have the opportunity to let them know they need to see a doctor; it’s the best feeling in the world. We made a difference and potentially saved a life.”

Patients respond well to student volunteers, said Donald, who is from Corpus Christi, Texas. “They see us and know we are here to help them. They thank me for coming even before I begin to help them,” he said.

One-third of the curriculum for professional student pharmacists includes practicing in health care settings and many of these experiences focus on serving communities in the South Texas region. Since 2011, students have provided vital services to patients in underserved communities and touched more than 50,000 patients’ lives.

To enhance service learning projects, the Texas A&M Rangel College of Pharmacy received a $5,000 grant from the Coastal Bend Community Foundation for professional student pharmacists on Sept. 10 at the Del Mar Economic Development Center in Corpus Christi.

“Through service learning projects, professional student pharmacists interact with the community to improve public health in the South Texas region,” said Mary Chavez, Pharm.D., interim vice dean, professor and chair of pharmacy practice. “Service learning educates professional student pharmacists, and these events highlight the increasing role of the pharmacist as a prominent member of the health care team.”

The Office of Experiential Education is the backbone for service learning at the college. The college offers a variety of learning opportunities for in-depth exposure to, and active participation in, patient care throughout a student’s academic career.

Experiential education supports and fosters the individual goals of each student, according to Anna Brozick, Pharm.D., assistant professor and director of introductory pharmacy practice experience (IPPE).

“This is done while allowing students to transform their classroom knowledge into skills, attitudes, values and behaviors when interacting with patients and other health care professionals,” she said.

Experiential education begins in the first year of curriculum for professional student pharmacists. The early exposure to direct patient care establishes the attitude of caring for others. Beginning in the second year, and continuing through fourth year, students are given increasingly advanced opportunities to practice in pharmacy settings, including community or independent pharmacies, ambulatory clinics, surgical centers, veterinary clinics, community hospitals as well as large teaching hospital institutions.

Professional student pharmacists reach South Texas communities in various ways by offering blood pressure, blood glucose, and cholesterol screenings; smoking cessation education and counseling sessions; hands-on activities to teach children about medication safety, nutrition and exercise.  Funds from the Coastal Bend Community Foundation will be used to support cholesterol screenings, blood pressure monitoring, health literature, and motivational materials for smoking cessation and cookbooks.

The Texas A&M Rangel College of Pharmacy opened its doors to students in 2006 to meet a critical need in the South Texas community where there is a shortage of pharmacists. Today, more than 41 percent of the college’s graduates return to South Texas to help underserved populations. The college’s leadership strives to entrench a culture of excellence, education, research, practice and patient care to each professional student enrolled. Within a record amount of time, the college has been ranked in the Top 50 for pharmacy programs in the country, according to the recent US News and World Report.

The Coastal Bend Community Foundation was incorporated in 1981 with the mission of enhancing and improving the quality of life in the seven counties of the Coastal Bend. The Foundation serves donors by providing a vehicle for the establishment of various types of charitable funds designed to fulfill their wishes. Since its inception, the Foundation has distributed more than $72 million from donor contributions and revenues to scholarships to students and grants to nonprofit organizations.

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Piecing together the puzzle: Addressing the primary care shortage http://news.tamhsc.edu/?post=piecing-together-the-puzzle-addressing-the-primary-care-shortage http://news.tamhsc.edu/?post=piecing-together-the-puzzle-addressing-the-primary-care-shortage#comments Mon, 15 Sep 2014 22:06:21 +0000 https://news.tamhsc.edu/?post_type=post&p=21310 Texas A&M Health Science Center is heeding the call to fill the overwhelming primary care gap, not only by producing more primary care physicians and working with partners where possible to develop new residency programs or expand existing ones, but also by extending health care teams through educational programs in nursing and pharmacy and empowering patients through targeted research and outreach programs]]>

It’s no surprise the United States has been facing a shortage of primary care physicians for several years. This shortage, coupled with a growing population, an aging population (physicians included) and the entrance of newly insured individuals following implementation of the Affordable Care Act, will increase the demand for primary care services across the country. In Texas, this demand will likely be even higher since the state currently falls below the national average with just 165 physicians for every 100,000 individuals. In 126 of 254 Texas counties, primary care services are so low that the U.S. Department of Health and Human Services has declared these regions Health Professional Shortage Areas.

But why, exactly, are physicians in such short supply? The Texas shortage can be attributed to several factors. First, primary care interest from medical school students has traditionally been relatively low due to low-income potential compared with other specialties, but demand for primary care physicians has gone up. Following implementation of the Affordable Care Act, millions of Americans who were not previously insured are entering the health care system. The Texas population is outpacing the national growth rate, and more aging Baby Boomers are becoming eligible for Medicare every day. In addition, the prevalence of chronic diseases, such as diabetes and hypertension, is growing, requiring more health care services. And to top it off, about one-third of all doctors plan to retire this decade, but the number of available residency slots hasn’t kept pace with the increase in medical graduates, leaving some graduates in limbo, unable to secure on-the-job training required before they can begin practice.

Texas A&M Health Science Center is heeding the call to fill the overwhelming primary care gap, not only by producing more primary care physicians and working with partners where possible to develop new residency programs or expand existing ones, but also by extending health care teams through educational programs in nursing and pharmacy and empowering patients through targeted research and outreach programs.

Producing more primary care physicians

More than half – 92 out of 157 – of Texas A&M College of Medicine graduates placed in primary care residencies in 2014, well above the national average. In fact, recent studies by the Council on Graduate Medical Education show that fewer than 20 percent of all U.S. medical students are choosing primary care specialties. So, why are future Aggie physicians more attracted to the primary care setting?

“It has a lot to do with the kind of students we recruit,” said Paul Ogden, M.D., interim dean of the Texas A&M College of Medicine. “Texas A&M has always possessed a service mentality due to our roots as a land-grant university, and the physicians we train want to serve their patients. They get to interact more with their patients in primary care settings, and they value that service more than the money other specialties can offer.”

Throughout the years, the college has also established key partnerships in rural areas where health care services are in dire need. One such partnership with DeTar Healthcare System recently established a Family Medicine Residency Program in Victoria that addresses the critical need for more primary care physicians in South Texas. The three-year program, which will accept its first six residents in July 2016, and other upcoming partnerships of this nature, will play a key role in the development of a comprehensive physician workforce solution for the state.

However, the problem is not one-dimensional, and medical schools alone cannot fill the growing need for primary care services.

“Fixing the nation’s primary care shortage goes far beyond recruiting and training more primary care doctors,” Ogden said. “The fix isn’t physician-centric, because medical schools simply can’t produce enough physicians to address the need.”

Extending the health care team

To make bigger strides toward closing the gap, the primary care team must be extended with additional nurses and pharmacists, and Texas A&M Health Science Center is doing just that.

The Texas A&M College of Nursing recently announced the creation of a new Master of Science in Nursing – Family Nurse Practitioner (M.S.N.-FNP) graduate program. The program is expected to launch in January 2015, pending final approval from the Texas Board of Nursing.

The family nurse practitioner program will produce nurses who can provide primary, acute and specialty health care. Like registered nurses, nurse practitioners perform thorough assessments, but in addition, have the training to diagnose patients, prescribe treatments and medications, and assume primary responsibility for patients’ overall care.

Expanding the role of pharmacists is another avenue for filling the rising demand for health care.

“Today, more than ever, pharmacists are likely to be found engaged in conversations with customers, providing information on over-the-counter drugs, administering immunizations, and assisting with overall disease prevention and management, while improving patient medication adherence and outcomes,” said Indra K. Reddy, Ph.D., professor and founding dean of the Texas A&M Irma Lerma Rangel College of Pharmacy in Kingsville, Texas.

Research shows that patients who work with a team that includes a pharmacist and one or more physicians are more likely to achieve improved health goals. This co-management of the patient with the primary care provider offers more direct, patient-focused care and ultimately, better patient outcomes.

To that end, the Texas A&M Rangel College of Pharmacy trains future pharmacists in a variety of health care settings, and oftentimes alongside medical and nursing students in the clinical setting. Fourth-year students complete rotations in community pharmacies, retail pharmacies, clinics and hospitals. Pharmacy students also rotate through the Texas A&M Health Science Center Diabetes Education program in Corpus Christi, Texas, teaching diabetes patients about medication options, insulin administration and medication adherence.

Empowering patients with self-care education

Working with a comprehensive health care team can help improve patient outcomes, but there is one person who has perhaps the most impact on your overall wellness: you.

Researchers at the Texas A&M School of Public Health are working with clinicians to develop programs that educate the public about the importance of self-care in their journey toward overall well-being.

One of the gaps they have identified, both in research and in practice, is the disconnect between what is recommended in the clinical setting and how, or if, patients are implementing those recommendations in their daily lives. These recommendations include becoming more physically active, eating a healthier diet, taking certain medications and incorporating dietary supplements or drinking more water.

To help bridge that gap, the school has developed evidence-based, chronic disease self-management programs and fall prevention programs to educate patients on how to take control of their own health. The goal is to keep people healthy so they don’t have to see their primary care provider often or utilize the emergency room, which should help alleviate congestion of those services.

The school currently offers chronic disease self-management, fall prevention, physical activity and nutrition, stress management and medication management programs in the Brazos Valley region of Texas. Partnerships have also been formed with the Texas Falls Prevention Coalition, the Texas Department of Aging and Disability Services and the Texas Department of State Health Services to build programs in other parts of the state.

“We are helping to build upon and expand the reach of clinicians by going beyond the clinic walls and into the community, engaging people in activities and teaching them skills that will help them better manage their chronic diseases, reduce their risk for falls, and avoid medication complications,” said Marcia Ory, Ph.D., regents and distinguished professor at the Texas A&M School of Public Health.

Utilizing community health workers

The Texas A&M Health Science Center Diabetes Education Program in Corpus Christi follows a similar formula as the programs disseminated by the School of Public Health. Health educators, who include nurses, certified diabetes educators, registered dietitians and nutritionists, teach diabetes patients in South Texas how to take control of their disease. The program consists of lab work evaluation, education and a one-year follow-up program to measure patients’ progress toward improved health. In rural areas where patients are unable to travel to the program’s clinic in the city, community health workers (CHWs) visit patients in their homes to take basic lab work such as blood pressure, cholesterol and blood sugar. They also answer questions, connect patients to services and provide informal counseling and social support.

Many health care providers are beginning to recognize the value of CHWs (also known as promotores de salud, community health advocates, lay health educators, peer health promoters and community health outreach workers) as a way to expand primary care services in rural areas. CHWs are usually not formally trained as health care providers, but they can deliver some basic direct services (like first aid) and administer health screening tests. Because they are members of the communities which they serve, CHWs are able to connect with patients on a peer level to provide culturally appropriate and accessible health education and information.

By expanding the health care team to include not only physicians, but nurses, nurse practitioners, pharmacists, community health workers, health educators and patients themselves, Texas A&M is piecing together the puzzle to help alleviate the current primary care shortage, and thus ensure that Texans are getting the best care possible. At the end of the day, health care is a team sport.

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Fast Facts: Hydrocodone products reclassified http://news.tamhsc.edu/?post=fast-facts-hydrocodone-products-reclassified http://news.tamhsc.edu/?post=fast-facts-hydrocodone-products-reclassified#comments Fri, 29 Aug 2014 16:25:27 +0000 https://news.tamhsc.edu/?post_type=post&p=21201 All hydrocodone combination products will be reclassified and more strictly regulated beginning October 2014, experts from the Texas A&M Rangel College of Pharmacy share what this means for consumers]]>

Beginning October 2014, all hydrocodone combination products will be reclassified and more strictly regulated. We sat down with Robert Hutchison Jr., Pharm. D., and John Bowman, M.S. Pharm., both faculty members at the Texas A&M Health Science Center Irma Lerma Rangel College of Pharmacy, to learn more about this reclassification and what it means to us as consumers.

Q: What products are we talking about?

A: According to the Texas Pain Advocacy Committee, pain is the most common reason that Texans access the health care system; and hydrocodone products and combination hydrocodone and acetaminophen products are among the most prescribed products in the U.S. As such, there are several hundred brands and generic products affected by this change.

Hydrocodone combination products contain hydrocodone, an opioid pain reliever and cough suppressant, in combination with other medications. Some combination products, such as Lortab®, Lorcet®, Norco®, and Vicodin®, contain hydrocodone and acetaminophen and are used to treat pain. Some combination products, like CodiCLEAR DH, contain hydrocodone and guaifenesin and are used to treat coughing associated with colds and flu.

Q: What are hydrocodone products now classified as?

A: The U.S. Drug Enforcement Agency (DEA), responding to the 2012 Food and Drug Administration Safety and Innovation Act, reclassified hydrocodone combination medications from Schedule III to Schedule II.   Schedule III drugs are defined as drugs with moderate to low potential for abuse, whereas Schedule II drugs are defined as drugs with a high potential for abuse. The move, announced in a federal notice this month, comes more than a decade after the DEA first recommended reclassifying hydrocodone due to its risks for abuse and addiction.

Q: I have a prescription for hydrocodone, what should I do?

A: Only prescriptions issued before Oct. 6 and authorized for refills may be dispensed, as long as such dispensing occurs before April 8, 2015. After Oct 6, the ruling allows a practitioner to issue multiple Schedule II prescriptions to provide up to a 90-day supply of medication. In addition, no verbal or faxed prescriptions will be allowed. Prescriptions may not be refilled without visiting with the health care professional first.

It is worth mentioning that individuals who use hydrocodone and other analgesics in the class called opioids are many times not seen by the prescriber for long periods. Seeing the health care professional for ongoing pain and monitoring analgesic effects provides for better care and helps prevent diversion.

Q: When will this ruling take effect?

A: The rule was published on Aug. 22 and becomes effective 45 days after this date.

Robert Hutchison Jr., Pharm.D., associate professor of pharmacy practice for the Texas A&M Health Science Center Irma Lerma Rangel College of Pharmacy, published several studies in pain management research, and also serves on the Texas Pain Advocacy and Information Network’s multidisciplinary committee. 

John Bowman, M.S., Pharm.D., associate professor of pharmacy practice for the Texas A&M Rangel College of Pharmacy, has been a practicing pharmacist since 1976, served on a chronic pain team, and served as a hospice pharmacist in pain relief. He also serves on the Regional Health Awareness Board representing the Coastal Bend area. 

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