Pharmacy and Pharmaceutical Sciences Commons^™

J Mich Dent Assoc December 2023

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following:

• A cover story on “New Dentists’ Most Asked Legal Questions”
• A case report on “Endodontic Therapy, Crown Amputation, and Soft Tissue Advancement to Treat a Hopeless Tooth”
• A feature “Be a Leader in Your Practice: What’s Your Style?”
• 2023 Author/Title Index to the Journal of the Michigan Dental Association
• News you need, a Guest Editorial and regular …

Ozgene: To Advance Humanity – Inspire Curiosity, Maarit Patrick, Mike Dixon

Huntsman School of Business Teaching Scholarship Series

The case introduces the students to Ozgene, an Australian firm that experienced a dramatic reduction in lead time of their products because of implementation of Lean principles. The case can be used in undergraduate or graduate courses in operations management or supply chain management as an introduction to Lean principles. The case also encourages students to consider the challenges that make-to-order differ from those of make-to-stock and explore production design principles.

Navigating The Path To Safe Compounding In Health Systems, Thomas Pile, Craig Kimble, Alberto Coustasse

Management Faculty Research

Across the country health systems are facing increasing drug shortages that are forcing pharmacists to rely far more heavily on compounding to meet the needs of patients. Additionally, several high-profile compounding incidents have helped highlight the importance of ensuring best practices are followed during sterile and nonsterile compounding to support patient safety and high-quality care. Specifically, in 2022, 160 drug shortages were reported in pharmacies. From January 1, 2023, to March 31, 2023, 47 drug shortages were reported, 55% of which were for injectables. In response, compounding has increasingly become a solution to bridge that gap.

President’S Address: Dr. Vince Benivegna, Vince Benivegna Dds

The Journal of the Michigan Dental Association

Dr. Vince Benivegna, the outgoing President of the Michigan Dental Association, addressed the House of Delegates, emphasizing the significant progress in enhancing Adult Dental Medicaid coverage and reimbursement in Michigan. He thanked the dedicated individuals who supported him during his tenure and shared his journey. Dr. Benivegna lauded Michigan's accomplishments in reducing opioid prescribing and highlighted the MDA's role as a model state society in advocacy, leadership, mentorship, continuing education, diversity, equity, and inclusion. He praised Michigan's achievements in improving Adult Dental Medicaid, encouraging Michigan dentists to participate and help address oral health disparities. Dr. Benivegna underscored how this aligns …

Dentistry And The Law: Accessing/Disclosing Prescription Information On Software Platforms, Dan Schulte Jd

The Journal of the Michigan Dental Association

This article discusses the access and disclosure of prescription information on software platforms like eScribe and MAPS. It highlights that HIPAA regulations govern such access, and as long as the information is obtained through business associate agreements and used for treatment purposes, specific patient consent may not be necessary. The article also mentions that the Michigan Automated Prescription System (MAPS) allows prescribers to access controlled substance prescription information without requiring patient consent.

Johnson & Johnson Strategic Audit, Hannah Headley, Lucy Peterkin, Ryan Nyffeler, Joshua Wiemers, Bailey Birkholtz

Honors Theses

Johnson & Johnson (J&J) is a healthcare company that generates economic value from its three core business segments: Consumer Health, Pharmaceuticals, and Medical Devices. Recent innovations include new pharmaceutical products, remote clinical trials, automated patient recruitment, improved scientific and digital literacy amongst employees, and innovative digitized models for supply chain planning. J&J has a competitive edge in R&D efficiency, with a 4.35 return on research capital ratio. Sociocultural, technological, and economic factors will play a large role in changing the pharmaceutical industry environment, and J&J is well positioned to benefit from sources of growth such as the increase in aging …

Takeda Pharmaceutical Rare Hematology Strategic Audit, Brian Duval

Honors Theses

Takeda Pharmaceutical Company is a large Japanese-based multinational pharmaceutical company that manufactures treatments for many different diseases. It is the largest pharmaceutical company in Asia and has a significant share in markets across the world. This report focuses specifically on Takeda’s treatments for rare bleeding disorders under its Rare Diseases & Hematology division. Using internal and external analysis tools, this report seeks to understand how Takeda has created and sustained competitive advantages in the complex environment of the pharmaceutical industry. Specific tools used to highlight this include Porter’s Five Forces and PESTEL analyses. This report also examines the environment surrounding …

Evaluate 503b Facilities For Outsourced Compounds, Sarah Clemente, Brittany Riley, Alberto Coustasse

Pharmacy Practice & Administration

The US health care system has encountered long-standing, complex challenges, including growing costs, overuse of care, staffing shortages and supply chain weaknesses. COVID-19 revived these pressures, transforming the health care landscape. Medication and staffing shortages plague hospital systems, and pharmacies are not exempt. Most health systems have experienced high levels of pharmacy technician turnover, with most reporting a minimum turnover rate of 21% last year. In addition, medication shortages of critical medications and infusions create significant workflow barriers that hospitals must address to ensure patient safety. In the face of these obstacles, health systems are turning to 503B compounding facilities …

Radio Frequency Identification Enhances Patient Safety, Craig Kimble, Alberto Coustasse, Ken Maxik

Pharmacy Practice & Administration

Radio Frequency Identification (RFID) is a technology that uses tags and readers to identify and collect asset information. In pharmacies, this usually means RFID is used for high cost equipment or pharmaceuticals. RFID applications have been in use for many years but recently gained traction in health systems. RFID is becoming particularly effective in drug inventory and automation applications, such as medication carousels and pick-to-light systems.

Gabapentin Presents High Potential For Misuse, Alberto Coustasse, Stacie Deslich, Susan W. Lanham, Brittany Riley

Management Faculty Research

The FDA Approved Gabapentin in 1993 as a non-controlled substance and it has remained a non-controlled substance at the federal level. The drug was created as an anticonvulsant and used to treat seizure disorders. The medication has also been used to treat hot flashes, neuropathic pain, pain, postoperative nausea, substance abuse issues, and vomiting. It is estimated that approximately 1% of people in the United States misuse gabapentin. This fact has compelled certain states to generate legislative initiatives designed to monitor the use and/or reclassify gabapentin. In 2019, US pharmacies dispensed 69 million prescriptions for gabapentin.

Prescribing Controlled Substances Goes Electronic, Alberto Coustasse, Craig Kimble, Ken Maxik

Management Faculty Research

With the Affordable Care Act in 2010 came interoperability and meaningful use requirements. Part of these requirements included the implementation of electronic medical records (EMRs), which was a crucial part of achieving these standards. With EMRs, prescribers began sending electronic prescriptions. EMRs can provide advanced decision support when writing prescriptions, and they include features such as auto populating the quantity prescribed, formulary information, therapeutic duplications, warnings about interactions, or other potential clinical or regulatory issues. This system results in enhanced patient care and a more streamlined dispensing process. In addition, electronic prescriptions for controlled substances (EPCS) has become more widely …

10-Minute Ebd: Stimulant Medications, Rampant Caries, And Prevention, Madison Thomas Bs, Nancy Poznick Dds, Melanie E. Mayberry Dds, Ms-Hcm

The Journal of the Michigan Dental Association

The 10-Minute Evidence-Based Dentistry Column illustrates how to implement the evidence-based dentistry search process to quickly identify and apply the best literature to answer a clinical question. Through critical appraisal, the author of this article answers the clinical question of a connection between stimulant medications, rampant caries, and prevention, with a focus on the impact of ADHD medication on oral health. The term "meth mouth" often associated with dental decay is discussed in the context of xerostomia (dry mouth), a common side effect of stimulant medications. The article uses the PICO (Population, Intervention, Comparison, Outcome) system to formulate a research …

10-Minute Ebd: Preferred Analgesia For Orthodontic Tooth Movement: Acetaminophen Or Nsaids?, Ryan N. Mcgovern

The Journal of the Michigan Dental Association

This 10-Minute EBD column explores the choice between acetaminophen and NSAIDs for managing pain during orthodontic tooth movement. The author presents a scenario involving a patient's discomfort after archwire adjustment and delves into the impact of tooth movement on the periodontium. The PICO question focuses on the effectiveness of NSAIDs and acetaminophen in controlling discomfort without impeding tooth movement. The literature search reveals varying recommendations on analgesics, with some studies favoring acetaminophen. The evidence suggests that acetaminophen and short-term celecoxib are suitable choices for orthodontic analgesia. However, caution is advised in extrapolating findings from animal studies to human conditions.

Penicillin Allergy Assessment And Medical Referral To Promote Antibiotic Stewardship, Elaine Bailey Pharmd, Mackenzie Connell, Marie Fluent Dds, Erinne Kennedy Dds, Mph, Mmsc

The Journal of the Michigan Dental Association

Antibiotic stewardship is an integral practice for the dental team to ensure a safe dental visit for patients. Now, with clinical practice guidelines and state toolkits, more dentists are aware of and actively practicing antibiotic stewardship. With the application of antibiotic stewardship practices, dentists are identifying the need for additional tools to enhance practice. For example, one need that has been identified is a tool for screening patients for true penicillin allergies. The Penicillin Allergy Assessment Tool (PAAT) is a decision-making tool that can be used chairside to screen patients who report an allergy to penicillin. After screening, dentists can …

Association Of Electronic Medical Records And Opioid Prescription, Archana Suwal, Jemimah Okonjo, Stacie Deslich, Alberto Coustasse

Management Faculty Research

A Prescription Drug Monitoring Program (PDMP) is an electronic database that tracks controlled substance prescriptions in a state. PDMPs can provide health authorities timely information about prescribing and patient behaviors that contribute to the epidemic and facilitate an agile and directed response. Electronic Prescribing for Controlled Substances (EPCS) aimed to eliminate paper prescriptions by allowing clinical prescribers to write prescriptions electronically, making them digital and trackable for both the prescriber and the pharmacist and has been an essential part of any health information technology system, as well as a requirement for 'meaningful use' (Blumenthal & Tavenner, 2010). However, one of …

Store, Handle, And Administer Vaccines Safely To Prevent Errors, Craig Kimble, Kenneth Maxik, Alberto Coustasse

Management Faculty Research

Insufficient training, multiple manufacturers, and noninterchangeable products increase the risk of vaccine-related errors. Increasing the complexity are the addition of boosters with different doses, personnel new to the vaccine administration process, changes in dosing, easily misidentified labeling or products, vaccines given together, and the interchanging of booster products.2,3 As a result, there is an increased need to be alert in safety efforts with vaccine administration and storage. Pharmacy staff members must work together to improve safety and prevent vaccine-related errors.

J Mich Dent Assoc July 2021

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story on “Measuring Outcomes to Improve the Quality of Clinical Care”.
• A feature article, “Is Your Office Winning or Losing the Race? You Won’t Know Without Measurement”.
• The feature article, “The DQA and Quality Measurement in Dental Programs and Plans”.
• News you need, Editorial and regular department articles on MDA Foundation activities, Dentistry …

J Mich Dent Assoc June 2021

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story “Team-Based Treatment of Oral Cancer: The U-M Experience”.
• A feature article, “Dental Management of the Head and Neck Cancer Patient Treated with Radiation Therapy: Update 2021”.
• A feature article on “Understanding Cyber Threats and the Risk they Pose to Your Practice”.
• "A Train-the-Trainer Education Model and Rural Dental Opioid Prescribing Outcomes”, a …

Association Of Electronic Prescription In Controlled Substances Used, Archana Suwal, Jemima Akinyi Okonjo

Theses, Dissertations and Capstones

Introduction: Controlled substances have been described as pharmaceuticals or illegal medicines that act primarily on the central nervous system and could cause physical and mental dependence, eventually leading to addiction. Prescription opioids were a significant contributor to the opioid epidemic, accounting for more than 70,000 opioid-related overdose deaths, including illicit and prescription opioids, between 2018 and 2019. The Electronic Prescriptions for Controlled Substances (EPCS) initiative recently aimed to reduce rates of prescription opioid addiction, abuse, diversion, and death. The system for controlled substances had become more widely used as providers and governments trying to combat the opioid problem. Because …

How Do Pharmacies Evaluate Cleanroom Automation Systems?, Kenneth Maxik, Craig Kimble, Alberto Coustasse, Chris Booth

Pharmacy Practice & Administration

Many pharmacies have implemented or considered implementing cleanroom automation or compounding systems. Intravenous (IV) admixture automation is one of the newest areas of technology that has been applied to pharmacy workflow. Manufacturers tout systems for reducing errors reaching patients. Clinical literature supports that cleanroom technology can aid in patient safety.

United States Medicaid And Pharmacy Fraud: An Unintended Consequence Of The Affordable Care Act, Sean Mcdaniel, Drew Blakely

Theses, Dissertations and Capstones

Introduction: The Affordable Care Act (ACA) increased access to health insurance throughout the United States. To date, an estimated 20 million previously uninsured individuals have gained access to coverage since the expansion. As a result, the number of fraudulent schemes reported has been on the rise. Among the many fraudulent activities in the healthcare sector, abuse of pharmacy benefits has been the most prevalent. The misuse and abuse of opioids, and opioid related overdoses has created a widespread epidemic throughout the country, thus extending opportunities for potential fraud within the pharmaceutical industry.

Purpose of the Study: The purpose …

340b Program Utilization In Rural Us Clinics, William Finley, Heather M. Kruel

Theses, Dissertations and Capstones

Introduction: The 340B program was an effective strategy in reaching more potential patients, providing more comprehensive services, and limiting the gap between affordability and healthcare. The uninsured and underprivileged often are unable to receive medications at the high market price due to the financial situation they face and inflation. The 340B program seeked to mend this issue to help the public and healthcare organizations. The main purpose of this research was to search and evaluate if the 340B program lived up to its purpose of decreasing the cost of medications in rural based clinics.

Methodology: The research strategy developed …

Post-Implementation Analysis Of The Impact Of Intravenous Automation Systems On Health-System Pharmacy Operations, Craig Kimble, Ken Maxik, Chris Booth, Michael Rudolph, Kim Broedel-Zaugg

Faculty Research Day

We have all seen the reports on the news about issues related to IV rooms and IV room compounding. Many health-system pharmacies have implemented, or are considering some form of intravenous (IV) automation and/ or compounding system in their clean rooms to reduce pharmacy errors and improve accuracy, productivity, and workflow. Manufacturers tout that automated systems, used appropriately, aid in reducing errors from reaching patients. Additionally, IV admixture automation is one of the most recent areas where technology has been added to pharmacy workflow.

The 340b Program, Contract Pharmacies And Hospitals: An Examination Of The First 25 Years Of Their Increasingly Complex Relationship, David P. Paul Iii, Morgan Cathlene Ludado, Morgan Ruley, Hannah Sayre, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

The 340B Drug Pricing Program, created by Congress in 1992 through the Veterans Health Care Act, has provided discounted drug prices to hospitals and other health care organizations serving a wide population of low-income patients. Some 340B programs use contract pharmacies, an arrangement whereby the hospital or health care organization signs a contract directly with a pharmacy to provide covered pharmacy services at discounted prices.

The federal 340B Drug Pricing Program has provided access to reduced price prescription drugs to over 35,000 individual healthcare facilities and sites certified by the U.S. Department of Health and Human Services (HHS), and clinics …

The 340b Program, Contract Pharmacies And Hospitals: An Examination Of The First 25 Years Of Their Increasingly Complex Relationship, David P. Paul Iii, Morgan Cathlene Ludado, Morgan Ruley, Hannah Sayre, Alberto Coustasse

Management Faculty Research

The 340B Drug Pricing Program, created by Congress in 1992 through the Veterans Health Care Act, has provided discounted drug prices to hospitals and other health care organizations serving a wide population of low-income patients. Some 340B programs use contract pharmacies, an arrangement whereby the hospital or health care organization signs a contract directly with a pharmacy to provide covered pharmacy services at discounted prices.

The federal 340B Drug Pricing Program has provided access to reduced price prescription drugs to over 35,000 individual healthcare facilities and sites certified by the U.S. Department of Health and Human Services (HHS), and clinics …

Strategies For Compliance With Government Regulations In A Pharmaceutical Company, Charles Jagun

Walden Dissertations and Doctoral Studies

Pharmaceutical companies accrued fines of over $30 billion within 25 years because of noncompliance with regulations. Noncompliance with regulations results in fines and an adverse impact on company profitability. Some pharmaceutical company managers lack effective strategies to ensure overall company compliance with regulation. Based on complexity leadership theory, the purpose of this single case study was to explore strategies pharmaceutical company managers used to ensure compliance with regulatory requirements in Nigeria. The target population was functional managers purposely selected because they had successfully implemented strategies for compliance with the regulatory requirements in Nigeria. Data were collected through face-to-face and telephone …

Evaluating Patient Preferences For Different Incentive Programs To Optimize Pharmacist-Provided Patient Care Program Enrollment, Daniel M. Tomaszewski, Tim Cernohaus, Rajiv Vaidyanathan

Pharmacy Faculty Articles and Research

BACKGROUND: Employers have increased efforts to engage employees in health and wellness programs. Providing employees with incentives to participate in these programs has been shown to improve overall enrollment and engagement. One program that has had challenges with enrollment and engagement is medication therapy management (MTM).

OBJECTIVES: To (a) determine how individuals evaluate different financial incentives to improve participation in an MTM program and (b) measure the effect of participant characteristics on incentive preference.

METHODS: This study was composed of a paper-based survey administered to participants after focus group sessions. Participants included MTMeligible beneficiaries from 2 employer groups and included …

Delirium Reduction Strategies For The Critically Ill, June Chaves, Sam Canonico, Will Cheney, Tammy Corey, Gil Fraser, Alex Kowalewski, Jen Low, Cardiac Intensive Care Unit, Haley Pelletier, Cathy Palleschi, Stephen Tyzik, Suneela Nayak, Ruth Hanselman

Maine Medical Center

Delirium, an acute and fluctuating disturbance of consciousness and cognition, is a common manifestation of acute brain dysfunction in critically ill patients. Patients with delirium have longer hospital stays and a lower 6-month survival rate than do patients without delirium. Preliminary research suggests that delirium may be associated with cognitive impairment that persists months to years after discharge.

In a large acute care hospital, the cardiac intensive care staff became interested in mitigating their unit’s high delirium rate of ventilated patients. At baseline, many members of the healthcare team did not believe that delirium could be prevented and the predominant …

Building A Pharmaceutical Company From Scratch, Singapore Management University

Perspectives@SMU

Carl Firth built ASLAN Pharmaceuticals thanks to Big Pharma, investment banking…and beer

Global Reach, Local Markets: The Challenges Of Leading Global Innovation, Sarah Higgins

Honors Theses

This Global Studies honors thesis addresses how managers and leaders of global firms manage innovation across multiple markets. Current research on multinational corporations provides an understanding of different kinds of innovation and the ways to attend to multiple markets. However, there is less documentation of how these innovation strategies are actually implemented on the ground and the tensions that these efforts might produce. Therefore, my research focuses in particular on the challenges and tensions faced by leaders of global firms as they implement transnational innovation strategies. This study is based upon in-depth interviews with 20 participants who held positions in …