It’s been said that adversity brings out our best, forcing us to go outside our comfort zones, pull together, and meet new challenges with innovative ideas, creative solutions, and concerted action. 1998 certainly held its share of adversity and tough challenges in the pharmacy and senior care arenas. But throughout the year I was truly impressed by the diligence and resourcefulness ASCP members demonstrated in rising to meet each new challenge. Guided by the knowledge and collective wisdom of the Society’s Board of Directors, policy Councils, advisory committees, individual members, and corporate partners, ASCP achieved significant strides in many areas and important victories on many fronts. We can all look back on 1998 with a strong sense of pride and accomplishment.

When my year as the Society’s president began, the nation’s consultant pharmacists were struggling to prepare for implementation of a new Medicare prospective payment system (PPS)—a radically new payment system that will set the tone of many public- and private- sector pharmacy cost control programs in the years to come. In 1997, ASCP was at the forefront of efforts to warn Congress and federal health officials that serious flaws in the PPS would pose a serious threat to the health and safety of millions of Americans in the years ahead. In 1998, ASCP backed up those warnings with solid research results illustrating the severity of the threat and aggressive lobbying for prompt corrective action. Definitive solutions to the PPS problem remain to be achieved, but ASCP members can take pride that their efforts during 1998 have provided a strong impetus for positive change.

In another standout accomplishment of 1998, ASCP made additional major strides toward completion of the landmark Fleetwood Project Research Initiative. From the Fleetwood Phase II research emerged new tools to reduce the $100-billion annual toll of medication-related problems, and a new model of pharmaceutical care that will soon enable senior care pharmacists to extend their quality-enhancing, cost-reducing services to many more Americans.

These are but two of the Society’s important accomplishments in 1998; many others are recounted in the following pages. The achievements of 1998 are perhaps best viewed as an extension of a tradition of ASCP innovation, patient care excellence, and senior-focused advocacy stretching back nearly 30 years. Now, as we prepare to enter the new millennium, no one can foresee what new challenges lie ahead. But one thing is clear: As America heightens its demands for innovative pharmaceutical care and effective senior-focused advocacy, ASCP members will be ready, willing, and able to answer the call.

Jan Allen
1997-98 ASCP President

President Jan Allen Wetumpka, Alabama	Immediate Past President and Chairman, Board of Directors Ralph F. Kalies Oshkosh, Wisconsin	President-elect David Kazarian St. Petersburg, Florida	Vice President Dianne Tobias Davis, California	Secretary/Treasurer Arnold B. Cammeyer Great Neck, New York
Region I Director Harlan Martin Clark, New Jersey	Region II Director Diane B. Crutchfield Knoxville, Tennessee	Region III Director Charles Hunt Dublin, Ohio	Region IV Director Richard Marasco Largo, Florida	Region V Director Mark Sey Woodbridge, California
Region I Director Robert Miller Buffalo, New York	Region II Director John Ricci Glenwood, Maryland	Region III Director Carl F. Skrabacz Des Plaines, Illinois	Region IV Director Alan Mason Oklahoma City, Oklahoma	Region V Director William Simonson Chesapeake, Virginia
A Redoubled Commitment to Senior Care Building upon work begun by ASCP leaders in 1998, ASCP entered 1999—designated by the United Nations as the “International Year of the Older Person”—reinvigorated with an updated mission statement reflecting the Society’s expanded organizational mission, refined operational vision, and redoubled commitment to promoting and enabling excellence in senior care: The American Society of Consultant Pharmacists is the international professional association that provides research, leadership, education, advocacy, and resources enabling senior care pharmacists to enhance quality of care and quality of life for older individuals through the provision and promotion of pharmaceutical care and healthy aging practices. Through initiatives, programs, and advocacy, ASCP will: Support and promote senior care pharmacy practice and senior care pharmacists Increase the number of pharmacists proficient in providing pharmaceutical care, knowledgeable about geriatrics and geriatric pharmacotherapy, and committed to the care of the geriatric patient Develop and disseminate standards, guidelines, and policies relevent to pharmaceutical care, geriatric pharmacotherapy, and senior care pharmacy practice Influence legislation, regulation, and health policy to foster quality health care for the senior population and create a favorable professional and business environment for senior care pharmacists Establish and maintain productive and collaborative relationships with other professional organizations, provider groups, and political and lay organizations concerned with health care for the senior population Continue its support of pharmacists providing services to long-term care patients.			Council of Presidents Richard S. Berman*, 1969-72 Allen Kratz, 1972-73 Naples, Florida John Kaufman, 1974-75 Sacramento, California Jack M. Machbitz, 1975-76 Clearwater, Florida Larry Niemerow*, 1976-77 Robert L. Hays*, 1977-78 Allen G. Odell, 1978-79 Waitsfield, Vermont Mark I. Abrams, 1979-80 Wilmington, Delaware Milton S. Moskowitz, 1980-81 Columbia, Maryland Jerome L. Fine, 1981-82 Baltimore, Maryland Steven B. Loevner, 1982-83 Newton Square, Pennsylvania Rolf K. Schrader, 1983-84 Toledo, Ohio Thomas C. Snader, 1984-85 Sellersville, Pennsylvania Arnold B. Cammeyer, 1985-86 Great Neck, New York Steven R. Adams, 1986-87 Lancaster, Kentucky Elliott D. Tertes, 1987-88 West Hartford, Connecticut Jack E. Sassone, 1988-89 Metairie, Louisiana Nelson L. Showalter, 1989-90 Harrisonburg, Virginia Charles Maples, 1990-91 Camas, Washington K. Scott Carruthers, 1991-92 Palmdale, California Herbert Langsam, 1992-93 Oklahoma City, Oklahoma Timothy E. Bien, 1993-94 Cincinnati, Ohio Lynn F. Williams, 1994-95 Tampa, Florida Brian A. Kahan, 1995-96 Boca Raton, Florida Ralph F. Kalies, 1996-97 Oshkosh, Wisconsin Janet M. Allen, 1997-98 Titus, Alabama *Deceased

A New Vision for the New Millennium

While modern medicines can work wonders, they can also create serious health care problems if not judiciously used and astutely managed. Despite major strides in knowledge and prevention of medication-related problems in recent years, these problems continue to exact a staggering toll in avoidable hospitalizations, falls and injuries, and other adverse consequences. All told, medication problems and their many direct and indirect adverse effects drain more than $100 billion each year from our nation’s health care budget.

Rising to the Senior Care Challenge

For 30 years, consultant pharmacists have served as a critical line of defense against medication-related problems in the most challenging group of patients—the 1.8 million mostly elderly residents of U.S. nursing facilities. Now consultant pharmacists are stepping into a critical new role.

A new kind of medication expert is emerging: the senior care pharmacist, specially trained to provide the highest level of geriatric pharmacotherapy services and commited to serving seniors wherever they reside—in hospitals and skilled nursing facilities, subacute care and assisted living settings, and in their communities and homes.

Consultant Pharmacist’s Creed

• I take responsibility for my patients’ medication-related needs.
• I ensure that my patients’ medications are the most appropriate, the most effective available, the safest possible, and are used correctly.
• I identify, resolve, and prevent medication-related problems that may interfere with the goals of therapy.

• Continuing education, traineeships, and professional development programs and resources focused on geriatric pharmacotherapy to consolidate and build upon ASCP’s position as the acknowledged leader in senior care pharmacy
• Interdisciplinary outreach to cultivate fruitful collaboration, information exchange, and idea sharing with physicians, nurses, and other senior care professionals
• Development and dissemination of guidelines, quality standards, and other clinical information through the Society’s peer-reviewed professional journal, web site, and other electronic and traditional means
• Vigorous legislative and regulatory activism to remove barriers to the provision of pharmaceutical care services, hasten the creation of innovative models of care, and foster adoption of policies and systems that allow senior care pharmacists to apply their unique skills to best advantage
• Targeted public education and aggressive advocacy to help America establish a policy and financing framework in which the promise of optimal health care for all seniors—and patients of all ages—can be fulfilled.

“Medications are probably the single most important health care technology in preventing illness, disability, and death in the geriatric population.”

—Jerry Avorn, MD, Harvard Medical School

A strong, sustained commitment to senior care. . . excellence in geriatric health care. . . innovation in research and education. . . strong leadership in public policy . . . These are the qualities America is demanding of the pharmacy profession and the individual pharmacists entrusted to care for America’s fast-growing population of senior citizens. Enabling pharmacists to meet the senior care challenge lies at the heart of ASCP’s efforts to maintain its position as the leader in senior care pharmacy—today, tomorrow, and into the 21st century.

The Fleetwood Project: Enabling Excellence in Senior Care

Phase I of the Fleetwood Project, completed in 1997, clearly delineated the enormous toll of medication-related problems in our nation’s nursing facilities and consultant pharmacists’ enormous impact in holding those problems to a minimum. The Phase I data showed that each year in U.S. nursing facilities, consultant pharmacists’ diverse quality assurance activities improve the frequency of optimal drug therapy outcomes by 43%, and yield an estimated $3.6 billion in health care cost savings through averted medication-related problems. Phase II of the Fleetwood Project, scheduled for full completion in early 1999, has already identified specific risk factors for medication-related problems in the elderly and is testing the an exciting new Fleetwood Model of prospective medication review and formalized care planning to head off those problems before they occur.

Phase III of the Fleetwood Project, scheduled to get under way in 1999, will focus on the incremental, widespread implementation of the Fleetwood Model through training of consultant pharmacists and collaboration with long-term care pharmacy providers, and will put the methods and tools developed in the Phase II pilot into the hands of consultant pharmacists. Training programs will be conducted to enable pharmacists to implement the Fleetwood Model and measure the impact of their clinical interventions on patient outcomes and costs.

The Fleetwood Project is funded exclusively by ASCP its, members, and long-term care pharmacy providers. For information on supporting this critical initiative, write to: Fleetwood Project, ASCP, 1321 Duke Street, Alexandria, VA 22314; 703-739-1300.

Informing Senior Care Policy

The study, conducted by prominent Cambridge, Massachusetts-based research firm Abt Associates, explored the quality-of-care impact of including medication services in a Medicaid prospective payment system. The data analysis revealed a clear association between prospective payment for medication services and decreased use of many drugs widely accepted to constitute optimal therapy for Alzheimer’s disease, schizophrenia, depression, asthma, osteoporosis, and other diseases and conditions common among the elderly.

ASCP forwarded the study report to federal health officials responsible for ongoing refinement of the new Medicare PPS, as well as many members of Congress. For a summary of the study findings, visit ASCP’s Web site at ascp.com.

“The adverse effects of insppaopriate drug use in the elderly are largely preventable. Public policy, properly guided, can play a positive role in improving the delivery of health care to this vulnerable population.”

—Daniel Perry, Alliance for Aging Research

Delivering ASCP’s Message on Capitol Hill

At a June briefing in the U.S. Capitol building called by Sen. Bill Frist (R-Tenn.) and attended by representatives of more than 45 House and Senate offices, ASCP Executive Director Tim Webster and ASCP Research and Education Foundation Director Janice Feinberg released an ASCP report including a comprehensive Advocacy Agenda for a stepped-up attack on medication-related problems. Central components of that agenda are:

• Prompt action by Congress, the White House, and federal regulatory agencies to make reduction of medication-related problems among elderly Americans a national priority
• Efforts by state legislators and regulators to remove policy barriers to enhanced senior care and enable increased collaboration by pharmacy and medical professionals in provision of optimal drug therapy services
• Increased emphasis of geriatrics-focused education and training in the nation’s schools and colleges of pharmacy
• Greater collaboration by ASCP and other leading pharmacy and senior care-focused professional organizations to develop, implement, and refine geriatric pharmacotherapy guidelines and innovative models of senior care

Gathering on the steps of the Capitol building after the congressional briefing are, from left, ASCP Executive Director R. Tim Webster, Alliance for Aging Research Executive Director Daniel Perry, ASCP Research and Education Foundation Director Janice Feinberg, and Georgetown University Center on Aging Director Richard Besdine, MD.

To receive a copy of the ASCP report—“ASCP’s Prescription for Quality Care: Preventing Medication-Related Problems Among Older Americans”—visit ASCP’s Web site at ascp.com.

Charting a Course for Pharmacy’s Future

• Recommendations on enhanced pharmacist counseling of geriatric patients to boost compliance and reduce costly medication-related problems
• Guidance to promote and enable pharmacists’ increased involvement in immunization programs
• Policy recommendations on improved prescription labeling to enable better counseling and monitoring of drug therapy effectiveness
• Detailed guidance to assist pharmacists in providing optimal pharmaceutical care to seniors residing in assisted living settings
• Recommended action steps to combat illegal diversion of controlled substances

1997-98 ASCP Policy Councils

The Society continued to meet this critical need in 1998 through development and dissemination of a variety of legislative and regulatory guidance documents, including:

• Comments opposing a proposed major scaling back of pharmacists’ essential medication management and quality assurance role in federally funded hospitals
• Detailed comments calling attention to serious threats to patient care posed by a new Medicare nursing facility prospective payment system and recommendations to expedite necessary system refinements to ensure patient access to needed and appropriate medications
• Detailed comments calling for through collection of medication use data on a new section of the federal Minimum Data Set—data that will be critical to
• In-depth guidance to assist federal officials in crafting revised Drug Therapy Survey Guidelines for enhanced oversight of nursing facility medication use
• Detailed guidance to assist federal officials in crafting major revisions to HCFA nursing facility survey procedures and interpretive guidelines, including expanded drug therapy guidelines

Under the direction of a new editor-in-chief, in 1998 The Consultant Pharmacist’s offerings of peer-reviewed research and clinical reports were augmented with a broader array of feature articles and news departments focusing on issues and challenges in senior care pharmacy. In addition, three supplements to The Consultant Pharmacist presented the latest information on advances in management of geriatric depression, psychoses, and aggressive behavior.

The Society also published for the first time a special 13th edition of the journal covering selected topics in geriatric pharmacotherapy.

Innovative Senior Care Pharmacy Tools

• An updated and expanded edition of Drug Regimen Review: A Process Guide for Pharmacists and companion DRR Reference Software, some of the most widely used clinical tools for geriatric pharmacotherapy (sponsored by Novartis)
• A comprehensive Medication Policy and Procedure Manual for Assisted Living, providing detailed guidance on all aspects of appropriate medication management in assisted living settings (sponsored by Pfizer Inc.)
• A new installment in ASCP’s Regulatory Resource Series presenting in-depth information and guidance on controlled substances disposal and facsimile transmission of controlled substances in long-term care settings
• New additions to ASCP’s popular line of Laminated Resource Sheets

For more information on these and other resources in ASCP’s growing line of professional products, call ASCP Customer Service at 800-355-2727, or click on the "Publications and Products" link at ASCP’s Web site.

A Wealth of Senior Care Information and Resources: ascp.com

Since 1996, when ASCP became one of the first national pharmacy organizations to establish a presence on the World Wide Web, the Society’s Web site has been continually expanded and refined for greater utility and ease of use. Major enhancements in 1998 included:

• A major expansion of clinical practice guidelines and other guidance docments available at the “Practice Resources” link
• New conference rooms to facilitate discussion of clinical challenges and practice issues by ASCP members and leaders
• A state legislative map offering point-and-click access to updates on state legislative and regulatory initiatives, as well as direct e-mail links to every state legislature and governor’s office

Sen. Bill Frist (R-Tenn.), after receiving ASCP’s Legislator of the Year Award during the Society’s Ninth Annual Conference on Legislative and Regulatory Affairs in Washington, D.C. Frist, a member of the Senate Special Committee on Aging, was honored primarily for his ongoing efforts to pass legislation broadening pharmacist’s patient care role in the Medicare program. Later in the year, during a special reception at ASCP’s 29th Annual Meeting in Seattle, ASCP member John Ricci was honored as the Society’s 1998 Political Contributor of the Year. Also at the reception, 1997-98 ASCP President Jan Allen presented the Society’s Award for Legislative Excellence to Sen. Rick Santorum (R-Penn.) in recognition of his role in advancing ASCP’s ongoing PPS lobbying campaign.

A Formidable Force in Public Affairs Anticipating and responding quickly and effectively to fast-breaking legislative and regulatory challenges—in the nation’s capital and in the states—is essential to protecting consultant pharmacists’ ability to provide high-quality, cost-effective patient care. ASCP, long the leader in public policy advocacy on behalf of senior care pharmacists and the patients they serve, fulfills these needs through vigilant issue monitoring and analysis, effective legislative representation, and prompt, reliable regulatory support. In 1998 these activities included: Aggressive lobbying to secure inclusion of pharmacists in a new Medicare program to provide self-care education and management training to patients with diabetes Ongoing meetings and correspondence with officials of the Health Care Financing Administration, Drug Enforcement Administration, and other federal agencies to address policy and reimbursement barriers to provision of optimal medication services Expansion of ASCP’s State Key Contacts program to include more than 600 legislatively active ASCP members in all 50 states, bolstering the Society’s ability to monitor and influence legislative and regulatory developments Coordinated lobbying by ASCP members and staff to help defeat ill-conceived Medicaid reform and drug pricing proposals and facilitate adoption of legislation and pharmacy board regulations to enhance the quality of senior care

1997–98 Government Affairs Committee		1997–98 ASCP-PAC Board of Trustees
Chair Larry Shipp Boulder, Colorado Board Liaison Diane B. Crutchfield Knoxville, Tennessee Clarence Cariker Coppell, Texas Donna DeNardo Naperville, Illinois Suzanne Eastman Columbus, Ohio Herbert Langsam Oklahoma City, Oklhoma	Michael E. Loomis E. Greenwich, Rhode Island Carl Pannuti Yonkers, New York Larry Price Little Rock, Arkansas Allan Vrable Columbus, OhioRobert Warnock Conyers, Georgia Kay Weidner Milwaukee, Wisconsin	Chair Dean Pedalino St. Petersburg, Florida Board Liaison Mark Sey Woodbridge, California Richard Baylis Pasadena, Maryland Kevin Fehring Cincinnati, Ohio Ernest Freeman, III Baton Rouge, Louisiana Don Isetti Stockton, California	Annamary Kisic Ebensburg, Pennsylvania Jerry S. Marlowe Dover, Ohio Martin Mintz Baltimore, Maryland Walter Senick Seminole, Florida Lawrence Sobel West Hartford, Connecticut Natalie Wenger Sharon, Pennsylvania

A Major Victory for America’s Seniors America is realizing that the need for consultant pharmacists’ quality-enhancing, cost-reducing services is not limited to nursing facilities but is also critical in the nation’s approximately 18,000 assisted living facilities —an increasingly important senior care setting. In late 1997 ASCP released Assisted Living Model State Language laying out a blueprint for enhanced medication monitoring in assisted living facilities, calling for close involvement by consultant pharmacists in interdisciplinary care planning, medication monitoring, compliance counseling, resident education, pre-discharge counseling, and other critical quality assurance activities. ASCP members have agressively promoted the model language in state legislatures across the country. Those efforts began to pay off in 1998, when Oklahoma became the first state in the country to mandate use of consultant pharmacists’ services in assisted living quality assurance. The Oklahoma regulation, which went into effect June 25, 1998, requires that in all assisted living facilities throughout the state, “medications shall be reviewed monthly by a registered nurse or pharmacist and quarterly by a consultant pharmacist.” In 1999, ASCP is redoubling its efforts to secure adoption of the model language in every state across the country. Educating Lawmakers An important part of ASCP’s public policy efforts is educating members of Congress, as well as state legislators and governors, on consultant pharmacists’ important and growing role in health care through coordination of visits to long-term care and pharmacy practice sites. In 1998, participants in ASCP-coordinated site visits included Reps. Michael Bilirakis (R-Fla.) and Connie Morella (R-Md.). Also in 1998, ASCP coordinated a group site visit designed to raise congressional awareness of the need to provide for appropriate pharmacist access to patient medical information as Congress works to legislate national confidentiality safeguards. Participants included legislative aides from the offices of Sens. Bob Bennett (R-Utah), Charles Grassley (R-Iowa), and Pat Leahy (D-Vt.), as well as senior staffers to the Senate Special Committee on Aging. The group toured a long-term care pharmacy in the Baltimore area, then visited the Johns Hopkins Geriatric Center, where they saw firsthand why ready access and timely exchange of patient information is essential to optimal patient care. A Crucial Advocacy Platform Contributions to the Capitol Fund, ASCP’s legislative lobbying fund, are vital to ensuring that the Society always has adequate resources to fight critical battles at both the state and federal levels. Major Capitol Fund outlays in 1998 were devoted to advancing ASCP’s ongoing campaign to ensure appropriate medication services for seniors under a new Medicare nursing facility prospective payment system (PPS). Hunderds of ASCP leaders and ASCP members came to Capitol Hill to alert their congressional representatives of Congress to the serious quality threats posed by the new PPS; many of other ASCP members reinforced these efforts through phone calls and ASCP-coordinated letter-writing campaigns hundreds of congressional offices. For information on supporting the Capitol Fund, call ASCP Government Affairs at 703-739-1316, ext. 141 or 170.

A Compelling Message for State Legislators Two years ago, ASCP joined with four other national pharmacy organizations—collectively known as the Alliance for Pharmaceutical Care—to host a joint exhibit at the National Conference of State Legislatures (NCSL) illustrating the enormous toll of medication-related problems and pharmacists’ key role in combating those problems. At the 1998 NCSL meeting, the Alliance was expanded to include six more member organizations. ASCP spearheaded development of the Alliance’s primary message: Enabling pharmacists and physicians to work more closely under formal collaborative practice protocols can greatly enhance the quality of pharmaceutical care while yielding major health care cost savings. So far 22 states have enacted legislation or regulations granting pharmacists some degree of collaborative practice authority. Securing adoption of such policies in every state will continue to be a major focus of ASCP’s advocacy agenda. In addition to ASCP, member organizations of the Alliance for Pharmaceutical Care are the Academy of Managed Care Pharmacy, American Association of Colleges of Pharmacy, American College of Clinical Pharmacy, American Pharmaceutical Association, American Society of Health-System Pharmacists, National Community Pharmacists Association, National Council of State Pharmacy Association Executives, National Wholesale Druggests’ Assocaition, and United States Pharmacopoeial Convention.

The centerpiece of the 100% Immunization Campaign will be a comprehensive immunization resource guide to close current gaps in geriatric immunization efforts. The resource guide is slated for completion in mid-1999 and will be distributed to all nursing facilities and assisted living facilities nationwide.

Interdisciplinary Collaboration

In a major collaborative initiative with other national pharmacy organizations, ASCP assisted with development of a new “Pharmacy Practice Activity Classification” system—a uniform language to facilitate more consistent pharmacy services coding and reimbursement.

Quality- and Patient-Focused Advocacy

The 1998 Archambault Award was presented to Mark Beers, MD, senior director of geriatrics at Merck & Co., Inc., and editor of The Merck Manuals. Dr. Beers, a trustee of the ASCP Research and Education Foundation, is the author of several seminal articles on geriatric pharmacotherapy. "Inappropriate use" drug therapy quality indicators he developed are widely used by leading long-term care pharmacy providers and were recently adopted as the backbone of revised federal medication quality assurance guidelines for nursing facilities. In presenting the award to Beers at ASCP's 29^th Annual Meeting in Seattle, 1997-98 ASCP President Jan Allen cited his important contributions over many years as a tireless advocate for the nation's seniors and as a champion of initiatives to enhance drug therapy for nursing facility residents.

Leadership

Mark Beers	Armon Neel	Kristie Wallace and Eli Lilly and Company representative Mark Poulin.

Past ASCP Hall of Fame inductees are Bayer Corporation, Pharmaceutical Division (1997); Bristol-Myers Squibb (1995); Ciba-Geigy Corportion (0000); Marion Merrell Dow (1992); Merck Human Health Division (1996); Ortho-McNeil Pharmaceutical (1989); Parke-Davis (1993); Sandoz Pharmaceuticals (1989); and Searle (1990).

New Chapters and Affiliates

In 1998, ASCP significantly expanded its presence in the states, chartering new State Chapters in Florida and Georgia and three new State Affiliated Organizations: the Arizona Pharmacy Association, Arizona Society of Health Systems, and Nevada Pharmacy Alliance. At year’s end, ASCP counted official chapters in 17 states and Canada, as well as 26 state affiliates, and more than 60 allied member companies.

Membership Report

1998 ASCP Allied Member Companies		ASCP Chapters Spearhead National Consultant Pharmacist Week Promotional Activities Each year in October, consultant pharmacists make a special effort to heighten public awareness of their important and growing role in senior care. In October 1998, armed with a variety of print and electronic resources provided by ASCP, individual ASCP members and ASCP Chapters across the United States and Canada marked the fourth annual observance of National Consultant Pharmacist Week with community outreach efforts, presentations at senior centers, and other promotional activities to educate the public about consultant pharmacists’ quality-enhancing services.
Abbott Laboratories ALPHARMA AmeriSource Corp. Amgen, Inc. Artromick International, Inc. Astra Pharmaceuticals, L.P. Baxter Healthcare Corporation Bayer Corporation Bindley Western Drug Company Boehringer Ingelheim Pharmaceuticals Cardinal Health, Inc. Center For Health Information Copley Pharmaceutical, Inc. Drustar, Inc. DuPont Pharmaceuticals Co E. Fougera & Company First Data Bank Forest Laboratories, Inc. Geneva Pharmaceuticals, Inc. GeriMed/IvMed Health Objects Corporation Hoechst Marion Roussel Janssen Pharmaceuticals, Inc. Johnson & Johnson Health Care Systems Knoll Pharmaceutical Company KVM Technologies, Inc Lionville Systems, Inc. Managed Healthcare Associates Med-Pass Incorporated Medical Packaging Inc. Medicom International, Inc. Medirex, Inc. Merck Human Health Division Modern Metals Industries, Inc.	MTS Packaging Systems, Inc. Mylan Institutional Division Novartis Pharmaceuticals Corp Novo Nordisk Pharmaceuticals Inc. Novopharm, Inc. Organon Inc. Ortho-McNeil Pharmaceutical Par Pharmaceutical, Inc. Parke-Davis PCI TransAid Pfizer Pharmaceuticals Pharmacia & Upjohn Purchase Connection Pyxis Corporation QS/1 Pharmacy Systems Rescot Systems Group, Inc. Respiratory Distributors, Inc. Rhone-Poulenc Rorer RNA, Inc. Roche Labortories Ross Products Division Roxane Laboratories, Inc. Rx Systems, Inc. Schein Pharmaceutical Schering Laboratories Searle SmithKline Beecham Pharmaceuticals TEVA Pharmaceuticals USA The Harloff Company UDL Laboratories, Inc. Vitalink Pharmacy Services, Inc. Wyeth-Ayerst Laboratories Zeneca Pharmaceuticals Group Zenith Goldline Pharmaceuticals

Despite challenges maintaining traditional sources of revenue and industry support in a climate of ongoing consolidation and downsizing throughout the health care world, ASCP achieved a record $7.6 million in total revenues in 1998. From these revenues, ASCP met all 1998 budget targets and posted an excess of revenues over expenses of $338,000. These numbers reflect the society’s success in:
• Posting solid attendance and profitability from meetings throughout the year
• Maintaining a high level of journal-related publication sales
• Continuing to emphasize cost control in all expense categories
• Earning an 11% return on ASCP’s investment portfolio

As the practice of consultant pharmacy enters the 21st Century, it faces new challenges and opportunities with the emerging elder population. With fewer than ten percent of seniors residing in institutional settings, there is an untapped market of community-dwelling seniors who could benefit from the services of consultant pharmacists. As outlined in its 1998 Annual Report, the ASCP Foundation has embarked on ambitious educational and research efforts to assist pharmacists prepare for the challenges and opportunities of providing pharmaceutical care services for both institutionalized and community-dwelling older persons.

Nowhere is the ASCP Foundation’s growth more evident than in the number and variety of new educational programs, research projects, and collaborative initiatives undertaken each year. In 1998, substantial time and effort was invested to develop unique and important new programs to improve medication use in the senior population and prepare consultant pharmacists for their clinical role as the providers of pharmaceutical care services for seniors.

Three initiatives in particular—the Fleetwood Project, Foundation Traineeships, and the MDS-Med Guide—form the nucleus from which consultant pharmacists will lead the profession into the next millennium through a re-engineering of pharmacy practice. The ASCP Foundation is pleased to make these opportunities available.

Fleetwood Project

The significance and relevance of the Fleetwood Project today is a direct outgrowth of the bold and prescient vision of the National Advisory Board, which conceptualized what consultant pharmacy practice had to look like in the future in order to distinguish consultant pharmacists and their services, demonstrate the impact of consultant pharmacist services, and determine the value of consultant pharmacist services. The Advisory Board dared to step beyond traditional drug regimen review in its vision for the Fleetwood Project, to create a new model of consultant pharmacy practice—a model that is prospective rather than retrospective; that focuses on patients at highest risk for medication-related problems; that identifies specific outcomes where consultant pharmacists have a measurable impact; a model where the pharmacist contacts the prescriber directly to resolve problems and when making recommendations; that removes arbitrary distinctions between the role of consultant pharmacist and “dispensing” pharmacist and requires equivalent clinical competence; a model that is rooted in the philosophy and practice of pharmaceutical care; one that could survive the tumultuous changes within the health care system and prepare consultant pharmacists for the future.

Traineeships

ASCP Foundation traineeships are intensive, patient-focused, interdisciplinary, experiential and didactic post-graduate educational programs intended to prepare pharmacists to provide a high level of pharmaceutical care to patients with various chronic diseases and conditions; create pharmacist advocates for appropriate care and treatment of their patients; and positively impact the way pharmacists perceive their role in caring for their patients.

Traineeship participants are competitively selected; complete a post-traineeship project; are expected to write up and submit at least two case consults for which they made recommendations for treatment or interventions to improve care of patients; and become members of the ASCP Foundation’s Traineeship Network, which meets at ASCP Midyear and Annual meetings and is linked through an email listserve. Many traineeships also require participation in local support groups.

ASCP Foundation traineeships offer pharmacists an opportunity to work with an interdisciplinary team of physicians, nurses, pharmacists, caregivers, family members, and patients; participate in direct patient care; contribute to the development of treatment plans; and provide input into problem identification and resolution. Pharmacists who have participated in ASCP Foundation traineeships describe the experience as life changing, both professionally and personally.

• Parkinson’s Disease Pharmacotherapy,Disease Pharmacotherapy, developed through an educational grant from The Merck Company Foundation and supported by an educational grant from Merck Human Health Division
• Multidisciplinary HIV/AIDS in Long-Term Care, supported by an educational grant from Glaxo Wellcome Inc
• Wound Care, supported by an educational grant from Knoll Pharmaceutical Company
• Alzheimer’s/Dementia, supported by an educational grant from Bayer Corporation
• GeroPsych/Behavioral Disorders (developed in 1998), supported by an educational grant from Eli Lilly and Company
• HIV/AIDS Pharmacotherapy (developed in 1998), supported by an educational grant from DuPont Pharmaceuticals Company

The MDS-Med Guide comes in three formats: Pocket Guide and Wall Chart, which contain grids linking medications and medication classes to the Resident Assessment Protocols and Minimum Data Set items and domains; and Query Software, which allows screening of patient-specific medications/medication classes and report generation.

The concept for the MDS-Med Guide was fostered by the 1995-1996 ASCP Organizational Affairs Council, which was charged with developing a Statement and Guidelines on the Role of the Consultant Pharmacist in Resident Assessment and Care Planning. The Guidelines were intended to identify specific areas where consultant pharmacists could contribute to the resident assessment and care planning process for individual residents, including the evaluation of drug therapy as a cause or aggravating factor contributing to the resident’s problem that can be avoided, managed, or reversed. The ultimate goal was to develop a “product” to be used by consultant pharmacists to achieve this end. With the MDS-Med Guide this goal has now been reached.

Support for the development of the MDS-Med Guide was provided through an educational grant from Pfizer Inc. The MDS-Med Guide Query Software was created by in-kind support from Pfizer’s Clinical Pharmacy Outcomes Research Group.

The ASCP Foundation will also train consultant pharmacists on the use of the MDS-Med Guide at a series of Pfizer-sponsored, freestanding regional meetings.

Visibility

During 1998, the ASCP Foundation undertook a number of initiatives to educate health professionals, aging organizations and advocacy groups, policy makers, the aging network of service providers, and the general public about the Fleetwood Project, the magnitude and cost of medication-related problems among the older population, and the role of consultant pharmacists in identifying, preventing, and resolving medication-related problems. These programs include When Medicine Hurts Instead of Helps: Preventing Medication Problems in Older Persons—Alliance for Aging Research Report and Congressional Briefing, and presentations at the American Society on Aging Annual Meeting, American Society on Aging International Conference on Long Term Care Case Management, American Society on Aging Summer Series, Gerontological Society of America Annual Meeting, Law Day for Older Adults, and Holy Cross Caregiver Resource Center. The ASCP Foundation also participated in the following initiatives: The National Council on the Aging Falls Prevention Initiative in Home and Community-Based Settings, National Resource Center for the Prevention of Unintentional Injuries Among Older Adults, LinkAges: Resources for People Caring for Older Adults, Initiative on Quality in Long-Term Care, and Nutrition Screening Initiative.

Research, Education, Initiatives

Research

• Continuity of Pharmaceutical Care
• Risk-Based Payment Systems for Medications and the Frail Elderly—Geriatric Drug Therapy Research Institute grant

• Pharmacoeconomic Fellowship in Geriatric Long-Term Care, funded by an unrestricted educational grant from Bristol-Myers Squibb
• Interdisciplinary PharmD Clerkship in Assisted Living and Eldercare, supported by an unrestricted educational grant from The Merck Company Foundation
• Research Workshop: Generating and Analyzing Data for Business and Clinical Applications, supported by an unrestricted educational grant from Merck Human Health Division

• www.ascpfoundation.org
• Total Quality Leadership (TQL) Initiative, supported in part by an educational grant from Bristol-Myers Squibb
• ASCP/Eli Lilly and Company Leadership in Education Award
• Automation in Pharmacy Initiative

W. Gary Erwin, PharmD, FASCP Omnicare, Inc. Radnor, Pennsylvania Jan Allen, RPh, FASCP GeriMed Titus, Alabama Mark Beers, MD Merck & Co. West Point, Pennsylvania Arnold Cammeyer, BS (Pharm), FASCP KAZ Consulting Corporation Great Neck, New York Jade Gong, RN, MPPM Health Strategy Associates Arlington, Virginia Ralph Kalies, PhD, FASCP Konsult, Inc. Oshkosh, Wisconsin David Kazarian, RPh, FASCP Infuserve America St. Petersburg, Florida Eleanor Perfetto, PhD, RPh MEDTAP systems, LLC Bethesda, Maryland

Penelope Pollard, MS, MBA The Lewin Group Fairfax, Virginia Mark Sey, RPh, FASCP Mark Sey and Associates Woodbridge, California Bret Stine, MHSA EverCare Baltimore, Maryland Elliott Tertes, PD, FASCP Quintessential Group West Hartford, Connecticut Carl Trinca, PhD Western University of Health Sciences Pomona, California Donna Wagner, PhD Towson University Towson, Maryland Tim Webster, RPh, ScD Executive Director American Society of Consultant Pharmacists