Specialty Roundtable: Exploring Practice Settings within Psychiatric

Specialty Roundtable: Exploring Practice Settings within Psychiatric and Neurologic Pharmacy
Sunday, April 19, 3:15-4:30 p.m.
Grand Ballroom E
Academic Detailing
Table 1:
Sarah J. Popish, PharmD, BCPP
Program Manager, Academic Detailing Program Office
Veterans Affairs Central Office, Pharmacy Benefits Management
Clinical Pharmacy Specialist-Mental Health
VA Northern California Healthcare System
Vallejo, CA
Dr. Popish is currently a Program Manager for Veterans Affairs Central Office, Pharmacy
Benefits Management, Academic Detailing Program office. After receiving her PharmD
from the University of Colorado School of Pharmacy she went on to complete an
Psychiatric Pharmacy Residency affiliated with Idaho State University College of
Pharmacy and a two year Pharmacogenomics and Psychopharmacology Research
Fellowship with Nova South Eastern University and Lake Erie College of Medicine. Dr.
Popish has lectured extensively on various topics in clinical psychiatry, published several
peer reviewed articles, and received numerous professional honors and awards, including
the National Pharmacy Benefits Management innovative practice award.
Academic Detailing
Academic Detailing is evidence based outreach programing that seeks to use the marketing
strategies of industry to promote evidence based guidelines and best practices. The
Veterans Affairs Academic Detailing (AD) program office develops educational
programing and trains healthcare professionals, primarily pharmacists, to deliver this
programing. This starts with a thorough evaluation of the available literature to develop
up-to-date, evidence-based recommendations that cover the comparative benefits, risks and
cost-effectiveness of treatments for a given therapeutic area. These recommendations or
key messages are then disseminated by Academic Detailers in an interactive educational
outreach visit that utilizes social marketing to engage the provider and meet his or her
specific educational needs. Academic detailing is based on relationship building and
provides specific practice-change recommendations through key message-focused
discussions with the clinician.
Table 2:
Tammie Lee Demler,BS, PharmD, MBA., BCPP
Director of Pharmacy Services and Psychiatric Pharmacy Residency Training
New York State Office of Mental Health at the Buffalo Psychiatric Center
Adjunct Clinical Associate Professor of Pharmacy Practice
Department of Pharmacy Practice
University of Buffalo School of Pharmacy and Pharmaceutical Sciences
Buffalo, New York
Dr. Tammie Lee Demler is the Director of the ASHP accredited post Doctoral psychiatric
pharmacy residency for the New York State Office of Mental Health and is the Director of
pharmacy services for the Buffalo Psychiatric Center. facility within the New York State
Office of Mental Health. Dr.Demler is past President of the Pharmacists’ Society of the
State of New York and President of the Pharmacists’ Association of Western New
York. She received her BS in pharmacy in 2002, Doctor of Pharmacy degree in 2002 and
Masters of Business Administration in 2009 from the University of Buffalo. She is board
certified (BCPP) in psychiatric pharmacy practice. Currently, Dr. Demler serves as
Clinical Associate Professor of pharmacy practice at the University of Buffalo School of
Pharmacy and Pharmaceutical Sciences, Clinical Assistant Professor at The University of
Florida, St. John Fisher College and D’Youville College in Buffalo, NY. She received a
gubernatorial appointment to the NYS Department of Motor Vehicles Medical Advisory
Board and currently collaborates with the New York State Department of Health as an
academic detailer/clinical pharmacist prescriber educator.Having found her passion for
media and community outreach, Dr. Demler has been host of “WNY Tonight with Tammie
Lee” for the last decade, and in addition to being featured as an expert in numerous media
interview she is also a contributing author for APA psychiatric news, US Pharmacist,
ACCP Ambulatory Care Self Assessment Progam (ASCAP) and Carlat behavioral report.
She most recently was promoted to community affairs radio reporter for Cumulus
Broadcast Company (97 Rock, 103 the edge, 104 WHTT). Among her most notable
awards, Dr. Demler was named the New York State Senate Woman of Distinction in 2004
for her professional contributions to the people of New York State and the Bowl of Hygeia
for her national professional advocacy.
Inpatient State Psychiatric Hospital
The New York State Office of Mental Health (NYS OMH) is responsible for the operation
of 17 psychiatric facilities, which serve mentally ill adults with each facility located
withon one of five geographic regions. The Buffalo Psychiatric Center provides
comprehensive mental health services to adults 18 and over who reside in Erie, Niagara,
Cattaraugus and Chautauqua counties (total population served 1,350,731). BPC inpatient
services has a bed capacity of 189 for 7 units and thousands of outpatients served by clinic
staff and ACT team members.
Primary Care
Table 3:
Glen L. Stimmel, PharmD
Professor of Clinical Pharmacy, Psychiatry and the Behavioral Sciences
University of Southern California School of Pharmacy and Keck School of Medicine
Los Angeles, CA
Dr. Stimmel is a founding member and Past President of CPNP and Board member of the
CPNP Foundation, a founding member, elected fellow, and Past President of the American
College of Clinical Pharmacy, and an original member and past Chair of the Board of
Pharmaceutical Specialties’ Specialty Council on Psychiatric Pharmacy Practice. Dr.
Stimmel has authored over 230 articles and textbook chapters in the areas of clinical
psychopharmacology, pharmacoeconomics, and expanded scope of practice for
pharmacists. He pioneered efforts in developing psychiatric pharmacy practice, education
and residency programs, as well as investigating and securing prescriptive authority for
pharmacists in California.
LAC/USC Geriatrics Primary Care Clinic
This clinic provides primary care to all seniors > 75 years old, seniors > 65 years old with
complex medical problems, and any elder or dependent adult suspected of being a victim
of abuse/neglect. The clinical team consists of attending geriatricians, a geriatrics fellow,
4-5 internal medicine residents, a clinical pharmacist (Dr. Stimmel), and an ambulatory
care pharmacy resident. The team together makes all treatment decisions. Dr. Stimmel
and the attending geriatrician consult with the internal medicine residents as they present
their cases where drug therapy decisions are made. The most common disorders in this
clinic include diabetes, hypertension, cardiovascular disease, incontinence, osteoporosis,
routine health maintenance, depression, insomnia, and mild to moderate dementia.
LAC/USC Rheumatology Clinic Depression Management Consult Service
This specialty clinic provides care to patients with all rheumatoid disorders; the most
common disorders are lupus and rheumatoid arthritis. The clinicians include 4-5
rheumatologist attending staff, 6 rheumatology fellows, Dr. Stimmel, and an ambulatory
care pharmacy resident. Depression is commonly seen in this clinic (>20% of patients).
Rheumatology attendings and fellows refer patients to Dr. Stimmel who have new
depressive symptoms, and patients who are already taking antidepressants. New patient
evaluations (typically ~45’ patient visit) result in either a referral to psychiatry (~20%), no
start of antidepressants since patient does not meet criteria for major depression (30%), or
start/continue antidepressants with individual follow-up appointments with Dr. Stimmel
(~50%). Prescriptive authority is not part of this practice since it was purposely set up to
be a consultative service to enhance the rheumatology fellows’ expertise in identifying and
treating depressive disorders with Dr. Stimmel.
Table 4:
Carla Cobb, PharmD, BCPP
Clinical Psychiatric Pharmacist
RiverStone Health
Billings, Montana
Carla Cobb is a psychiatric pharmacy specialist at RiverStone Health and the Montana
Family Medicine Residency in Billings, Montana where she has practiced for 16 years.
She is a Clinical Professor in Pharmacy Practice at the University of Montana. Carla
graduated from the University of Manitoba and received her Doctor of Pharmacy degree
from the University of Texas. She completed a residency in psychiatric pharmacy at the
University of Texas and San Antonio State Hospital. She is board certified in psychiatric
pharmacy. She is a founding member of the College of Psychiatric and Neurologic
Pharmacists and serves on the drug utilization review board for Montana Medicaid, the
Montana Patient Centered Medical Home stakeholder council, and the Pharmacy Quality
Alliance. Her practice and research is focused on the team approach of care for people
with psychiatric disorders in the primary care setting, including the role of pharmacistprovided comprehensive medication management. In 2013 she was awarded the Bowl of
Hygeia for outstanding community service.
Primary Care Clinic
RiverStone Health is a federally-qualified community health center that includes a primary
care clinic, outpatient pharmacy, healthcare for the homeless, Medicaid case management,
hospice, home health, family health, and public health services. The health clinic is a
NCQA Level 1 recognized patient-centered medical home and serves as the outpatient
clinic for the Montana Family Medicine Residency with a total of 24 residents. Students
from the University of Montana School of Pharmacy also enjoy 8-week required
ambulatory care or four-week psychiatry or medication management elective advanced
practice experiences in the clinic. The clinic provides an integrated team approach to care
with physicians, non-physician providers, residents, behavioral health (psychologist,
therapist, addiction counselor), diabetes educator, dietician, care coodinators, and resource
advocates, all part of the patient care team. Three part-time pharmacists, including one
board certified psychiatric pharmacist, along with pharmacy students, provide clinic
pharmacy services.
Pharmaceutical
Industry
Table 5:
Toya Bowles, PharmD, MS, BCPP
Principal Medical Science Liaison, CNS Medical Affairs
Janssen Scientific Affairs, L.L.C.
Titusville, NJ via Miami, FL
Dr. Toya Bowles is a CNS Principal Medical Science Liaison for Janssen. She has worked
in the pharmaceutical industry, specifically in CNS, for the last 12 year. Prior, Dr. Bowles
worked as a clinical psychiatric pharmacist. She received her BS Pharm and Pharm D
from the University of Kansas, and a Psychopharmacology Fellowship and Masters of
Science in pharmacy law, policy, and regulatory from the University of Florida. She is
Board Certified in Psychiatric Pharmacy.
Field Science
Medical Science Liaisons (MSL) are generally experts in the field (PharmD, PhD, MD).
CNS MSL’s and have been specialty trained in psychiatric pharmacy with many years of
clinical experience, and usually BCPP prior to working in industry. Generally, MSL’s
provide detailed medical information, gather medical insights both regionally/nationally,
and connect/liaise research and projects with the company. Though each pharmaceutical
company operates differently, there are common regulatory processes all follow.
Table 6:
Judy L. Curtis, PharmD, BCPP, FASHP
Director, Medical Science Liaisons, MidAtlantic Region
Sunovion Pharmaceuticals Inc.
Marlborough, Ma
Dr. Judy Curtis is a board certified psychiatric pharmacist and recently joined Sunovion as
a Director, Medical Science Liaison, MidAtlantic region. Previously, she was with OrthoMcNeil Janssen Scientific Affairs as a CNS Principal Scientific Affairs Liaison for nine
years. Prior to industry, Dr. Curtis was an Associate Professor at the University of
Maryland, School of Pharmacy in Baltimore, Maryland, Her primary clinical practice was
with developmentally delayed adults with severe behavioral problems. She also developed
and directed the Psychiatric Pharmacy Practice Residency program for the Mental Health
Program at University of Maryland for 16 years. She was a consultant for the Department
of Justice, Department of Health and Mental Hygiene and Developmental Disabilities
Administration for the State of Maryland, Clifton T. Perkins Hospital Center (forensic
facility), Washington County ARC and various other state agencies. She is a founding
member of the College of Psychiatric and Neurologic Pharmacists and served as the
association’s secretary from 2000-2002. Dr. Curtis frequently presented at national and
regional meetings on various psychiatric topics. She has numerous publications and was
the primary author for chapters in Applied Therapeutics and Pharmacotherapy.
I work as part of the Medical Affairs division of Sunovion Pharmaceuticals Inc., as a
Medical Science Liaison. My job is to disseminate clinical information about the
company’s product(s) to health care professionals and formulary decision makers and
initiate and maintain relationships with researchers, academic leaders, key opinion and
thought leaders. I also answer clinical questions regarding the product(s), including offlabel questions upon unsolicited request. I attend, represent and support the company’s
presence at professional meetings and participate in speaker training for the company’s
speaker’s bureau. I am responsible for MSL activities in the MidAtlantic Region of the
US. The views and opinions expressed here are mine and not those of Sunovion
Pharmaceuticals.”
Substance Use
Disorder
Table 7:
Christopher Stock, PharmD, BCPP
Clinical Pharmacy Specialist, Substance Abuse Programs
Pharmacy Research Program Manager
Co-Director, CSP InterMountain NODES Center
George E Wahlen VA Medical Center
Salt Lake City, UT
Chris Stock, PharmD, BCPP is a clinical pharmacy specialist for the substance abuse
treatment programs at the George E Wahlen VA Medical Center in Salt Lake City and
Adjunct Professor at the University of Utah. He completed his PharmD and a clinical
pharmacy residency at the University of Utah and affiliated hospitals and clinics in 1985.
He taught at Ferris State University in Michigan for several years before returned to Salt
Lake City in 1992. He has 30 years of experience working in the substance abuse field
with adolescent and adults. He ran the VA’s outpatient detoxification clinic for alcohol and
opioids for nearly 10 years and now is part of a multidisciplinary Recovery Clinic at the
VA providing Medication Assisted Treatments including methadone, Suboxone and
naltrexone for opioid dependent veterans. He is an active clinical investigator, has
partnered with NIDA (the National Institutes on Drug Abuse) and the VA research office
for the past 20 years conducting studies on Medication Assisted Treatments for Opiate,
Alcohol, Tobacco, Methamphetamine and Cocaine Addiction. He along with other VA and
University of Utah colleagues recently published results of a trial treating symptoms of
alcohol withdrawal with either gabapentin or chlordiazepoxide. Chris has authored and
coauthored numerous publications, primarily regarding pharmacotherapy trials for
substance use disorders. He has recently become the naloxone distribution and overdose
prevention champion at this VA and in Utah. He is on several national committees related
to naloxone distribution. He is co-chairing this facilities opioid safety initiative. He is a
long standing member of the U of U’s IRB committee. He bicycles, hikes, swims, loves to
travel with his wife.
VA Inpatient and Clinics
 VA Substance Use disorder 15 bed residential program and weekly clinics,
including tobacco cessation clinic and buprenorphine clinic.
 Educational groups, medication groups, overdose awareness and prevention
group, naloxone distribution for overdose prevention
 VA Chairman overseeing VA/NIDA interagency research contract – this clinical
trial group (10 clinics) has conducted over a dozen RCTs of medications for
substance use disorders ( tobacco, cocaine, methamphetamine, and opioid
dependence in the past 15 years)
 Community outreach
 Legislative champion for increased naloxone access in Utah 2014
 Working with the Utah Department of Health, several healthcare systems to
implement Overdose Education and Naloxone Distribution throughout Utah.
Table 8:
Bethany DiPaula, PharmD, BCPP
Associate Professor, University of Maryland
Director of Pharmacy, Springfield Hospital Center
Clinical Pharmacist, Howard County Health Department
Dr. DiPaula is a residency trained, board certified psychiatric pharmacist. She is an
associate professor at the University of Maryland, Baltimore School of Pharmacy and the
Residency Program Director for the PGY2 Psychiatric Pharmacy Residency Program
Director. Dr. DiPaula has been active in developing physician-pharmacist collaborative
practices. She created a buprenorphine/naloxone-maintenance program at the Howard
County Health Department. She works collaboratively with the Health Department’s
physicians to assess and manage opioid dependent patients, many of which are indigent.
She previously worked with opioid dependent patients in a pharmacist-physician
collaborative care model at People’s Community Health Center. Dr. DiPaula developed
PGY2 psychiatric pharmacy residency rotations at both the Howard County Health
Department and People’s Community Health Center. She has also mentored addicted
pharmacists while volunteering with the Pharmacist Education and Assistance Committee
(PEAC). Within the mental health program, Dr. DiPaula has provided clinical pharmacy
and administrative services at Maryland state psychiatric hospitals and has served as
Director of Pharmacy. Dr. DiPaula has participated in national committees and programs
relating to psychiatric and substance use disorders. Most recently, she has been serving as
the chair of the 2014 College of Psychiatric and Neurologic Pharmacists (CPNP)
Substance Abuse Task Force.
Howard County Health Department, Columbia, Maryland
I work within a physician-pharmacist collaborative practice at the Howard County Health
Department in the Behavioral Health-Substance Abuse Bureau. This is a suburban health
department which provides full substance abuse treatment programming as well as
medication management for substance use and psychiatric disorders. Under Maryland
State approved protocols, I provide medication management services for
buprenorphine/naloxone maintained patients during individual and group appointments. I
also assist with patient follow up, medication prior authorization, and diversion
monitoring.