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Pharmacy & Pharmacology Council: With Great Power Comes Great Responsibility

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Walter E. Uber, PharmD
Medical University of South Carolina
Charleston, SC, USA

It is amazing to me to think about how far we have come as a council since "7 people met in a room" in San Diego 5 years ago to discuss the formation of a Pharmacy and Pharmacology Council within ISHLT. It is certainly ironic to me as we begin planning once again for our next meeting in San Diego on how we have evolved and how I hope we will continue to move forward "as a collective" with our contributions to the intellectual content and practice ideas and help the Society advance the care of this very complex patient population.

Over the past year we have continued to make progress in making our presence felt within the Society and in advancing our council initiatives. This was clearly in evidence with our presence at the 36th Annual Meeting in Washington, DC. Our council submitted a total of 10 symposia to the Program Committee for consideration for placement on the meeting agenda. In addition, there were 8 other submissions by other councils that had Pharmacy and Pharmacology members included. Through the Program Committee process, we were able to secure and sponsor 2 sessions. Our pre-meeting symposium session entitled "Lifecycle Journey of Hepatitis C Heart Failure Patient in 2016" marked the return of this symposium format for our council after a one year absence. Our sunrise session entitled "Precision Medicine in Transplantation: Drug Levels and Beyond" focusing on potential future innovative monitoring strategies received high acclaim by those in attendance. At this meeting we also had council members as speakers and/or chairs in 8 sessions sponsored by other councils. With the quality of abstracts submitted through our council, we were also able to sponsor a full oral abstract session, a mini-oral session co-sponsored with MCS, and a poster session. In total, 27 abstracts were accepted through our council for presentation. Of equal importance to many was our ability this year to offer 13 hours of ACPE credit as a value enhancement for our members. This level of representation speaks volumes about how far we have come in this venue as a council in such a short time.

We also continue to make great strides with regards to other council activities within the Society. Efforts lead by Mike Shullo resulted in the revision, submission, and approval of our core competencies document by the ISHLT Board this past September and are now are available on the ISHLT website. As a follow-up to this work, Mike, along with Robert Page will be leading an effort to further call attention to standards pertaining to the practice of Thoracic Transplant Pharmacy highlighting our core competencies document as a reflection of this. Another council project lead by Rebecca Florez and Patty Uber looking at the development of a standardized/universal set of patient education materials using various types of media/technology as well as tools to verify learning and retention continues to make progress. Work to this point has resulted in the creation of a survey to identify specific needs will be circulated to the broad membership soon. Results from this survey will be used to support a "proof of concept" and identify next steps going forward. Our involvement in work with Standards & Guidelines committee continues to intensify as our expertise in pharmacotherapy continues to be sought. Our members have participated in multiple guideline projects (ex: lung AMR, antifungal guidelines, MCS infections, primary graft dysfunction, and consensus on perioperative management of lung transplants) many of which have now made it to publication. Future projects here include a major effort on our part as we as a council lead by Chris Ensor, Patty Uber, and Robert Page will be taking the lead role in the effort to update the guideline on generic drugs in thoracic transplantation.

Education continues to be a central role in our council activities. Activity is already underway in planning for next year's meeting in San Diego with our members working with Kyle Dawson and his education workforce on symposia ideas for submission to the Program Committee by the June 2nd deadline. In addition, we are making headway on our goal to be involved with the planning and participation in Academy efforts within the Society. We emphatically endorsed the ID councils Academy: Core Competencies Course in Infectious Diseases and Cardiothoracic Transplantation and Mechanical Support which was approved and will be conducted at the 2017 meeting in San Diego. Members of our council are serving as content advisors to review session titles and presentation topics at this time. We are also now involved in the development of a proposal for a donor procurement academy being put forth by the Heart Failure/Transplant and Pulmonary Transplant Council. Submission of this proposal is due by the end of May 2016 for consideration and potential presentation in 2018 or 2019 if accepted. Potential for involvement in future Academy proposals such as pediatric heart failure academy are also being entertained. Much of our abilities to compete in this arena have to do with the strength and diversity of our council membership which allows us to have representation and interests in virtually all areas of the Society.

Our involvement with the LINKS continues to be a successful venture for us as a council. We were the primary contributors to the September 2015 issue with 3 articles published. In addition, our council was the recipient of 3 LINKS awards including Writer of the Year Winner (Kyle Dawson) and 2 Runner-up awards (Adam Cochrane, Christa Kirk). This continues to be a format where we excel (previous winners: Chris Ensor 2014, Runner-up: Amanda Ingemi 2014) and where our contributions are highly sought after. Our next focus issue will be in September 2016 with a submission deadline in August.

The Strategic Planning initiative has been a major objective of the Society over the last year and in the years to come, one in which we will continue to play an integral part. Council participation on our part included participation by the council leadership in various conference calls with Society leaders, survey of council members on strategic objectives, and a council report to the Strategic Planning Committee on perceived strengths, weaknesses, opportunities, and threats to our council going forward. Our report, as well as reports from all other councils, lead to the development of the present strategic going forward. The 4 major areas that make up the strategic framework include: 1) enhance membership value, 2) improve science and drive innovation, 3) engage our community worldwide, 4) organizational vitality. In our report to the Board we, as council leaders, were asked to evaluate our needs going forward. Focus issues for us included: 1) continued support for ACPE at future meetings, 2) engagement of newer and younger members to support the growing initiatives of our council, 3) continued support of multidisciplinary efforts for participation in Society initiatives and competition for awards, and continued education and support to develop leaders within the councils and define their roles. With this in mind we will: 1) evaluate the CE process including the data on how much was claimed and re-apply to the Board for continued support for ACPE for future meetings as a value enhancement to our members, 2) we will continue to work with other councils on symposia ideas to continue to increase our presence in this multidisciplinary forum and allow for increased intellectual contributions from our members. In addition, we will continue to search out and become involved in other educational (ex: participation in on going Masters Academy initiatives) and guideline projects where our expertise can be effectively utilized and employed, 3) continue to educate our newer and younger members about what opportunities exist for their involvement that is commensal with their level of comfort (for example members looking for more limited exposure or junior members looking to gain initial experience, opportunities that exist include involvement in workforce groups or project workgroups), 4) work with Society leadership on clearly defining leadership roles and accountability.

It continues to be my privilege to serve as chair of our council. Our growth as a council has been dramatic over the last 5 years. We truly have arrived as a mainstream council and are now interwoven into the Society fabric. The Society realizes this and much of its strategic planning has centered around providing value to its all of its members, engaging multiple disciplines, and making them part of its framework. However, as the Society invests in us, we must remember that to stay relevant at this level, investment is a two way street. As has been quoted by many, we must remember that "with great power comes great responsibility." The good news is that our opportunities for involvement in projects and initiatives continue to increase as our true capabilities continue to be realized. The bad news is that as this is occurring, expectations for our council are increasing and our members must continue to rise to meet these challenges. Today we have a tendency to focus a lot on our value as an individual and what our institutions can do for us. For us to continue to succeed as a council, we must be willing to give of ourselves a little as well. So as we move forward, I ask you to also consider my adaption of President Kennedy's famous inaugural address which is "ask not what your council can do for you, ask what you can do for your council". ■

Disclosure Statement: The author has no conflicts of interest to disclose.

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