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We hope you were able to join the March and April presentations from our 2021 clinical webinar series, Budget Busters – Best Practices with NOACs, Insulins, and COPD Drugs in Hospice. Throughout the webinar, our Senior Clinical Pharmacist, Melissa Corak presented pearls and practical strategies to promote cost avoidance in circumstances where hospices would otherwise be on the hook for paying for these often high cost medications. If you didn’t have the opportunity to tune-in (or want a refresher), the webinar can still be viewed on-demand on OneConnectPoint under the Clinical Resources tab.

Our “Together as One” series spotlights nurses, physicians, pharmacists and others who positively impact the lives of hospice patients and their families every day. Through the dedicated and compassionate work of these inspiring professionals, patients receive the high-quality care and attentive consideration they deserve. Together with innovative and responsive hospice partners, they create the network of support so essential to hospice care. We invite you to meet the people behind the mission—and see what one can do.

Alia Brodie, PharmD

Pharmacist-in-Charge

Farmington, MI

How did you become interested in pharmacy?

My cousin graduated pharmacy school back in the early 2000’s and told me about her job and how at the time there was a large shortage of pharmacists. As a 14 year old, job security sounded pretty good to me and I already knew I wanted to do something in the medical field.

What are your favorite aspects of your job?

ACE-inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are mainstays of heart failure treatment. But, if you have heart failure patients on your census, it might seem like more of them are taking sacubitril/valsartan (marketed as Entresto) – a sign that providers are keeping up with the 2021 update to the American College of Cardiology’s (ACC) heart failure guidelines.¹ The latest recommendation is to use Entresto over ACEIs/ARBs in most cases, even as initial therapy, due to demonstrated reductions in death, hospitalizations, improved cardiac function and reversed cardiac remodeling.

Our “Together as One” series spotlights nurses, physicians, pharmacists and others who positively impact the lives of hospice patients and their families every day. Through the dedicated and compassionate work of these inspiring professionals, patients receive the high-quality care and attentive consideration they deserve. Together with innovative and responsive hospice partners, they create the network of support so essential to hospice care. We invite you to meet the people behind the mission—and see what one can do.

Wilson Vong, PharmD

Pharmacist-in-Charge

San Leandro, CA

How did you become interested in pharmacy?

After college, I started working as a pharmacy clerk to test the waters. Prior to that, I wasn’t sure if pharmacy was a path that I wanted to pursue. After working at my first pharmacy job, I quickly learned that I enjoy interacting with and helping people from different paths of life—customers, doctors, nurses, and of course, fellow colleagues.

What are your...

Hydroxyzine is a first generation histamine (H₁) antagonist that’s been on the market since the 1950’s.¹ Its mechanisms of action are unique. Not only does it compete with histamine for H₁ receptor sites in the GI tract, blood vessels, and respiratory tract, but it also it exhibits activity at muscarinic, serotonergic, and dopaminergic receptors in various parts of the brain, which may explain its anxiolytic effect.² Hydroxyzine is available in two different salt forms, hydroxyzine hydrochloride (HCl) (commonly known as Atarax) and hydroxyzine pamoate (commonly known as Vistaril).

Our “Together as One” series spotlights nurses, physicians, pharmacists and others who positively impact the lives of hospice patients and their families every day. Through the dedicated and compassionate work of these inspiring professionals, patients receive the high-quality care and attentive consideration they deserve. Together with innovative and responsive hospice partners, they create the network of support so essential to hospice care. We invite you to meet the people behind the mission—and see what one can do.

Nickyia Harper, MS HRMD

Supervisor, Connect+ HUB Services

Morton Grove, IL

How did you become interested in pharmacy?

My passion to help others and desire to become a pharmacist during my childhood, along with having the opportunity to work in a hospital throughout my high school years, all played a huge role in me becoming interested in healthcare and pharmacy.

What are your favorite aspects of your job?

With my educational background being in Human Resources,...

Most of us don’t think twice about where we keep our cell phones as we go about our daily business. However, for people with implanted cardiac devices, storing the phone in a shirt or jacket pocket near the chest could have serious unintended consequences.

A Quick Overview of the Causes of Urinary Discoloration

Terminally ill patients may experience a variety of changes and new symptoms as the end of life approaches. Urinary symptoms may be especially troublesome for patients, family members, caregivers, and clinicians. Hospice patients commonly experience incontinence, retention, and decreased output. Another distressing change that patients may experience is abnormal urine color.

Being a prognosticator, or a predictor, is one of many hats that hospice clinicians wear. The ability to provide an accurate prognosis plays a crucial role in many clinical decisions. In addition to clinical experience, hospice clinicians use tools like the Palliative Performance Scale (PPS) to help predict survival. Believe it or not, there’s one very unconventional prognosticator that’s seemingly able to predict a patient’s imminent death with amazing accuracy - a cat named Oscar.

Pseudobulbar affect (PBA), also called emotional lability, is a condition of uncontrollable laughing or crying without provocation that isn’t consistent with a patient’s emotional state. PBA is most often observed in patients with neurological disorders such as amyotrophic lateral sclerosis (ALS), multiple sclerosis, Parkinson’s disease, Alzheimer’s disease, brain tumors, or as a sequela of stroke. The management of this condition includes an FDA-approved drug combo of dextromethorphan and quinidine, or Nuedexta®, which has also been used off-label for controlling agitation or aggression in Alzheimer’s dementia patients. Nuedexta® comes with a hefty price tag (AWP is $26.70 per dose) and is only available as an oral capsule, presenting potential barriers to use in hospice given capitated reimbursement rates and drug administration challenges in patients with dysphagia.

Since treatment with Nuedexta® may be cost-prohibitive and dextromethorphan (DM) is readily available as an...