Lyndon B. Johnson Tropical Medical Center pharmacist Malaefou Anesi, left, and Chief of Pharmacy Evelyn Ahhing-Faaiuaso, right, welcome a delegation from the University of Hawaii at Hilo College of Pharmacy that includes third-year students Daniel Navas and Robert Esteban; Dr. Carolyn Ma, associate professor and chair for Pharmacy Practice and director of experiential education; and Drs. Anita Ciarleglio and Scott Holuby, assistant professors in the Department of Pharmacy Practice. (Photo courtesy of UH-Hilo)

MEDIA RELEASE

There’s only one place in the small, far-flung U.S. territory of American Samoa for its 60,000-plus residents to fill their prescription needs.

Dr. Evelyn Ahhing-Faaiuaso oversees it all as the chief of pharmacy for the Lyndon B. Johnson Tropical Medical Center. She’s one of only two pharmacists on this group of islands 2,600 miles southwest of Hawaii and is the only one licensed in the U.S. That distinction presents tremendous challenges for her.

“There’s such a great need for pharmacists in our setting,” said Ahhing-Faaiuaso, who is a native of American Samoa. “There are not enough to serve our population.”

That’s where the University of Hawaii at Hilo hopes to step in. Three College of Pharmacy faculty members and two third-year pharmacy students recently spent a week in American Samoa to assess the hospital’s pharmacy needs, educate medical staff and encourage island students to pursue a pharmacy career.

The delegation returned July 3.

“My hope is to promote pharmacy to students here so they take up the profession,” Ahhing-Faaiuaso said, “and to return back home and serve our community.”

Dr. Carolyn Ma, associate professor and chair for pharmacy practice and director of experiential education, first visited the hospital in March to determine how UH-Hilo’s burgeoning pharmacy program could help the territory now and in the long term, in line with its mission to improve the quality of health care in Hawaii and throughout the Pacific.

The college has begun a pre-pharmacy initiative at American Samoa Community College through a grant from the U.S. Department of Education.

Ma said she was impressed by the hospital’s successes despite its limited resources.

“The health care providers at the hospital do an incredible job with what they have, and I really admire and respect them for their dedication,” Ma said.

Ma also is a member of an interdisciplinary health-care team from the June Jones Foundation, whose summer mission overlapped the College of Pharmacy’s work in American Samoa.

Jones, the head football coach at Southern Methodist University, worked with athletes at a football camp while his nonprofit medical mission donated $400,000 worth of supplies to the hospital. Members of the pharmacy delegation helped deliver those supplies.

Ma and Drs. Anita Ciarleglio and Scott Holuby, assistant professors in the Department of Pharmacy Practice, also offered continuing education classes for pharmacy staff, physicians and nurses.

Topics included diabetes, hypertension and asthma, which are all prevalent in American Samoa, as well as the prevention of medication errors. The faculty attended rounds to offer assistance to providers, patients and families regarding their medications and to learn more about hospital functions.

“There’s such a huge potential for pharmacy services, but they truly need more pharmacists who are familiar with the culture and sensitive to the needs of the Samoan people,” Holuby said.

“We want to promote pharmacy as the beautiful profession that it is,” Ciarleglio said. “It’s a fine way to give back to one’s community and serve others.”

Ma’s other purpose on this mission was to evaluate a potential partnership between the college and the hospital to place students in fourth-year, advanced pharmacy practice experiential rotations while encouraging island residents to consider a pharmacy career.

“It became apparent from this visit that certainly the LBJ medical center would welcome and benefit from fourth-year students to help build their inpatient pharmacy services, and also that our students could help promote the pharmacy profession at the intermediate, high school and community college levels,” Ma said.

College of Pharmacy students Robert Esteban and Daniel Navas were selected for the medical mission and also will receive elective credits for their efforts.

Both are third-year students on track to graduate with the college’s inaugural class in 2011.
Esteban and Navas shared their educational journeys with a crowded classroom of community college students and encouraged them to follow a similar path.

“I hope I gave students the impression that they are able to make a difference in their communities, as well as their own lives, through education,” said Esteban, a 32-year-old student from Honolulu.

Navas, 36, of Honolulu hopes he has piqued the interest of Samoan students so that one day they will help their islands.

“Understanding the culture is essential in communication and effective patient care,” Navas said. “The situations I encountered here are real and complicated, and need real solutions despite limited resources.”

The need for pharmacists is great, Ahhing-Faaiuaso said, especially native-born people who understand the Samoan language and the islands’ traditions. She received a bachelor’s degree in pharmacy in 1987 and a doctorate in pharmacy in 2003. She took over the pharmacy in 2007 after gaining experience in retail pharmacy and at Tripler Army Medical Center on Oahu.

“An affiliation with UH-Hilo would bring the current standards of pharmacy practice into our setting,” Ahhing-Faaiuaso said, “and with the limited resources we have, we can meet them halfway with ongoing teaching for the students who will be spending time here.”

The College of Pharmacy was awarded candidate accreditation status by the Accreditation Council for Pharmacy Education in July 2008.

The college will be eligible for full accreditation when its first class of students graduates from the four-year program in 2011. It will welcome its third class of 90 students in August.

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The University of Hawaii at Hilo College of Pharmacy offered its second annual spring preceptor training in April and May on Oahu and Maui to student mentors in the pharmaceutical profession. 

This marks the first time pharmacy students from Hilo will be able to receive the experiential phase of their education off the Big Island.

More than 60 preceptors came from the major hospitals such as The Queens Medical Center, Kaiser Permanente, Kapiolani Women and Children’s, Pali Momi Medical Center, Castle Medical Center and Maui Memorial Hospital.

The training prepared the preceptor to receive the third-year class in a two-week clinical pharmacy/hospital rotation. The rotation is part of the Introductory Pharmacy Practice Experience, which is a major portion of their work toward earning their doctorate in pharmacy, also called a Pharm.D.

“Students in their first and second years have received experience in local health care facilities, such as Hilo Medical Center, the retail stores in Hilo, Hale Anuenue Restorative Care Center and in the Veterans Administration long-term care home,” said Carolyn Ma, chairwoman of the Department of Pharmacy Practice. “Support on the Big Island has been amazing. The experiential training will give students more options to consider when they see additional facets of the pharmacy profession on the other islands.”

In 2007, the College of Pharmacy seated its first class, which will be preparing to enter its third year of study in Hilo this fall. 

During their first year of study, students gained retail and hospital experience by observing pharmacists, nurses and physicians with patients, learning about drugs and gaining some patient contact skills. In their second year, students become more comfortable with patients, and can take blood pressure as well as give immunizations. 

Third-year experiences will help students to become even more comfortable with patient interview skills and the various components of pharmacy practice in the acute hospital setting. 

The experience will help to prepare the students and the preceptor for the more extensive Advanced Pharmacy Practice rotations that will comprise the entire curriculum for the fourth and final year, which the first class will begin in 2010.

“Virtually every possible pharmacy practice site in the State of Hawaii is involved in our experiential program during the four years of experiential curriculum,” Ma said. “The support from the pharmacy community has been tremendous.”

MEDIA RELEASE

If residents in the greater Hilo area look closely behind the counters at their local pharmacy, they may see people behind the counter wearing white lab coats with the University of Hawaii at Hilo logo. These are students from the university’s College of Pharmacy, who are receiving retail experience while they earn their doctorate in pharmacy degrees.

Other students are working in local health care facilities, such as Hilo Medical Center, Hale Anuenue Restorative Care Center and in the Veterans Administration long-term care home. 

Pharmacy Dean John Pezzuto said the College will place additional pharmacists and faculty supervisors, or preceptors, at various sites throughout the state, which will enhance healthcare while easing the increasingly prevalent economic burden of healthcare.

The program is part of the experiential program that newly named UH-Hilo College of Pharmacy Chair of Pharmacy Practice Dr. Carolyn Ma helped develop when the college enrolled its first students in 2007.

“Our curriculum is very different from any other College of Pharmacy in the past,” said Ma, who has been serving as Clinical Education Coordinator for the College since it began. “Previously, students didn’t get a chance to develop foundational clinical skills until their fourth year. We moved it up so they’re better prepared by the time they graduate and to help us meet accreditation standards.”

Pharmacy students at UH-Hilo jumpstart their careers during their first year by getting retail and hospital experience, observing pharmacists and patients, learning about medicine and gaining some patient contact skills from the registered pharmacists.

“Support from the retail side in Hilo has been tremendous,” Ma said. “The pharmacies are small and extremely busy, but the pharmacists have been very interested and helpful in teaching these future colleagues.”

Second-year students begin building skills through primary care providers and community healthcare in Hilo, Keaau and Pahoa at Bay Clinic, Kaiser, Hui Malama and Kauka Express as well as at Ka`u Hospital in Pahala. At this stage, students become more comfortable with patients, and can take blood pressure as well as give immunizations.

By the time students are in their second of four years getting their doctorate in pharmacy, they also become more involved with patients, especially in facilities that offer long-term care, said Dr. Doug Adriance-Mejía, assistant professor in pharmacy practice and clinical pharmacist at Hilo Medical Center.

“We hope to expand the role of the pharmacist and bring about change in the way pharmacy is practiced not only on the island but in the state,” said Adriance-Mejía, who supervises students working in Hilo Medical Center. “Most of the doctors and nurses I’ve talked to are excited at how much healthcare will be improved by increased pharmacist interaction.”

First-year student Angelina Lovell is working at Hilo Medical Center in her second semester, after working at the pharmacy in KTA Super Stores last fall. She will be shadowing medical staff from different departments each week.

“Although I truly enjoyed my retail experience, I feel most at home in a hospital setting,” said Lovell, who is from Northern California and returned to school after 12 years working at Kaiser Permanente. “The experience that I will receive at HMC can only enhance my understanding of the medical field as a whole.”

For the majority of the students, HMC is their first exposure to hospital pharmacy, said Dr. Nelson Nako, director of pharmacy at Hilo Medical Center.

“It is a new experience for them seeing how intravenous medications are handled, observing medication distribution within a hospital and observing the clinical activities pharmacist perform,” Nako said.

Pezzuto said the relationship between the College of Pharmacy and the retail and hospital pharmacies is a good example of how the college is doing something about the health care crisis as well as filling a need in future job markets.

“The bonus for students spending time at these sites is that the pharmacist-in-charge not only trains the students but has the chance to evaluate their future potential as employees,” Pezzuto said. “We are looking forward to expanding this training as our students enter their third and fourth year. We want to prepare our inaugural class of 2011 to be ready to hit the ground running, ready to take part in improving health care in Hawaii and throughout the Pacific.”