Binh Tran, Pharm.D.

Executive Director – Asian Pacific Health Foundation San Diego, California

I applied to Leadership Development Institute (LDI) to reach out to pharmacists to expand their role in public health issues. This aspect of pharmacy practice is most timely as healthcare issues are being debated at all levels in the government and consumer advocacy administration. Help from LDI and CPhA is essential in spreading the news to pharmacy schools for academic preparation, and potential sponsors for grant proposals.

I have worked on Hepatitis B prevention in Asian populations in San Diego County for the past 16 years, and since 2008, Asian Pacific Health Foundation, a non-profit organization, has focused on education and screening of populations at risk for Hepatitis B and C. Screening for hypertension, diabetes, cholesterol and osteoporosis were added to encourage participants to come to the event.

Hepatitis B and C have affected over 5 million Americans, with 40-80% of them unaware of their infection. Certain U.S. populations are disproportionately impacted by, and die from chronic Hepatitis B and its complications such as cirrhosis and liver cancer. Each year, nearly 20,000 people in the U.S. die from HCV and its complications, and HCV associated deaths now exceed the number of deaths from 60 other nationally notifiable diseases combined, including HIV. The recent epidemic of Hepatitis A in San Diego shows disturbing statistics. Averaging 28 acute Hepatitis cases per year from 2012 through 2016, as of October 17, the death toll was 19, with 507 cases of Hepatitis A in San Diego County since March 2017. How can pharmacists alleviate the problems?

Last October 7, at the National Meeting of the Vietnamese American Medical Association in conjunction with the VAMA Southern CA chapter, APHF coordinated the Pharmacy CE program for pharmacists in the audience. Since October is National Pharmacy Month, this was a great opportunity to showcase the role of pharmacists in the public health field. The topic of my presentation “A Novel Community-based Model of screening for Diabetes, Osteoporosis, and Hepatitis” originated from the work initiated by our organizations since 2001.

UC San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences approved the pharmacy program for 4 CAPE CE units, and the program has been announced to 11 of the 13 pharmacy schools in California, thanks to references provided by LDI coaches and team leaders at LDI brainstorming session

I was surprised to learn that many LC are deans and chairs of Schools of Pharmacy in the state, thus could facilitate the reach to a wider audience. One faculty from UC San Francisco even recalled the former collaboration of UCSF School of Pharmacy in the retraining of Vietnamese pharmacy graduates at UC San Diego in 1984-85, allowing the first 109+ pharmacists to take the Pharmacy Foreign Graduate exam and subsequent CA Board of Pharmacy exam.

Pharmacy practice has evolved into diverse areas, and issues dealing with public health concern all in the community. Pharmacists are health professionals providing health information and services at critical check points. Vaccination gives the best prevention for diseases where vaccines exist. San Diego County Pharmacists Association pharmacists have joined San Diego County Department of Public Health to provide Hepatitis A vaccinations at free clinics and other sites. Hepatitis A injections are given two times: one now and another one 6 months after.

At outreach events, people are screened with 3 tests for HBsAg, anti-HBc, and anti-HBs giving a spectrum of 5 Hepatitis profiles. Profile 1 with all negative results calls for vaccination: one injection on day 1, one after 1 month, and one after 6 months. Hepatitis B cannot be cured, but progress is being made in the search for a cure.

There is no vaccine for Hepatitis C, but effective medications are available for curing the disease. Pharmacists working in specialty pharmacy determine client eligibility to obtain the medications, monitor client compliance, and assess treatment outcomes.

In summary, for a short-term project, aim for relief of Hepatitis A epidemic by signing up for the Hep A Clinic organized by San Diego County Department of Public Health, collaborate with UCSD University Free clinic to hold educational sessions for students, and vaccinate people at risk for contracting the disease, especially the homeless people. The long-term impact of the project will be the elimination of hepatitis B and C by 2030 according to the 2017 report of the National Academies of Sciences, Engineering, and Medicine.

From LDI, I needed stronger leadership skills to start conversations, explore new sites, and adjust protocols to fit the new population groups.

I learned the value of GRIT. An unknown word for me until LDI session 2, grit means firmness of mind or spirit. Although one of my strengths is curiosity, and I enjoy reading on various topics, too many interests can detract me from the main trajectory. I need to focus on my major project, set priorities, and learn to say no to unrelated demands from co-workers and friends, no matter how compelling the requests may appear.

RESILIENCE is the ability to regain control of the situation, after experiencing drawbacks. I have been through a major shift in career after being executive director of the organizations that I co-founded. Time has changed, and there was the need to recruit a replacement for the position. The task was daunting, due to the many constraints, but I learned the process through talking with LDI team members, coaches, and finally succeeded in finding the right person. After six months of intensive training and transferring of tasks, the final step is Closure Conversation, to validate an overall smooth transition.

LEARNING THROUGH EXAMPLES: The CPhA BBQ party after Session 3 was a wonderful testimony of former leaders who tend to the building of future leadership. I was honored to meet the current president, the president-elect, and several past presidents, along with Chapters’ leaders, many of whom are enrolled in the beneficial LDI program. Thank you to LDI 2017.