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https://www.readbyqxmd.com/read/28621658/zoning-out-methadone-and-rising-opioid-related-deaths-in-ontario-reforms-and-municipal-government-actions
#1
Carol Strike, Miroslav Miskovic
In this commentary, we argue that the use of amendments to bylaws by Ontario cities and municipalities to restrict where and how methadone maintenance treatment (MMT) clinics and pharmacies operate may run counter to efforts to prevent record high rates of opioid-related overdoses. As the province of Ontario seeks to reform the opioid treatment system, it is crucial to understand the structural (e.g., stigma) and treatment system organization factors that drive the actions of municipalities such as those described above...
June 16, 2017: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
https://www.readbyqxmd.com/read/28535455/the-effectiveness-of-telemedicine-delivered-opioid-agonist-therapy-in-a-supervised-clinical-setting
#2
Joseph K Eibl, Graham Gauthier, David Pellegrini, Jeffery Daiter, Michael Varenbut, John C Hogenbirk, David C Marsh
OBJECTIVE: Opioid use disorder has been declared a public health crisis across North America and opioid agonist therapy (OAT) is the standard of care for these patients. Despite the increasing adoption of telemedicine as a delivery method for OAT, its effectiveness has not yet been evaluated against traditional in-person treatment. This study compared treatment outcomes for in-person versus telemedicine-delivered OAT. METHODS: We conducted a non-randomized cohort comparison study using an administrative database for patients who commenced OAT between 2011 and 2012 across 58 clinic sites in the province of Ontario, Canada...
May 17, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28507655/how-are-pharmacists-in-ontario-adapting-to-practice-change-results-of-a-qualitative-analysis-using-kotter-s-change-management-model
#3
Beatriz Teixeira, Paul A M Gregory, Zubin Austin
BACKGROUND: The pace of practice change in community pharmacy over the past decade has been significant, yet there is little evidence documenting implementation of change in the profession. METHODS: Kotter's change management model was selected as a theoretical framework for this exploratory qualitative study. Community pharmacists were interviewed using a semistructured protocol based on Kotter's model. Data were analyzed and coded using a constant-comparative iterative method aligned with the stages of change management outlined by Kotter...
May 2017: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
https://www.readbyqxmd.com/read/28462792/implementation-of-a-reimbursed-medication-review-program-corporate-and-pharmacy-level-strategies
#4
Linda D MacKeigan, Nadine Ijaz, Elizabeth A Bojarski, Lisa Dolovich
BACKGROUND: In 2006, the Ontario drug plan greatly reduced community pharmacy reimbursement for generic drugs. In exchange, a fee-for-service medication review program was introduced to help patients better understand their medication therapy and ensure that medications were taken as prescribed. A qualitative study of community pharmacy implementation strategies was undertaken to inform a mixed methods evaluation of the program. PURPOSE: To describe strategies used by community pharmacies to implement a government-funded medication review service...
March 31, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28320403/incorporating-sex-gender-and-vulnerable-populations-in-a-large-multisite-health-research-programme-the-ontario-pharmacy-evidence-network-as-a-case-study
#5
MULTICENTER STUDY
Martin Cooke, Nancy Waite, Katie Cook, Emily Milne, Feng Chang, Lisa McCarthy, Beth Sproule
BACKGROUND: Funders now frequently require that sex and gender be considered in research programmes, but provide little guidance about how this can be accomplished, especially in large research programmes. The purpose of this study is to present and evaluate a model for promoting sex- and gender-based analysis (SGBA) in a large health service research programme, the Ontario Pharmacy Evidence Network (OPEN). METHODS: A mixed method study incorporating (1) team members' critical reflection, (2) surveys (n = 37) and interviews (n = 23) at programme midpoint, and (3) an end-of-study survey in 2016 with OPEN research project teams (n = 6)...
March 20, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28091833/the-gap-between-indicated-and-prescribed-stroke-prevention-therapies-in-a-high-risk-geriatric-population
#6
Mohammed Shurrab, Eugene Crystal, Denis O'Donnell, Hrishikesh Navare, Paula Neves, Rasha Khatib, Ilan Lashevsky, David Newman
PURPOSE: The use of oral anticoagulation (OAC) in the elderly population with atrial fibrillation (AF) treated in long-term care (LTC) facilities is inconsistent. We examined the magnitude and sources of the gap between indicated and prescribed OAC in the elderly population with AF. METHODS: We retrospectively scanned the electronic medical record (EMR) and pharmacy data of 25 LTC facilities in Ontario, Canada. The diagnosis of AF was drawn from EMR. Different attributable risk factors for possible failure to prescribe OAC were examined...
January 16, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/27871324/factors-affecting-the-delivery-of-community-pharmacist-led-medication-reviews-evidence-from-the-medscheck-annual-service-in-ontario
#7
Petros Pechlivanoglou, Lusine Abrahamyan, Linda MacKeigan, Giulia P Consiglio, Lisa Dolovich, Ping Li, Suzanne M Cadarette, Valeria E Rac, Jonghyun Shin, Murray Krahn
BACKGROUND: Medication reviews have become part of pharmacy practice across developed countries. This study aimed to identify factors affecting the likelihood of eligible Ontario seniors receiving a pharmacy-led medication review called MedsCheck annual (MCA). METHODS: We designed a cohort study using a random sample of pharmacy claims for MCA-eligible Ontario seniors using linked administrative data from April 2012 to March 2013. Guided by a conceptual framework, we constructed a generalized-estimating-equations model to estimate the effect of patient, pharmacy and community factors on the likelihood of receiving MCA...
November 21, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27708675/uptake-of-the-medscheck-annual-medication-review-service-in-ontario-community-pharmacies-between-2007-and-2013
#8
Lisa Dolovich, Giulia Consiglio, Linda MacKeigan, Lusine Abrahamyan, Petros Pechlivanoglou, Valeria E Rac, Nedzad Pojskic, Elizabeth A Bojarski, Jiandong Su, Murray Krahn, Suzanne M Cadarette
BACKGROUND: MedsCheck Annual (MCA) is an Ontario government-funded medication review service for individuals taking 3 or more prescription medications for chronic conditions. METHODS: This cohort study analyzed linked administrative claims data from April 1, 2007, to March 31, 2013. Trends in MCA claims and recipient characteristics were examined. RESULTS: A total of 1,498,440 Ontarians (55% seniors, 55% female) received an MCA. One-third (36%) had 2 or more MCAs within 6 years...
September 2016: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
https://www.readbyqxmd.com/read/27453699/medications-for-children-a-survey-of-community-pharmacists
#9
Alina R Rashid, Mark Duffett
BACKGROUND: Seamless and safe discharge of children from hospital requires successful collaboration with community pharmacists, for whom pediatrics is often a small part of their practice. OBJECTIVES: The purpose of this study was to understand community pharmacists' comfort level and confidence in providing care for children. METHODS: We conducted a self-administered online survey of community pharmacists in Ontario, Canada. Respondents rated their comfort and confidence on a scale of 1 to 7 in each of 3 scenarios: oral morphine, prednisone, and amoxicillin...
May 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/27402997/management-of-hospital-formularies-in-ontario-challenges-within-a-local-health-integration-network
#10
Natasha Burke, James M Bowen, Sue Troyan, Jathishinie Jegathisawaran, Carolyn Gosse, Marita Tonkin, Sandra Kagoma, Ron Goeree, Anne Holbrook
BACKGROUND: Expenditures on drugs dispensed and administered to patients in Canadian hospitals have been estimated at $2.4 billion per year. Pharmacy and therapeutics (P&T) committees play a key role in the evaluation and management of drug therapies in this setting. Hospitals differ with respect to the composition of these committees, their members' expertise, and the processes used for making formulary decisions. OBJECTIVES: To examine the current processes for formulary drug review from the perspective of P&T committees and their individual members, and to examine the needs and preferences of these stakeholders related to evidence review and potential collaborative drug review processes within a large Local Health Integration Network (LHIN) in Ontario...
May 2016: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/27280120/diabetic-retinopathy-screening-with-pharmacy-based-teleophthalmology-in-a-semiurban-setting-a-cost-effectiveness-analysis
#11
Andrea C Coronado, Gregory S Zaric, Janet Martin, Monali Malvankar-Mehta, Francie F Si, William G Hodge
BACKGROUND: Diabetic eye complications are the leading cause of visual loss among working-aged people. Pharmacy-based teleophthalmology has emerged as a possible alternative to in-person examination that may facilitate compliance with evidence-based recommendations and reduce barriers to specialized eye care. The objective of this study was to estimate the cost-effectiveness of mobile teleophthalmology screening compared with in-person examination (primary care) for the diabetic population residing in semiurban areas of southwestern Ontario...
January 2016: CMAJ Open
https://www.readbyqxmd.com/read/27076820/how-do-community-pharmacists-make-decisions-results-of-an-exploratory-qualitative-study-in-ontario
#12
Paul A M Gregory, Brenna Whyte, Zubin Austin
BACKGROUND: As the complexity of pharmacy practice increases, pharmacists are required to make more decisions under ambiguous or information-deficient conditions. There is scant literature examining how pharmacists make decisions and what factors or values influence their choices. The objective of this exploratory research was to characterize decision-making patterns in the clinical setting of community pharmacists in Ontario. METHODS: The think-aloud decision-making method was used for this study...
March 2016: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
https://www.readbyqxmd.com/read/27076819/community-pharmacy-rapid-influenza-a-and-b-screening-a-novel-approach-to-expedite-patient-access-to-care-and-improve-clinical-outcomes
#13
John Papastergiou, Chris Folkins, Wilson Li, Leslie Young
OBJECTIVE: To investigate the impact and feasibility of community pharmacist-directed influenza screening and to evaluate the proportion of influenza-positive cases that resulted in the initiation of antiviral therapy by pharmacists. METHODS: Patients aged 5 and older with symptoms suggestive of influenza were recruited at 2 Shoppers Drug Mart locations in Toronto, Ontario, from December 12, 2014, to February 4, 2015. Nasal swabs were collected by pharmacists and screened using the BD Veritor system for Rapid Detection of Flu A+B...
March 2016: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
https://www.readbyqxmd.com/read/26715781/survey-of-pharmacy-preceptors-expectations-and-experiences-with-students-on-rotations-in-an-inaugural-combined-bscphm-pharmd-class
#14
Artemis Diamantouros, Romina Marchesano, Grace Rzyczniak, Brian Hardy
BACKGROUND: In September 2011, the Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, began offering a combined BScPhm/PharmD program to third-year students and postbaccalaureate graduates. Learning consisted of in-class teaching and Advanced Pharmacy Practice Experience (APPE) rotations. OBJECTIVE: To explore preceptors' expectations and perceptions of student performance in the APPE rotations of the new combined degree program. METHODS: A survey was distributed via email to 132 pharmacists from the Toronto Academic Health Science Network who had acted as preceptors for the combined degree program in academic year 2011/2012...
November 2015: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/26698027/prognosis-treatment-benefit-and-goals-of-care-what-do-oncologists-discuss-with-patients-who-have-incurable-cancer
#15
W Raskin, I Harle, W M Hopman, C M Booth
AIMS: Documentation of advance directives among patients with terminal cancer is known to be poor. Here we describe documentation of prognosis, treatment benefit and goals of care discussions in outpatients with advanced cancer. MATERIALS AND METHODS: All patients receiving first-line palliative chemotherapy for metastatic pancreas or lung cancers during 2010-2013 at the Cancer Centre of Southeastern Ontario were identified from electronic pharmacy records. Clinical notes from medical oncology were reviewed to identify documentation of discussions regarding prognosis, treatment benefit and goals of care...
March 2016: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/26393233/retrospective-analysis-of-trends-in-dispensing-long-acting-non-tamper-resistant-oxycodone-near-the-canada-united-states-border
#16
Tara Gomes, J Michael Paterson, Mariam Mukati, David Henry
BACKGROUND: Since 2010, tamper-resistant long-acting oxycodone has been available in both the United States and Canada; however, generic non-tamper-resistant brands of the drug have only been introduced in Canada. We aimed to determine whether the introduction of generic non-tamper-resistant oxycodone in Canada led to increased sales from Canadian pharmacies near the Canada-US border. METHODS: We conducted a retrospective analysis of trends in dispensing of long-acting oxycodone from Canadian community pharmacies in geographic areas contiguous with the Canada-US border between Feb...
April 2015: CMAJ Open
https://www.readbyqxmd.com/read/26195679/rates-of-anomalous-bupropion-prescriptions-in-ontario-canada
#17
Leah S Steele, Erin M Macdonald, Tara Gomes, Simon Hollands, J Michael Paterson, Muhammad M Mamdani, David N Juurlink
PURPOSE: Reports of bupropion misuse have increased since it was first reported in 2002. The purpose of this study was to explore trends in bupropion prescribing suggestive of misuse or diversion in Ontario, Canada. METHODS: A serial cross-sectional study was conducted of Ontarians aged younger than 65 years who received prescriptions under Ontario's public drug program from April 1, 2000, to March 31, 2013. We determined the number of potentially inappropriate prescriptions in each quarter, defined as early refills dispensed within 50% of the duration of the preceding prescription, as well as potentially duplicitous prescriptions, defined as similarly early refills originating from a different prescriber and different pharmacy...
July 2015: Annals of Family Medicine
https://www.readbyqxmd.com/read/26156222/change-management-in-pharmacy-a-simulation-game-and-pharmacy-leaders-rating-of-35-barriers-to-change
#18
Aurélie Guérin, Denis Lebel, Kevin Hall, Jean-François Bussières
OBJECTIVES: The primary objective was to rank barriers to change in pharmacy practice. Our secondary objective was to create a simulation game to stimulate reflection and discussion on the topic of change management. METHODS: The game was created by the authors and used during a symposium attended by 43 hospital pharmacy leaders from all regions of Canada (Millcroft Conference, Alton, Ontario, June 2013). The main theme of the conference was 'managing change'. KEY FINDINGS: The simulation game, the rating of 35 barriers to change and the discussion that followed provided an opportunity for hospital pharmacy leaders to reflect on potential barriers to change, and how change might be facilitated through the use of an organized approach to change, such as that described in Kotter's eight-step model...
December 2015: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/26138581/glucocorticoid-induced-osteoporosis-management-among-seniors-by-year-sex-and-indication-1996-2012
#19
J M Albaum, L E Lévesque, A S Gershon, G Liu, S M Cadarette
UNLABELLED: We identified that glucocorticoid-induced osteoporosis management (bone mineral density testing or osteoporosis treatment) among seniors improved among men (2 to 23 %) and women (10 to 48 %) between 1996 and 2007, and then remained relatively stable through to 2012. Differences were also noted by indication (from a low of 21 % for respiratory conditions to a high of 41 % for rheumatic conditions). PURPOSE: The aim of our study was to describe the proportion of chronic oral glucocorticoid (GC) users that receive osteoporosis management (bone mineral density test or osteoporosis treatment) by sex and over time...
December 2015: Osteoporosis International
https://www.readbyqxmd.com/read/25962885/successful-knowledge-translation-intervention-in-long-term-care-final-results-from-the-vitamin-d-and-osteoporosis-study-vidos-pilot-cluster-randomized-controlled-trial
#20
RANDOMIZED CONTROLLED TRIAL
Courtney C Kennedy, George Ioannidis, Lehana Thabane, Jonathan D Adachi, Sharon Marr, Lora M Giangregorio, Suzanne N Morin, Richard G Crilly, Robert G Josse, Lynne Lohfeld, Laura E Pickard, Mary-Lou van der Horst, Glenda Campbell, Jackie Stroud, Lisa Dolovich, Anna M Sawka, Ravi Jain, Lynn Nash, Alexandra Papaioannou
BACKGROUND: Few studies have systematically examined whether knowledge translation (KT) strategies can be successfully implemented within the long-term care (LTC) setting. In this study, we examined the effectiveness of a multifaceted, interdisciplinary KT intervention for improving the prescribing of vitamin D, calcium and osteoporosis medications over 12-months. METHODS: We conducted a pilot, cluster randomized controlled trial in 40 LTC homes (21 control; 19 intervention) in Ontario, Canada...
May 12, 2015: Trials
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