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https://www.readbyqxmd.com/read/29123598/ready-or-not-pharmacist-perceptions-of-a-changing-injection-scope-of-practice-before-it-happens
#1
Esther Ai-Leng Foong, David J Edwards, Sherilyn Houle, Kelly A Grindrod
Background: Since 2012, Ontario pharmacists have been authorized to administer the influenza vaccine. In April 2016, the Ontario College of Pharmacists (OCP) proposed to expand the Pharmacy Act to allow pharmacists to vaccinate against 13 additional conditions. The OCP held an online public consultation and invited pharmacists, members of the public and organizations to weigh in on the proposed changes. Our objective was to explore the factors influencing how Ontario pharmacists may adopt or reject an expanding scope of practice, using data from the public consultation...
November 2017: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
https://www.readbyqxmd.com/read/29117991/availability-of-naloxone-in-canadian-pharmacies-a-population-based-survey
#2
Alex M Cressman, Graham Mazereeuw, Qi Guan, Wenting Jia, Tara Gomes, David N Juurlink
BACKGROUND: Naloxone is life-saving when administered after opioid overdose. In March 2016, the Canadian government made the antidote available without prescription, but anecdotal reports suggest members of the public have difficulty in procuring it. We examined the availability of naloxone in community pharmacies across Canada. METHODS: We identified community pharmacies in Canada (n = 10 296) and randomly selected 506, stratified using proportionate allocation by population size...
November 8, 2017: CMAJ Open
https://www.readbyqxmd.com/read/29113728/expanding-the-clinical-role-of-community-pharmacy-a-qualitative-ethnographic-study-of-medication-reviews-in-ontario-canada
#3
Sarah J Patton, Fiona A Miller, Lusine Abrahamyan, Valeria E Rac
Medication reviews by community pharmacists are an increasingly common strategy to improve medication management for chronic conditions, and are part of wider efforts to make more effective use of community-based health professionals. To identify opportunities to optimize the medication review program in Ontario, Canada, we explored how providers and clients interpret and operationalize medication reviews within everyday community pharmacy practice. We conducted a qualitative ethnographic study at four pharmacies in Ontario, Canada, including non-participant observation of provider and client activities and interactions with specific attention to medication reviews, as well as brief ethnographic interviews with providers and clients, and in-depth, semi-structured interviews with providers...
November 4, 2017: Health Policy
https://www.readbyqxmd.com/read/29037573/pharmacists-scope-of-practice-supports-for-canadians-with-diabetes
#4
Kerry Mansell, Kirsten Edmunds, Lisa Guirguis
OBJECTIVES: The pharmacists' role in Canada has significantly advanced over the past decade, resulting in increasing access to primary care services. This study aimed to characterize pharmacists' expanded scope of practice as it relates to providing services to Canadians with diabetes. METHODS: This environmental scan characterized services that could be useful to Canadians with diabetes in each of the provinces (excluding the territories): immunizations, medication prescribing, ordering and interpreting laboratory tests, and medication reviews...
October 13, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28972983/gabapentin-opioids-and-the-risk-of-opioid-related-death-a-population-based-nested-case-control-study
#5
Tara Gomes, David N Juurlink, Tony Antoniou, Muhammad M Mamdani, J Michael Paterson, Wim van den Brink
BACKGROUND: Prescription opioid use is highly associated with risk of opioid-related death, with 1 of every 550 chronic opioid users dying within approximately 2.5 years of their first opioid prescription. Although gabapentin is widely perceived as safe, drug-induced respiratory depression has been described when gabapentin is used alone or in combination with other medications. Because gabapentin and opioids are both commonly prescribed for pain, the likelihood of co-prescription is high...
October 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28872697/perceived-barriers-and-facilitators-to-providing-methadone-maintenance-treatment-among-rural-community-pharmacists-in-southwestern-ontario
#6
Joseph Fonseca, Andrew Chang, Feng Chang
PURPOSE: Misuse of opioids has become a public health concern across North America. Rural patients have limited access to methadone maintenance treatment (MMT), an opioid addiction-treatment service that could be offered by community pharmacists. The aim of this study was to identify rural community pharmacists' perceived barriers, motivations, and solutions to offering MMT to their patients. METHODS: One-on-one, semistructured interviews were conducted with 11 community pharmacists who practice in rural southwestern Ontario...
September 5, 2017: Journal of Rural Health
https://www.readbyqxmd.com/read/28835370/screening-for-atrial-fibrillation-in-canadian-pharmacies-an-economic-evaluation
#7
Jean-Eric Tarride, Lisa Dolovich, Gordon Blackhouse, Jason Robert Guertin, Natasha Burke, Veena Manja, Alex Grinvalds, Ting Lim, Jeff S Healey, Roopinder K Sandhu
BACKGROUND: Screening for undiagnosed atrial fibrillation may lead to treatment with oral anticoagulation therapy, which can decrease the risk of ischemic stroke. The objective of this study was to conduct an economic evaluation of the Program for the Identification of 'Actionable' Atrial Fibrillation in the Pharmacy Setting (PIAAF-Pharmacy), which screened 1145 participants aged 65 years or more at 30 community pharmacies in Ontario and Alberta between October 2014 and April 2015. METHODS: We used a 2-part decision model to evaluate the short- and long-term costs and quality-adjusted life-years (QALYs) of a pharmacy screening program for atrial fibrillation compared to no screening...
August 22, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28757409/beyond-plan-b-a-qualitative-study-of-canadian-pharmacists-emergency-contraception-counselling-practices
#8
Karen Wong, Susan Hum, Lisa McCarthy, Sheila Dunn
OBJECTIVE: Pharmacists are often the front-line health care providers for women seeking emergency contraception (EC). This study explored Ontario pharmacists' EC counselling practices and their perceived barriers to recommending the most effective EC method, the copper IUD (Cu-IUD). METHODS: This qualitative study used one-on-one, semistructured interviews with 20 pharmacists working in pharmacies located within a 1-km radius of a large sexual health clinic that offered postcoital IUDs in downtown Toronto...
November 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28689706/the-innovative-canadian-pharmacogenomic-screening-initiative-in-community-pharmacy-icanpic-study
#9
John Papastergiou, Peter Tolios, Wilson Li, Jane Li
OBJECTIVES: The safety and efficacy of medications can vary significantly between patients as a result of genetic variability. As genomic screening technologies become more widely available, pharmacists are ideally suited to use such tools to optimize medication therapy management. The objective of this study was to evaluate the feasibility of implementing personalized medication services into community pharmacy practice and to assess the number of drug therapy problems identified as a result of pharmacogenomic screening...
July 6, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28621658/zoning-out-methadone-and-rising-opioid-related-deaths-in-ontario-reforms-and-municipal-government-actions
#10
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
#11
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
#12
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
#13
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...
September 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
#14
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
#15
MULTICENTER STUDY
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...
April 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
#16
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
#17
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
#18
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
#19
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
#20
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
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