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Pharmacy Ontario

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
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
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
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
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
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
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
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
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
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
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
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
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...
2015: Trials
Racquel Jandoc, Nathaniel Jembere, Saba Khan, Storm J Russell, Yvon Allard, Suzanne M Cadarette
UNLABELLED: Half of Métis citizens, compared to less than 10 % of the general population of Ontario, reside in northern regions, with little access to bone mineral density (BMD) testing. Métis citizens had lower sex-specific and age-standardized rates of BMD testing, yet similar rates of fracture (both sexes) and pharmacotherapy (women only). PURPOSE: To examine osteoporosis management and common osteoporosis-related fractures among Métis citizens compared to the general population of older adults residing in Ontario...
2015: Archives of Osteoporosis
Courtney C Kennedy, George Ioannidis, Lehana Thabane, Jonathan D Adachi, Denis O'Donnell, Lora M Giangregorio, Laura E Pickard, Alexandra Papaioannou
This study described prescribing trends before and after implementing a provincial strategy aimed at improving osteoporosis and fracture prevention in Ontario long-term care (LTC) homes. Data were obtained from a pharmacy provider for 10 LTC homes in 2007 and 166 homes in 2012. We used weighted, multiple linear regression analyses to examine facility-level changes in vitamin D, calcium, and osteoporosis medication prescribing rates between 2007 and 2012. After five years, the estimated increase in vitamin D, calcium, and osteoporosis medication prescribing rates, respectively, was 38...
June 2015: Canadian Journal on Aging, la Revue Canadienne du Vieillissement
A M Burden, M Tadrous, A Calzavara, S M Cadarette
UNLABELLED: The addition of Limited Use criteria (less restrictive access) for zoledronic acid resulted in an immediate and significant increase in uptake and resulted in differences in patient/physician characteristics. In comparison, the uptake of denosumab (only listed with Limited Use) was rapid. Thus, formulary access restrictions have significant implications for prescribing. INTRODUCTION: We sought to describe the use of zoledronic acid and denosumab by physicians and patients over time and examine the impact of a 2012 provincial formulary modification that removed the administrative burden on physicians when prescribing zoledronic acid...
May 2015: Osteoporosis International
Tara Gomes, David Juurlink, Zhan Yao, Ximena Camacho, J Michael Paterson, Samantha Singh, Irfan Dhalla, Beth Sproule, Muhammad Mamdani
BACKGROUND: The increased use of opioid analgesics, sedative hypnotics and stimulants, coupled with the associated risks of overdose have raised concerns around the inappropriate prescribing of these monitored drugs. We assessed the impact of new legislation, the Narcotics Safety and Awareness Act, and a centralized Narcotics Monitoring System (implemented November 2011 and May 2012, respectively), on the dispensing of prescriptions suggestive of misuse. METHODS: We conducted a time series analysis of publicly funded prescriptions for opioids, benzodiazepines and stimulants dispensed monthly in Ontario from January 2007 to May 2013, based on information in the Ontario Public Drug Benefit Database...
October 2014: CMAJ Open
Marko Tomas, Natalie Crown, Debaroti Borschel, Lisa McCarthy
BACKGROUND: Medication reconciliation (MR) is associated with reduced discrepancies and adverse events within institutions. In ambulatory care, MR is often considered more challenging due to periodic, brief patient encounters and the involvement of multiple prescribers who lack shared records. MedsCheck, a community pharmacy program in Ontario for patients with diabetes or those taking 3 or more medications, generates a best possible medication history (BPMH) that can serve as a starting point for MR...
September 2014: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
Paul Gregory, Zubin Austin
BACKGROUND: A recent shift in the pharmacy workforce away from stable, long-term employment has been reported by students. Few data exist regarding the postgraduation employment experiences of students. METHODS: An electronic survey exploring postgraduation employment experiences was distributed to 2012-2013 graduates from the Universities of Waterloo and Toronto (including the International Pharmacy Graduate program). Follow-up interviews were undertaken to explore survey findings...
September 2014: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
Melanie Trinacty, Barbara Farrell, Theresa J Schindel, Lisa Sunstrum, Lisa Dolovich, Natalie Kennie, Grant Russell, Nancy Waite
BACKGROUND: Expanding into new types of practice, such as family health teams, presents challenges for practising pharmacists. The Primary Care Pharmacy Specialty Network (PC-PSN) was established in 2007 to support collaboration among pharmacists working in primary care. The PC-PSN offers to its members a listserv (also referred to as an electronic mailing list) jointly hosted by the Canadian Society of Hospital Pharmacists and the Canadian Pharmacists Association. OBJECTIVES: To characterize PC-PSN membership and participation in the listserv and to examine how the listserv is used by analyzing questions posted, concerns raised, and issues discussed...
September 2014: Canadian Journal of Hospital Pharmacy
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