Canadian Pharmacists Journal最新文献

{"title":"Environmentally sustainable opportunities for health systems: Metered-dose inhaler prescribing, dispensing, use and waste at a tertiary academic centre.","authors":"Carolanne Caron, Shellyza Sajwani, Katherine Bateman, Owen Degenhardt, Mathilde Gaudreau-Simard, Smita Pakhale, Salmaan Kanji","doi":"10.1177/17151635241268299","DOIUrl":"10.1177/17151635241268299","url":null,"abstract":"<p><strong>Background: </strong>The Canadian health sector's carbon footprint is among the highest in the world and is responsible for 4.6% of Canada's total greenhouse gas emissions, a quarter of which is linked to pharmaceuticals, with metered-dose inhalers (MDIs) contributing disproportionally high amounts.</p><p><strong>Objectives: </strong>To describe MDI prescribing, dispensing, use and waste patterns at a Canadian tertiary care academic hospital.</p><p><strong>Methods: </strong>In a retrospective point-prevalence cohort study, 100 consecutive patients discharged from medical and surgical services who were prescribed at least 1 MDI during their admission were included. Data were collected to describe patient demographics, MDI prescribing, dispensing, use and waste patterns. Use and waste data were applied to annual purchasing data to estimate annual usage and waste. Financial cost was computed using local purchasing estimates and carbon cost was calculated using published estimates.</p><p><strong>Results: </strong>In 100 consecutively discharged patients, 315 MDIs were dispensed in total, of which 96 were unused. This represents 61,440 actuations dispensed, with 56,773 (92%) of doses unused or wasted. Waste data were applied to annual estimates, with a calculated annual carbon footprint of 315.8 tons of carbon dioxide equivalent (tCO2e). We estimate that a 20% waste reduction would result in carbon savings of 68.5 tCO2e. If 20% of salbutamol prescriptions were switched to the dry powder inhaler alternative, terbutaline, a 14% reduction in waste would be required to offset the additional monetary cost.</p><p><strong>Conclusions: </strong>This study suggests that 92% of MDI doses are unused and wasted. Opportunities for waste reduction exist and would be associated with both financial and carbon savings.</p>","PeriodicalId":46612,"journal":{"name":"Canadian Pharmacists Journal","volume":" ","pages":"315-323"},"PeriodicalIF":1.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A pharmacist-led, digital health informatics-based, insight-led care approach to aid clinical prioritization of people with diabetes and heart failure.","authors":"Ciara Doherty, Gayle Campbell, Ollie French, Alastair Smith, Anna Hodgkinson, Daghni Rajasingam, Jessica Webb, Janaka Karalliedde","doi":"10.1177/17151635241277547","DOIUrl":"10.1177/17151635241277547","url":null,"abstract":"","PeriodicalId":46612,"journal":{"name":"Canadian Pharmacists Journal","volume":" ","pages":"286-289"},"PeriodicalIF":1.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Climate-conscious pharmacy practice: An exploratory study of community pharmacists in Ontario.","authors":"Andy Zhao, Paul A M Gregory, Zubin Austin","doi":"10.1177/17151635241267856","DOIUrl":"10.1177/17151635241267856","url":null,"abstract":"<p><strong>Background: </strong>Climate change remains a significant challenge to global health. The health care system is a major contributor of greenhouse gas (GHG) emissions. While pharmacists are aware of climate change as an important societal issue, there is little known about the level of implementation of climate-conscious practices in community pharmacies throughout Ontario.</p><p><strong>Methods: </strong>An interview-based system was developed to gather insights from pharmacists regarding their perspectives on climate change and identify strategies to involve them in sustainable practices. Convenience and snowball sampling techniques were used to recruit pharmacists. Interviews were conducted by phone or Zoom, and transcripts were developed and analyzed for common themes using a qualitative method.</p><p><strong>Results and discussion: </strong>Twenty-four community pharmacists were interviewed. Three overarching themes emerged: 1) there is a knowledge and awareness gap in the pharmacy profession; 2) before pharmacists can prioritize sustainable practices, they must first address more immediate concerns in the pharmacy; 3) sustainable practice integration requires employment and regulatory changes as relying solely or extensively on the good intentions of frontline pharmacists is insufficient.</p><p><strong>Conclusion: </strong>While pharmacists show concern about the environmental impacts of their work, sustainable practice integration is very limited in community pharmacies across Ontario. There are many challenges and barriers to address. This includes closing the knowledge and awareness gap by incorporating climate-related topics into pharmacy curricula and providing educational seminars and resources for practicing pharmacists. In addition, improving workflow, changing standard operating procedures at a corporate level and providing incentives for implementing eco-friendly practices are crucial steps to address time and financial limitations. To manage patient safety concerns, providing resources that consider climate considerations as a secondary objective, when clinically appropriate for the patient, is the right approach to engage pharmacists. Lastly, advocating for employment and regulatory changes will be necessary for large-scale, durable changes to pharmacy practice.</p>","PeriodicalId":46612,"journal":{"name":"Canadian Pharmacists Journal","volume":" ","pages":"324-333"},"PeriodicalIF":1.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening primary care: Elevating the role of pharmacists in Canada's health-care future.","authors":"","doi":"10.1177/17151635241269087a","DOIUrl":"https://doi.org/10.1177/17151635241269087a","url":null,"abstract":"","PeriodicalId":46612,"journal":{"name":"Canadian Pharmacists Journal","volume":"157 5","pages":"208"},"PeriodicalIF":1.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacists' prescribing of opioids in Nova Scotia under Health Canada's Controlled Drugs and Substances Act temporary exemption during the COVID-19 pandemic.","authors":"Ronald Watema-Lord, Ingrid Sketris, Heather Neville, Mark Asbridge, Chiranjeev Sanyal","doi":"10.1177/17151635241267008","DOIUrl":"10.1177/17151635241267008","url":null,"abstract":"","PeriodicalId":46612,"journal":{"name":"Canadian Pharmacists Journal","volume":"157 5","pages":"240-245"},"PeriodicalIF":1.6,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of the pharmacist caring for people at risk of or living with HIV in Canada.","authors":"Stacey Tkachuk, Erin Ready, Shanna Chan, Jennifer Hawkes, Tracy Janzen Cheney, Jeff Kapler, Denise Kreutzwiser, Linda Akagi, Michael Coombs, Pierre Giguere, Christine Hughes, Deborah Kelly, Sheri Livingston, Dominic Martel, Mark Naccarato, Salin Nhean, Carley Pozniak, Tasha Ramsey, Linda Robinson, Jonathan Smith, Jaris Swidrovich, Jodi Symes, Deborah Yoong, Alice Tseng","doi":"10.1177/17151635241267350","DOIUrl":"10.1177/17151635241267350","url":null,"abstract":"","PeriodicalId":46612,"journal":{"name":"Canadian Pharmacists Journal","volume":"157 5","pages":"218-239"},"PeriodicalIF":1.6,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CPhA Strategic Plan 2024-2026.","authors":"","doi":"10.1177/17151635241269087","DOIUrl":"https://doi.org/10.1177/17151635241269087","url":null,"abstract":"","PeriodicalId":46612,"journal":{"name":"Canadian Pharmacists Journal","volume":" ","pages":"17151635241269087"},"PeriodicalIF":1.6,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CPhA Strategic Plan 2024-2026.","authors":"","doi":"10.1177/17151635241269087","DOIUrl":"https://doi.org/10.1177/17151635241269087","url":null,"abstract":"","PeriodicalId":46612,"journal":{"name":"Canadian Pharmacists Journal","volume":"157 5","pages":"207"},"PeriodicalIF":1.6,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thanks, Renée.","authors":"Ross T Tsuyuki, Rosemary Killeen","doi":"10.1177/17151635241269081","DOIUrl":"https://doi.org/10.1177/17151635241269081","url":null,"abstract":"","PeriodicalId":46612,"journal":{"name":"Canadian Pharmacists Journal","volume":"157 5","pages":"205-206"},"PeriodicalIF":1.6,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community pharmacists' comfort levels with and barriers to application of an expanded scope of practice in Québec.","authors":"Léonie Rouleau, Léa Prince-Duthel, Marie-Claude Vanier, Nicolas Dugré, Anne Maheu, Line Guénette","doi":"10.1177/17151635241264517","DOIUrl":"10.1177/17151635241264517","url":null,"abstract":"<p><strong>Background: </strong>In recent years, community pharmacists have seen their profession transition from a dispensing-focused role to a rapidly evolving clinically oriented practice. In Québec, Bill 31, adopted in 2020, increased the clinical opportunities for pharmacists with independent prescribing privileges in various defined clinical situations. As this expanded role can lead to different barriers, it is crucial to explore pharmacists' comfort levels with implementing such changes in their practice.</p><p><strong>Methods: </strong>A web-based survey was conducted from March 25 to May 28, 2021, among community pharmacists in Québec. We collected data with a questionnaire developed for this study. Questions were grouped into 4 domains: (1) characteristics of the respondents; (2) workload and work setting; (3) comfort level with, and barriers to, adjusting medications and following up pharmacologic treatments (86 clinical situations evaluated); and (4) general barriers and facilitators to implementation.</p><p><strong>Results: </strong>A total of 146 community pharmacists completed the questionnaire. Most were women (71.9%), younger than 50 years of age (86.2%), had a bachelor's degree (64.4%) as their highest academic level and had more than 10 years of experience as pharmacists (56.8%). Most of them worked exclusively in a community pharmacy (86.3%). Among the 86 clinical situations evaluated, there were 16 in which at least 80% of respondents felt comfortable. The main barriers identified were a lack of knowledge, experience and dedicated time and difficulties integrating these activities into the workflow; facilitators were having an adequate environment and resources.</p><p><strong>Conclusion: </strong>This study shows community pharmacists can confidently adjust pharmacotherapy for several conditions. However, they must have adequate time and resources. Also, the more complex the clinical situations were, the less comfortable community pharmacists felt adjusting pharmacotherapy. This study identified several areas where continuing education, training and mentoring could be offered and where the work environment and organization could be improved.</p>","PeriodicalId":46612,"journal":{"name":"Canadian Pharmacists Journal","volume":"157 5","pages":"246-260"},"PeriodicalIF":1.6,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}