CANADIAN JOURNAL OF HOSPITAL PHARMACY最新文献

{"title":"Risk Factors, Screening, Diagnosis, and Treatment of Osteoporosis in HIV-Infected Adults in an HIV Primary Care Clinic.","authors":"Kevin Kwok,&nbsp;Caitlin Olatunbosun,&nbsp;Erin Ready,&nbsp;Osric Sin,&nbsp;Junine Toy,&nbsp;Alena Spears,&nbsp;Vickie Lau,&nbsp;Greg Bondy,&nbsp;Sarah Stone","doi":"10.4212/cjhp.3144","DOIUrl":"https://doi.org/10.4212/cjhp.3144","url":null,"abstract":"<p><strong>Background: </strong>The population of people living with HIV is aging, and with aging come emergent comorbidities, including osteoporosis, for which screening and treatment are becoming increasingly important. Osteoporosis prevalence among those living with HIV is 3 times greater than among HIV-uninfected controls.</p><p><strong>Objective: </strong>To assess and describe osteoporosis risk factors, screening, diagnosis, and treatment for people 50 years of age or older living with HIV and receiving care at a multidisciplinary HIV primary care clinic.</p><p><strong>Methods: </strong>A retrospective chart review of people 50 years of age or older living with HIV was conducted at the John Ruedy Clinic in Vancouver, British Columbia, between June 1, 2016, and June 1, 2019. Patients who had had fewer than 2 yearly follow-up appointments were excluded.</p><p><strong>Results: </strong>A total of 146 patients were included in the analysis; most were male (<i>n</i> = 134, 92%), and the median age was 55 years. Patients had a median of 3 osteoporosis risk factors (in addition to age and HIV infection), and 145 patients had at least 1 risk factor. All screening for osteoporosis was conducted by dual-energy X-ray absorptiometry (DXA). Thirty-nine (27%) of the patients were screened with DXA, 92 (63%) were not screened, and 15 (10%) already had a diagnosis of osteoporosis. The DXA screening identified osteoporosis in an additional 10 patients and osteopenia in 22 patients. Treatments for patients with osteoporosis included bisphosphonates (<i>n</i> = 15, 60%) and vitamin D or calcium (or both), without any other medications (<i>n</i> = 4, 16%). In the overall study population, 32 (22%) of the patients were taking calcium and 46 (32%) were taking vitamin D.</p><p><strong>Conclusions: </strong>Many patients aged 50 years or older and receiving HIV care at the John Ruedy Clinic had or were at risk for osteoporosis. An opportunity exists to increase screening and treatment of these individuals. A multidisciplinary team may be crucial in achieving this goal.</p>","PeriodicalId":51646,"journal":{"name":"CANADIAN JOURNAL OF HOSPITAL PHARMACY","volume":"75 3","pages":"178-185"},"PeriodicalIF":0.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9245408/pdf/cjhp-75-178.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10490174","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":"To Go Far, Go Together.","authors":"Zack Dumont","doi":"10.4212/cjhp.v75i1.3256","DOIUrl":"https://doi.org/10.4212/cjhp.v75i1.3256","url":null,"abstract":"","PeriodicalId":51646,"journal":{"name":"CANADIAN JOURNAL OF HOSPITAL PHARMACY","volume":"75 1","pages":"63"},"PeriodicalIF":0.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8676998/pdf/cjhp-75-63.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39787519","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":"TLC-Act: A Novel Tool for Managing Drug Interactions.","authors":"Casara Hong,&nbsp;Michael Legal,&nbsp;Harkaryn Bagri,&nbsp;Louise Lau,&nbsp;Karen Dahri","doi":"10.4212/cjhp.3171","DOIUrl":"https://doi.org/10.4212/cjhp.3171","url":null,"abstract":"<p><strong>Background: </strong>Clinical decision support systems (CDSS) are used by pharmacists to assist in managing drug-drug interactions (DDIs). However, previous research suggests that such systems may perform suboptimally in providing clinically relevant information in practice.</p><p><strong>Objectives: </strong>The primary objective of this study was to develop a novel DDI management tool to reflect the clinical thought process that a pharmacist uses when assessing a DDI. The secondary objective was to investigate practitioners' perceptions of this tool.</p><p><strong>Methods: </strong>This study was conducted in 3 phases: development of the DDI management tool, implementation of the tool in clinical practice, and collection of practitioners' opinions of the tool through an online qualitative survey (although because of circumstances related to the COVID-19 pandemic, the study population for the survey phase included only pharmacy residents). A comprehensive literature search and analysis by an expert panel provided underlying context for the DDI management tool. The tool was validated through simulation against a known list of DDIs before implementation into practice by hospital pharmacists and pharmacy residents. Participating pharmacy residents were invited to provide feedback on the tool. Survey results were analyzed using descriptive statistics.</p><p><strong>Results: </strong>The novel tool that was developed in this study (called TLC-Act) consisted of components important to a pharmacist when assessing a DDI, including the duration of concomitant use of the interacting medications and patient-specific risk factors. Study participants implemented the tool in clinical practice for a total of 6 weeks. Of the 28 pharmacy residents surveyed, 15 (54%) submitted a response, of whom 11 (73%) found the TLC-Act tool to be slightly more useful for assessing a DDI than usual care with the CDSS alone.</p><p><strong>Conclusions: </strong>The TLC-Act tool maps out a pharmacist's clinical thought process when assessing a DDI in practice. This novel tool may be more useful than a CDSS alone for managing DDIs, as it takes into account other important factors pertinent to the assessment of a DDI.</p>","PeriodicalId":51646,"journal":{"name":"CANADIAN JOURNAL OF HOSPITAL PHARMACY","volume":"75 3","pages":"193-200"},"PeriodicalIF":0.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9245403/pdf/cjhp-75-193.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10485669","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":"Design and Development of an Escape Game as a Knowledge Transfer Tool in Preparation for an Accreditation Visit in a Health Care Facility.","authors":"Amélie Chabrier,&nbsp;Aurélia Difabrizio,&nbsp;Geneviève Parisien,&nbsp;Suzanne Atkinson,&nbsp;Jean-François Bussières","doi":"10.4212/cjhp.3163","DOIUrl":"https://doi.org/10.4212/cjhp.3163","url":null,"abstract":"<p><strong>Background: </strong>Knowledge transfer helps health care staff to be competent, well informed, and up to date. It also contributes to adherence to standards and best practices.</p><p><strong>Objectives: </strong>To design, implement, and evaluate an escape game based on a selection of Accreditation Canada required organizational practices (ROPs).</p><p><strong>Methods: </strong>This prospective descriptive study involved nurses and pharmacists in a health care centre. An escape game based on 6 ROPs was designed. The game was played by teams of participants in a patient room within the centre, with each game lasting 25 minutes. Participants' satisfaction with various aspects of their experience was assessed.</p><p><strong>Results: </strong>A total of 200 people (52 teams) participated in the escape game. About half of the teams (<i>n</i> = 28) completed the game within the allotted time (average completion time 20 minutes, 53 seconds; standard deviation [SD] 2 minutes, 45 seconds). On average, 1.32 (SD 0.88) clues were provided to successful teams and 1.88 (SD 0.95) to unsuccessful teams. Participants were very satisfied with their experience. However, members of unsuccessful teams had significantly lower agreement that the escape game was relevant to their practice and that it was an effective method of communication.</p><p><strong>Conclusions: </strong>An escape game based on a selection of ROPs was successfully implemented as part of the hospital's preparation for an accreditation visit. Use of an escape game as a knowledge transfer tool was appreciated by the staff.</p>","PeriodicalId":51646,"journal":{"name":"CANADIAN JOURNAL OF HOSPITAL PHARMACY","volume":"75 4","pages":"251-258"},"PeriodicalIF":0.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9524550/pdf/cjhp-75-251.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9290845","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":"Burnout among Hospital Pharmacists in Canada: A Cross-Sectional Analysis.","authors":"Courtney L Blue,&nbsp;Odette N Gould,&nbsp;Corry Clarke,&nbsp;Heather Naylor,&nbsp;Meghan MacKenzie,&nbsp;Sarah Burgess,&nbsp;Stacey MacAulay,&nbsp;Andrew J Flewelling","doi":"10.4212/cjhp.3224","DOIUrl":"https://doi.org/10.4212/cjhp.3224","url":null,"abstract":"<p><strong>Background: </strong>Burnout is a growing problem among health care professionals, with consequences for patient safety and personal satisfaction. The prevalence of burnout among hospital pharmacists in Canada is unknown; however, it has been documented at over 60% in other countries.</p><p><strong>Objectives: </strong>To assess the prevalence of burnout and variables associated with burnout among hospital pharmacists in Canada.</p><p><strong>Methods: </strong>This cross-sectional cohort study was based on a survey made available to more than 2600 Canadian hospital pharmacists from February 10 to April 2, 2020, through the Canadian Society of Hospital Pharmacists QID platform. The questionnaire collected data for the Maslach Burnout Inventory Human Services Survey for Medical Personnel (MBI-HSSMP), demographic data, employment characteristics, and workplace factors; it also included an open-ended question about burnout.</p><p><strong>Results: </strong>A total of 171 respondents provided data suitable for analysis. Of these, only 13 (7.6%) met the criteria for burnout on all 3 subscales of the burnout inventory; however, 105 respondents (61.4%) surpassed the threshold for burnout on the emotional exhaustion subscale. In univariate analyses, not working to one's full scope of practice was associated with meeting the criteria for burnout on all 3 scales. Linear regression highlighted associations between scores on the emotional exhaustion subscale and gender identity, perceived excessive on-call duties, area of practice, and positivity of workplace culture. Content analysis of the open-ended question supported the quantitative findings and pointed to 3 major themes: workload quantity, workload quality, and workplace culture.</p><p><strong>Conclusions: </strong>Results on the emotional exhaustion subscale of the MBI-HSSMP and responses to the open-ended question suggested a relatively high prevalence of burnout among Canadian hospital pharmacists, and indicated potential links between burnout and certain workplace characteristics.</p>","PeriodicalId":51646,"journal":{"name":"CANADIAN JOURNAL OF HOSPITAL PHARMACY","volume":"75 4","pages":"326-334"},"PeriodicalIF":0.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9524553/pdf/cjhp-75-326.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9237694","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":"Nocturnal Hypoglycemia Associated with Bedtime Administration of Premixed Insulin Preparations in Hospitalized Patients.","authors":"Kelsey K Mann,&nbsp;Heather Neville,&nbsp;John Robert Manderville","doi":"10.4212/cjhp.v75i1.3251","DOIUrl":"https://doi.org/10.4212/cjhp.v75i1.3251","url":null,"abstract":"<p><strong>Background: </strong>Patients with diabetes mellitus for whom premixed insulin preparations (PMIPs) are ordered in the hospital setting may be at risk of hypoglycemia if the PMIP is incorrectly administered at bedtime (instead of suppertime).</p><p><strong>Objectives: </strong>The primary objective was to determine, retrospectively, the incidence of bedtime administration of PMIPs at a tertiary teaching hospital. The secondary objective was to investigate whether bedtime administration of PMIPs led to an increase in nocturnal hypoglycemia.</p><p><strong>Methods: </strong>Inpatient PMIP orders for the period April 1, 2013, to March 31, 2017, were extracted from the pharmacy information system of the Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia. Two hundred randomly selected inpatient admissions were audited, and instances of PMIP administration after 2000 (8 pm) were recorded. Data from an additional random sample of inpatient admissions, from January 1, 2016, to December 31, 2017, were reviewed to determine whether bedtime administration of PMIPs was associated with increased incidence of nocturnal hypoglycemia, relative to suppertime administration.</p><p><strong>Results: </strong>In the randomly selected sample of 200 inpatient admissions, a PMIP was administered at bedtime at least once during 47 admissions (24%). In the additional sample of 123 inpatient admissions during which a PMIP had been administered, the mean nocturnal hypoglycemia rate was 4.15% for suppertime administration and 14.85% for bedtime administration (<i>p</i> = 0.13).</p><p><strong>Conclusions: </strong>For a substantial proportion of patients, PMIPs were inappropriately ordered and administered at bedtime in this hospital setting and may have been associated with nocturnal hypoglycemic events. Recommendations to reduce this practice include ongoing education and a review of preprinted order sets.</p>","PeriodicalId":51646,"journal":{"name":"CANADIAN JOURNAL OF HOSPITAL PHARMACY","volume":"75 1","pages":"21-25"},"PeriodicalIF":0.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8676995/pdf/cjhp-75-21.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39787513","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":"Opioid Prescribing Habits of Orthopedic Surgeons Following Total Hip Arthroplasty and Total Knee Arthroplasty: A Pilot Study.","authors":"Carter VanIderstine,&nbsp;Michael Dunbar,&nbsp;Emily Johnston","doi":"10.4212/cjhp.3282","DOIUrl":"https://doi.org/10.4212/cjhp.3282","url":null,"abstract":"<p><strong>Background: </strong>Adequate pain management is important in patients' recovery from total hip arthroplasty (THA) and total knee arthroplasty (TKA).</p><p><strong>Objective: </strong>To determine whether risk factors for prolonged opioid use are considered when discharge prescriptions for postoperative pain are written following THA and TKA.</p><p><strong>Methods: </strong>Opioid prescriptions written between June 14 and July 9, 2021, for patients who underwent THA or TKA were analyzed. Data were also collected on the patients' age, sex, type of surgery, type of anesthesia (regional or general), preoperative use of opioids, and preoperative use of antidepressants.</p><p><strong>Results: </strong>Among the 59 patients included in the study, the most common prescriptions were for hydromorphone 2 mg (<i>n</i> = 15, 25%) and hydromorphone 1 mg (<i>n</i> = 15, 25%). At discharge, patients received a median of 400 morphine milligram equivalents (MMEs). There was no significant difference in the quantity of opioids (MMEs) prescribed at discharge in relation to surgery type (<i>p</i> = 0.63), sex (<i>p</i> = 0.44), preoperative antidepressant use (<i>p</i> = 0.22), or preoperative opioid use (<i>p</i> = 0.97). There also appeared to be no correlation between a patient's age and MMEs at discharge (<i>p</i> = 0.21; <i>r</i> ² = 0.028). None of these variables could be used to predict which patients would receive more than 400 MMEs.</p><p><strong>Conclusions: </strong>Patient-specific factors appeared not to be taken into consideration when opioids were prescribed for postoperative pain among patients who underwent THA or TKA.</p>","PeriodicalId":51646,"journal":{"name":"CANADIAN JOURNAL OF HOSPITAL PHARMACY","volume":"75 4","pages":"335-339"},"PeriodicalIF":0.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9524559/pdf/cjhp-75-335.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9237692","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":"Health Care Professionals' Perceptions of the Role of the Clinical Pharmacist and Expanded Pharmacist Coverage in Critical Care.","authors":"Kristin Kaupp,&nbsp;Emma K Reid,&nbsp;Hannah Corney,&nbsp;Sarah Burgess,&nbsp;Lauren Hutton","doi":"10.4212/cjhp.v75i1.3134","DOIUrl":"https://doi.org/10.4212/cjhp.v75i1.3134","url":null,"abstract":"<p><strong>Background: </strong>During the first wave of the COVID-19 pandemic, coverage by critical care pharmacists (CCPs) was expanded in 2 medical-surgical intensive care units at the Queen Elizabeth II Health Sciences Centre, in Halifax, Nova Scotia, from 8 hours per day, 5 days per week, excluding holidays, to 8 hours per day, 7 days per week, including holidays.</p><p><strong>Objectives: </strong>To describe health care professionals' opinions about and perceived impacts of the expanded CCP coverage on patient care, as well as their opinions about the role of the CCP as a member of the critical care team.</p><p><strong>Methods: </strong>An electronic 22-item survey was distributed to critical care health care professionals to capture opinions and perceived impacts of expanded CCP coverage. The perceived importance of 25 evidence-informed CCP activities was assessed using a 5-point Likert scale.</p><p><strong>Results: </strong>Thirty-eight complete responses were included (15% response rate, based on distribution of the survey to 249 health care professionals). Most respondents agreed or strongly agreed with the following statements: CCPs are integral members of the critical care team (34/38 [89%]), CCPs play an important role in improving patient outcomes (34/38 [89%]), the presence of CCPs on the unit and on patient care rounds allows other health care professionals to concentrate on their own professional responsibilities (33/38 [87%]), and the expanded CCP coverage improved patient care (29/35 [83%]). Respondents most frequently categorized 23 of the 25 CCP activities as very important.</p><p><strong>Conclusions: </strong>Expanded CCP coverage was perceived to have a positive effect on both patient care and members of the critical care team. Most CCP activities were perceived as very important. Given the findings of this quality project, novel staffing models are being explored to optimize CCP coverage.</p>","PeriodicalId":51646,"journal":{"name":"CANADIAN JOURNAL OF HOSPITAL PHARMACY","volume":"75 1","pages":"41-45"},"PeriodicalIF":0.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8677002/pdf/cjhp-75-41.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39787516","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":"Gestion des approvisionnements en médicaments pendant la pandémie de COVID-19 : expérience québécoise en établissement de santé.","authors":"Lucie Verret,&nbsp;Marie-Claude Racine,&nbsp;Diem Vo,&nbsp;François Paradis,&nbsp;Geneviève Cayer,&nbsp;Cécile Lecours,&nbsp;Isabelle Nolet,&nbsp;Jean-François Bussières","doi":"10.4212/cjhp.v75i1.3090","DOIUrl":"https://doi.org/10.4212/cjhp.v75i1.3090","url":null,"abstract":"","PeriodicalId":51646,"journal":{"name":"CANADIAN JOURNAL OF HOSPITAL PHARMACY","volume":"75 1","pages":"54-57"},"PeriodicalIF":0.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8676997/pdf/cjhp-75-54.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39787518","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":"Si on veut aller loin, il faut partir ensemble.","authors":"Zack Dumont","doi":"10.4212/cjhp.v75i1.3255","DOIUrl":"https://doi.org/10.4212/cjhp.v75i1.3255","url":null,"abstract":"","PeriodicalId":51646,"journal":{"name":"CANADIAN JOURNAL OF HOSPITAL PHARMACY","volume":"75 1","pages":"64"},"PeriodicalIF":0.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8676992/pdf/cjhp-75-64.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39787521","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}