CANADIAN JOURNAL OF HOSPITAL PHARMACY最新文献

{"title":"Training for Collaborative Care: How Hospital Team Members View Pharmacy Students.","authors":"Kerry Wilbur, Tila Pelletier","doi":"10.4212/cjhp.3283","DOIUrl":"10.4212/cjhp.3283","url":null,"abstract":"<p><strong>Background: </strong>Interprofessional education activities are prevalent across health professional curricula in Canada. Students develop collaborative roles through structured on-campus programming; however, the ways in which established teams engage learners in hospital settings are unknown.</p><p><strong>Objective: </strong>To explore how mixed-discipline professionals describe expectations and experiences related to collaborating with pharmacy students who join their team for training.</p><p><strong>Methods: </strong>Mixed-discipline team members of an acute medicine clinical teaching unit were interviewed according to a semistructured interview guide. Participants described encounters with pharmacy trainees and shared expectations of the students' collaborator roles in patient care. Audiorecordings of the interviews were transcribed and coded independently by 2 researchers, who synthesized the data and used the template analysis method to derive themes.</p><p><strong>Results: </strong>Fourteen team members from various disciplines were recruited. Participants' descriptions of collaborative roles were organized into 2 main themes: pharmacy students as informants and pharmacy students as a bridge. A third integrative theme, engagement, encompassed how team members described pharmacy trainees enacting these roles. Team members sought pharmacy students' medication-oriented expertise (e.g., dosing, compatibilities), and physicians often relied on the students' familiarity with study data to guide treatment choices. Nonphysicians capitalized on pharmacy student proximity to physicians to understand such decision-making and inform their own patient care. Accounts of pharmacy students' consultations with team members for patient assessments or to access other multidisciplinary knowledge were infrequent.</p><p><strong>Conclusions: </strong>Most team members' expectations of pharmacy students in terms of the collaborator role lacked routine engagement or shared decision-making. These views represent challenges to the development of skills in collaborative care in workplace-based learning, which might be addressed through intentional interprofessional exercises assigned by preceptors. Further study is required to understand the potential of practice-based interprofessional education initiatives.</p>","PeriodicalId":51646,"journal":{"name":"CANADIAN JOURNAL OF HOSPITAL PHARMACY","volume":"76 3","pages":"228-233"},"PeriodicalIF":0.9,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10284288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9807856","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: A Real Problem in Need of Multifaceted Solutions.","authors":"Peter J Zed","doi":"10.4212/cjhp.3494","DOIUrl":"10.4212/cjhp.3494","url":null,"abstract":"","PeriodicalId":51646,"journal":{"name":"CANADIAN JOURNAL OF HOSPITAL PHARMACY","volume":"76 3","pages":"173-174"},"PeriodicalIF":0.6,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10284278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9794892","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":"Assessment and Prevention of Burnout in Canadian Pharmacy Residency Programs.","authors":"Caitlin Dempsey, Kirsten Fox, Kaitlyn Pagel, Stephanie Zimmer","doi":"10.4212/cjhp.3269","DOIUrl":"10.4212/cjhp.3269","url":null,"abstract":"<p><strong>Background: </strong>There is a paucity of literature describing the incidence of burnout among Canadian pharmacy residents, despite evidence that pharmacy professionals are at high risk of burnout.</p><p><strong>Objectives: </strong>To characterize Canadian pharmacy residents experiencing high levels of burnout, as defined by the Maslach Burnout Inventory (MBI), to describe existing interventions that Canadian pharmacy residents perceive to be effective in managing burnout, and to describe opportunities for Canadian pharmacy residency programs in managing resident burnout.</p><p><strong>Methods: </strong>An online survey, consisting of 22 validated questions from the MBI and 19 nonvalidated questions developed by the investigators, was distributed by email to 558 Canadian pharmacy residents from the 2020/21, 2019/20, and 2018/19 residency years.</p><p><strong>Results: </strong>A total of 115 partial or complete survey responses were included in the analysis, and 107 respondents completed the MBI section of the survey. Of these, 62% (66/107) were at high risk of burnout according to at least 1 MBI subscale, with a slight majority of the entire sample being at high risk of burnout on the emotional exhaustion subscale (55/107 [51%]). The most common interventions offered to pharmacy residents to reduce or prevent burnout were mentorship programs, schedule changes, and promotion of self-organization. Current interventions reported to be the most useful were self-care workshops, discussion groups, and workload adjustment. Potential future interventions perceived to be most useful for reducing and preventing burnout were schedule changes and workload adjustment.</p><p><strong>Conclusions: </strong>More than half of Canadian pharmacy residents who responded to the survey were at high risk of burnout. Canadian pharmacy residency programs should consider implementing additional interventions to help reduce and prevent resident burnout.</p>","PeriodicalId":51646,"journal":{"name":"CANADIAN JOURNAL OF HOSPITAL PHARMACY","volume":"76 3","pages":"177-184"},"PeriodicalIF":0.9,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10284294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9801149","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":"Setting Our Sights on a Sustainable Future.","authors":"Megan Riordon","doi":"10.4212/cjhp.3488","DOIUrl":"10.4212/cjhp.3488","url":null,"abstract":"","PeriodicalId":51646,"journal":{"name":"CANADIAN JOURNAL OF HOSPITAL PHARMACY","volume":"76 3","pages":"259"},"PeriodicalIF":0.9,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10284284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9807853","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":"Hospital Pharmacy Contribution to COVID-19 Vaccination Rollout in Rural Communities.","authors":"Kang-Wei David Liu, Katherine Bishop-Williams","doi":"10.4212/cjhp.3325","DOIUrl":"10.4212/cjhp.3325","url":null,"abstract":"","PeriodicalId":51646,"journal":{"name":"CANADIAN JOURNAL OF HOSPITAL PHARMACY","volume":"76 3","pages":"246-249"},"PeriodicalIF":0.9,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10284289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9805029","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":"L’épuisement professionnel : un vrai problème qui demande des solutions multiformes.","authors":"Peter J Zed","doi":"10.4212/cjhp.3504","DOIUrl":"10.4212/cjhp.3504","url":null,"abstract":"","PeriodicalId":51646,"journal":{"name":"CANADIAN JOURNAL OF HOSPITAL PHARMACY","volume":"76 3","pages":"175-176"},"PeriodicalIF":0.6,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10284280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9807854","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":"Characterizing the Use of Nabiximols (Δ9-Tetrahydrocannabinol-Cannabidiol) Buccal Spray in Pediatric Patients.","authors":"Lianne Hagg, Sarah Leung, Roxane Carr","doi":"10.4212/cjhp.3349","DOIUrl":"10.4212/cjhp.3349","url":null,"abstract":"<p><strong>Background: </strong>Nabiximols is a commercially available cannabinoid buccal spray containing 2.7 mg Δ9-tetrahydrocannabinol (THC) and 2.5 mg cannabidiol (CBD) per spray. It is approved by Health Canada for adults with cancer pain or spasticity/neuropathic pain related to multiple sclerosis. Despite a lack of published studies regarding the use of nabiximols in children, it is being used in clinical practice for indications of pain, nausea/vomiting, and spasticity.</p><p><strong>Objective: </strong>To describe the use of nabiximols in children.</p><p><strong>Methods: </strong>This retrospective single-cohort study involved hospitalized pediatric patients who received at least 1 dose of nabiximols between January 2005 and August 2018. Descriptive statistical analyses were performed.</p><p><strong>Results: </strong>A total of 34 patients were included. The median age was 14 (range 0.6-18) years, and 11 patients (32%) were admitted under the oncology service. The median dose of nabiximols was 1.9 (range 0.3-10.8) sprays per day, and the median duration was 3.8 (range 1-213) days. Nabiximols was most commonly used to treat pain and nausea/vomiting and was most frequently prescribed by pain specialists. Perceived effectiveness was documented in 17 (50%) of the cases, with variable results being reported. The most commonly reported adverse effects were drowsiness and tachycardia (3/34, 9%, for each).</p><p><strong>Conclusion: </strong>In this study, nabiximols was prescribed for children in all age groups, for a variety of conditions, but most commonly for pain and nausea/vomiting. Further study, in the form of a large, prospective randomized controlled trial with clearly defined efficacy and safety end points for nausea/vomiting and/or pain, is needed to determine whether nabiximols is effective and safe in children.</p>","PeriodicalId":51646,"journal":{"name":"CANADIAN JOURNAL OF HOSPITAL PHARMACY","volume":"76 3","pages":"216-220"},"PeriodicalIF":0.9,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10284286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9807857","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":"Neonatal Abstinence Syndrome: A Review of Treatment in the Neonatal Intensive Care Unit.","authors":"Sarah Kain, Brandi Newby","doi":"10.4212/cjhp.3381","DOIUrl":"10.4212/cjhp.3381","url":null,"abstract":"<p><strong>Background: </strong>Neonatal abstinence syndrome (NAS) is a collection of symptoms that neonates may experience following antenatal exposure to substances that induce withdrawal. Optimal management remains unknown, and there is variation in management and outcomes.</p><p><strong>Objectives: </strong>To describe the management, length of hospitalization, and adverse events in near-term and full-term neonates with NAS for whom treatment (pharmacotherapy and/or supportive care) was initiated in the neonatal intensive care unit (NICU).</p><p><strong>Methods: </strong>A chart review was conducted of neonates admitted to the NICU of Surrey Memorial Hospital, Surrey, British Columbia, who received treatment for NAS between September 1, 2016, and September 1, 2021.</p><p><strong>Results: </strong>A total of 48 neonates met the inclusion criteria. Opioids represented the most frequent type of antenatal exposure. Polysubstance exposures occurred in 45 (94%) of the neonates. Morphine was given to 29 (60%) of the neonates, and phenobarbital to 6 (13%); 5 of these neonates received both medications. The average duration of morphine treatment was 14 days, and the average length of hospitalization (all patients) was 16 days. All of the neonates experienced adverse events; in particular, 9 (30%) of the 30 who received pharmacotherapy were too sedated to feed, compared with 0% of the 18 with no pharmacotherapy.</p><p><strong>Conclusions: </strong>The common finding of polysubstance antenatal exposure, involving predominantly opioids, was associated with scheduled morphine pharmacotherapy for the majority of patients, prolonged hospitalization, and frequent adverse events. Pharmacotherapy for NAS was associated with levels of sedation that interfered with feeding in neonates.</p>","PeriodicalId":51646,"journal":{"name":"CANADIAN JOURNAL OF HOSPITAL PHARMACY","volume":"76 3","pages":"234-238"},"PeriodicalIF":0.9,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10284283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9807859","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":"The Role of Home Care Pharmacists in the Edmonton Zone: A Retrospective Study.","authors":"Jasmine Gill,&nbsp;Erin Duteau,&nbsp;Tammy J Bungard,&nbsp;Danielle Kuzyk,&nbsp;Melanie Danilak","doi":"10.4212/cjhp.3172","DOIUrl":"https://doi.org/10.4212/cjhp.3172","url":null,"abstract":"<p><strong>Background: </strong>Despite the rising demand for home-based health care services in Canada and the increasing medical complexity of elderly patients, there is limited literature exploring the role of home care pharmacists and the clinical activities they perform.</p><p><strong>Objectives: </strong>The primary objective was to describe the types and frequencies of clinical activities (both interventions and recommendations) performed by home care pharmacists upon initial consultation. The secondary objective was to determine which patient characteristics resulted in the highest number of clinical activities.</p><p><strong>Methods: </strong>This study was a retrospective review of adult patients who had an initial in-person or telemedicine consultation with home care pharmacists from June 2018 to May 2019 in the Edmonton Zone of Alberta Health Services.</p><p><strong>Results: </strong>Of the 355 patients whose records were screened, 318 (89.6%) were included in the analysis. Of these, 191 (60.1%) were female, and the median age was 79 years (interquartile range [IQR] 68-86 years). The median numbers of medical conditions and medications were 6 and 10, respectively. Of the total of 1172 clinical activities, there was a median of 3 (IQR 2-5) per patient, irrespective of the patient's medical conditions, including those with the most common conditions. The most common activities were patient counselling (<i>n</i> = 160, 13.7%), collaboration with another health care professional (<i>n</i> = 157, 13.4%), and deprescribing (<i>n</i> = 140, 11.9%). Across all activities, pharmacists performed a total of 562 interventions and made 610 recommendations. Each additional year of age and each additional medication on a patient's medication list resulted in an increase in the number of clinical activities (by 0.01 for each additional year of age [<i>p</i> = 0.003] and by 0.03 for each additional medication [<i>p</i> < 0.001]).</p><p><strong>Conclusions: </strong>Home care pharmacists in the Edmonton Zone performed a wide range of clinical activities, particularly for older patients and those with more medications. Further research is required to evaluate the outcomes of pharmacist consultations.</p>","PeriodicalId":51646,"journal":{"name":"CANADIAN JOURNAL OF HOSPITAL PHARMACY","volume":"76 1","pages":"56-62"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9817229/pdf/cjhp-76-56.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10121176","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":"In Need of a North Star for Canadian Pharmacy Practice.","authors":"Zack Dumont","doi":"10.4212/cjhp.3412","DOIUrl":"https://doi.org/10.4212/cjhp.3412","url":null,"abstract":"","PeriodicalId":51646,"journal":{"name":"CANADIAN JOURNAL OF HOSPITAL PHARMACY","volume":"76 1","pages":"77-78"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9817227/pdf/cjhp-76-77.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10121177","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}