The Canadian journal of hospital pharmacy最新文献

{"title":"Changes in Acute Care Pharmacist Prescribing and Laboratory Ordering over Time: CAPLET Study.","authors":"Alexandra Charlton, Cheryl Hill, Deonne Dersch-Mills, Aliksander Savin, Dalyce Zuk, Sydney Saunders, Elizer Erpilla","doi":"10.4212/cjhp.3565","DOIUrl":"10.4212/cjhp.3565","url":null,"abstract":"<p><strong>Background: </strong>In Alberta, pharmacists may obtain additional prescribing authorization (APA) and a practice identification number (PRAC-ID) for ordering laboratory tests. Pharmacists working within Alberta Health Services were mandated by the employer to attain APA by 2018, whereas laboratory ordering has been in place since 2009. Five acute care sites within the Calgary Zone had a computerized provider order entry (CPOE) system that allowed tracking of these activities.</p><p><strong>Objectives: </strong>To describe changes in prescribing and laboratory ordering by acute care pharmacists over time and to compare these activities across hospitals, sites, and specialty teams.</p><p><strong>Methods: </strong>A retrospective, descriptive review of acute care pharmacist orders for medications and laboratory tests was completed using data from the CPOE system for the period 2018 to 2021.</p><p><strong>Results: </strong>Over the study period, the rates of prescribing and laboratory ordering by pharmacists increased by 67.5% (from 1423 to 2383 per full-time equivalent [FTE]) and by 5.5% (from 235 to 248 per FTE), respectively. Pharmacists at the 5 hospitals increased their prescribing rates during that time (by proportions ranging from 7% to 176%). Cardiology, intensive care, and mental health teams had the largest increases in prescribing rates, whereas mental health, hospitalist, and intensive care teams had the greatest increases in rates of laboratory ordering. In each year of the study, the most frequently ordered medication for adult patients was vancomycin, and the most frequently ordered laboratory test was measurement of vancomycin before dose administration. The proportion of medication orders conveyed verbally decreased from 60.0% to 47.4% over the study period.</p><p><strong>Conclusions: </strong>The application of expanded scope of practice increased among acute care pharmacists, to a greater extent for prescribing than for laboratory ordering; however, the proportion of verbal medication orders remains high, a situation that should be addressed to improve patient safety. This study showed that prescribing and laboratory ordering are complementary, given that the top medications and laboratory tests were frequently related. The results of this study can be used for practice development and as the basis for further research within an expanded CPOE system.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 4","pages":"e3565"},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11426962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396458","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":"Embrasser notre avenir: un nouveau nom pour la SCPH.","authors":"Jody Ciufo, Katie Hollis, Megan Riordon, Sean Spina, Ashley Walus","doi":"10.4212/cjhp.3691","DOIUrl":"https://doi.org/10.4212/cjhp.3691","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 3","pages":"e3691"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11361311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305287","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":"Inspirer la relève à devenir des pharmaciennes et pharmaciens des réseaux de la santé.","authors":"Ema Ferreira","doi":"10.4212/cjhp.3694","DOIUrl":"https://doi.org/10.4212/cjhp.3694","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 3","pages":"e3694"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11361312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305288","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":"Embracing Our Future: A Revised Name for CSHP.","authors":"Jody Ciufo, Katie Hollis, Megan Riordon, Sean Spina, Ashley Walus","doi":"10.4212/cjhp.3679","DOIUrl":"https://doi.org/10.4212/cjhp.3679","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 3","pages":"e3679"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11361309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305286","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":"Discharge Opioid Prescription and Consumption Following Surgery: The POPCORN Observational Study.","authors":"Kenzi Wassil Mohktari, Anna Wong, Michelle Nguyen, Arianne Giard, Brian Ly, Dana Wazzan, David Williamson, Vincent Dagenais-Beaulé","doi":"10.4212/cjhp.3574","DOIUrl":"10.4212/cjhp.3574","url":null,"abstract":"<p><strong>Background: </strong>Few studies have evaluated opioid consumption after various inpatient surgical procedures.</p><p><strong>Objectives: </strong>To describe opioid prescription patterns and to characterize patient-reported use of opioids after surgery.</p><p><strong>Methods: </strong>This single-centre prospective observational study was conducted between February and October 2021 at the Jewish General Hospital in Montréal, Quebec. Patients 18 years of age or older who underwent a surgical procedure, were hospitalized for 24 hours or longer after the procedure, and had an opioid prescription at the time of discharge were included. Data were collected for the quantity of opioids prescribed, as documented in hospital records, and the quantity consumed, as reported by participants. Various potential predictors of opioid consumption were explored, and data were also collected on patients' use of non-opioid coanalgesia, scores on the Numeric Rating Scale for pain, opioid renewal requests, and proper opioid disposal during the 30-day follow-up period.</p><p><strong>Results: </strong>A total of 150 participants completed the study. The median dose prescribed was 10 opioid pills (75.0 morphine milligram equivalents). By the end of the follow-up period, a median of 1 pill (7.5 morphine milligram equivalents) had been consumed from the total amount in the discharge prescription. Overall, 66 participants (44.0%) did not consume any of the opioids prescribed at discharge. Of the total number of pills prescribed, 58.2% (1193/2050) were unused, and 7.0% (5/71) of participants with unused pills disposed of them properly.</p><p><strong>Conclusions: </strong>Following discharge from hospital, postoperative patients consumed a median proportion of only 10% of prescribed opioid pills. More than half of all prescribed pills were unused. Protocols implementing specific prescribing strategies warrant further investigation to evaluate their potential impact on opioid prescription and consumption.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 3","pages":"e3574"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11361310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305285","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 Baby Step Toward Planetary Health: A Collaborative Quality Improvement Initiative to Reduce Single-Use Plastics in a Pharmacy and Neonatal Intensive Care Unit.","authors":"Gurneet Rana, Brandi Newby","doi":"10.4212/cjhp.3575","DOIUrl":"https://doi.org/10.4212/cjhp.3575","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 3","pages":"e3575"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11361308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305284","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":"Inspiring Students to Become Healthcare-System Pharmacists.","authors":"Ema Ferreira","doi":"10.4212/cjhp.3675","DOIUrl":"https://doi.org/10.4212/cjhp.3675","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 3","pages":"e3675"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11361307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305289","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":"Prescribing Trends for Oral Vancomycin and Fidaxomicin after Guideline and Formulary Changes in Ontario, Canada: An Interrupted Time-Series Analysis.","authors":"Mira Maximos, Colleen Maxwell, John-Michael Gamble","doi":"10.4212/cjhp.3560","DOIUrl":"10.4212/cjhp.3560","url":null,"abstract":"<p><strong>Background: </strong><i>Clostridioides difficile</i> is a pathogen causing diarrheal illness, which can be treated with vancomycin or fidaxomicin.</p><p><strong>Objective: </strong>To evaluate changes in monthly prescription volumes for oral vancomycin and fidaxomicin in Ontario community pharmacies following implementation of the 2017 and 2021 updates to guidelines from the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) and after a 2019 provincial formulary change for vancomycin.</p><p><strong>Methods: </strong>An interrupted time-series analysis was conducted from November 2015 to October 2021 using monthly projected prescription volumes obtained from IQVIA's Compuscript database. Level and slope (trend) changes in prescribing were assessed using segmented linear regression.</p><p><strong>Results: </strong>The volume of vancomycin prescriptions increased by 74 prescriptions per month (95% confidence interval [CI] 16 to 132) following implementation of the 2017 guideline update and by 73 prescriptions per month (95% CI 13 to 133) after the 2019 formulary change; however, no statistically significant changes were observed after implementation of the 2021 guideline update. No significant trend changes were observed for fidaxomicin.</p><p><strong>Conclusion: </strong>Guidelines and formulary changes were correlated with increased volume of vancomycin prescriptions.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 3","pages":"e3560"},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11285109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984231","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":"Standardized Orders for Salbutamol and Ipratropium: Do They Lead to Waste and Irrational Prescribing?","authors":"Lillian Lo, Aaron M Tejani","doi":"10.4212/cjhp.3561","DOIUrl":"10.4212/cjhp.3561","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 3","pages":"e3561"},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11285107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984232","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 Perceived Need for Advanced Clinical Pharmacy Training in British Columbia.","authors":"Lillian Cao, Karen Dahri, Michael Legal","doi":"10.4212/cjhp.3562","DOIUrl":"10.4212/cjhp.3562","url":null,"abstract":"<p><strong>Background: </strong>Currently in Canada there are limited opportunities for advanced clinical pharmacy training after a year 1 residency. Advanced training programs currently in existence are year 2 residencies, clinical Master's degrees, and Fellowships.</p><p><strong>Objectives: </strong>To characterize the perceived need for advanced clinical pharmacy training in British Columbia and to determine the desired educational competencies to be gained through advanced training.</p><p><strong>Methods: </strong>Current pharmacy residents (academic year 2021/22) and residency graduates of the past 5 years (2017-2021), together referred to as early career pharmacists or ECPs, were surveyed. Provincial health authority pharmacy leaders who hire clinical pharmacists were also surveyed and invited to participate in key informant interviews.</p><p><strong>Results: </strong>Eighty-four ECPs and 22 pharmacy leaders participated in the surveys (estimated response rates 26% and 35%, respectively). Eleven (13%) of the ECPs had already completed advanced clinical training, and an additional 24 (29%) planned to pursue such training within 5 years. Sixteen (73%) of the pharmacy leaders had experienced difficulties in filling advanced practice positions over the previous 3 years due to a lack of qualified applicants, and 21 (95%) believed that more advanced training positions should be offered. The majority of ECPs interested in advanced training (39/60, 65%) chose year 2 residency as their preferred program, and 20 (91%) of the pharmacy leaders agreed that British Columbia should offer year 2 residencies. Both ECPs and leaders rated clinical skills and knowledge as the most important educational competencies.</p><p><strong>Conclusions: </strong>Pharmacy leaders expressed a need for more pharmacists with advanced clinical pharmacy training, and many ECPs were interested in pursuing such advanced training. Most respondents preferred the year 2 residency, with the most common goal being to improve clinical competencies.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 3","pages":"e3562"},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11285110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984228","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}