The Canadian journal of hospital pharmacy最新文献

{"title":"Counting the Carbon: Quantifying Financial and Environmental Implications of Wasted Inhaler Doses in the Hospital Setting.","authors":"Alison Bentley, Celia L Culley, Valeria Stoynova","doi":"10.4212/cjhp.3606","DOIUrl":"https://doi.org/10.4212/cjhp.3606","url":null,"abstract":"<p><strong>Background: </strong>Inhalers contribute to health care-related environmental impacts, particularly through greenhouse gas emissions. They are dispensed in multidose formats, which leads to waste, yet little is known about the environmental impact of inhaler waste in the hospital setting.</p><p><strong>Objectives: </strong>The primary objective was to quantify wasted inhaler actuations on adult medicine and respiratory wards at a community and a tertiary hospital. Secondary objectives were to quantify the cost and carbon footprint of wasted doses, to determine the rate of duplicate inhaler dispensing, and to quantify the prevalence of dispensed inhalers remaining unused.</p><p><strong>Methods: </strong>For this multicentre, retrospective chart review, the pharmacy informatics team generated a report of adult inpatients for whom one or more inhalers were dispensed from the pharmacy to the respiratory and general medicine wards at a 500-bed tertiary hospital or to the medicine-surgery ward at a 48-bed community hospital over 3 nonconsecutive months (during fiscal year 2021/22). The number of inhalers dispensed was compared with the number of doses documented on patients' medication administration records.</p><p><strong>Results: </strong>In this study, 23 031 actuations (211 inhalers) were dispensed for 132 patients. Of these, 81.9% were wasted, at a total cost of $6172.82 over the 3 months of the study. For 22 patients (16.7%), at least one inhaler was dispensed, yet no doses were administered; for 16 (12.1%), a duplicate inhaler was dispensed. The carbon footprint of the wasted doses was 1 226 342 g carbon dioxide equivalent, equivalent to driving 5951 km by car.</p><p><strong>Conclusions: </strong>This study showed significant inhaler waste in the hospital setting, which contributes to the health care-related carbon footprint without contributing to patient care. These results raise important questions about how to continue providing high-quality patient care while minimizing carbon footprint and health care costs.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"78 2","pages":"e3606"},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032736","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":"Expanding Opioid Stewardship: Collaboration between Hospital and Primary Care Pharmacists.","authors":"Joycelyn Lac, Carmen Leung, Karen Yan, Anita I Kapanen, Tiana Tilli","doi":"10.4212/cjhp.3664","DOIUrl":"https://doi.org/10.4212/cjhp.3664","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"78 2","pages":"e3664"},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045476","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":"Awareness of and Interest in Green Initiatives and Practices in Hospital Pharmacy: A Canada-Wide Survey.","authors":"Ariane Blanc, Delphine Moulin, Jameason Cameron","doi":"10.4212/cjhp.3608","DOIUrl":"10.4212/cjhp.3608","url":null,"abstract":"<p><strong>Background: </strong>Climate change poses significant risks to both the environment and public health. The Canadian health care system accounts for an estimated 4.6% of national carbon emissions, and hospital pharmacy contributes substantially to these emissions.</p><p><strong>Objectives: </strong>To evaluate the awareness of green initiatives and green practices in hospital pharmacy and to explore the overall interest of pharmacy staff in improving on sustainable and climate-resilient pharmacy practices.</p><p><strong>Methods: </strong>A cross-sectional survey was administered securely online to Canadian hospital pharmacy staff, between February 15 and April 30, 2023. The survey contained 38 questions with specified themes related to sustainability and climate resilience.</p><p><strong>Results: </strong>A total of 214 participants responded to the survey. Of these, 84% (141/167) were motivated or highly motivated to engage in sustainable pharmacy practices. When asked about specific green initiatives planned by their hospital, 53% (109/206) reported not being aware of any initiatives, and 10% (20/206) indicated that no plans existed. The green practices that were at least partially implemented were \"reduced paper use\" (27% of responses), \"improved recycling programs\" (18%), and \"raised awareness\" (11%). The top 3 areas of pharmacy waste were identified as \"single-use plastic\" (28% of responses), \"excessive paper use\" (18%), and \"improper recycling\" (17%). The top 3 barriers to implementing eco-friendly practices were identified as \"cost\" (50% [83/166]), \"time consumption\" (50% [83/166]), and \"added complexity\" (30% [49/166]).</p><p><strong>Conclusions: </strong>Hospital pharmacy staff participating in this survey study shared a willingness and strong motivation to engage in more sustainable and climate-resilient pharmacy practices, but they reported significant barriers, such as time consumption and perceived complexity, that must be addressed in implementing these changes.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"78 1","pages":"e3608"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618100","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":"Tribute to the Reviewers of the <i>Canadian Journal of Hospital Pharmacy</i>.","authors":"","doi":"10.4212/cjhp.3770","DOIUrl":"https://doi.org/10.4212/cjhp.3770","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"78 1","pages":"e3770"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618113","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":"Our Shared Pharmacy Community.","authors":"Ashley Walus","doi":"10.4212/cjhp.3791","DOIUrl":"https://doi.org/10.4212/cjhp.3791","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"78 1","pages":"e3791"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618109","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":"Advancing Climate Care in Health Care: Pharmacy's Green Light.","authors":"Robert MacLaren","doi":"10.4212/cjhp.3751","DOIUrl":"10.4212/cjhp.3751","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"78 1","pages":"e3751"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618098","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 Prolonged-Release Once-Daily Tacrolimus (LCPT) across Canada.","authors":"Vanessa Phommavong, Cathy Burger, M Khaled Shamseddin, Holly Mansell","doi":"10.4212/cjhp.3624","DOIUrl":"10.4212/cjhp.3624","url":null,"abstract":"<p><strong>Background: </strong>Tacrolimus is the most common calcineurin inhibitor given to kidney and liver transplant recipients. Prolonged-release once-daily tacrolimus (LCPT) is the newest formulation of this drug, but prescribing practices for tacrolimus across Canada are unknown.</p><p><strong>Objectives: </strong>To investigate the use of tacrolimus across Canada, by determining coverage for the drug, exploring prescribing practices and factors related to decision-making, and identifying management methods for patients with rapid metabolism of tacrolimus.</p><p><strong>Methods: </strong>A mixed-methods, descriptive study using survey-based data collection and qualitative interviews was undertaken. The medical director and a pharmacist from each adult kidney and liver transplant centre in Canada were invited to complete an electronic questionnaire consisting of 8 open-ended questions concerning their respective transplant programs' coverage for and use of tacrolimus. Interested participants completed a one-on-one virtual follow-up interview to explore experiences.</p><p><strong>Results: </strong>A total of 28 health care providers participated in the survey, of whom 18 completed an interview, achieving representation from 15 (79%) of 19 kidney transplant programs and 3 (38%) of 8 liver transplant programs. Prescribing habits varied, with immediate-release tacrolimus (IR-Tac) being the most commonly preferred formulation (due to provider experience), followed by extended-release tacrolimus (ER-Tac) and LCPT. Most survey respondents (26/28) indicated that their centres used LCPT for maintenance but not de novo immunosuppression. The most common reason for conversion to LCPT was to reduce tremors or to address suspected rapid metabolism; barriers to uptake of LCPT included perceived disadvantages related to cost and coverage.</p><p><strong>Conclusions: </strong>Prescribing practices for tacrolimus varied across Canada. IR-Tac was the most commonly used formulation, followed by ER-Tac. LCPT was used primarily in the maintenance phase for people with neurotoxicity or rapid metabolism, but there was a lack of consistency in how rapid metabolism was defined.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"78 1","pages":"e3624"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618101","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":"Faire avancer les soins climatiques dans les soins de santé : feu vert au secteur de la pharmacie.","authors":"Robert MacLaren","doi":"10.4212/cjhp.3786","DOIUrl":"10.4212/cjhp.3786","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"78 1","pages":"e3786"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618103","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":"La pharmacie : une communauté qui dépasse les frontières.","authors":"Ashley Walus","doi":"10.4212/cjhp.3794","DOIUrl":"https://doi.org/10.4212/cjhp.3794","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"78 1","pages":"e3794"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618107","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 CSHP Vision for Pharmacy.","authors":"","doi":"10.4212/cjhp.3746","DOIUrl":"10.4212/cjhp.3746","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"78 1","pages":"e3746"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618111","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}