The Canadian journal of hospital pharmacy最新文献

{"title":"Evaluating Opioid Agonist Therapy and Safer Supply Medications during Transitions of Care for Medical Inpatients with Opioid Use Disorder: A Retrospective Chart Review.","authors":"Yousif Jaheinsha, Amanda Shea, My-Linh Nguyen, Alexandra Sasha Goldstein","doi":"10.4212/cjhp.3907","DOIUrl":"https://doi.org/10.4212/cjhp.3907","url":null,"abstract":"<p><strong>Background: </strong>Hospital admissions for patients living with opioid use disorder (OUD) are increasing, and patient-centred interventions are required to maximize the impact of OUD treatment. It is important to continue pharmacotherapy for hospitalized patients with OUD to prevent withdrawal and self-directed discharge.</p><p><strong>Objectives: </strong>The primary objective was to identify the proportion of any OUD pharmacotherapy administered more than 24 hours after hospital presentation. Secondary objectives included determining the proportion of home OUD regimens ordered during transitions of care, the incidence of OUD pharmacotherapy initiation during hospitalization, and the incidence of deleterious events.</p><p><strong>Methods: </strong>A retrospective chart review was conducted for 100 adult medicine patients with OUD and existing OUD pharmacotherapy or newly initiated opioid agonist therapy seen in hospital between November 2023 and June 2024.</p><p><strong>Results: </strong>Of the 74 patients on prior OUD pharmacotherapy, 64 (86%) received a dose of any OUD pharmacotherapy within 24 hours of hospital presentation. In addition, 54 (73%) of these patients did not have their full home OUD regimens ordered on admission, and for 20 (37%) of these 54 patients, changes to home regimens lacked documented justification. Intentional changes to home regimens on admission were most often due to opioid toxicity events and altered level of consciousness. Deleterious outcomes were common and included self-directed discharge and code white events.</p><p><strong>Conclusions: </strong>Most patients with existing OUD pharmacotherapy received doses of any OUD pharmacotherapy within 24 hours of presentation to hospital. Gaps in care were identified in the continuation of home OUD pharmacotherapy regimens, especially among patients with multiagent regimens.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"79 2","pages":"e3907"},"PeriodicalIF":0.0,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870991","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":"Pharmacist-Led Assessment of Y-Site Compatibility in Pediatric Total Parenteral Nutrition: A Prospective Study of Clinical Practice.","authors":"Beatriz Leal Pino, Belén Riva de la Hoz, Marta Echávarri de Miguel, Esther Algarra Sánchez, Isabel García López","doi":"10.4212/cjhp.3903","DOIUrl":"https://doi.org/10.4212/cjhp.3903","url":null,"abstract":"<p><strong>Background: </strong>Hospital pharmacists are essential for the safe use of total parenteral nutrition (TPN), a complex high-alert medication. Errors may occur during TPN administration; for example, Y-site incompatibilities may cause embolism or thrombosis. Pediatric patients are especially vulnerable because of complex formulations and limited venous access. The stability of both TPN and any drugs administered concurrently depends on physicochemical properties. The American Society for Parenteral and Enteral Nutrition emphasizes the pharmacist's role in preventing such incompatibilities.</p><p><strong>Objective: </strong>To describe the role of pharmaceutical care in, and a systematic approach to, managing Y-site administration of medications with TPN in pediatric patients.</p><p><strong>Methods: </strong>A prospective observational study was conducted from May to October 2024 at a university children's hospital in Madrid, Spain. The study involved hospitalized pediatric patients who were receiving TPN by central venous catheter. A clinical pharmacist evaluated the compatibility of IV drugs with TPN using an evidence-based approach, with information from specialized sources and the literature. Each TPN-drug combination was classified as compatible, incompatible, contradictory, or unknown, and pharmacists' recommendations were documented in the electronic prescription system.</p><p><strong>Results: </strong>A total of 37 patients (accounting for 40 TPN episodes) were included. Their median age was 11 (interquartile range 2.9-12.8) years, and most were receiving oncological care. Pharmacists undertook 604 interventions; 311 (51.5%) involved compatible combinations, 100 (16.6%) involved incompatible combinations, 150 (24.8%) involved combinations lacking data, and 43 (7.1%) involved combinations with contradictory information. Of the 75 drugs that were reviewed, 25 (33.3%) were compatible with TPN, 15 (20.0%) were incompatible, 32 (42.7%) lacked data, and 3 (4.0%) had contradictory reports.</p><p><strong>Conclusions: </strong>Pharmacist-led assessment of Y-site compatibility in pediatric TPN is essential for medication safety and good outcomes. The high proportion of drugs with unknown or conflicting information about compatibility highlights the need for further research to support clinical decision-making.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"79 2","pages":"e3903"},"PeriodicalIF":0.0,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147871049","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":"Defining Optimal Pharmacist-to-Patient Ratios for Comprehensive Direct Patient Care in Pediatric Settings: A Nationwide Survey in Canada.","authors":"Iona Berger, Jennifer Kendrick, Michael Legal, Roxane Carr","doi":"10.4212/cjhp.3893","DOIUrl":"https://doi.org/10.4212/cjhp.3893","url":null,"abstract":"<p><strong>Background: </strong>The pharmacist staffing ratios required for comprehensive patient care are not well defined, particularly in pediatrics. Understanding optimal clinical pharmacist staffing ratios for pediatrics may help in advocating for appropriate staffing and optimizing patient outcomes.</p><p><strong>Objectives: </strong>The primary objective was to describe optimal pediatric clinical pharmacist staffing ratios in general pediatric, surgical, and hematology-oncology-bone marrow transplant (heme-onc-BMT) units in tertiary pediatric hospitals in Canada. The secondary objectives were to quantify how pediatric clinical pharmacists spend their time and to qualify their perspectives on current workload.</p><p><strong>Methods: </strong>Two electronic surveys were distributed. One survey, sent to leaders in tertiary pediatric health care centres, was designed to describe current staffing ratios. The second survey, sent to pediatric clinical pharmacists, aimed to estimate the frequency of and time spent on 13 comprehensive pharmaceutical care activities, as validated by a working group. The survey data were used to estimate pharmacist staffing ratios according to the World Health Organization workforce calculator.</p><p><strong>Results: </strong>Seven (50%) of the 14 sites responded to the management survey, and 33 clinical pharmacists responded to the clinical pharmacist survey. Optimal pharmacist-to-patient ratios (based on clinical pharmacist survey responses) were estimated to be 1:11 for general pediatric units, 1:14 for pediatric surgery units, and 1:6 for pediatric heme-onc-BMT units, with median lengths of stay of 4.9, 2.5, and 7 days, respectively.</p><p><strong>Conclusions: </strong>Further research is needed to validate these ratios in various pediatric clinical pharmacy settings.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"79 2","pages":"e3893"},"PeriodicalIF":0.0,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870993","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":"Perceptions of Mannequin-Based Simulation Learning in Hospital Pharmacy.","authors":"Harleen Chohan, Ke Su, Vincent H Mabasa, Timothy S Leung, Gloria Su, Michael Kammermayer","doi":"10.4212/cjhp.3923","DOIUrl":"https://doi.org/10.4212/cjhp.3923","url":null,"abstract":"<p><strong>Background: </strong>Mannequin-based simulations are widely used in health professional education; however, their adoption in pharmacy practice and education remains limited, especially outside critical care and emergency settings.</p><p><strong>Objectives: </strong>To evaluate perceptions, previous experiences, perceived benefits and barriers, and future interest regarding mannequin-based simulation among hospital pharmacists, pharmacy residents, and pharmacy leaders.</p><p><strong>Methods: </strong>A province-wide scoping survey was conducted in British Columbia from June to August 2024. The survey assessed previous exposure to, perceived benefits and barriers to participation in, and future interest in mannequin-based simulations. Descriptive analysis was performed on quantitative data, and thematic analysis was used for qualitative data.</p><p><strong>Results: </strong>Of 160 respondents, 146 submitted completed surveys suitable for analysis. Participants supported the use of mannequin-based simulation in pharmacy practice for creating a safe learning environment (<i>n</i> = 143, 98%), enhancing knowledge and skills (<i>n</i> = 125, 86%), and improving confidence (<i>n</i> = 123, 84%). Major barriers included limited access to mannequin-based simulation opportunities (<i>n</i> = 121, 83%) and perceived need for prior content knowledge (<i>n</i> = 96, 66%). The proportions of participants perceiving the specified benefits were 10%-15% higher among those with previous exposure to mannequin-based simulation than among those without previous exposure, whereas perceptions of barriers were similar in the 2 groups. Of the total group, 104 (71%) expressed interest in pharmacy-led mannequin-based simulations, with 96 (66%) supporting its integration into residency programs.</p><p><strong>Conclusions: </strong>Hospital pharmacists showed strong interest in mannequin-based simulations to improve clinical and nontechnical skills. Limited access remains the primary barrier and hinders understanding of the adaptability of such simulations to pharmacy practice. Structured pharmacy-led sessions could enhance exposure to and applicability of this learning method in pharmacy education and practice.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"79 2","pages":"e3923"},"PeriodicalIF":0.0,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147871075","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":"Unsolicited Email and Predatory Solicitations: A Retrospective Case Study of a Canadian Hospital Pharmacist and the Tip of a Larger Iceberg.","authors":"Juliette Mutin, Victor El-Jammal, Armand Lebel, Jean-François Bussières","doi":"10.4212/cjhp.3863","DOIUrl":"10.4212/cjhp.3863","url":null,"abstract":"<p><strong>Background: </strong>Open access publishing has broadened research dissemination, but it has also enabled the rise of predatory journals and conferences, posing challenges for health care professionals, including pharmacists.</p><p><strong>Objectives: </strong>To analyze unsolicited professional emails received by a hospital pharmacist and to characterize potentially predatory solicitations.</p><p><strong>Methods: </strong>All email messages received over a 31-day period in 2024 by a senior Canadian hospital pharmacist involved in research were reviewed and assessed according to 12 indicators of predation, including false impact factors, suggestion to submit manuscript by email, flattery, solicitation for an unrelated field, and short deadlines.</p><p><strong>Results: </strong>Of 1228 emails received over the study period, 453 (37%) contained at least one predatory indicator, with a total of 494 distinct solicitations: 347 (70%) for manuscript submission, 116 (24%) for conference attendance, 15 (3%) for republication of a previously published article, 11 (2%) for peer review, and 5 (1%) for webinar participation. The emails contained an average of 3.6 (standard deviation 1.7) indicators.</p><p><strong>Conclusions: </strong>One-third of the emails received were predatory in nature, highlighting the scale of the phenomenon.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"79 2","pages":"e3863"},"PeriodicalIF":0.0,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625229","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":"Hypomagnesemia Associated with Omeprazole Use in Patients Treated with Platinum Derivatives: An Exploratory Randomized Placebo-Controlled Clinical Trial.","authors":"Ney Moura Lemos Pereira, Rand Randall Martins, Telma Maria Araújo Moura Lemos, Andréa Carla Pinto Fernandes, Andréa Juliana Pereira Gomes, Marcos Dias Leão, Priscilla Karilline do Vale Bezerra, Antonio Gouveia Oliveira, Fernanda Nervo Raffin","doi":"10.4212/cjhp.3600","DOIUrl":"10.4212/cjhp.3600","url":null,"abstract":"<p><strong>Background: </strong>Hypomagnesemia, characterized by decreased levels of magnesium in the blood, is common among patients with cancer and may be related to the administration of proton pump inhibitors (PPIs) and/or platinum derivatives.</p><p><strong>Objective: </strong>To evaluate the safety and potential impact on serum magnesium levels of concomitant use of the PPI omeprazole in patients receiving a platinum derivative.</p><p><strong>Methods: </strong>This prospective, randomized, double-blind, single-dose, placebo-controlled study involved fixed doses of PPI administered on an outpatient basis. It spanned 4 cycles of platinum-based combination chemotherapy (21 days per cycle), and entailed a screening period (14 days before chemotherapy), 2 PPI treatment periods (total of 60 days), and a follow-up period (1 cycle). Patients recruited between May 2019 and March 2020 at 3 hospitals in Brazil were randomly assigned to receive placebo or PPI in a 1:1 ratio. Data analysis employed a linear mixed-effects model and Kaplan-Meier analysis.</p><p><strong>Results: </strong>A total of 164 patients were included in the study, 83 in the placebo group and 81 in the PPI group. Blood magnesium levels showed a modest decrease over time (by approximately 20%) across all patients. A correlation was observed between treatment duration and decrease in serum magnesium in the total sample (β = -0.035, 95% confidence interval [CI] -0.048 to -0.0021; <i>p</i> < 0.001). Compared with the placebo group, the PPI group showed a slightly greater decline (β = -0.121, 95% CI -0.231 to -0.011; <i>p</i> = 0.031). Additionally, no differences were noted between groups regarding the occurrence of neuropathy (<i>p</i> = 0.77), anorexia (<i>p</i> = 0.77), diarrhea (<i>p</i> = 0.34), or constipation (<i>p</i> = 0.39). Omeprazole use was associated with a lower incidence of nausea and vomiting (<i>p</i> = 0.005).</p><p><strong>Conclusion: </strong>These exploratory findings suggest that the concomitant use of omeprazole with platinum derivatives may be associated with a slightly faster rate of serum magnesium depletion than occurs with chemotherapy alone, but without clinical relevance or occurrence of frank hypomagnesemia.</p><p><strong>Clinical trial registration: </strong>Brazilian Registry of Clinical Trials (ReBEC) RBR-8vsb7k2.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"79 2","pages":"e3600"},"PeriodicalIF":0.0,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625269","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":"Antimicrobial Administration Delays for Patients with Suspected Sepsis in a Canadian Emergency Department: Prevalence and Risk Factors.","authors":"Kristin Kaupp, Sarah Smit, Sarah Burgess, Emily Black, Osama Loubani, Meghan MacKenzie","doi":"10.4212/cjhp.3830","DOIUrl":"10.4212/cjhp.3830","url":null,"abstract":"<p><strong>Background: </strong>For patients with sepsis, timely administration of antimicrobials is imperative, with evidence demonstrating that delays may be associated with an increase in mortality.</p><p><strong>Objective: </strong>To determine whether antimicrobial administration is delayed among patients with sepsis admitted through the Queen Elizabeth II Health Sciences Centre Emergency Department (QEII-HSC-ED) in Halifax, Nova Scotia.</p><p><strong>Methods: </strong>A single-centre, retrospective health records review was conducted for adult patients with sepsis admitted through the QEII-HSC-ED between January 1, 2021, and December 31, 2022. Differences between groups with and without antimicrobial administration delays were compared by univariate analysis, and an adjusted multivariate regression was completed to examine associations between risk factors and significant delays.</p><p><strong>Results: </strong>A total of 275 patient encounters were included in the analysis, accounting for a total of 1208 antimicrobial doses: 275 first doses and 933 subsequent doses. Of the 275 patient encounters, 216 (78.5%) had at least one significant dose delay; 135 (49.1%) of the encounters had delay of the first dose, and 169 (61.5%) had delay of a subsequent dose. Of the 933 subsequent doses administered, 276 (29.6%) had a significant delay. Relative to patients admitted to a medicine service, surgical patients had reduced odds of experiencing significant delay of a subsequent dose (odds ratio 0.25, 95% confidence interval 0.08-0.77).</p><p><strong>Conclusions: </strong>Many patients with sepsis admitted through the QEII-HSC-ED experienced significant delays in administration of first and/or subsequent doses of antimicrobial therapy, which may have increased their risk of negative outcomes. These results can be used to develop future initiatives aimed at improving time to administration of antimicrobials for patients with sepsis admitted to the study institution.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"79 2","pages":"e3830"},"PeriodicalIF":0.0,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625232","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":"Changes in Medication Errors after Implementation of an Electronic Health Record System in a Canadian Community Hospital.","authors":"Lidia Yrigoyen-DaCruz, Antoinette Duronio, Eric Dinunzio","doi":"10.4212/cjhp.3798","DOIUrl":"10.4212/cjhp.3798","url":null,"abstract":"<p><strong>Background: </strong>The introduction of electronic health records (EHRs) and computerized physician order entry has been associated with a reduction in medication errors due to the safety features of these systems.</p><p><strong>Objectives: </strong>To identify changes in medication errors-specifically related to the types and severity of errors documented and the numbers and types of errors by clinical program-before and after implementation of an EHR system and to identify medication safety initiatives.</p><p><strong>Methods: </strong>This retrospective observational study was conducted at a 2-campus, 500-bed Canadian community hospital before (April 10, 2019, to April 10, 2021) and after (April 11, 2021, to April 11, 2023) implementation of an EHR system. Data were categorized according to event type to ascertain changes in types of errors before and after EHR implementation by clinical program. Data were also collected to determine changes in the severity of errors, as well as changes in categories and changes in frequency of event types (e.g., barcode scanning, medications not ordered, incorrect orders).</p><p><strong>Results: </strong>Totals of 1379 and 1269 medication errors were reported before and after EHR implementation, respectively. The reduction in frequency of errors was statistically significant (<i>z</i> score = 2.14). Overall, statistically significant reductions were observed for errors that did not reach the patient and for errors that reached the patient and necessitated increased monitoring. There were statistically significant decreases in errors secondary to medication(s) not being ordered (197 before vs 121 after EHR implementation) and medications being administered to the incorrect patient (58 vs 20, respectively).</p><p><strong>Conclusion: </strong>Implementation of the EHR system was associated with a reduction in overall medication incidents at the study institution. Findings from this study allowed the medication safety committee to identify targeted medication safety initiatives focused on barcode scanning (of both medications and patient identification) to reduce the frequency of patients receiving incorrect medications.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"79 2","pages":"e3798"},"PeriodicalIF":0.0,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625297","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 Challenge of Generative Artificial Intelligence for Journals.","authors":"Cynthia A Jackevicius","doi":"10.4212/cjhp.3979","DOIUrl":"10.4212/cjhp.3979","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"79 1","pages":"e3979"},"PeriodicalIF":0.0,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12956287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358495","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 and Dispensing Delayed Antibiotics for Pediatric Patients with Otitis Media and Pharyngitis.","authors":"Shobhitha Balasubramaniam, Melanie MacInnis, Katrina Hurley, Eleanor Fitzpatrick, Katelyn Zwicker, Emily Black","doi":"10.4212/cjhp.3876","DOIUrl":"10.4212/cjhp.3876","url":null,"abstract":"<p><strong>Background: </strong>Providing patients with a delayed prescription for antibiotics to treat acute otitis media (AOM) or pharyngitis may result in decreased antibiotic use.</p><p><strong>Objectives: </strong>To characterize antibiotic prescribing for patients discharged from a pediatric emergency department (PED) with AOM or pharyngitis and to determine the percentage of delayed antibiotic prescriptions dispensed prematurely by a community pharmacy.</p><p><strong>Methods: </strong>This study was completed by linking provincial administrative data on prescriptions dispensed from community pharmacies and a retrospective chart review at a single PED. The study included any pediatric patient who was seen in the PED between March 2019 and February 2021, given a diagnosis of AOM or pharyngitis, and discharged with a prescription for an antibiotic. Patient data were collected from scanned medical records. The chart review was linked to records for dispensed antibiotics in the provincial drug information system. Results were summarized and reported descriptively.</p><p><strong>Results: </strong>A total of 1569 (53.3%) of the 2945 patients seen in the PED with the diagnoses of interest received a prescription for an antibiotic. Delayed prescriptions were given in 21.2% (332/1569) of these encounters. An antibiotic was dispensed within 7 days of the PED visit for fewer than half of the patients (40.4%, 134/332) who received a delayed prescription. About a third of caregivers filled delayed prescriptions within 48 hours (30.1%, 100/332), and 16.9% (43/254) did so earlier than advised.</p><p><strong>Conclusion: </strong>Caregivers who were given a discharge prescription for a delayed antibiotic generally adhered to guidance provided by prescribers and waited to fill the prescription. This strategy may reduce overuse of antibiotics.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"79 1","pages":"e3876"},"PeriodicalIF":0.0,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12956290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358453","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}