The Canadian journal of hospital pharmacy最新文献

{"title":"Describing and Evaluating the Clinical Pharmacist's Role in a Canadian Multiple Sclerosis Clinic.","authors":"Gabrielle Busque, Sharan Lail, Norman Dewhurst, Henry Halapy","doi":"10.4212/cjhp.3555","DOIUrl":"10.4212/cjhp.3555","url":null,"abstract":"<p><strong>Background: </strong>The current approach to treatment of multiple sclerosis (MS) involves use of disease-modifying therapies to slow progression of the disease, as well as the symptomatic management of fixed neurological deficits. Although pharmacists are uniquely positioned to support MS care teams with all aspects of medication management, their presence is rare among MS ambulatory care teams in Canada.</p><p><strong>Objectives: </strong>To document the pharmacist's contributions and to evaluate the impact of the pharmacist's role following creation of a clinical pharmacist position in a Canadian MS clinic within a large, urban, university-affiliated, tertiary care centre.</p><p><strong>Methods: </strong>This study was conducted in 2 parts: a prospective, descriptive case study of the clinical pharmacist's role and a retrospective assessment of medication-related patient calls before and after implementation of the pharmacist position.</p><p><strong>Results: </strong>The pharmacist performed a variety of clinical activities, with the greatest proportions of time spent on patient care (63.3%), drug access research (15.7%), and development and review of internal documents (9.0%). Patient care primarily involved conducting patient assessments, making medication recommendations, and assisting patients with medication-related issues. The proportion of medication-related issues resolved remained similar at 92.9% before and 95.7% after implementation of the clinical pharmacist (<i>p</i> = 0.48). The median time to resolve medication-related issues was reduced from 4.1 to 2.9 days (<i>p</i> = 0.016) with pharmacist involvement.</p><p><strong>Conclusions: </strong>Pharmacists can support MS care teams through a variety of medication-related clinical activities aligned with their scope and expertise. The presence of a pharmacist on the MS care team significantly reduced turnaround times for resolving medication-related issues, improving the efficiency and timeliness of care.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 3","pages":"e3555"},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11210592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581980","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":"Impact of the COVID-19 Pandemic on Pharmacist Interventions: A Retrospective Study with Inpatients in a University Hospital.","authors":"Guilherme Cezar Ambrósio, Karine Dal Paz, Vinicius Albuquerque Moreira de Souza, Michelle Garcia Discacciatii, Ana Campa","doi":"10.4212/cjhp.3514","DOIUrl":"10.4212/cjhp.3514","url":null,"abstract":"<p><strong>Background: </strong>Despite growing interest in understanding the challenges faced by multidisciplinary health teams during the COVID-19 pandemic, there is a lack of studies specifically focusing on changes in pharmacist interventions and drug-related problems.</p><p><strong>Objectives: </strong>To analyze and compare the interventions performed by pharmacists during comprehensive medication management in the adult intensive care unit and general internal medicine ward of the University Hospital of the University of São Paulo, Brazil, for defined periods before the onset of the COVID-19 pandemic and during the pandemic itself.</p><p><strong>Methods: </strong>All pharmacist interventions performed in relation to inpatient prescriptions from March to December 2019 (before the pandemic) and from March to December 2021 (during the pandemic) were collected and tabulated. These interventions were then classified according to the Pharmaceutical Care Network Europe (PCNE) system, version 9.1, and categorized based on first-level codes of the Anatomical Therapeutic Chemical classification system.</p><p><strong>Results: </strong>The analysis revealed substantial changes in the patterns of pharmacist interventions and the therapeutic classes of drugs for COVID-19-positive and COVID-19-negative patients during the pandemic relative to patients in the pre-pandemic period. Among COVID-19-positive patients, interventions were predominantly related to enhancing patient safety (PCNE code P2), drug selection (C1), dose selection (C3), prescribing and dispensing processes (C5), the drug-use process (C6), and patient transfers between different levels of care (C8). The drug-related problems addressed by pharmacist interventions primarily involved COVID-19-positive patients in the pandemic period and were related to systemic hormonal preparations (excluding sex hormones and insulins), anti-infective agents for systemic use, nervous system and drugs for the blood and blood-forming organs.</p><p><strong>Conclusion: </strong>The results of this study highlight the adaptability and competence of pharmacists in responding to critical scenarios such as the COVID-19 pandemic. These scenarios are characterized by new work dynamics, the hiring of additional professionals, an increase in the number of beds, the rapid evolution of evidence-based information, and drug shortages that necessitate the use of alternative medications. Pharmacists play a crucial role in ensuring patient safety during these difficult times.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 3","pages":"e3514"},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11210597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581983","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":"Establishing a Multisectoral Collaborative Drug Diversion Program in a Canadian Health System.","authors":"Neil Braun","doi":"10.4212/cjhp.3551","DOIUrl":"10.4212/cjhp.3551","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 3","pages":"e3551"},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11210596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581982","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 of Effectiveness of 2 Medication-Use Process Quality Audit Tools Using Clinical Performance Feedback Intervention Theory.","authors":"Amélie Monnier, Charlotte Jacolin, Suzanne Atkinson, Jean-François Bussières","doi":"10.4212/cjhp.3487","DOIUrl":"10.4212/cjhp.3487","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 3","pages":"e3487"},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11210594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581979","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":"Effect of JAK Inhibitors on the Risk of Death in Patients with Moderate to Severe COVID-19: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Chia Siang Kow, Dinesh Sangarran Ramachandram, Syed Shahzad Hasan","doi":"10.4212/cjhp.3493","DOIUrl":"10.4212/cjhp.3493","url":null,"abstract":"<p><strong>Background: </strong>The pathophysiology of COVID-19 involves a signalling pathway based on the Janus kinases (JAKs) and the signal transducer and activator of transcription (STAT) family of proteins. As such, there has been growing interest in exploring JAK inhibitors as potential therapeutic agents for this disease.</p><p><strong>Objective: </strong>To provide a comprehensive summary of the efficacy of JAK inhibitors in the treatment of COVID-19 through a systematic review and meta-analysis.</p><p><strong>Data sources: </strong>A systematic literature search was conducted in multiple electronic databases (PubMed, Scopus, and the Cochrane Central Register of Controlled Trials) and preprint repositories, without language restrictions, to identify relevant studies published up to December 31, 2023.</p><p><strong>Study selection and data extraction: </strong>The primary outcome of interest was all-cause mortality. Randomized controlled trials (RCTs) investigating the administration of JAK inhibitors in patients with COVID-19 were included.</p><p><strong>Data synthesis: </strong>Through the systematic literature search, a total of 20 RCTs meeting the inclusion criteria were identified. A random-effects model was employed to estimate the pooled odds ratio for death with administration of a JAK inhibitor relative to non-administration of such an agent, with 95% confidence interval. Meta-analysis of these trials revealed a significant reduction in mortality among patients with COVID-19 who received JAK inhibitors relative to those who did not receive these agents (pooled odds ratio 0.70, 95% confidence interval 0.58-0.84).</p><p><strong>Conclusions: </strong>The results of this systematic review and meta-analysis suggest that JAK inhibitors, specifically baricitinib, may address the urgent need for effective treatments in the ongoing COVID-19 pandemic by reducing the risk of death among affected patients. However, further research, including larger-scale RCTs, is needed to establish the efficacy and safety of other JAK inhibitors in the treatment of COVID-19 and to generate more robust evidence regarding their use in this specific patient population.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 2","pages":"e3493"},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11146300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312699","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":"Leadership Development in Pharmacy Students: A Literature Review.","authors":"Alimah Thobani, Maria Anwar","doi":"10.4212/cjhp.3496","DOIUrl":"10.4212/cjhp.3496","url":null,"abstract":"<p><strong>Background: </strong>A deeper understanding of leadership competencies and development of these competencies in pharmacy students are essential to enable future pharmacists to take a more advanced role in patient care and serve as interdisciplinary team members and leaders. Such efforts are also needed to help guide succession planning.</p><p><strong>Objective: </strong>To identify and describe the competencies and experiences involved in leadership development for pharmacy students.</p><p><strong>Data sources: </strong>A literature review was conducted using the MEDLINE, PubMed, and Google Scholar databases (from inception to November 2023), as well as syllabi from pharmacy leadership courses.</p><p><strong>Study selection and data extraction: </strong>Articles discussing leadership competencies in a health care setting and during pharmacy education and training were included. Competencies and experiences related to leadership development were extracted and organized into categories, with each category given a single descriptor.</p><p><strong>Data synthesis: </strong>A total of 34 resources were included in the analysis, which revealed the following 7 leadership competencies: leadership knowledge, self-awareness, collaboration, leading change, business skills, systems thinking, and lifelong learning.</p><p><strong>Conclusions: </strong>Pharmacy students can develop their leadership abilities through a variety of experiences and activities aligned with the core leadership competencies identified here. Pharmacy schools in Canada can design and offer leadership placements to help enhance students' leadership skills. This study has highlighted activities that may help prepare pharmacy students for leadership roles in the changing landscape of pharmacy practice.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 2","pages":"e3496"},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11146301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312700","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":"« Une vision sans stratégie demeure une illusion ».","authors":"Megan Riordon","doi":"10.4212/cjhp.3632","DOIUrl":"10.4212/cjhp.3632","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 2","pages":"e3632"},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11146297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312694","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 Vision Without a Strategy Remains an Illusion\".","authors":"Megan Riordon","doi":"10.4212/cjhp.3623","DOIUrl":"10.4212/cjhp.3623","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 2","pages":"e3623"},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11146299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312693","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":"Describing Intravenous Extravasation Injuries in Children (DIVE2 Study).","authors":"Jamil Alnoor Devsi, Vanessa Paquette, Roxane R Carr","doi":"10.4212/cjhp.3525","DOIUrl":"10.4212/cjhp.3525","url":null,"abstract":"<p><strong>Background: </strong>Extravasation is the erroneous delivery of IV medication or fluid into the extravascular space. Complications ranging from mild injury to amputation can result, depending on the physical and pharmacologic properties of the infusate. Children are at increased risk for extravasation injuries. There is a paucity of data on the treatment and outcomes of extravasation injuries, particularly in terms of the role of pharmacologic antidotes.</p><p><strong>Objectives: </strong>To describe the incidence of extravasation at a tertiary pediatric care centre (as an update to a previous study), to identify the agents most commonly involved in extravasation injuries, to describe the antidotes used for management of injuries and their related adverse drug effects, and to describe complications related to injuries.</p><p><strong>Methods: </strong>The medical records of pediatric patients who experienced an extravasation injury at the BC Children's and BC Women's Hospitals, between September 1, 2008, and September 30, 2020, were reviewed. Data regarding management (adherence with institutional protocol) and outcomes of injuries were collected.</p><p><strong>Results: </strong>The 242 charts included in the analysis noted a total of 245 extravasation injuries, for an extravasation incidence of 0.04% per patient-day. Of the 242 patients, 110 were excluded from secondary outcome analysis due to lack of data detailing the extravasation event. Of the remaining 132 patients, the majority were neonates (<i>n</i> = 54, 40.9%), infants (<i>n</i> = 33, 25.0%), and children (<i>n</i> = 34, 25.8%), and more than a third were treated on general pediatric wards (<i>n</i> = 50, 37.9%). The medications most frequently involved were total parenteral nutrition with lipids (36/132, 27.3%), vancomycin (36/132, 27.3%), and IV fluids (35/132, 26.5%). Most of the patients had mild outcomes and recovered without complications. No adverse drug events from antidotes were reported.</p><p><strong>Conclusions: </strong>The incidence of extravasation at the study institution remained low, with the medications involved being similar to those reported in the literature and the majority of patients having mild outcomes. Additional prospective studies are needed to assess the efficacy and safety of antidotes administered for extravasation injuries.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 2","pages":"e3525"},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11146302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312698","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":"Canadian Hospital Pharmacy Residency Graduates / Diplômés De Programmes Canadiens De Résidence En Pharmacie Hôpitalière.","authors":"","doi":"10.4212/cjhp.3619","DOIUrl":"10.4212/cjhp.3619","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 2","pages":"e3619"},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11146295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312695","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}