The Canadian journal of hospital pharmacy最新文献

{"title":"Development of a Provincial Hospital Drug Formulary from 12 Former Regional Health Authority Formularies: Methods of Alignment","authors":"Jillian Madey, Mellissa Glab, Leah Heilman, Crystal Richter, Kassandra Stahl, Kirsten Fox","doi":"10.4212/cjhp.3400","DOIUrl":"https://doi.org/10.4212/cjhp.3400","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135786546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Effectiveness of Calcitonin Gene– Related Peptide-Binding Monoclonal Antibodies for Migraine Prevention: A Systematic Review","authors":"Andrea Zovi, Roberto Langella, Anna Chiara Aloisi, Cosimo De Giorgio, Marta Del Vecchio, Chiara Dondi, Giulia Handschin, Claudia Lauria, Carlotta Marchetti, Oscar Martinazzoli, Renata Nozza, Valentina Scalzi, Elena Tratta, Costantino Jemos, Ruggero Lasala","doi":"10.4212/cjhp.3382","DOIUrl":"https://doi.org/10.4212/cjhp.3382","url":null,"abstract":"Background: Migraine is a neurological disease with a high incidence. The new anti-calcitonin gene-related peptide monoclonal antibodies (anti-CGRP mAbs) have demonstrated effectiveness in preventing episodic and chronic migraine. Objective: To collect evidence of the real-world effectiveness of anti-CGRP mAbs by assessing outcomes such as reduction in monthly migraine days (MMDs), reduction in monthly headache days (MHDs), and percentage of patients having a 50% reduction in MMDs. Data Sources: The PubMed database was searched for the period from inception to October 20, 2021. Study Selection and Data Extraction: Of interest for this review were studies that evaluated the real-world effectiveness of anti-CGRP mAbs in terms of MMDs and reduction in MHDs. The search terms included “migraine”, “monthly migraine days”, and various drug names. The data are reported in terms of patients’ baseline characteristics and treatment effectiveness. Data Synthesis: A total of 46 studies were evaluated, of which 30 (enrolling a total of 4273 patients across 10 countries) were included in the systematic review. The greatest absolute reduction in MMD was from 20.4 at baseline to 10.7 after 3 months of treatment. After 6 months, the greatest absolute difference was 10, relative to baseline. The largest absolute reduction in MHD at 3 months was from 22 to 8, whereas at 6 months, the greatest absolute reduction in MHD was 13. The treatment could be considered clinically effective (≥ 50% reduction in MMDs) for 41% of patients at 3 months and about 44% of patients at 6 months. Conclusions: Despite substantial variability in baseline values, this review confirmed the effectiveness of anti-CGRP mAbs, which yielded important clinical reductions in both MMDs and MHDs. Keywords: anti-CGRP mAbs, migraine, effectiveness, real-life, prevention RÉSUMÉ Contexte : La migraine est une maladie neurologique à incidence élevée. Le nouvel anticorps monoclonal qui se lie au peptide lié au gène de la calcitonine (AcM anti-CGRP) a démontré son efficacité pour prévenir les migraines épisodiques et chroniques. Objectif : Recueillir des éléments probants concernant l’efficacité réelle des AcM anti-CGRP en évaluant des résultats comme la réduction du nombre de jours de migraine par mois (JMM), la réduction du nombre de jours de céphalées par mois (JCM) ainsi que le pourcentage de patients ayant une réduction de 50 % du nombre de JMM. Sources des données : La base de données PubMed a été utilisée pour mener une recherche pour la période allant du début jusqu’au 20 octobre 2021. Sélection des études et extraction des données : Les auteurs de la revue se sont intéressés aux études qui avaient évalué l’efficacité réelle des AcM anti-CGRP en termes de réduction du nombre de JMM et du nombre de JCM. Les termes de recherche comprenaient « migraine », « jours de migraine par mois » et divers noms de médicaments. Les données sont rapportées en termes de caractéristiques de base des patients et d’eff","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135786547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of Prescribing Practices for Uncomplicated Streptococcal and Enterococcal Bacteremias: The NARRATE Study","authors":"Tracy Liu, Michelle Hinch, Victor Leung, Colin Lee","doi":"10.4212/cjhp.3391","DOIUrl":"https://doi.org/10.4212/cjhp.3391","url":null,"abstract":"Background: Bloodstream infections (BSIs) rank among the top causes of death in North America. Despite the prevalence of these infections, there remain significant practice variations in the prescribing of antibiotics. Objective: To investigate current prescribing practices for management of uncomplicated streptococcal and enterococcal BSIs. Methods: A retrospective cohort study was conducted using charts forpatients admitted to an acute care centre in British Columbia between November 16, 2019, and October 20, 2020. Adult patients (≥ 18 years of age) with a diagnosis of uncomplicated streptococcal or enterococcal BSI were included. Patients were excluded if they had polymicrobial bacteremia or deep-seated infection or had been admitted for no more than 48 hours. The primary outcomes were duration of antibiotic therapy (IV and oral) and time to appropriate oral therapy for treatment of BSI. The secondary outcomes were observed rates of re-initiation of antibiotics and readmission with recurrent BSI. Descriptive statistics were calculated and regression analysis was performed for the primary and secondary outcomes. Results: A total of 96 patients met the inclusion criteria. The median total duration of therapy for uncomplicated streptococcal and enterococcal BSI was about 2 weeks. Streptococcus pneumoniae BSIs were associated with a significantly shorter duration of IV therapy and were more likely to be associated with transition to oral antibiotics. No recurrent BSIs were observed in patients for whom therapy was transitioned to oral antibiotics. Conclusions: Further study is warranted to explore shorter duration of antibiotic therapy and transition to oral therapy as treatment approaches for uncomplicated streptococcal and enterococcal BSI. Other outcomes of interest for future research include determining the optimal time for transition to oral therapy. Keywords: bacteremias, streptococcal infection, enterococcal infection, antimicrobial stewardship, bloodstream infection RÉSUMÉ Contexte : Les infections du sang (IS), ou bactériémies, se classent parmi les causes principales de décès en Amérique du Nord. Malgré leur prévalence, la pratique de la prescription d’antibiotiques continue de varier grandement. Objectif : Étudier les pratiques actuelles de la prescription pour la gestion des bactériémies à streptocoque et à entérocoque non compliquées. Méthodes : Une étude de cohorte rétrospective a été menée à l’aide de dossiers de patients admis à un centre de soins aigus en Colombie-Britannique entre le 16 novembre 2019 et le 20 octobre 2020. Des patients adultes (≥ 18 ans) ayant reçu un diagnostic de bactériémie a streptocoque ou à entérocoque non compliquée ont été inclus. Les patients étaient exclus s’ils présentaient une bactériémie polymicrobienne ou une infection profonde ou s’ils avaient été hospitalisés depuis moins de 48 heures. Les résultats principaux étaient la durée de l’antibiothérapie (IV et orale) et le temps écoulé avant la transit","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135786362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"De sages paroles du bon docteur (Seuss).","authors":"Ashley Walus","doi":"10.4212/cjhp.3540","DOIUrl":"10.4212/cjhp.3540","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"76 4","pages":"347"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10522358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41173704","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":"Treatments and Outcomes of Critically Ill Patients with <i>Candida</i> spp. Colonization of the Lower Respiratory Tract in Regina, Saskatchewan.","authors":"Adam Lanigan, Jonathan F Mailman, Sandy Kassir, Kristin Schmidt, Stephen B Lee, Eric Sy","doi":"10.4212/cjhp.3408","DOIUrl":"10.4212/cjhp.3408","url":null,"abstract":"<p><strong>Background: </strong>Among critically ill patients receiving mechanical ventilation, Candida spp. are commonly detected in the lower respiratory tract (LRT). This is generally considered to represent colonization.</p><p><strong>Objective: </strong>To evaluate the use of antifungal treatments and the clinical outcomes of patients with Candida colonization of the LRT.</p><p><strong>Methods: </strong>This retrospective analysis involved consecutive patients admitted to the intensive care unit between April 2016 and May 2021with positive results on Candida spp. testing of LRT samples. Data related to antifungal treatment and clinical outcomes were analyzed descriptively, and multivariable logistic regression was performed.</p><p><strong>Results: </strong>Of 200 patients initially identified, 160 (80%) died in hospital. Antifungal therapy was given to 103 (51.5%) of the patients, with treatment being more likely among those with shock and those who received parenteral nutrition. Mortality was high among patients with positive Candida results on LRT culture, regardless of treatment. Multivariable logistic regression, with adjustment for age, sex, comorbidities, and sequential organ failure assessment (SOFA) score, showed that antifungal treatment was associated with lower odds of death (odds ratio 0.39, 95% confidence interval 0.17-0.87) compared with no treatment (p = 0.021).</p><p><strong>Conclusions: </strong>This study showed higher mortality rates than have been reported previously. Further investigation into the role of antifungal therapy among critically ill patients with Candida spp. colonization is required.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"76 4","pages":"309-313"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10522344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41160891","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":"Association between Pharmacists' Country of Qualifying Education and Practising in a Hospital Setting: A Cross-Sectional Ontario Study.","authors":"Deep Patel, Tim Mickleborough, Ali Elbeddini, Mhd Wasem Alsabbagh","doi":"10.4212/cjhp.3440","DOIUrl":"10.4212/cjhp.3440","url":null,"abstract":"<p><strong>Background: </strong>It is hypothesized that international pharmacy graduates (IPGs) are underrepresented in more clinically challenging work.</p><p><strong>Objective: </strong>To examine the association between country of qualifying education for pharmacists in Ontario and the likelihood of practising in a hospital setting.</p><p><strong>Methods: </strong>This study was based on publicly available data from the Ontario College of Pharmacists website, specifically records for all Ontario pharmacists with authorization to provide patient care and for whom country of qualifying education and an accredited pharmacy as a place of practice were reported. Pharmacists who met the inclusion criteria were categorized as Canadian graduates or IPGs. The odds ratio (OR) and 95% confidence interval (CI) for reporting hospital pharmacy as a place of practice were estimated by fitting a logistic regression, with adjustment for gender and years since graduation.</p><p><strong>Results: </strong>A total of 14 689 pharmacists were included in the study: 7403 (50.4%) Canadian graduates and 7286 (49.6%) IPGs. These pharmacists worked in a total of 5028 accredited pharmacies (243 hospital pharmacies [4.8%] and 4785 community pharmacies [95.2%]). Among Canadian graduates, 2458 (33.2%) reported at least 1 hospital pharmacy practice site, whereas the proportion was much smaller among IPGs (427, 5.9%). Canadian graduates represented 85.2% (2458/2885) of all pharmacists who reported hospital practice. The estimated crude OR for practice in a hospital pharmacy was 7.98 (95% CI 7.16-8.91), and the adjusted OR was 7.12 (95% CI 6.39-7.98).</p><p><strong>Conclusions: </strong>IPGs may face barriers impeding their ability to practise in a hospital setting. Providing opportunities such as structured clinical training and experiential placements may facilitate integration of IPGs in institutional settings.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"76 4","pages":"282-289"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10522356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41168394","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’avenir de la pratique de la pharmacie hospitalière : Voies vers la pratique indépendante de la pharmacie clinique.","authors":"Jonathan Penm","doi":"10.4212/cjhp.3539","DOIUrl":"10.4212/cjhp.3539","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"76 4","pages":"265-266"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10522349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41163963","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":"Misunderstandings about Tonicity and Osmolality Can Lead to Patient Harm.","authors":"John Robert Manderville, Keigan M More, Karthik Tennankore","doi":"10.4212/cjhp.3417","DOIUrl":"10.4212/cjhp.3417","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"76 4","pages":"324-326"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10522352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41167937","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 Pharmacist-Initiated Interventions on Duration of Antibiotic Therapy for Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Community-Acquired Pneumonia.","authors":"Giovanni Iovino, Lynn Nadeau","doi":"10.4212/cjhp.3421","DOIUrl":"10.4212/cjhp.3421","url":null,"abstract":"<p><strong>Background: </strong>Current guidelines for the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and community-acquired pneumonia (CAP) recommend 5 days of antimicrobial therapy. Despite these recommendations, the duration of therapy exceeds 5 days for up to 70% of patients, with most superfluous prescribing occurring upon discharge from hospital. Shortening the duration of antibiotic therapy could decrease adverse events, resistance, and costs.</p><p><strong>Objective: </strong>To determine whether a pharmacist-initiated modification to the duration of antibiotic therapy prescribed for the treatment of AECOPD or CAP reduced the duration of antibiotic prescriptions.</p><p><strong>Methods: </strong>In this prospective, single-centre study of adult inpatients receiving antibiotics for the treatment of AECOPD or CAP between October 2020 and March 2021, pharmacists assigned a 5-day duration to antimicrobials prescribed for these indications. For patients discharged before completion of therapy, the antibiotic start date and intended duration were included on the discharge prescription. Study patients were matched 1:1 with historical controls to compare the total duration of antibiotic therapy with and without the intervention.</p><p><strong>Results: </strong>A total of 100 patients (66 with CAP and 34 with AECOPD) met the inclusion criteria and had their antibiotic treatment duration modified to 5 days. Mean total duration of antibiotic therapy was 5.31 days in the intervention group and 7.11 days in the control group (p < 0.001). Outpatient antibiotic prescribing was 0.86 days in the intervention group and 3.2 days in the control group (p < 0.001). In both groups, the rates of readmission at 30 and 90 days were 19% and 31%, respectively.</p><p><strong>Conclusions: </strong>Pharmacist-initiated modification of antimicrobial therapy resulted in shortening of the duration of therapy by almost 2 days. Including information about treatment duration on the discharge prescription reduced outpatient prescribing without affecting readmission rates.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"76 4","pages":"296-301"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10522359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41168537","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":"Clozapine for Management of Neuropsychiatric Symptoms in Dementia with Lewy Bodies: Case Report and Literature Review.","authors":"Nikoo Hashemi, Dean Yang, David Shergold, Gayla Tennen, Chris Fan-Lun","doi":"10.4212/cjhp.3390","DOIUrl":"10.4212/cjhp.3390","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"76 4","pages":"340-345"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10522355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41174878","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}