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Houle SKD, Timony P, Waite NM, Gauthier A. Identifying vaccination deserts: The availability and distribution of pharmacists with authorization to administer injections in Ontario. Can Pharm J (Ott) 2022; 155:258-266. [PMID: 36081916 PMCID: PMC9445507 DOI: 10.1177/17151635221115183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/03/2022] [Accepted: 04/11/2022] [Indexed: 11/17/2022]
Abstract
Introduction: Pharmacist-administered immunizations have been associated with improved vaccination rates; however, little is known about whether areas with little to no access to this service (“vaccination deserts”) exist. The objective of this work is to determine the geographic availability of pharmacists with authorization to administer injections in the province of Ontario. Methods: Ontario College of Pharmacists registry data were used to identify patient care–providing pharmacists in community pharmacies and their ability to administer injections. Their number of hours worked was converted into full-time equivalents (FTEs), assuming 40 hours per week represents 1 FTE. Practice site(s) were mapped by postal code and presented by Public Health Unit (PHU) area. Communities within PHUs were further categorized as urban or rural and northern or southern, with ratios of FTEs per 1000 population calculated for both injection-trained and non-injection-trained pharmacists. Results: In total, 74.6% of Ontario’s practising community pharmacists are authorized to provide injections. Northern PHUs had slightly better access to pharmacist injectors (0.61 FTEs/1000 overall vs 0.56/1000 in the south), while rural communities had lower availability (0.41 FTEs/1000) than urban communities (0.58 FTEs/1000). PHUs with greater population size and density had greater availability of pharmacist immunizers, while PHUs with greater land area were more likely to not have any immunizing pharmacists present ( p < 0.001 for all). Discussion: As pharmacists increasingly become preferred vaccination providers, awareness of disparities related to access to pharmacy-based immunizations and collaboration with public health and primary care providers to address them (e.g., through mobile vaccination clinics) will be required to ensure equitable access. Can Pharm J (Ott) 2022;155:xx-xx.
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Rzepka AM, Wong L, Chaudhry M, Sproule BA, He N, Cadarette SM. The Ontario Pharmacy Evidence Network Atlas of Smoking Cessation Services. Can Pharm J (Ott) 2022; 155:194-199. [PMID: 35813528 PMCID: PMC9266378 DOI: 10.1177/17151635221101366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 04/21/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Anna M. Rzepka
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario
| | - Lindsay Wong
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario
| | - Maha Chaudhry
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario
- ICES, Toronto, Ontario
| | - Beth A. Sproule
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario
- Centre for Addiction and Mental Health Toronto, Ontario
| | - Nancy He
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario
- ICES, Toronto, Ontario
| | - Suzanne M. Cadarette
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario
- ICES, Toronto, Ontario
- Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, North Carolina, United States
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3
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Cadarette SM, He N, Chaudhry M, Dolovich L. The Ontario Pharmacy Evidence Network Interactive Atlas of Professional Pharmacist Services. Can Pharm J (Ott) 2021; 154:153-159. [PMID: 34104268 PMCID: PMC8165887 DOI: 10.1177/17151635211004969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
| | - Nancy He
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario
| | - Maha Chaudhry
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario
| | - Lisa Dolovich
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario
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Kim JJ, Tian AH, Pham L, Nakhla N, Houle SKD, Wong WWL, Alsabbagh MW. Economic evaluation of pharmacists prescribing for minor ailments in Ontario, Canada: a cost-minimization analysis. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2021; 29:228-234. [PMID: 33778880 DOI: 10.1093/ijpp/riab006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 01/21/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVES The objective of this study was to use a decision-analytic model to examine the potential economic impact of establishing a remunerated programme for pharmacists prescribing for minor ailments (PPMA) in Ontario, Canada. METHODS A novel decision tool was developed to assess the economic impact of pharmacists prescribing for upper respiratory tract infections (URTIs), contact dermatitis (CD) and conjunctivitis by performing a cost-minimization analysis from a public payer perspective. Two prescribing strategies were compared: (1) PPMA, where patients may seek care from pharmacists or physicians, and (2) the usual care model (UCM), where all patients receive care from physicians. Two remuneration models for the PPMA strategy were also compared: (1) a prescription-detached scenario (PDS), where pharmacists were remunerated CAD$18.00 for each consultation, and (2) a Prescription-Attached Scenario (PAS), where pharmacists were only remunerated if a decision to prescribe was made. KEY FINDINGS At a service uptake rate of 38% for the PDS, the PPMA model led to savings of $7.51, $4.08 and $5.15 per patient for URTIs, CD and conjunctivitis, respectively. Per 30 000 patients, the PPMA model for these minor ailments was projected to lead to cumulative reductions in visits to the emergency department, family physician and walk-in clinics by 799, 3677 and 5090, respectively. CONCLUSIONS The results of the study strongly suggest that enabling community pharmacists to assess and prescribe for minor ailments could potentially lead to large savings for the government in Ontario, Canada. In 100% of the PAS scenarios simulated, pharmacists as prescribers led to cost savings.
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Affiliation(s)
- John J Kim
- School of Pharmacy, Faculty of Science, University of Waterloo, Kitchener, ON, Canada
| | - Adeline H Tian
- School of Pharmacy, Faculty of Science, University of Waterloo, Kitchener, ON, Canada
| | - Lee Pham
- School of Pharmacy, Faculty of Science, University of Waterloo, Kitchener, ON, Canada
| | - Nardine Nakhla
- School of Pharmacy, Faculty of Science, University of Waterloo, Kitchener, ON, Canada
| | - Sherilyn K D Houle
- School of Pharmacy, Faculty of Science, University of Waterloo, Kitchener, ON, Canada
| | - William W L Wong
- School of Pharmacy, Faculty of Science, University of Waterloo, Kitchener, ON, Canada
| | - Mhd Wasem Alsabbagh
- School of Pharmacy, Faculty of Science, University of Waterloo, Kitchener, ON, Canada
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Raiche T, Pammett R, Dattani S, Dolovich L, Hamilton K, Kennie-Kaulbach N, Mccarthy L, Jorgenson D. Community pharmacists' evolving role in Canadian primary health care: a vision of harmonization in a patchwork system. Pharm Pract (Granada) 2020; 18:2171. [PMID: 33149795 PMCID: PMC7603659 DOI: 10.18549/pharmpract.2020.4.2171] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Canada's universal public health care system provides physician, diagnostic, and hospital services at no cost to all Canadians, accounting for approximately 70% of the 264 billion CAD spent in health expenditure yearly. Pharmacy-related services, including prescription drugs, however, are not universally publicly insured. Although this system underpins the Canadian identity, primary health care reform has long been desired by Canadians wanting better access to high quality, effective, patient-centred, and safe primary care services. A nationally coordinated approach to remodel the primary health care system was incited at the turn of the 21st century yet, twenty years later, evidence of widespread meaningful improvement remains underwhelming. As a provincial/territorial responsibility, the organization and provision of primary care remains discordant across the country. Canadian pharmacists are, now more than ever, poised and primed to provide care integrated with the rest of the primary health care system. However, the self-regulation of the profession of pharmacy is also a provincial/territorial mandate, making progress toward integration of pharmacists into the primary care system incongruent across jurisdictions. Among 11,000 pharmacies, Canada's 28,000 community pharmacists possess varying authority to prescribe, administer, and monitor drug therapies as an extension to their traditional dispensing role. Expanded professional services offered at most community pharmacies include medication reviews, minor/common ailment management, pharmacist prescribing for existing prescriptions, smoking cessation counselling, and administration of injectable drugs and vaccinations. Barriers to widely offering these services include uncertainties around remuneration, perceived skepticism from other providers about pharmacists' skills, and slow digital modernization including limited access by pharmacists to patient health records held by other professionals. Each province/territory enables pharmacists to offer these services under specific legislation, practice standards, and remuneration models unique to their jurisdiction. There is also a small, but growing, number of pharmacists across the country working within interdisciplinary primary care teams. To achieve meaningful, consistent, and seamless integration into the interdisciplinary model of Canadian primary health care reform, pharmacy advocacy groups across the country must coordinate and collaborate on a harmonized vision for innovation in primary care integration, and move toward implementing that vision with ongoing collaboration on primary health care initiatives, strategic plans, and policies. Canadians deserve to receive timely, equitable, and safe interdisciplinary care within a coordinated primary health care system, including from their pharmacy team.
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Affiliation(s)
- Taylor Raiche
- BSP. Medication Assessment Centre, University of Saskatchewan. Saskatoon, SK (Canada).
| | - Robert Pammett
- BSc, BSP, MSc. Northern Health, Prince George, Faculty of Pharmaceutical Sciences, University of British Columbia. Vancouver, BC (Canada).
| | - Shelita Dattani
- BScPhm, PharmD. Canadian Pharmacists Association. Ottawa, ON (Canada).
| | - Lisa Dolovich
- BScPhm, PharmD, MSc. Leslie Dan Faculty of Pharmacy, University of Toronto. Toronto, ON (Canada).
| | - Kevin Hamilton
- BSP, MSc. College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba. Winnipeg, MB (Canada).
| | - Natalie Kennie-Kaulbach
- BSc(Pharm), ACPR, PharmD. College of Pharmacy, Faculty of Health, Dalhousie University. Halifax, NS (Canada).
| | - Lisa Mccarthy
- BScPhm, PharmD, MSc. Leslie Dan Faculty of Pharmacy, University of Toronto. Toronto, ON (Canada).
| | - Derek Jorgenson
- BSP, PharmD. Medication Assessment Centre, College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK (Canada).
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Choremis B, Campbell T, Tadrous M, Martins D, Antoniou T, Gomes T. The uptake of the pharmacy-dispensed naloxone kit program in Ontario: A population-based study. PLoS One 2019; 14:e0223589. [PMID: 31626648 PMCID: PMC6799925 DOI: 10.1371/journal.pone.0223589] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 09/24/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Naloxone is a life-saving antidote for opioid overdoses. In June 2016, the Ontario government implemented the Ontario Naloxone Program for Pharmacies (ONPP) to enhance access to naloxone. OBJECTIVE We examined the initial uptake of naloxone through the ONPP and characteristics of the individuals receiving and pharmacies dispensing naloxone kits. METHODS We conducted a population-based study of all Ontario residents who received a naloxone kit between July 1, 2016 and March 31, 2018. This involved 1) a cross-sectional analysis of monthly rates of kits dispensed; and 2) a descriptive analysis of all individuals and pharmacies who accessed and dispensed naloxone, respectively. We stratified individuals according to their opioid exposure as: prescription opioid agonist therapy (OAT) recipients, prescription opioid recipients, those with past opioid exposure and those with no/unknown opioid exposure. We calculated a Lorenz curve comparing the cumulative percent of naloxone-dispensing pharmacies and cumulative percent of naloxone kits dispensed and the corresponding Gini coefficient. RESULTS Naloxone dispensing through the ONPP increased considerably from 1.9 to 54.3 kits per 100,000 residents over the study period. In this time, 2,729 community pharmacies dispensed 91,069 kits to 67,910 unique individuals. Uptake was highest among prescription OAT recipients (40.7% of OAT recipients dispensed at least one kit), compared with 1.6% of prescription opioid recipients, 1.0% of those with past opioid exposure and 0.3% with no/unknown opioid exposure. Naloxone dispensing was highly clustered among pharmacies (Gini = 0.78), with 55.6% of Ontario pharmacies dispensing naloxone, and one-third (33.7%) of kits dispensed by the top 1.0% of naloxone-dispensing pharmacies. CONCLUSION The ONPP launch led to a rapid increase in the number of naloxone kits dispensed in Ontario. Although the program successfully engaged people prescribed OAT, efforts to increase uptake among others at risk of opioid overdose appear warranted. Opportunities for expanding pharmacy participation should be identified and pursued.
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Affiliation(s)
| | | | - Mina Tadrous
- ICES, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Women’s College Hospital, Toronto, Ontario, Canada
| | - Diana Martins
- Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Tony Antoniou
- ICES, Toronto, Ontario, Canada
- Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
- Department of Family and Community Medicine, St. Michael’s Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Tara Gomes
- ICES, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- * E-mail:
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Uptake of Travel Health Services by Community Pharmacies and Patients Following Pharmacist Immunization Scope Expansion in Ontario, Canada. PHARMACY 2019; 7:pharmacy7020035. [PMID: 31013879 PMCID: PMC6630201 DOI: 10.3390/pharmacy7020035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 04/06/2019] [Accepted: 04/11/2019] [Indexed: 11/17/2022] Open
Abstract
In December 2016, pharmacists in Ontario, Canada with authorization to administer injections saw an expansion in their scope from a restriction to the influenza vaccination only to now including an additional 13 vaccine-preventable diseases, largely those related to travel. It was uncertain whether this change in scope would see sufficient uptake, or translate to a corresponding expansion in other travel health service offerings from community pharmacies. In October/November 2017 a survey was conducted of all licensed community pharmacists in Ontario, followed by semi-structured interviews with 6 survey respondents in June 2018. A web-based survey of members of the public from a single region of the province was also conducted in September 2018 to assess uptake of expanded vaccination services. Broad variability in uptake of these services was noted, ranging from the dispensing of travel-related medications and vaccinations only through to vaccine administration and prescribing under medical directive; however, uptake was generally at the lower end of this spectrum. This was evidenced by 94% of pharmacists reporting administering fewer than 10 travel vaccinations per month, fewer than 10% of patients reporting receiving a travel vaccine administered by a pharmacist, and a maximum of 30 pharmacies (of nearly 6000 in the province) designated to provide yellow fever vaccinations. Fewer than 1 in 3 pharmacists reported performing some form of pre-travel consultation in their practice, often limited to low-risk cases only. Barriers and facilitators reported were similar for these services as they were for other non-dispensing services, including insufficient time to integrate the service into their workload, perceived lack of knowledge and confidence in travel health, and low patient awareness of these new services available to them through community pharmacies.
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Grootendorst P, Ranjithan R. Pharmacists should counsel users of medical cannabis, but should they be dispensing it? Can Pharm J (Ott) 2018; 152:10-13. [PMID: 30719190 DOI: 10.1177/1715163518814273] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Paul Grootendorst
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario
| | - Rajivi Ranjithan
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario
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Lancaster K, Thabane L, Tarride JE, Agarwal G, Healey JS, Sandhu R, Dolovich L. Descriptive analysis of pharmacy services provided after community pharmacy screening. Int J Clin Pharm 2018; 40:1577-1586. [PMID: 30474769 PMCID: PMC6280862 DOI: 10.1007/s11096-018-0742-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 10/16/2018] [Indexed: 12/01/2022]
Abstract
Background Community pharmacies are promising locations for opportunistic screening due to pharmacist accessibility and ability to perform various health and medication management services. Little is known as to the provision of pharmacy services following screening initiatives. Objective To describe provision of pharmacy services for participants following a community pharmacy stroke screening initiative. Setting The Program for the Identification of "Actionable Atrial" Fibrillation Pharmacy initiative took place in 30 pharmacies in Alberta and Ontario, Canada. 1149 participants ≥ 65 were screened for atrial fibrillation, type 2 diabetes, and hypertension. Method Retrospective, secondary analysis of data using participant case-report forms, pharmacy data, and pharmacy claims to describe pharmacy services received by participants post-screening. Main Outcome Measure Number and types of remunerated pharmacy services received by participants post-screening. Results A total of 535/1149 (46.6%) participants screened at their regular pharmacy were included in this analysis. Of these, 165 (30.8%) participants received 229 pharmacy services within 3 months post-screening, including 146 medication reviews, 57 influenza vaccinations, and 21 pharmaceutical opinions. A median (interquartile range, IQR) of 6 (2-11) pharmacy services were delivered, and median (IQR) reimbursement was $187.50 ($67.50-$342.50). Conclusions Approximately one-third of participants received a pharmacy service within 3 months post-screening. Relatively large numbers of annual and follow-up medication reviews were delivered despite low eligibility for annual-only reviews and despite many missed opportunities for pharmacy service provision in at-risk patients. In-pharmacy screening may facilitate provision of some services, namely medication reviews, by providing opportunities to identify patients at-risk.
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Affiliation(s)
- Karla Lancaster
- McMaster University, 1280 Main St. W., Hamilton, ON, L8S 4L8, Canada
| | - Lehana Thabane
- McMaster University, 1280 Main St. W., Hamilton, ON, L8S 4L8, Canada
| | - Jean-Eric Tarride
- McMaster University, 1280 Main St. W., Hamilton, ON, L8S 4L8, Canada
| | - Gina Agarwal
- McMaster University, 1280 Main St. W., Hamilton, ON, L8S 4L8, Canada
| | - Jeff S Healey
- Population Health Research Institute, 237 Barton St. E., Hamilton, ON, L8L 2X2, Canada
| | - Roopinder Sandhu
- University of Alberta, 116 St. and 85th Ave., Edmonton, AB, T6G 2R3, Canada
| | - Lisa Dolovich
- McMaster University, 1280 Main St. W., Hamilton, ON, L8S 4L8, Canada. .,Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College St., Room 607, Toronto, ON, M5S 3M2, Canada.
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10
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Farrell B, Archibald D, Pizzola L, Ward N, Cho A, Tsang C. Impact on confidence and practice: How the ADAPT online patient care skills program made a difference for pharmacists. Res Social Adm Pharm 2018; 15:1251-1258. [PMID: 30448031 DOI: 10.1016/j.sapharm.2018.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 10/25/2018] [Accepted: 11/01/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND The ADAPT "ADapting pharmacists' skills and Approaches to maximize Patients' drug Therapy effectiveness" online education program was developed to enable pharmacists to overcome a lack of confidence in patient care and collaborative skills, enabling successful adoption of expanded scope of pharmacist practice. OBJECTIVES This study examined responses of ADAPT participants, to determine if acquisition of knowledge, skill, and confidence is retained and translated into adoption of expanded scope of practice and billable services, perceived improvement in quality of patient care, and increased professional satisfaction. METHODS A sequential exploratory mixed methods approach was used for this study. RESULTS Fifty-four surveys were completed and 13 interviews were conducted. Greater than 86% agreed or strongly agreed that their confidence in their ability to perform ADAPT skills had improved. Billing for services varied based on province. Four themes emerged through the interview process: confidence, change, impact and barriers/facilitators. CONCLUSIONS Respondents described confidence in their ability to use ADAPT skills to make changes in personal practice activities, and this appeared to lead to taking on new roles that provided both professional satisfaction and improved patient care and professional relations. However, some barriers remained in providing or billing for certain practice activities.
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Affiliation(s)
- Barbara Farrell
- Bruyère Research Institute, 43 Bruyère St, Ottawa, Ontario, K1N 5C8, Canada; Department of Family Medicine, University of Ottawa, 43 Bruyère St, Ottawa, Ontario, K1N 5C8, Canada; School of Pharmacy, University of Waterloo, 10A Victoria St S, Kitchener, Ontario, N2G 1C5, Canada.
| | - Douglas Archibald
- Department of Family Medicine, University of Ottawa, 43 Bruyère St, Ottawa, Ontario, K1N 5C8, Canada
| | - Lisa Pizzola
- Bruyère Research Institute, 43 Bruyère St, Ottawa, Ontario, K1N 5C8, Canada
| | - Natalie Ward
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd, Ottawa, Ontario, K1H 8L1, Canada
| | - Ara Cho
- Bruyère Research Institute, 43 Bruyère St, Ottawa, Ontario, K1N 5C8, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College St, Toronto, Ontario, M5S 3M2, Canada
| | - Corey Tsang
- Bruyère Research Institute, 43 Bruyère St, Ottawa, Ontario, K1N 5C8, Canada; School of Pharmacy, University of Waterloo, 10A Victoria St S, Kitchener, Ontario, N2G 1C5, Canada
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Waite NM, McCarthy L, Milne E, Hillier C, Houle SK, Dolovich L. Perceived preparedness for full-scope pharmacist services among recent Doctor of Pharmacy graduates from Ontario schools of pharmacy. J Am Pharm Assoc (2003) 2018; 58:630-637. [DOI: 10.1016/j.japh.2018.06.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 06/11/2018] [Accepted: 06/25/2018] [Indexed: 12/17/2022]
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McCarthy L, Milne E, Waite N, Cooke M, Cook K, Chang F, Sproule BA. Sex and gender-based analysis in pharmacy practice research: A scoping review. Res Social Adm Pharm 2016; 13:1045-1054. [PMID: 27908657 DOI: 10.1016/j.sapharm.2016.11.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 09/22/2016] [Accepted: 11/18/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Recognizing the potential effect of sex and gender on health outcomes, there is a shift toward conducting sex and gender-based analysis (SGBA) within health research. However, little is known about the extent to which SGBA has been incorporated into pharmacy practice research. OBJECTIVES To understand the extent to which SGBA is included in pharmacy practice research. METHOD Scoping review of English-language studies identified through MEDLINE, Embase, International Pharmacy Abstracts (IPA), and CINAHL (inception to Jan 2014). Two raters independently screened citations to identify titles and abstracts that included key words related to sex or gender and studies that could be categorized as pharmacy practice research. One author extracted data from included studies related to study design, population, intervention/exposure and outcomes, with results reviewed by another. All authors reviewed eligible articles to categorize them based on a previously-developed typology, and to assess four criteria: 1) the inclusion of sex or gender in research objectives, 2) the depth of sex/gender analysis incorporated into study designs and reporting, 3) the inclusion of sex or gender considerations in interpretation of study results, 4) the intentional and accurate use of sex/gender language. RESULTS Of 458 unique search results, only six articles met the inclusion criteria. Two of these six publications included sex/gender considerations in a model consistent with sex/gender based analysis as described by Hammarström. Three of the six studies inaccurately applied sex and gender terminology, whereas the two studies that featured sex or gender in their primary research question did use these terms appropriately. CONCLUSION Despite increasing attention on the need for considering sex and gender, there was a paucity of pharmacy practice research publications that conducted SGBA. This presents an opportunity to explore sex, gender and intersectionality when pursuing studies that explore the impact of pharmacists interventions on patient outcomes.
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Affiliation(s)
- Lisa McCarthy
- Women's College Research Institute at Women's College Hospital, 76 Grenville Street, Toronto, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, Ontario, Canada; Department of Family and Community Medicine, University of Toronto, 500 University Avenue, Toronto, Ontario, Canada.
| | - Emily Milne
- School of Pharmacy, University of Waterloo, 10 Victoria Street, Kitchener, Ontario, Canada
| | - Nancy Waite
- School of Pharmacy, University of Waterloo, 10 Victoria Street, Kitchener, Ontario, Canada
| | - Martin Cooke
- School of Pharmacy, University of Waterloo, 10 Victoria Street, Kitchener, Ontario, Canada; Department of Sociology & Legal Studies, University of Waterloo, 200 University Avenue E, Waterloo, Ontario, Canada; School of Public Health and Health Systems, University of Waterloo, 200 University Avenue E, Waterloo, Ontario, Canada
| | - Katie Cook
- School of Pharmacy, University of Waterloo, 10 Victoria Street, Kitchener, Ontario, Canada
| | - Feng Chang
- School of Pharmacy, University of Waterloo, 10 Victoria Street, Kitchener, Ontario, Canada
| | - Beth A Sproule
- Women's College Research Institute at Women's College Hospital, 76 Grenville Street, Toronto, Canada; Centre for Addiction and Mental Health, 1001 Queen Street, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, Canada
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13
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Havlicek AJ, Mansell H. The community pharmacist's role in cancer screening and prevention. Can Pharm J (Ott) 2016; 149:274-282. [PMID: 27708673 DOI: 10.1177/1715163516660574] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
As the Canadian population continues to age, the incidence of cancer is on the rise. To help alleviate the burden malignancy imposes on our health care system, a shift toward early cancer detection is necessary. Pharmacists are well positioned and willing to assume a more active role in cancer surveillance. Patients are receptive to pharmacist involvement and seem to prefer a convenient community pharmacy-based location for screening programs. The community pharmacist's current and potential role in cancer screening and prevention is summarized in this article. A review of screening recommendations and a discussion of opportunities will hopefully inspire pharmacists to consider incorporating malignancy screening initiatives into their practice.
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Affiliation(s)
| | - Holly Mansell
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan
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Winslade N, Eguale T, Tamblyn R. Optimising the changing role of the community pharmacist: a randomised trial of the impact of audit and feedback. BMJ Open 2016; 6:e010865. [PMID: 27207626 PMCID: PMC4885441 DOI: 10.1136/bmjopen-2015-010865] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To evaluate the impact of comparative performance feedback to community pharmacists on provision of professional services and the quality of patients' medication use. DESIGN Randomised, controlled, single-blind trial. SETTING All 1833 community pharmacies in the Quebec province, Canada. PARTICIPANTS 1814 pharmacies not opting out and with more than 5 dispensings of the target medications during the 6-month baseline were randomised by a 2×2 factorial design to feedback first for hypertension adherence (907 control, 907 intervention) followed by randomisation for asthma adherence (791 control, 807 intervention). 1422 of 1814 pharmacies had complete information available during the follow-up for hypertension intervention (706 intervention, 716 control), and 1301 of 1598 had the follow-up information for asthma (657 intervention, 644 control). INTERVENTION Using provincial billing data to measure performance, mailed comparative feedback reported the pharmacy-level percentage of dispensings to patients non-adherent to antihypertensive medications or overusing asthma rescue inhalers. PRIMARY AND SECONDARY OUTCOME MEASURES The number of hypertension/asthma services billed per pharmacy and percentage of dispensings to non-adherent patients over the 12 months post intervention. RESULTS Feedback on the asthma measure led to increased provision of asthma services (control 0.2, intervention 0.4, RR 1.58, 95% CI 1.02 to 2.46). However, this did not translate into reductions in patients' overuse of rescue inhalers (control 45.5%, intervention 44.6%, RR 0.99, 95% CI 0.98 to 1.01). For non-adherence to antihypertensive medications, feedback resulted in no difference in either provision of hypertension services (control 0.7, intervention 0.8, RR 1.25, 95% CI 0.86 to 1.82) or antihypertensive treatment adherence (control 27.9%, intervention 28.0%, RR 1.0, 95% CI 0.99 to 1.00). Baseline performance did not influence results, and there was no evidence of a cumulative effect with repeated feedback. CONCLUSIONS Comparative pharmacy performance feedback increased the provision of asthma pharmacists' services but did not improve the performance on medication-use measures. Billing data can be used to evaluate the impact of billable services rendered by pharmacists on the quality of patients' medication use.
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Affiliation(s)
- Nancy Winslade
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Tewodros Eguale
- Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada
- Massachusetts College of Pharmacy and Health Sciences, Boston, Massachusetts, USA
| | - Robyn Tamblyn
- Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada
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Dolovich L. Playing in the Sandbox: Considerations When Leading or Participating on a Multidisciplinary Research Team. Can J Hosp Pharm 2015; 68:401-5. [PMID: 26478586 DOI: 10.4212/cjhp.v68i5.1487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Lisa Dolovich
- BScPhm, PharmD, MSc, is Professor and Associate Chair, Research in the Department of Family Medicine, McMaster University, Hamilton, Ontario
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16
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Cadarette SM, Wong L. An Introduction to Health Care Administrative Data. Can J Hosp Pharm 2015; 68:232-7. [PMID: 26157185 DOI: 10.4212/cjhp.v68i3.1457] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Suzanne M Cadarette
- PhD, is Associate Professor with the Leslie Dan Faculty of Pharmacy, University of Toronto, and Senior Adjunct Scientist with the Institute for Clinical Evaluative Sciences, Toronto, Ontario
| | - Lindsay Wong
- BScPhm, PharmD, was, at the time of writing, a student in the Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario. She is currently a pharmacy intern at St Michael's Hospital, Toronto, Ontario
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