Latest News

Latest News

CPRB News - April 2024 / avril 2024

April 23, 2024
 
 

Accreditation Policies and Procedures Update 

The Canadian Pharmacy Residency Board (CPRB) has worked on updates to the Accreditation Policies and Procedures over the last year.  These 2024 updates are now posted to the CPRB website. Highlights of the key changes include the addition of the accreditation award definitions and modifications to the definitions and categories for residency programs.  In addition, the CPRB has updated the Notification of Intent form that new residency programs wishing to request accreditation must complete and submit to the CPRB coordinator at cprb@cshp.ca.  This PDF Fillable form can also be found on the CPRB website.

Pfizer Award Winners – Year 1

The Pharmacy Practice Residency Award recognizes Year 1 Pharmacy Residents whose major residency project (typically a research project) are judged to be most deserving in terms of significant innovation, practical application, and/or development in an institutional pharmacy practice setting. Winners receive a $1,000 cash prize.
To be eligible, each candidate must:
  • Be a current member of CSHP and must have been a member of CSHP at the time the residency was completed;
  • Be currently enrolled in, or one-year post-completion, of a CPRB-accredited (or accreditation-pending) Year 1 pharmacy residency program in the province of the CSHP branch administering the award;
  • Submit an award application to the CSHP branch in the province in which the residency was completed.   

The winners of the 2023 Pharmacy Practice Residency Award, sponsored by Pfizer Canada are listed below.

British Columbia Branch (5 awards)

1. Kathleen Lau (Lower Mainland Pharmacy Services)

  • The Effect of Infographic Counselling Aid on Patient Treatment Satisfaction and Understanding in Heart Failure with Reduced Ejection Fraction (INFOSat-HF): A Prospective Single- Arm Before-and-After Study 

2. Amy Jradi (Northern Health)

  • Pharmacists’ Perceived Confidence and Efficacy in Managing Patients with Suicidal Ideation-An Assessment of a Pilot Workshop 

3. Zoe Hopkins  (Island Health)

  • A Retrospective Evaluation of Pulmonary Embolism and Thrombolysis in patients admitted to the Intensive Care Unit (REPEAT ICU) 

4. Alison Bentley (Island Health)

  • Counting the Carbon: Quantifying Financial and Environmental Implications of Wasted Inhaler Doses in the Hospital Setting 

5. Franklin Hu (Lower Mainland Pharmacy Services)

  • Patient-reported Outcomes and Experience following Initiation of Elexacaftor/Tezacaftor/Ivacaftor for the Treatment of Cystic Fibrosis 

Alberta Branch (1 award)

6. Christina Watts (Alberta Health Services)

  • Pharmacist Telephone Follow-up for Antineoplastic Agents used in Hematologic Cancers 

Saskatchewan Branch (1 award)
7. Calvin Yee and Habiba Elshorbagy (Saskatchewan Health Authority)

  • Entrust the Process: Development and Implementation of an Entrustable Professional Activity Assessment Tool for Pharmacy Students Educating Patients on Oral Anticoagulant 

Manitoba Branch (1 award)
8. Danielle D'Entremont  (Winnipeg Regional Health Authority)

  • Characterizing Empiric Antibiotic Therapy for Pediatric Cellulitis at a Hospital with a High Prevalence of MRSA 

New Brunswick and Nova Scotia Branches (1 award)
9. Austin Harding (Nova Scotia Health Authority)

  • Identifying Influences on Decision-Making Regarding Antipsychotic Prescribing to Long-Term Care Residents with Dementia: A Systematic Review of Qualitative Literature

Newfoundland and Labrador Branch (1 award)
10. Courtney Donovan (Newfoundland and Labrador Health Services)

  • A quality-of-life assessment and personal recount of patients currently receiving Cystic Fibrosis therapy with elexacaftor/tezacaftor/ivacaftor 

Ontario Branch (4 awards)
11. Sarah Tessier (The Ottawa Hospital)

  • Assessing Hospital Pharmacists’ Clinical Scope of Practice in Ontario 

12. Spencer Candy (The Ottawa Hospital)

  • Prospective Comparison of Vancomycin Area Under the Curve and Trough Concentration in Specific Populations 

13. Gabrielle Busque (Unity Health Toronto)

  • Describing and Evaluating the Clinical Pharmacist's Role in a Canadian Multiple Sclerosis Clinic

14.  Mishka Danchuk-Lauzon (Sunnybrook Health Sciences Centre)

  • Cannabis Prevalence and Patterns of Use in Cancer Patients Receiving Systemic Anticancer Treatment at Sunnybrook Odette Cancer Centre: A Prospective Survey Study

2023 Graduates

Congratulations to the 2022-2023 residents who successfully completed the Accredited & Accreditation-Pending (Year 1 and Advanced Practice – Year 2) Pharmacy Residency Programs!  


Nouvelles du CCRP – Mars 2024  

23 avril, 2024  

Mise à jour des politiques et procédures d'agrément 

Au cours de la dernière année, le Conseil canadien de la résidence en pharmacie (CCRP) a travaillé à la mise à jour des politiques et procédures d'agrément. Ces mises à jour pour 2024 sont maintenant affichées sur le site Web du CCRP (à noter, la version française sera disponible sous peu).  Les principaux changements comprennent l'ajout des définitions des catégories de certificats d'agrément, ainsi que des modifications aux définitions et aux catégories des programmes de résidence.  En outre, le CCRP a mis à jour le formulaire d’Avis d’intention que les nouveaux programmes de résidence souhaitant demander l'agrément doivent remplir et soumettre au coordonnateur du CCRP à l'adresse cprb@cshp.ca.  Ce formulaire PDF remplissable est également disponible sur le site web du CCRP.

Lauréats des prix Pfizer – Année 1

Le prix de la résidence en pratique pharmaceutique récompense les résidents en pharmacie (Année 1) dont les principaux projets de résidence (typiquement un projet de recherche) sont jugés les plus méritants en termes d'innovation, d'application pratique et/ou de développement d'une pratique pharmaceutique institutionnelle.  Les lauréats reçoivent un prix de 1 000 dollars. 
Pour être éligible, chaque candidat doit:

  • Être membre actuel de la SCPH et avoir été membre de la SCPH au moment où la résidence a été complétée ;
  • Être actuellement inscrit à un programme de résidence en pharmacie (Année 1) agréé (ou en attente d'agrément) dans la province de la division de la SCPH qui administre le prix, ou avoir terminé ce programme depuis un an ; 
  • Soumettre une demande de prix à la division de la SCPH de la province dans laquelle la résidence a été complétée.    

Les lauréats du Prix de la résidence en pratique pharmaceutique 2023, parrainé par Pfizer Canada, sont énumérés ci-dessous.

Division Colombie-Britannique (5 prix) 

1. Kathleen Lau (Lower Mainland Pharmacy Services)

  • The Effect of Infographic Counselling Aid on Patient Treatment Satisfaction and Understanding in Heart Failure with Reduced Ejection Fraction (INFOSat-HF): A Prospective Single- Arm Before-and-After Study 

2. Amy Jradi (Northern Health)

  • Pharmacists’ Perceived Confidence and Efficacy in Managing Patients with Suicidal Ideation-An Assessment of a Pilot Workshop 

3. Zoe Hopkins  (Island Health)

  • A Retrospective Evaluation of Pulmonary Embolism and Thrombolysis in patients admitted to the Intensive Care Unit (REPEAT ICU) 

4. Alison Bentley (Island Health)

  • Counting the Carbon: Quantifying Financial and Environmental Implications of Wasted Inhaler Doses in the Hospital Setting 

5. Franklin Hu (Lower Mainland Pharmacy Services)

  • Patient-reported Outcomes and Experience following Initiation of Elexacaftor/Tezacaftor/Ivacaftor for the Treatment of Cystic Fibrosis 

Division Alberta (1 prix) 

6. Christina Watts (Alberta Health Services)

  • Pharmacist Telephone Follow-up for Antineoplastic Agents used in Hematologic Cancers 

Division Saskatchewan (1 prix) 
7. Calvin Yee and Habiba Elshorbagy (Saskatchewan Health Authority)

  • Entrust the Process: Development and Implementation of an Entrustable Professional Activity Assessment Tool for Pharmacy Students Educating Patients on Oral Anticoagulant 

Division Manitoba (1 prix) 
8. Danielle D'Entremont  (Winnipeg Regional Health Authority)

  • Characterizing Empiric Antibiotic Therapy for Pediatric Cellulitis at a Hospital with a High Prevalence of MRSA 

Divisions Nouveau-Brunswick et Nouvelle-Écosse (1 prix) 
9. Austin Harding (Nova Scotia Health Authority)

  • Identifying Influences on Decision-Making Regarding Antipsychotic Prescribing to Long-Term Care Residents with Dementia: A Systematic Review of Qualitative Literature

Division Terre-Neuve-et-Labrador (1 prix) 
10. Courtney Donovan (Newfoundland and Labrador Health Services)

  • A quality-of-life assessment and personal recount of patients currently receiving Cystic Fibrosis therapy with elexacaftor/tezacaftor/ivacaftor 

Division Ontario (4 prix) 
11. Sarah Tessier (The Ottawa Hospital)

  • Assessing Hospital Pharmacists’ Clinical Scope of Practice in Ontario 

12. Spencer Candy (The Ottawa Hospital)

  • Prospective Comparison of Vancomycin Area Under the Curve and Trough Concentration in Specific Populations 

13. Gabrielle Busque (Unity Health Toronto)

  • Describing and Evaluating the Clinical Pharmacist's Role in a Canadian Multiple Sclerosis Clinic

14.  Mishka Danchuk-Lauzon (Sunnybrook Health Sciences Centre)

  • Cannabis Prevalence and Patterns of Use in Cancer Patients Receiving Systemic Anticancer Treatment at Sunnybrook Odette Cancer Centre: A Prospective Survey Study

Diplômés 2023

Félicitations aux résidents de 2022-2023 qui ont terminé avec succès les programmes de résidence en pharmacie agréés ou en attente d'agrément (année 1 et pratique avancée - année 2)!


April 12, 2024
CPRB News - April 2024

Latest News

Resource Spotlight: Opioid stewardship

April 9, 2024
Written by Mojan Fazelipour 
 
This article was written and researched by a CSHP student member for Interactions, our biweekly newsletter. Crafting these pieces not only helps students gain in-depth knowledge of specific conditions, treatments, and resources, it also helps them hone their skills in research, critical appraisal, evaluation, synthesis, and writing – all of which will serve them well in clinical practice. The Professional Practice Team works with the student to select topics that are of interest and utility to both the student and to you, the reader. We hope you enjoy this piece by one of our future colleagues! Let us know what you think: If you would like to provide any comments or constructive feedback for our students, please email us at practice@cshp.ca

Background

Opioids are widely consumed in Canada, with increasing usage leading to notable harms. In fact, Canada ranks second globally in opioid consumption, and incorrect prescription or use frequently results in opioid harms, including death. Opioid Stewardship emphasizes strategies to ensure the safe use and monitoring of opioids. This resource spotlight aims to highlight some resources about opioids stewardship, with links to associations, guidelines and studies that help pharmacy professionals learn more about opioid prescribing and its management, along with helpful resources to share with patients. To learn more about opioid stewardship and the role of clinical pharmacists, check out CSHP’s recent clinical pearl

CSHP-Specific Resorces

Briefing and Guidelines

Canadian Medication Optimization Briefing & Guidelines: Safe Transitions of Care for Patients Taking Opioids
Within CSHP's Canadian Medication Optimization Briefings, this resource presents perspectives on patient preferences during the initiation or continuation of opioid pharmacotherapy. It offers a comprehensive guide on collecting information about an individual's opioid use, principles of opioid stewardship, and methods for identifying care gaps. Furthermore, it emphasizes the importance of seamless care transitions for patients on opioids, proposing best practices, and includes illustrative case studies.

Advocacy Initiatives

Opioid Crisis Engagement
Here, you can access a comprehensive statement that delineates CSHP's unwavering commitment to addressing the opioid crisis. The document provides an encapsulated view of our advocacy efforts, initiatives, and contributions to combat this significant challenge, capturing the essence of our consultations and commitments in this arena.

External Resources

Canadian Pharmacists Association (CPhA)
The CPhA provides an extensive collection dedicated to enhance the pivotal role of pharmacists in addressing the opioid crisis. Their compendium features evidence-based recommendations and guidelines, tailored to direct pharmacists towards optimal opioid prescription and monitoring practices. Furthermore, the CPhA emphasizes patient engagement by offering resources that elucidate the nuances of opioid therapy, allowing for informed decision-making. This collection of tools serves as an invaluable asset for pharmacists navigating the complexities of the opioid crisis. 

Here are two webinar recordings on this topic: 

The College of Physicians and Surgeons of Ontario (CPSO)
The CPSO aims to address the opioid crisis, ensuring Ontario's providers and patients use opioids appropriately. Their strategy emphasizes safe over non-prescribing, provides physicians with their prescribing data, educational resources, and feedback. To enhance quality, CPSO advocates for real-time patient medication histories, comparative prescribing data, and a provincial monitoring program. The ultimate goal is to promote safe prescribing and promptly address any deviations for both patients and providers. CPSO has developed several guidelines and tools for the appropriate prescribing of opioids.  This is one of their published articles on Dialogue magazine: opioid prescribing. They also provide a message to patients experiencing chronic non-cancer pain: A Message to Patients Living with Chronic Non-Cancer Pain.

Canadian Guideline for Opioids for Chronic Non-cancer Pain (2017)
The 2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain was introduced to promote evidence-based prescribing. Developed by the Michael G. DeGroote National Pain Centre and funded by Health Canada and the Canadian Institutes of Health Research, this guideline updates the 2010 version. While advisory for physicians, it isn't a regulatory mandate and focuses solely on chronic non-cancer pain, excluding acute pain, cancer pain, palliative care, and opioid use disorder treatments.

(Opioid Wisely) Choosing Wisely Canada
The opioid crisis is having devastating consequences for individuals, families, and communities across Canada. It is a complex health and social issue, and there are no simple solutions. In response, Choosing Wisely Canada has launched Opioid Wisely, a campaign that encourages thoughtful conversation between clinicians and patients to reduce harms associated with opioid prescribing. The Opioid Wisely campaign launched on March 1, 2018 with the support of over 30 participating organizations representing doctors, dentists, pharmacists, nurse practitioners, other health professionals, as well as patients and their families. Central to the campaign is a set of 20 specialty-specific recommendations for when the use of opioids should not be first line therapy. These recommendations cover 16 different clinical specialties. 

The Opioid Wisely campaign was initiated at the encouragement of the Pan-Canadian Collaborative on Education for Improved Opioid Prescribing.

The Opioid Wisely campaign also includes information resources to help patients have informed conversations with their clinicians about safe options for managing pain:

Opioid Patient Booklet
Provided by RX Files, this is a patient-friendly document summarizing questions and answers for those considering reduction or elimination of their opioid use.

Canadian Centre on Substance Use and Addiction (CCSA)
The Canadian Centre on Substance Use and Addiction (CCSA) offers a range of evidence-based resources to address the opioid crisis. They focus on both prevention and intervention, covering the entire spectrum from prescription to addiction treatment. Besides research reports and guidelines, the CCSA provides infographics to simplify data for both professionals and the public, promoting informed decisions on opioid stewardship.  The following poster, toolkit, as well as the stigma training are examples of such resources the CCSA provides.

Opioid and Pain Management
This poster delineates the role of opioids in pain management, emphasizing their use in conjunction with non-medical treatments. It also sheds light on the potential risks associated with opioid dependence and offers links to additional opioid-related resources.

Adaptation Toolkit: Co-creating a Local Resource with Caregivers Supporting a Young Person with Substance Use Disorder A comprehensive toolkit designed for healthcare professionals, caregivers, and their allies, aimed at facilitating the co-creation of a localized handbook lead by families and caregivers.
 
Overcoming Stigma Through Language
Developed by the CCSA, the document aims to facilitate conversations and heighten awareness of the stigma faced by individuals who use substances, as well as their support networks and community service providers.  
 

These following three resources also provide insight into the stigma surrounding drug use, raise awareness of its implications, and offer strategies to overcome it, thereby enhancing patient care outcomes.

Canada.ca Opioid Data
The Canadian government provides data on opioid-related harms, monitoring, and surveillance. This can offer insights into patterns of opioid use and misuse across the country.

Institute for Safe Medication Practices Canada (ISMP)
The Institute for Safe Medication Practices (ISMP) has curated a collection of sophisticated resources emphasizing opioid stewardship. Central to their offerings is an emphasis on safeguarding the prescribing, administration, and monitoring processes to abate the inherent risks of opioid utilization. A notable instrument they've developed is "The Pain Check-In". This systematic methodology facilitates precise data collection, utilizing validated instruments, which in turn affords clinicians a robust framework for patient evaluation and joint decision-making. By aiming to standardize the data acquisition process during pain-centric consultations, it addresses and rectifies the observed inconsistencies in clinical approaches. Implemented as a pre-consultation procedure, patients engage with "The Pain Check-In" through either paper-based or electronic mediums, with the data subsequently integrated into clinical documentation systems. This pre-emptive data collection subsequently equips physicians with the necessary insights for efficacious pain management deliberations. You may access both the paper and electronic versions accompanied by their guidebooks here: 

Pain BC Toolbox
Pain BC is a non-profit organization in British Columbia comprised of healthcare professionals, individuals with chronic pain, and passionate advocates. They strive to enhance the quality of life for those with chronic pain, equip healthcare providers with effective assessment and treatment tools, and serve as a central resource for healthcare decision-makers. These are two of their online resources:

  • Pain BC’s Live Plan Be: Live Plan Be, crafted by Pain BC, is a complimentary online platform designed to aid individuals at any stage of their pain experience. It encompasses four key elements: pain knowledge, evaluation tools, Brief Action Planning, and a confidential community discussion space.
  • Pain Waves by Pain BC Podcast: Pain Waves Podcast, devised by Pain BC, features insights from prominent chronic pain specialists and individuals experiencing pain. The podcast delves into the most recent research, methods, and developments in pain management. Audiences can tune into both new and previous episodes online at their convenience. 

The British Columbia Centre on Substance Use (BCCSU)
Established in 2017, the BC Centre on Substance Use emphasizes research and evidence-based strategies to improve substance use healthcare. Their three-fold approach focuses on pioneering research, enhancing addiction medicine education, and providing evidence-based clinical guidance.  Developed by the BCCSU, the Provincial Opioid Addiction Treatment Support Program  provides training to clinicians in BC to obtain their prescribing privileges. It dives deeper into different types of OAT (opioid agonist treatments) including buprenorphine/naloxone, methadone, slow-release oral morphine and iOAT. Although this free course is geared towards prescribers in BC, anyone who has an interest in OAT may take this course. Registration for this course can be found here.

Fraser Health Pain and Opioid Stewardship Mobile App
The Fraser Health Pain and Opioid Stewardship Mobile App – this year’s winning Excellence in Pharmacy Practice – Leadership project – was co-led by Dr. Karen Ng who sought to develop a novel, open-access mobile app customized to deliver opioid stewardship-focused pain management guidance and decision-support tools including medications, pain management strategies, tools, monographs, and live opioid stewardship support. Access the app by clicking here

Opioid Manager APP
Dr. Andrea Furlan and Amy Robidas (RN) have introduced "My Opioid ManagerTM (MyOM),"  a mobile app available for iOS and Android. Complemented by iBook content, this app educates chronic pain patients about pain management using opioids. Originating from the success of the clinician-targeted "Opioid Manager (TM)", MyOM equips patients for consultations, covering pain causes, opioid use, side effects, pain tracking, and safe usage tips. Developed by NetFunctional, the app's interactivity enables pain mapping, medication tracking, and pain change measurements, promoting patient safety and collaborative decision-making. However, its resources are selective, and some linked sites are outside the University Health Network's purview. Sample ECHO Didactic Recording:

Online Opioid Self-Assessment Program

This accredited self-assessment module allows participants to refine their opioid prescribing skills based on the 2017 Canadian Opioid Guideline, offering feedback through case-based questions, and suggesting tailored courses and resources to address knowledge gaps.

 
April 09, 2024
Resource Spotlight: Opioid stewardship

Latest News

CPRB News - March 2024 / mars 2024

March 26, 2024
 
 

Gen Next: Residency & Student Networking Event @ PPC 

Connect with other pharmacy professionals at the Student and Resident Networking Event at the CSHP Professional Practice Conference (PPC) April 19-21, 2024, in Niagara Falls, Ontario. The networking event will be held on Saturday, April 20th from 5 to 6h30 pm. When registering for the conference, be sure to put the Residency and Student Networking Event as an add-on to your ticket.  To register, please go to CSHP Professional Practice Conference 2024

CPRB Accreditation Visits 

In Fall 2023, CPRB visited a total of four programs including: IWK Health Centre (Halifax, NS), Newfoundland and Labrador Health Services (St. John’s, NL), University Health Network/McGill University Health Centre – Year 2 HIV Advanced Residency Program (Toronto, ON and Montréal, QC), and Lower Mainland Pharmacy Services – Year 2 Critical Care (Vancouver, BC).    

In Spring 2024, CPRB surveyors will be visiting another five programs including: Saskatchewan Regional Health Authority (Saskatoon, SK), Centre for Addiction and Mental Health (Toronto, ON), University Health Network – Year 1 General (Toronto, ON), University Health Network – Year 1 Primary Care (Toronto, ON), and Lower Mainland Pharmacy Services – Year 1 (Vancouver, BC). 

We would like to thank the directors and coordinators of these programs for all the work they and their teams have devoted to preparing for the surveys. The Board appreciates your time, effort, and commitment to residency training.  We look forward to visiting you again!  As well, we would like to thank all the surveyors for the precious time they dedicated to these visits. 
 

PRAMS Statistics 2024 

The Pharmacy Residency Application Matching Services (PRAMS) successfully matched 147 residents to residency programs for the 2024-2025 year. Applications to residency programs continue to be competitive. The chart below provides the residency match statistics for the last seven years. Though the number of candidates has decreased in the last few years, the number of positions filled has increased due to an increase in the number of residency programs and an increase in the number of positions available.

Please note this table does not include residents recruited for the programs in Quebec as applications are conducted through university registration later in the Spring. This data will be provided in the next couple of months for the 2024/2025 year. 
CPRB wishes to thank those who provided feedback in the recent PRAMS Survey. We are working to implement changes based on the feedback provided to further improve the matching process. 

--

Nouvelles du CCRP – Mars 2024  

26 mars, 2024  

Gen Next : Événement de réseautage pour les étudiants et résidents au CPP 

Entrez en contact avec d'autres professionnels de la pharmacie lors de l'événement de réseautage pour les étudiants et les résidents qui aura lieu dans le cadre du Congrès de pratique professionnelle (CPP) de la SCPH, du 19 au 21 avril 2024, à Niagara Falls, en Ontario. L’événement de réseautage aura lieu le samedi 20 avril de 17h à 18h30. Lorsque vous vous inscrivez au congrès, assurez-vous d'ajouter l'événement de réseautage pour les résidents et les étudiants à votre billet. Pour vous inscrire, rendez-vous à CSHP Professional Practice Conference 2024.  

Visites d'agrément du CCRP  

À l'automne 2023, le Conseil canadien CCRP a visité un total de quatre programmes, notamment : IWK Health Centre (Halifax, NS), Newfoundland and Labrador Health Services (St. John's, NL), University Health Network/McGill University Health Centre – Résidence de pratique avancée (année 2) en VIH (Toronto, ON et Montréal, QC), et Lower Mainland Pharmacy Services – Soins Critiques (Année 2) (Vancouver, BC).     

Au printemps 2024, les évaluateurs du CCRP visitrons cinq autres programmes, notamment : Saskatchewan Regional Health Authority (Saskatoon, SK), Centre for Addiction and Mental Health (Toronto, ON), University Health Network – Programme général (Année 1) (Toronto, ON), University Health Network – Programme de soins primaires (Année 1) (Toronto, ON), et Lower Mainland Pharmacy Services – Année 1 (Vancouver, BC).  

Nous tenons à remercier les directeurs et les coordinateurs de ces programmes pour tout le travail qu'eux et leurs équipes ont consacré à la préparation des visites d’agrément. Le Conseil apprécie votre temps, vos efforts et votre engagement envers la formation des résidents.  Nous avons hâte de vous rendre visite à nouveau! Nous tenons également à remercier tous les évaluateurs pour le temps précieux qu'ils ont consacré à ces visites.

Statistiques PRAMS 2024  

Le service de jumelage des résidents (Pharmacy Residency Application and Matching Service, PRAMS) a réussi à jumeler 147 résidents à des programmes de résidence pour l'année 2024-2025. Les candidatures aux programmes de résidence continuent d'être compétitives. Le tableau ci-dessous présente les statistiques de jumelage pour les sept dernières années. Bien que le nombre de candidats ait diminué au cours des dernières années, le nombre de postes pourvus a augmenté en raison de l'augmentation du nombre de programmes de résidence et du nombre de postes disponibles.  

Veuillez noter que ce tableau n'inclut pas les résidents recrutés pour les programmes au Québec, car les candidatures se font par le biais des inscriptions universitaires et plus tard au printemps.  Ces données seront fournies dans les prochains mois pour l'année 2024/2025.  
Le CCRP souhaite remercier les personnes qui ont fait part de leurs commentaires dans le cadre de la récente enquête PRAMS.  Nous nous efforçons de mettre en œuvre des changements basés sur les commentaires fournis afin d'améliorer encore le processus d'appariement. 
March 26, 2024
CPRB News - March 2024

Clinical Pearls: Navigating the opioid crisis and the role of clinical pharmacists 

March 26, 2024
By Mojan Fazelipour 

This article is part of a series appearing in Interactions, our biweekly newsletter, written and researched by CSHP's students. We've created this series as a valuable learning activity for pharmacy students undertaking rotations at CSHP. Crafting these pieces not only helps students gain in-depth knowledge of specific conditions, treatments, and resources, it also helps them hone their skills in research, critical appraisal, evaluation, synthesis, and writing – all of which will serve them well in clinical practice. The Professional Practice Team works with the students to select hot topics that are of interest and utility to both the students and to you, the reader. We hope you enjoy this piece by one of our future colleagues! Let us know what you think: If you would like to provide any comments or constructive feedback for our students, please email us at practice@cshp.ca.
 

Background

In the first quarter of 2023, opioid-related hospitalizations averaged 15, up from 13 in 2016 and 12 in 2019, pre-COVID-19. Base on the latest national data in the fall of 2023, the opioid-related deaths rose from 8 per day in 2016 to 21 per day.1 

This upward trend  underlines the increased strain on healthcare systems, marking a rising demand for emergency services and hospitalizations.2 The economic burden of opioid misuse is immense, leading to significant disability-adjusted life-year (DALY) losses .3,4 A multitude of factors drive the ongoing opioid crisis, prominently including the management of pain through opioids for non-cancer conditions. While opioids are widely prescribed for both acute and chronic pain, their application for chronic non-cancer pain remains controversial.5 

The misuse of both prescription opioids and illicit drugs has escalated in recent years, resulting in more deaths than those from suicides and motor vehicle accidents combined.1 This scenario brings to light   the opportunity for hospital pharmacists to play a vital role in combating the overdose epidemic.6 In numerous hospitals, unnecessary or over-prescription of opioids is common, at times even contravening Canadian guidelines.7 Although the importance of proper opioid prescriptions is often overlooked in many hospital settings, evidence indicates that inappropriate practices can lead to adverse effects, including prolonged use after discharge, opioid disorders, and overdoses.8 

In spite of their critical nature, there is a scarcity of research on interventions aimed at improving the safety and adequacy of opioid prescriptions in hospitals. Emerging as a potential solution is the "opioid stewardship" model, which advocates for safer opioid prescriptions. However, studies reveal that only a minority of hospitals have adopted such programs.Pharmacists in healthcare settings, notably hospitals, are at the frontline in addressing in-hospital substance use and mitigating the associated stigma – a primary barrier to opioid stewardship and management programs.Additionally, stigma can lead to patients hiding substance use and experiencing disbelief or disregard from healthcare providers regarding their pain and medication requests.10 The stigma and shame associated with the fear of disclosing drug use can significantly impede appropriate care.11 It is imperative for pharmacists to be advocates for patient-centered care and harm reduction efforts, yet a standardization in pharmacy practices concerning opioid stewardship is lacking across jurisdictions.By engaging in medication reviews and reconciliations, managing  pain clinics, and providing dedicated education on pain management and medication safety, pharmacists play a pivotal role in opioid stewardship. Pharmacists guide treatment referrals, conduct patient screenings, assess and optimize medication therapies, educate both patients and healthcare professionals, and influence policy and guideline development, thereby becoming an integral part of the solution to the opioid crisis.78,9,12

The multifaceted role of clinical pharmacists in opioid stewardship

Clinical pharmacists, with their profound expertise in medication management, are uniquely positioned to advocate for and implement effective opioid stewardship.8,14,15,17 Their strategic role is emphasized as they tackle barriers and facilitate access to medications for Opioid Use Disorder (OUD), marking them as essential players in addressing the opioid epidemic.

In their capacity as opioid stewards, clinical pharmacists take a proactive approach to identify and rectify misuse and suboptimal opioid prescribing. Their rigorous regimen assessments provide insightful recommendations, identifying potential therapeutic pitfalls and adding another layer of safety to pain management.15 The development of patient-centered care plans and collaboration with physicians can optimize the provision of safe and effective pain management strategies. Moreover, clinical pharmacists’ skillset to perform substance use disorder screenings and assessment, coupled with their ability to provide referrals and inter-professional collaborations, adds another layer to their multifaceted role in opioid stewardship.14 Their integration into primary care settings further amplifies clinical outcomes, especially in chronic disease management, culminating in a comprehensive approach to the opioid crisis.18

Empirical evidence consistently highlights the influential roles clinical pharmacists play in opioid stewardship, spanning domains such as education, medication therapy adjustments, pain care plan formulation, policy development, and risk assessments.8,14
By championing these roles, clinical pharmacists stand as allies in the battle against the opioid epidemic. 

Screening and therapeutic optimization

Addressing co-morbid conditions (i.e. psychiatric comorbidities) within pain management programs is crucial for a comprehensive approach to effective pain management.14 This focus on opioid stewardship accentuates the multifaceted roles of pharmacists in ensuring safe opioid use, de-prescribing, and education.14,19 For example, the development of the MORE tool reinforces this need for a multifaceted approach.16 Amidst the opioid crisis, new hospital regulations have emerged, placing an increased emphasis on opioid stewardship by clinical pharmacists and underscoring the necessity for actions that enhance care, safety, and the monitoring roles of pharmacists.20
 

Academic detailing and patient education 

Equipped with public health training, emergency preparedness, and OUD management expertise, pharmacists are uniquely positioned to lead research and educational initiatives addressing the opioid crisis. Their expanded roles in chronic pain management, equipped with interdisciplinary collaboration, promise to relieve pressures on physicians and strengthen guideline-concordant opioid care.17 However, as these roles expand, challenges arise. It's imperative to clearly define their scopes of practice and bolster awareness among primary care providers about these expanded capacities.17 Among the strategic tools employed, academic detailing shines as a potent educational outreach method, proven to refine prescribing practices and curb inappropriate opioid use. Such initiatives have catalyzed improvements in knowledge, attitudes, and prescribing behaviors across healthcare professionals, resulting in superior patient outcomes and a downturn in opioid-related harms and hospitalizations.8,21 The successful integration of such education-centric initiatives reiterates the significant influence of pharmacists in promoting safe opioid usage.It reinforces the assertion that education remains a cornerstone of holistic opioid stewardship approaches.

Pharmacists as advocates in policy and guideline developments 

Programs centered on opioid and pain stewardship are instrumental in identifying opportunities to enhance adherence to best practice guidelines. This encompasses standardizing opioid dosing strategies, prescribing multimodal and opioid-sparing regimens, recognizing substance misuse, reviewing patient histories, acknowledging pain as a disease state, and increasing the dispensing of opioid reversal medications.22 Pharmacists can play a pivotal role in opioid stewardship, actively participating in policy and best practice guideline developments. Indeed, clinical pharmacists are instrumental in operationalizing opioid stewardship guidelines within general practice, guiding reviews for long-term opioid patients, and aiding the de-prescribing journey.15 Moreover, they offer education to patients and healthcare peers on opioid safety and usage, oversee adverse effect monitoring and drug interactions, and work in tandem with healthcare teams to guarantee coordinated care.15 Particularly within interdisciplinary teams, clinical pharmacists contribute significantly by fostering a collective, inter-professional approach to care, influencing opioid stewardship at the initial stages of prescription and playing a key role in both policy creation and execution.7,8,23,24 

Organizations such as the Centre for Disease Control (CDC) and the American Society of Health-System Pharmacists recognize pharmacists for their unique skills in substance abuse prevention, patient education, and integrated pain management approaches, highlighting their indispensable role in executing opioid and pain stewardship programs effectively.22 Effective implementation and uptake of opioid stewardship programs are essential for ensuring consistent best practices in pain treatment and reducing opioid use and availability. Further research into pharmacist-driven opioid stewardship programs is encouraged to continue enhancing their impact and effectiveness.22

Collaborative care 

Evidence underscores the effectiveness of an inter-professional, team-based approach in enhancing clinical outcomes in chronic disease management, spotlighting the critical role pharmacists play in collaboratively addressing the opioid crisis with other healthcare professionals.25 Recognized as medication experts on interprofessional healthcare teams, pharmacists find their roles continually expanding and integrating more closely with the broader healthcare system. This emphasizes the importance of collaborative and interdisciplinary approaches.25 In public health emergencies, clinical pharmacists can collaborate with authorities, manage medical/biological waste, provide quality counseling and medication management for at-risk groups, and prevent opioid misuse through education and pain care plan development.14 Moreover, fostering collaboration and open communication between physicians and pharmacists has been proven to yield positive outcomes, improving opioid decision-making and indicating a need for ongoing research to enhance the quality of such communication.14,24

Pharmacists are progressively positioning themselves at the forefront of addressing public health crises, advocating for safe opioid use policies, and drawing from their medication expertise to contribute substantively to policy development. 19 Recognizing the expanding scope of their practice, there's a pressing need to amend regulations to maximize the potential contributions of pharmacists in this field. At the core of their approach is the intent to challenge stigma, advocate for patient-centered care, and ensure the safe use of opioids—actions which undoubtedly reduce societal costs and impacts associated with misuse.19 As pillars in public health, pharmacists are expanding their preventive services in primary care settings and strategizing to accomplish these roles effectively.26 Their proactive stance has addressed issues ranging from low immunization rates to adverse drug event management, and optimizing therapeutic strategies, underlining their versatility and commitment in combating public health issues.27

In response to the public health emergency presented by the opioid crisis hospital and community pharmacists are leading the way in harm reduction strategies, and playing a pivotal role in reducing the stigma surrounding opioid addiction by addressing deeply entrenched attitudes and beliefs about opioid use through knowledge translation. Notable strategies include conduction of medication reviews, academic detailing and education, opioid use risk assessment and pain management, and collaboration with the interdisciplinary teams as the medication experts. These measures, along with the community-based strategies (e.g., Safe Injection Sites, Drug checking with fentanyl test strips, and Naloxone distribution and training) not only shift the perception of substance use away from criminality and moral judgment but also underscore the importance of compassionate care. Validating the efficacy and suitability of such interventions, especially in clinical pharmacy settings, is essential to ensure sustained impact and success in combating this crisis.12

Opioid stewardship in hospitals 

The ongoing opioid crisis has precipitated a significant increase in hospital-related adverse events, with opioids now ranking as the second leading cause of such incidents.13 In response, a cross-sectional, descriptive survey, funded by the American Society of Health-System Pharmacists (ASHP) Foundation, was conducted to assess best practices in opioid use and determine the prevalence of opioid stewardship programs across hospitals.13 Of the 133 hospitals surveyed, a mere 23% had established an opioid stewardship program, and only 14% implemented proactive screening for patients at high risk of opioid-related adverse events (ORAEs). The survey revealed variability in screening criteria and formulary restrictions, contingent on specific opioid types. Notably, 45% of the hospitals had imposed restrictions on patient-controlled analgesia. Although a majority of hospitals (90%) maintained pain management services, palliative care offering pain management was available in only 67% of them. These findings underscore a pressing need for more hospitals to adopt opioid stewardship programs, integrate proactive ORAE screening, and employ best practices to ensure safe opioid use.13

Hospital pharmacists have the opportunity to collaborate with community pharmacists to address opioid overdoses and related harm. Initiatives that uphold a patient-centered and individualized approach to opioid use disorder recovery are crucial. These efforts should also aim to shift perceptions of opioid use away from criminality and moral judgment, fostering an environment of compassionate care and challenging the stigma associated with substance use.11

Examples of hospital pharmacist-led initiatives in opioid stewardship

Pharmacists play an integral role in ensuring the safe and appropriate use of opioids, involving not only proper prescribing, dispensing, and education but also participating in ongoing training within pain management programs. Their essential responsibilities encompass minimizing opioid misuse and implementing effective opioid stewardship strategies, including de-prescribing practices, to further protect patient health.

To address this, a study assessed a pharmacist-led initiative in primary care between November 2017 and May 2018.14 The initiative involved pharmacists in identifying at-risk patients, formulating care plans, and liaising with physicians. Results showed a substantial increase in the number of patients with pharmacist-created care plans and a marked rise in opioid tapering.14 Furthermore, the intervention led to an 11% decrease in daily opioid doses and an 8% drop in benzodiazepine doses. This underscores the potential of clinical pharmacists in mitigating opioid-related risks and emphasizes their role as opioid stewards.

Another notable example of a pharmacist-led initiative is a hospital-based opioid stewardship program that was initiated in January 2020 by The British Columbia Centre on Substance Use and St Paul’s Hospital in Vancouver, BC.Comprising of a diverse team of healthcare professionals, including physicians, pharmacists, and researchers, the program aimed to refine opioid prescription practices. The initiative involved an advisory committee and incorporated patients as key stakeholders, emphasizing the importance of "Audit and Feedback" in identifying and assessing patients exposed to prescription opioids. The program, which also incorporated a consultation service and multiple educational initiatives, screened over 3,000 patients in its inaugural year and achieved a 93% intervention acceptance rate. Overall, a total of 576 patient encounters resulted in 1,599 interventions, with the primary recommendations including adjusting opioid dosages, adding non-opioid analgesics, and providing patient education on opioid use.The success of this program, defined by the acceptance rate of the recommended interventions, at St Paul’s highlights the transformative role pharmacists can play in the broader health system, although the unique demographic of the hospital may influence the wider applicability of such initiatives.  

Additionally, a study was conducted as part of a mixed-methods pharmacist pilot initiative, aiming to enhance opioid management in general practice through a pharmacist-led program.15 The initiative, supported by organizational policy, leadership, and education, facilitated a person-centered approach to opioid review and weaning. GPs reported increased accountability and reflection regarding opioid prescribing, and feedback on successful de-prescribing outcomes further reinforced commitment to the program. Despite initial challenges in patient communication, the learnings from this initiative were applied to other high-risk medicines, showcasing the practicality and effectiveness of such pharmacist-led approaches in improving opioid management.15 

In Canada, amidst the escalating opioid overdose crisis, the development of the MORE tool (Medication review, Optimization, Reassessment, and Education) emerged as a strategic response to fortify opioid prescribing practices within hospital settings.16 Designed through rigorous literature reviews and deliberative pharmacist focus groups, this tool was subsequently piloted among clinical pharmacists, highlighting their instrumental role in opioid stewardship. The clinical tool was tested by pharmacists on general medical and surgical wards of the St. Paul’s hospital in Vancouver, BC, over a 3-week period in February 2018. Clinical pharmacists employed the tool for patient assessment when an opioid was combined with a benzodiazepine, a regular opioid medication was ordered, or opioids were prescribed as-needed for over 5 days. These criteria aimed to optimize the pharmacists’ impact without adding excessive work to their existing duties. This innovative tool demonstrated notable efficacy in discerning pertinent risk factors and suggesting potential interventions for patients exhibiting non-malignant pain symptoms within general medical and surgical wards.16 The study's findings underscore the necessity for further refinement in the tool's structural design and content presentation, a step deemed crucial for enhancing its overall user experience and fostering more widespread acceptance within the clinical pharmacist community.16

Future directions 

Moving forward, the expanding role of pharmacists in public health—including pharmacist-led opioid agonist treatment prescribing and opioid stewardship programs—presents a promising avenue for more integrated and holistic approaches to combating opioid harm and other public health challenges. There is a palpable need for additional research in design, implementation, and evaluation of clinical pharmacist-led opioid stewardship programs. This underscores the necessity for continued innovation, research, and collaboration to maximize the impact and reach of pharmacist-led initiatives.

References

  1. Opioid- and stimulant-related harms — Canada.ca [Internet]. [cited 2023 Sep 21]. Available from: https://health-infobase.canada.ca/substance-related-harms/opioids-stimulants/
  2. Bolshakova M, Bluthenthal R, Sussman S. Opioid use and misuse: health impact, prevalence, correlates and interventions. Psychol Health. 2019 Sep;34(9):1105–39.
  3. Rosenblum A, Marsch LA, Joseph H, Portenoy RK. Opioids and the treatment of chronic pain: Controversies, current status, and future directions. Experimental and Clinical Psychopharmacology. 2008 Oct;16(5):405–16.
  4. Naghavi M, Abajobir AA, Abbafati C, Abbas KM, Abd-Allah F, Abera SF, et al. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet. 2017 Sep;390(10100):1151–210.
  5. Tamblyn R, El-Gabalawy H, Volkow N. CIHR assessment of the Canadian Guideline for Opioids for Chronic Non-Cancer Pain. Ottawa, ON, CA: Canadian Institutes of Health Research; 2017.
  6. Belzak L, Halverson J. Evidence synthesis - The opioid crisis in Canada: a national perspective. Health Promot Chronic Dis Prev Can. 2018 Jun;38(6):224–33.
  7. Ti L, Mihic T, James H, Shalansky S, Legal M, Nolan S. Implementation of an Opioid Stewardship Program to Promote Safer Opioid Prescribing. CJHP [Internet]. 2022 Apr 4 [cited 2023 Sep 21];75(2). Available from: https://www.cjhp-online.ca/index.php/cjhp/article/view/3115
  8. Gondora N, Versteeg SG, Carter C, Bishop LD, Sproule B, Turcotte D, et al. The role of pharmacists in opioid stewardship: A scoping review. Research in Social and Administrative Pharmacy. 2022 May;18(5):2714–47.
  9. Canada PHA of. Addressing Stigma: Towards a More Inclusive Health System [Internet]. 2021 [cited 2023 Sep 21]. Available from: https://www.canada.ca/en/public-health/corporate/publications/chief-public-health-officer-reports-state-public-health-canada/addressing-stigma-toward-more-inclusive-health-system.html
  10. Donovan E, Bratberg J, Baird J, Burstein D, Case P, Walley AY, et al. Pharmacy leaders’ beliefs about how pharmacies can support a sustainable approach to providing naloxone to the community. Research in Social and Administrative Pharmacy. 2020 Oct;16(10):1493–7.
  11. Strike C, Robinson S, Guta A, Tan DH, O’Leary B, Cooper C, et al. Illicit drug use while admitted to hospital: Patient and health care provider perspectives. Davidson P, editor. PLoS ONE. 2020 Mar 5;15(3):e0229713.
  12. Bach P, Hartung D. Leveraging the role of community pharmacists in the prevention, surveillance, and treatment of opioid use disorders. Addict Sci Clin Pract. 2019 Dec;14(1):30.
  13. Ardeljan LD, Waldfogel JM, Bicket MC, Hunsberger JB, Vecchione TM, Arwood N, et al. Current state of opioid stewardship. American Journal of Health-System Pharmacy. 2020 Apr 1;77(8):636–43.
  14. Tilli T, Hunchuck J, Dewhurst N, Kiran T. Opioid stewardship: implementing a proactive, pharmacist-led intervention for patients coprescribed opioids and benzodiazepines at an urban academic primary care centre. BMJ Open Qual. 2020 Apr;9(2):e000635.
  15. Jordan M, Young-Whitford M, Mullan J, Stewart A, Chen TF. A pharmacist-led intervention to improve the management of opioids in a general practice: a qualitative evaluation of participant interviews. Int J Clin Pharm. 2022 Feb;44(1):235–46.
  16. Woods B, Legal M, Shalansky S, Mihic T, Ma W. Designing a Pharmacist Opioid Safety and Intervention Tool. CJHP [Internet]. 2020 Feb 20 [cited 2023 Sep 21];73(1). Available from: https://www.cjhp-online.ca/index.php/cjhp/article/view/2952
  17. Giannitrapani KF, Glassman PA, Vang D, McKelvey JC, Thomas Day R, Dobscha SK, et al. Expanding the role of clinical pharmacists on interdisciplinary primary care teams for chronic pain and opioid management. BMC Fam Pract. 2018 Dec;19(1):107.
  18. Luli AJ, Bounthavong M, Watanabe JH. Pharmacists on the front-line of solving a public health crisis: Increasing access to medications for opioid use disorder. Journal of the American Pharmacists Association. 2020 Mar;60(2):297–303.
  19. Sanyal C. Economic burden of opioid crisis and the role of pharmacist-led interventions. Journal of the American Pharmacists Association. 2021 May;61(3):e70–4.
  20. Ghafoor VL, Phelps PK, Pastor J, Meisel S. Transformation of Hospital Pharmacist Opioid Stewardship. Hosp Pharm. 2019 Aug;54(4):266–73.
  21. Himstreet JE, Shayegani R, Spoutz P, Hoffman JD, Midboe AM, Hillman A, et al. Implementation of a pharmacy-led virtual academic detailing program at the US Veterans Health Administration. American Journal of Health-System Pharmacy. 2022 May 24;79(11):909–17.
  22. Santalo O. Before It Is Too Late: Implementation Strategies of an Efficient Opioid and Pain Stewardship Program. Hosp Pharm. 2021 Jun;56(3):159–64.
  23. Toma A, Crişan O. Improving the Pharmacists’ Response to Public Health Emergencies—Documentary Research on Online Resources Provided by National Pharmacists’ Associations. Int J Public Health. 2022 Aug 24;67:1604537.
  24. Curran GM, Freeman PR, Martin BC, Teeter BS, Drummond KL, Bradley K, et al. Communication between pharmacists and primary care physicians in the midst of a U.S. opioid crisis. Research in Social and Administrative Pharmacy. 2019 Aug;15(8):974–85.
  25. Kosobuski L, O’Donnell C, Koh-Knox Sharp CP, Chen N, Palombi L. The Role of the Pharmacist in Combating the Opioid Crisis: An Update. SAR. 2022 Dec;Volume 13:127–38.
  26. DiPietro Mager N. Expanding Pharmacy Services to Support Public Health. Innov Pharm. 2021 Nov 9;12(4):14.
  27. Renfro ML, Moczygemba LR, Baumgartner J, Baumgart G, Hill LG. Opioid-Related Education Provided by Continuing Education Divisions at US Pharmacy Schools. American Journal of Pharmaceutical Education. 2020 Oct;84(10):ajpe8001. 

Latest News

March 26, 2024
Clinical Pearls: Navigating the opioid crisis and the role of clinical pharmacists

Latest News

Advocacy in Action: March 12

March 12, 2024
 
  

February 1, Special Multistakeholder Committee Debrief 

Health Canada provided stakeholders with more information on Florida's bulk importation proposal and the associated regulatory measures the government is enacting to minimize its impact Canadians. CSHP CPO Rita Dhami expressed her concerns about the proposal, highlighting the potential consequences for certain patient groups and called for increased protection of a Vulnerable Drugs List. 

February 1, Choosing Wisely Canada Meeting of the Associations and Societies 

CSHP participated in the Meeting of the Associations and Societies hosted by Choosing Wisely Canada. The meeting's main agenda revolved around developing a handbook addressing climate change with an emphasis on hospital pharmacy-based recommendations. CSHP and CPhA will be collaborating to craft recommendations relevant to the pharmacy sector.

February 5, ASOP Canada FDA Drug Importation Letter to Minister Holland 

Following up the Special Multistakeholder Committee Debrief on February 1, CSHP cosigned a letter alongside members of ASOP Canada that requested further meetings to discuss gaps identified in the current regulatory framework. 

February 8, Drug Shortages Expert Review Panel

As part of a multistakeholder panel, CSHP is working to develop a framework to assess the clinical and supply chain risk of certain drugs. In turn, this tool will aid in creating a systematic, adaptable, transparent, and regularly updated National Vulnerable Drugs List. For information on the status of this project, please view CADTH’s health technology review.

Ongoing, Health Canada Drug Shortages Meetings

CSHP is continuing to monitor these ongoing drug shortages:

  • February 22 : Health Canada Meeting on Shortages of Semaglutide (Ozempic): –  CSHP is actively engaged in multistakeholder meetings with Health Canada to oversee the supply of Ozempic. Despite ongoing efforts to enhance and stabilize the situation, intermittent delays may persist for Canadians due to sustained high global demand.
  • February 26: Tier Assignment Committee (Propofol Injectable) – Health Canada is closely monitoring the propofol supply situation and has designated it as a Tier 3 shortage, indicating its significant potential impact on Canada's drug supply and healthcare system. It will be listed on the shortages list accordingly.
  • February 27: Tier Assignment Committee (Thiamine Injectable)–  Both market authorization holders in Canada, Omega and Sandoz, are reporting a shortage of Thiamine Hydrochloride Injectable. This shortage has been classified as Tier 3, prompting the drug shortages unit to seek foreign-authorized supply to address the issue.

To catch up on CSHP advocacy news, click here.

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Reach out to our professional practice team!   

March 12, 2024
Advocacy in Action: March 12

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