News

Latest News

Call for applications: CSHP Foundation Board Industry Trustee

June 4, 2024

 

Call for applications
The Board of the CSHP Foundation is seeking applications for an
Industry Trustee

Selection Criteria:

  • Employed by either a research-based or generic pharmaceutical company.
  • A CSHP Member or employed by a CSHP Corporate member.
  • Demonstrated interest in hospital pharmacy practice and supporting the initiatives of the Foundation, its Mission and Vision.
  • Demonstrated employer support for the commitment required to fill the Trustee role.
  • No conflict of interest with the work of the Foundation.
     

Industry Trustee Term: 3 years (option to renew once, 6 years total).
Term of appointment will start November 1, 2024.

CSHP Foundation Industry Trustees are voting members of the Foundation Board. This is your opportunity to become directly involved in the work of the CSHP Foundation.
 
Are you interested? Information on CSHP Foundation Board Member responsibilities and application forms are available on the Foundation’s website at  https://cshp-scph.ca/foundation-board-member-recruitment

For additional information on position responsibilities and commitments, contact Michael LeBlanc, Chair, CSHP Foundation Board Trustees, at michael.leblanc@horizonnb.ca.

Completed application forms and other required documents should be submitted electronically to Rosemary Pantalone at rpantalone@cshp.ca.

Deadline Date for Applications is September 12, 2024
June 04, 2024
Call for applications: CSHP Foundation Board Industry Trustee

Latest News

Advocacy in Action: May 7

May 7, 2024
 
  

What's happened

May 15, Choosing Wisely Canada Climate Conscious Recommendations 

Professional Practice Specialist, Kiet-Nghi Cao, presented CSHP and CPhA’s joint hospital pharmacy recommendations to the hundreds in attendance on May 15’s Choosing Wisely Talks. 
 
The presentation of our ten new recommendations was part of Choosing Wisely Canada’s 40 new recommendations focused on sustainability. These recommendations were developed by national societies or associations spanning 20 specialties. Their goal is to provide practical ways to stop or reduce routine practices harming the environment without compromising patient care. 
 
To check out a recording of the presentation, click here.

May 15, Multi-Stakeholder Steering Committee on Drug Shortages 

CPO, Rita Dhami, participated in the Multi-Stakeholder Steering Committee on Drug Shortages to help work towards a more rigorous, coordinated approach to handling shortages. Health Canada provided an update on work being done as they evolve into the new Drug Shortages Directorate. The engaging drug shortage sessions at PPC and the Harrison Management Seminar were a topic of discussion. Health Canada expressed their appreciation for the opportunity to participate at Harrison. 

Ongoing, Health Canada Drug Shortages Meetings

CSHP is continuing to monitor these ongoing drug shortages:
  • May 7, Tier Assignment Committee: Shortages of Bupivacaine and epinephrine
  • May 17, Tier Assignment Committee: Thyrogen (Thyrotropin Alfa, 0.9 mg/vial) 

What's happening

May to June, NAPRA Consultation on Modernization of Drug Schedules

CSHP was part of an expert panel contributing to the modernization of the NAPRA Drug Schedules. After initial discussions with expert groups, NAPRA has outlined two potential models for non-prescription drug (NPD) scheduling, along with their respective terms of sale, for potential inclusion in the updated program. Moving forward, CSHP will be asking all members to contribute to formulating a response to these proposals.

June 6, Transforming Primary Care in Canada Summit

CSHP CEO Jody Ciufo and CPO Rita Dhami will be meeting with pharmacy leaders from across Canada- along with other prominent healthcare professionals, policymakers, and patient advocacy groups- at CPhA’s inaugural national summit. 

The Transforming Primary Care in Canada Summit aims to achieve consensus on the future roles of pharmacists and pharmacy teams in primary care. It will identify barriers and facilitators for integrating community pharmacies into primary care and outline priority areas for actionable initiatives. 

What's worth repeating

April 19-21, Bilateral Meetings with Officers  

CSHP's executive team, comprising President Ashley Walus, President Elect Katie Hollis, Past President Sean Spina, and Treasurer Megan Riordon, together with CEO Jody Ciufo and CPO Rita Dhami, engaged in discussions with these organizations to explore further collaboration: 

  • Indigenous Pharmacy Professionals of Canada: Jaris Swidrovich and Cassandra McClelland 
  • Canadian Association of Pharmacy Students and Interns: Madison Wong 
  • Association des pharmaciens des établissements de santé du Québec: Julie Racicot, Linda Vaillant, and Suzanne Atkinson 
  • American Society of Health-System Pharmacists: Nishaminy Kasbekar 
  • Board of Pharmacy Specialties: Sejal Lewis  
  • Pharmacy Examining Board of Canada: John Pugsley, Terri Schindel, and Harriet Davies 



To catch up on CSHP advocacy news, click here.

Have a question about Advocacy in Action or CSHP's advocacy and consultation work?
Reach out to our professional practice team!   

May 21, 2024
Advocacy in Action: May 21

Latest News

PPC 2024: A spectacular return 

May 21, 2024
 
 

By the numbers 

  • 482 Attendees 
  • 29 Sponsors 
  • 58 Exhibitors 
  • 1,635 Game codes redeemed 
  • $2,400 in Prizes 
  • 31 Educational sessions delivered 
  • 64 Posters presented 
  • 16 CEUs available

CCCEP Accreditation for PPC 2024 has ended, but there is still plenty to learn!
Head to the conference portal to catch up on sessions you may have missed or rewatch your favourite sessions. 

 

Access portal


Professional Practice Conference 2024 wrap-up

 
After three years of being combined with the Banff and Harrison Seminars, the Professional Practice Conference made its triumphant return as a standalone event, taking place both in-person in Niagara Falls, ON, and virtually worldwide. Attendees of this hybrid conference experienced leading educational sessions and social aspects of the event.
 

This year’s educational offerings were kicked off with an immersive pre-conference workshop led by Indigenous Pharmacy Professionals of Canada’s Amy Lamb and Cassandra McLelland alongside Elder Blu Waters, teaching those in attendance how to best frame health and wellness values of diverse Indigenous Peoples.
 
    
 

Then, at the opening ceremonies, Nkem Iroh welcomed CSHP delegates with an official introduction to the Black Pharmacy Professionals of Canada and helped to welcome International Keynote speaker Dr. John Clark to the stage.

  

Additional sessions encompassed a diverse range of topics, spanning from mRNA editing and climate-conscious pharmacy practice, to antibiotic-resistant infections in Canada or technologies for sterile compounding in addition to the Vision for Hospital Pharmacy Panel which empowered the driving forces of change, future roles, and best practices in pharmacy.


Plus, attendees took in six keynote speeches including Dr. Muhammad Mamdani’s speech on “Practical Applications of Artificial Intelligence in Healthcare" and Mark Black’s moving talk providing us with a look “Through a Patient’s Eyes” that perfectly closed out the conference. 

    

Meanwhile, PPC 2024 was also an excellent opportunity to reconnect with friends both familiar and new. Friday gave guests the chance to visit industry partners to learn more about their latest innovation, hospital partners to discuss career opportunities or head to the booths of our non-profit partners to learn more about their organizations! Later that evening, everyone was invited to have a roarin’ good time at the Hospitality at the Hard Rock where there were drinks, light snacks, spectacular surroundings, good music, and even better people. 

    

Saturday held a multitude of can’t miss events including the Gen Next: Student and Resident Networking Event, the Gala Dinner with Duelling Pianos Niagara closing out the evening with everyone out on the dance floor.  

Then, on Sunday morning, delegates were invited to relax and recharge for the conference’s final day with Rise ‘N Shine Yoga. This was not to forget the awesome prizes available to both in-person and virtual attendees, including gift cards, complimentary registration for next year’s Professional Practice Conference, and an abundance of swag. 

As we officially wrap up this year’s Professional Practice Conference, we’re already looking forward to next year when we’ll be welcoming you to the Nation’s Capital for the 56th edition of PPC! 

 
May 21, 2024
PPC 2024: A spectacular return

Latest News

Resource Spotlight: Green Practices in Hospital Pharmacy

May 7, 2024
Written by Huy Pham
 
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

There are numerous environmental impacts from the use of pharmaceuticals throughout their life cycles. These can manifest from the greenhouse emissions associated with pharmaceuticals, from the ecological effects of pharmaceuticals in the environment, or from the impact of plastic waste from pharmaceutical packaging. However, there are green procurement strategies that can be implemented to reduce the environmental impact of the Canadian drug supply chain.

This “Resource Spotlight” contains links to tools and resources to help pharmacists learn more about environmental sustainability and green procurement and to aid in the implementation of sustainability initiatives, as well as provide examples of green initiatives that have been implemented. To learn more about the environmental impact of pharmaceuticals and sustainable procurement of pharmaceuticals, check out CSHP’s recent Clinical Pearls article on green supply chains in hospital pharmacy.

 

Canadian Resorces

Creating A Sustainable Canadian Health System In A Climate Crisis (CASCADES)
CASCADES is a pan-Canadian coalition that is dedicated to support the transition of the Canadian healthcare community system towards environmental sustainability and climate resilience. Their website contains a step-by-step guide to creating a practice of pharmacy that is climate resilient and low carbon sustainable. The CSHP Sustainability Task Force was involved with the review of the playbook. In addition, CASCADES has a playbook that aims to address the issue of environmental sustainability in organizational readiness, with an activity matrix to help identify opportunities for the implementation of sustainability.

Choosing Wisely Canada
The recommendations by Choosing Wisely Canada can reduce the amount of unnecessary treatments, which not only prevent undue harm to the patient as a result of unnecessary treatments but also reduces overall production of waste. There are recommendations drafted by CSHP specific to the hospital pharmacy setting as well as patient resources to enable conversations about their medications. In addition, Choosing Wisely had a webinar on the environmental co-benefits of reducing overuse and low-value care.

Plus, on May 15, CSHP will be joining Choosing Wisely Canada's talks to introduce CSHP and CPhA's brand new joint recommendations, offering practical ways to stop or reduce routine pharmacy practices that harm the environment without compromising patient care alongside the likes of Dr. Srinivas Murthy and Dr. Marko Balan from the Canadian Critical Care Society and many more. You can learn more about this event here and register here

Canadian Association of Pharmacy for the Environment (CAPhE)
CAPhE is a volunteer-run organization of pharmacy professionals who aims to improve and promote planetary health in the pharmacy profession. Their “Planetary Health & Pharmacy” webpage outlines topics such as pharmacy's contribution to pollution, disaster planning, and medication management during heat waves. They have a dedicated QID community for the exchange of best practices for climate change management and for encouraging the creation of committees to address environmental issues.

Canadian Coalition for Green Health Care
Canadian Coalition for Green Health Care is a green health care resource network that strives to create a net zero, climate resilient, environmentally sustainable health system by enabling the development of green policies and practices in healthcare. They have a free monthly Green Health Care Digest that outlines initiatives in green health care, upcoming events, and updates on Coalition activities. There is also an Environmental Stewardship Guidebook for hospitals that serves as a primer to facilitate the transition towards an overall greener structure. The Coalition, in partnership with the Children’s Hospital of Eastern Ontario (CHEO), drafted a Green Hospital Procurement Guide to aid health care institutions and organizations with implementing policies and procedures on environmentally preferable purchasing. A webinar hosted by Canadian Coalition for Green Health Care, PEACH Health Ontario, and CASCADES covers the issue of pharmaceuticals in the environment, how they enter the environment, and their impacts on wildlife.

Partnerships for Environmental Action by Clinicians and Communities for Hospitals / Health care facilities (PEACH)
PEACH is an Ontario initiative for the engagement, encouragement, and empowerment of individuals in the health care sector to create climate action at their facilities. The website acts as a hub for the information sharing on new initiatives and a platform for project collaboration. They have infographics and resources on topics including sustainable prescribing, the safe elimination of certain products and packaging, and creating a hospital green team.

Canadian Agency for Drugs and Technologies in Health (CADTH)
CADTH has published a Horizon Scanning report on the environmental impact of clinical care. The report outlines the principles and concepts behind environmentally sustainable health care and gives examples of initiatives and activities in sustainable clinical care such as inhaler prescribing and opportunities in procurement.

International Resources

Health Care Without Harm (HCWH)
HCWH is an international nongovernmental organization that works to reduce the environmental footprint of health care worldwide and lead a global movement for environmental health and justice. The U.S. and Canada branch has sample policies for hospitals to help facilitate environmental preferable purchasing. The website also has a dedicated page for waste management, describing strategies for waste management and the principles for sustainable health care waste management. 

Global Green and Healthy Hospitals (GGHH) 
GGHH is an international network of over 1,750 hospitals, health care facilities, health systems, and health organizations from more than 80 countries that strives to reduce the environmental impact of hospital care and promote environmental and public health. Their Sustainable Procurement Guide provides guidance on creating and advocating for sustainable purchasing strategies with examples of healthcare organizations worldwide.

National Health Service
The NHS has released a report on their ambitions towards net zero. This report outlines the specific interventions that the NHS has undertaken to reduce the carbon footprint of the NHS, as well as their proposition for new, sustainable models of care. The NHS has a monthly bulletin that provides updates on their efforts toward net zero and ways to be involved with the NHS's push towards sustainable care.

JanusInfo Pharmaceutical and Environment
JanusInfo is a Swedish drug information website developed by the Stockholm Region Pharmaceutical Committee. They have a database that classifies pharmaceuticals based on their environmental hazard and risk. Each drug in the database has a profile that describes their capacity for bioaccumulation, environmental persistence in aquatic environments, and toxicology to aquatic organisms. 

 
May 07, 2024
Resource Spotlight: Green Practices in Hospital Pharmacy

Clinical Pearls: Green supply chains in hospital pharmacy

April 23, 2024
By Huy Pham
 
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

The Canadian drug supply chain can be conceptualized as having four phases: drug approval, manufacturing, procurement/distribution, and front-line delivery. The drug approval phase concerns the process of development of drugs by pharmaceutical companies and reviews of efficacy, safety, and quality performed by Health Canada to determine whether a drug product is approved for use in Canada. The manufacturing phase pertains to the mass production of pharmaceuticals and includes the process of acquiring the raw materials for the active pharmaceuticals, batch production, and surrounding Good Manufacturing Practices and quality control. The procurement/distribution phase of the drug supply chain describes the movement of pharmaceutical products from the manufacturers to the front-line users. Key players include the wholesalers and distributors, who are responsible for the warehousing and delivery of pharmaceutical products, and group purchasing organizations, who are the intermediaries for direct negotiation with manufacturers to secure cost savings. The front-line delivery phase refers to the end-user of the pharmaceutical products and includes hospitals, healthcare professionals, and patients.¹

Figure 1. Product flow of drugs to hospital pharmacies in Canada (adapted from Multi-Stakeholder Toolkit: A Toolkit for Improved Understanding and Transparency of Drug Shortage Response in Canada¹)

Environmental Impacts of Pharmaceuticals

There are many environmental impacts associated with the life cycle of pharmaceuticals and the drug supply chain, from the acquisition of raw materials to the disposal of drug products. These environmental impacts may broadly fall into these three categories: greenhouse gas emissions, pharmaceutical waste, and plastic waste.

Healthcare contributes 4.6% of Canada’s total greenhouse gas emissions and thus is a major contributor to climate change and its adverse impacts on health such as increased frequency of heat-related illness, exacerbations of asthma and chronic obstructive pulmonary disease due to exposure of wildfire smoke made more likely due to climate change, and worsening of mental disorders. The effects of climate change have both direct impacts on healthcare facilities and indirect impacts via effects on their supply chains, with the former contributing approximately 10% of total Canadian healthcare emissions and the latter the remaining 90% of the total emissions from healthcare in Canada. Pharmaceuticals, prescription and non-prescription drugs, contribute 25% of healthcare greenhouse gas emissions in Canada.²

Pharmaceuticals may appear in the natural environment through a variety of pathways. Pharmaceuticals excreted from the human body via urinary or fecal excretion pass through sewage treatment plants that are likely incapable of removing pharmaceuticals and its metabolites, effectively enabling their entry into natural waterways as part of the treated water and as part of the sewer sludge. Pharmaceuticals may also find entry into waterways when unused medications are improperly disposed. In addition, medications that are improperly disposed in solid waste may end up in landfills, where pharmaceutical residue can leach into the environment (soil, groundwater). Finally, the incineration of unused medications has the potential to release pollutants into the atmosphere.3

The presence of pharmaceuticals in the environment has numerous ecological impacts. Pharmaceuticals bioaccumulate up the food chain/web as predators consume organisms that are exposed to these pharmaceuticals. Humans may also be at risk through the consumption of organisms who have bioaccumulated pharmaceuticalse.4-6 Several studies have detected active pharmaceutical ingredients at concentrations that are known to cause acute and chronic toxicitiese.For instance, perch that were exposed to oxazepam in effluent-influenced surface waters exhibited alterations to their behaviour such as increased boldness, reduced sociality and increased feeding ratese.8,9 Another example includes vultures in South Asia who developed renal failure and gout due to exposure to diclofenac, causing the population to decline.10 The population decline of vultures had downstream effects. As scavengers, the vultures fed on uneaten carcasses that serve as breeding grounds for pathogenic bacteria and infectious diseases such as anthrax, which can posed a public health threat as these carcasses were in close proximity to human habitation. In addition, the decline in vultures enabled the growth of opportunistic species like feral dogs and rats, who are reservoirs of rabies and other zoonotic diseases. This resulted in the increased spread of rabies to humans.11,12 The overall decline in vulture populations and subsequence growth in dog and rat populations imposed an annual cost of over $1 billion cost to India.13 There is also a concern of increased antimicrobial resistance due to pharmaceuticals in the environment. A study of pharmaceutical pollution in the world's rivers found that over a quarter of the sampling sites had concentrations of ≥1 active pharmaceutical ingredient that exceeded what is considered safe for aquatic organisms or raised concern for antimicrobial resistance, with low- to middle-income countries being more likely to have these contaminated sites.14 Currently, there are no studies that observed a direct, acute impact of pharmaceuticals in the environment on human health.15-18 However, the possibility of harm from human exposure to pharmaceuticals in the environment cannot be ruled out as there are uncertainties relating to the effects of long-term exposure to pharmaceuticals in the environment through drinking water or the effects of simultaneous or sequential exposure to subtherapeutic concentrations of pharmaceuticals in the environment.17,19

Plastic waste from healthcare is also an environmental issue, where approximately 30% of all hospital waste is plastic.20 87% of all plastics in Canada, including healthcare plastics, ends up in landfills and the natural environment.21 Furthermore, 47% of plastic waste is from packaging.21 Plastics in the environment can cause physical harm to organisms through strangulation, starvation due to neck entanglement, and gastrointestinal obstruction due to ingestion of plastic debris.22 There is also ecological harm from the environmental leaching of the additives. For example, phthalate esters, which are widely used as plasticizers, can easily leach out of plastic products (specifically polyvinyl chloride products), where they can disrupt the endocrine and reproductive functions of organisms.23-25 Bisphenol A, another commonly used plasticizer, can interfere with the development and reproduction of aquatic animals and mammals.23-25 Exposure to these chemicals is associated with an increased risk of metabolic abnormalities like diabetes, reproductive dysfunctions, and breast cancer in humans.26,27

How Hospitals and Hospital Pharmacies Help Address the Environmental Impact of Pharmaceuticals

As one of the end-users of pharmaceuticals, hospitals, hospital pharmacists, and hospital pharmacy technicians  can play a major role in making the Canadian drug supply chain to become more environmentally sustainable. There is also growing interest in sustainable practices in the realm of Canadian healthcare, particularly with the formation of Creating A Sustainable Canadian Health System In A Climate Crisis (CASCADES) Canada with the aim of supporting a transition towards environmentally sustainable and resilient healthcare systems and the establishment of the Canadian Association of Pharmacy for the Environment (CAPhE) with a mission to promote planetary health in the pharmacy profession. In addition, CSHP has made environmental sustainability, one of its’ key priorities and has formed a sustainability task force in collaboration with CAPhE that will develop recommendations on how CSHP can move forward to integrate sustainability into hospital practice through advocacy and partnerships, education, sharing of research and quality improvement initiatives, and policy and procedure development.

One area that can be addressed is what specific medications are supplied to and used at the hospital. This is primarily based on what is listed in the hospital formulary, which is developed and approved by the Medical Advisory Committee (MAC) and the Pharmacy and Therapeutics (P&T) Committee. A drug is approved for use in a hospital based on a myriad of factors such as clinical efficacy of the drug, the financial impact of the hospital budget, and cost-effectiveness relative to available therapeutic alternatives. For the purposes of transitioning towards more environmentally friendly healthcare, the environmental impact of the drug can be included in the formulary submission and may serve as a criteria for evaluating the addition of the drugs to the formulary. The extent at which the active pharmaceutical ingredient(s) persist in the environment prior to degradation, the extent of bioaccumulation, and the ecological toxicity in particular could be points of consideration for determining if a drug may be added to the formulary. These would require discussions with the drug manufacturers and Health Canada to regulate this type of information pertaining to impacts on environment be included in their initial submission for drug approval.

A related area is the choice of suppliers from which the hospitals obtain their medications. Ideally, medications are being supplied from manufacturers that are intent on implementing green practices in the drug manufacturing process such as a transition to 100% renewable energy sources and waste minimization. This would involve discussions with the group purchasing organization, who can aid with identifying and prioritizing manufacturers implementing sustainability initiatives. Cooperation with group purchasing organizations may also help influence manufacturers towards sustainable practices through the leverage of collective purchasing power.

Hospitals may also address the environmental impact of pharmaceuticals (and by extension, hospital practice) through the establishment of a sustainability committee. This would ideally involve representatives from a variety of departments including representatives who are hospital pharmacists and pharmacy technicians. Sustainability committees could aid in facilitating change towards more sustainable practices including the green procurement of pharmaceuticals. They could also engage with suppliers and advocate for green proposals such as reducing the use of single-use plastic packaging for their products.

Hospital pharmacies can reduce the environmental impact of their operations by adopting green inventory management practices. For instance, the bulk purchase of drugs used at large quantities could aid in reducing emissions from transportation and waste from packaging. On the other hand, the purchase of smaller vial sizes could minimize the amount of waste from unused liquid medications. Regular monitoring of drug inventory may aid in reducing the amount of expired medications due to overstocking. A unit-dose medication distribution system could aid in reducing medication wastage compared to a traditional or ward stock system, with the additional benefit of reducing the error rate. Increasing the frequency for batch compounding of sterile products can also reduce the amount of unnecessary waste.28,29 For instance, a pediatric pharmacy's switch from a 1-batch-per-day to a 3-batch-per-day schedule reduced pharmaceutical waste by 31.3% from 28.7% to 19.7% with additional annual cost savings of $183,380.28 The reuse of supplies can also be useful in reducing waste. For example, metered-dose inhalers that are previously used with a patient-specific spacer can be reprocessed and reused after proper disinfection of the MDI canister, cap, and actuator with 70% isopropyl alcohol. The disinfection process may be performed by pharmacy technicians. These inhalers would have to assess for their remaining doses either by checking the dose counter or weighing the inhaler.30-32 This initiative would require cooperation with infection control departments to minimize cross-contamination and transmission of infections.

Individual hospital pharmacists may also consider environmental impact as part of their clinical decision-making for their pharmacotherapy care plan. For example, pharmacists can promote the use of dry powder inhalers or soft mist inhalers over metered-dose inhalers for asthma and chronic obstructive pulmonary disorder given that, unlike meter-dose inhalers dry powder inhalers and soft mist inhalers lack the use of hydrofluorocarbons, which are potent greenhouse gases. As a result, these inhalers have a smaller carbon footprint than metered-dose inhalers.33-35 This would ideally involve assessment of patients to determine if these inhalers are clinically appropriate as well as a discussion of patient preferences. Hospital pharmacists, through medication reviews, may also identify unnecessary drug therapies that can be deprescribed, thereby removing the environmental impacts associated with the follow-up monitoring and refill visits post-discharge.
 

References

  1. The Multi-Stakeholder Steering Committee on Drug Shortages in Canada. Multi-Stakeholder Toolkit: A Toolkit for Improved Understanding and Transparency of Drug Shortage Response in Canada [Internet]. Drug Shortages Canada. 2017 [cited 2023 Jun 30]. Available from: https://www.drugshortagescanada.ca/files/MSSC_Toolkit_2017.pdf
  2. Eckelman MJ, Sherman JD, MacNeill AJ. Life cycle environmental emissions and health damages from the Canadian healthcare system: An economic-environmental-epidemiological analysis. PLoS Med. 2018 Jul 31;15(7):e1002623.
  3. Thornber K, Adshead F, Balayannis A, Brazier R, Brown R, Comber S, et al. First, do no harm: time for a systems approach to address the problem of health-care-derived pharmaceutical pollution. Lancet Planet Health. 2022 Dec;6(12):e935–7.
  4. Anand U, Adelodun B, Cabreros C, Kumar P, Suresh S, Dey A, et al. Occurrence, transformation, bioaccumulation, risk and analysis of pharmaceutical and personal care products from wastewater: a review. Environ Chem Lett. 2022 Aug 17;20(6):3883–904.
  5. Muir D, Simmons D, Wang X, Peart T, Villella M, Miller J, et al. Bioaccumulation of pharmaceuticals and personal care product chemicals in fish exposed to wastewater effluent in an urban wetland. Sci Rep. 2017 Dec 5;7(1).
  6. Xie Z, Lu G, Yan Z, Liu J, Wang P, Wang Y. Bioaccumulation and trophic transfer of pharmaceuticals in food webs from a large freshwater lake. Environ Pollut. 2017 Mar;222:356–66.
  7. Brausch JM, Connors KA, Brooks BW, Rand GM. Human Pharmaceuticals in the Aquatic Environment: A Review of Recent Toxicological Studies and Considerations for Toxicity Testing. In: Whitacre D, editor. Reviews of Environmental Contamination and Toxicology. Springer Science & Business Media; 2012. p. 1–99.
  8. Brodin T, Fick J, Jonsson M, Klaminder J. Dilute Concentrations of a Psychiatric Drug Alter Behavior of Fish from Natural Populations. Science. 2013 Feb 14;339(6121):814–5.
  9. Brodin T, Nordling J, Lagesson A, Klaminder J, Hellström G, Christensen B, et al. Environmental relevant levels of a benzodiazepine (oxazepam) alters important behavioral traits in a common planktivorous fish, (Rutilus rutilus). J Toxicol Environ Health A. 2017 Aug 22;80(16–18):963–70.
  10. Oaks JL, Gilbert M, Virani MZ, Watson RT, Meteyer CU, Rideout BA, et al. Diclofenac residues as the cause of vulture population decline in Pakistan. Nature. 2004 Jan 28;427(6975):630–3.
  11. Ogada DL, Keesing F, Virani MZ. Dropping dead: causes and consequences of vulture population declines worldwide. Ann N Y Acad Sci. 2011 Dec 16;1249(1):57–71.
  12. Pain DJ, Cunningham AA, Donald PF, Duckworth JW, Houston DC, Katzner T, et al. Causes and Effects of Temporospatial Declines of Gyps Vultures in Asia. Conserv Biol. 2003 Jun;17(3):661–71.
  13. Markandya A, Taylor T, Longo A, Murty MN, Murty S, Dhavala K. Counting the cost of vulture decline—An appraisal of the human health and other benefits of vultures in India. Ecological Economics. 2008 Sep;67(2):194–204.
  14. Wilkinson JL, Boxall ABA, Kolpin DW, Leung KMY, Lai RWS, Galbán-Malagón C, et al. Pharmaceutical pollution of the world’s rivers. Proc Natl Acad Sci U S A. 2022 Feb 14;119(8).
  15. Bercu JP, Parke NJ, Fiori JM, Meyerhoff RD. Human health risk assessments for three neuropharmaceutical compounds in surface waters. Regul Toxicol Pharmacol. 2008 Apr;50(3):420–7.
  16. Dai C, Li S, Duan Y, Leong KH, Tu Y, Zhou L. Human health risk assessment of selected pharmaceuticals in the five major river basins, China. Sci Total Environ. 2021 Dec;801:149730
  17. Daughton CG. Pharmaceuticals as Environmental Pollutants: The Ramifications for Human Exposure. In: Heggenhougen HK (Kris), editor. International Encyclopedia of Public Health [Internet]. Elsevier; 2008 [cited 2023 Jul 6]. p. 66–102. Available from: http://dx.doi.org/10.1016/b978-012373960-5.00403-2
  18. Le Corre KS, Ort C, Kateley D, Allen B, Escher BI, Keller J. Consumption-based approach for assessing the contribution of hospitals towards the load of pharmaceutical residues in municipal wastewater. Environ Int. 2012 Sep;45:99–111.
  19. Jones OAH, Voulvoulis N, Lester JN. Potential Ecological and Human Health Risks Associated With the Presence of Pharmaceutically Active Compounds in the Aquatic Environment. Crit Rev Toxicol. 2004 Jan;34(4):335–50.
  20. Lee BK, Ellenbecker MJ, Moure-Eraso R. Analyses of the recycling potential of medical plastic wastes. Waste Manag. 2002 Aug;22(5):461–70.
  21. Environment and Climate Change Canada. Economic study of the Canadian plastic industry, markets and waste : summary report to Environment and Climate Change Canada [Internet]. Government of Canada. 2019 [cited 2023 Jun 21]. Available from: https://publications.gc.ca/collections/collection_2019/eccc/En4-366-1-2019-eng.pdf
  22. Li P, Wang X, Su M, Zou X, Duan L, Zhang H. Characteristics of Plastic Pollution in the Environment: A Review. Bull Environ Contam Toxicol. 2020 Mar 12;107(4):577–84.10.
  23. Mathieu-Denoncourt J, Wallace SJ, de Solla SR, Langlois VS. Plasticizer endocrine disruption: Highlighting developmental and reproductive effects in mammals and non-mammalian aquatic species. Gen Comp Endocrinol. 2015 Aug;219:74–88.
  24. Oehlmann J, Schulte-Oehlmann U, Kloas W, Jagnytsch O, Lutz I, Kusk KO, et al. A critical analysis of the biological impacts of plasticizers on wildlife. Philos Trans R Soc Lond B Biol Sci. 2009 Jul 27;364(1526):2047–62.
  25. Talsness CE, Andrade AJM, Kuriyama SN, Taylor JA, vom Saal FS. Components of plastic: experimental studies in animals and relevance for human health. Philos Trans R Soc Lond B Biol Sci. 2009 Jul 27;364(1526):2079–96.
  26. Giulivo M, Lopez de Alda M, Capri E, Barceló D. Human exposure to endocrine disrupting compounds: Their role in reproductive systems, metabolic syndrome and breast cancer. A review. Environ Res. 2016 Nov;151:251–64.
  27. North EJ, Halden RU. Plastics and environmental health: the road ahead. Rev Environ Health. 2013 Jan 1;28(1):1–8.
  28. Abbasi G, Gay E. Impact of Sterile Compounding Batch Frequency on Pharmaceutical Waste. Hosp Pharm. 2017 Jan;52(1):60–4.
  29. Toerper MF, Veltri MA, Hamrock E, Mollenkopf NL, Holt K, Levin S. Medication Waste Reduction in Pediatric Pharmacy Batch Processes. J Pediatr Pharmacol Ther. 2014 Jun 1;19(2):111–7.
  30. Gowan M, Bushwitz J, Watts P, Silver PC, Jackson M, Hampton N, et al. Use of a Shared Canister Protocol for the Delivery of Metered-Dose Inhalers in Mechanically Ventilated Subjects. Respir Care. 2016 May 3;61(10):1285–92.
  31. Liou J, Clyne K, Knapp D, Snyder J. Establishing a Quality Control Program: Ensuring Safety from Contamination for Recycled Metered-Dose Inhalers. Hosp Pharm. 2014 May;49(5):437–43.
  32. Matt L, Mirzoyan M, Taylor HC, Butler R, Gopalakrishna KV. Bacteriologic Assessment of Reused Metered Dose Inhalers. Infect Dis Clin Pract (Baltim Md). 2011 Jul;19(4):265–7.
  33. Jeswani HK, Azapagic A. Life cycle environmental impacts of inhalers. J Clean Prod. 2019 Nov;237:117733.
  34. Starup‐Hansen J, Dunne H, Sadler J, Jones A, Okorie M. Climate change in healthcare: Exploring the potential role of inhaler prescribing. Pharmacol Res Perspect. 2020 Oct 30;8(6).
  35. Woodcock A, Beeh KM, Sagara H, Aumônier S, Addo-Yobo E, Khan J, et al. The environmental impact of inhaled therapy: making informed treatment choices. Eur Respir J. 2021 Dec 16;60(1):2102106.
  36. Wilkinson A, Woodcock A. The environmental impact of inhalers for asthma: A green challenge and a golden opportunity. Br J Clin Pharmacol. 2021 Dec 13;88(7):3016–22.  
     

Latest News

April 23, 2024
Clinical Pearls: Green supply chains in hospital pharmacy

Latest News

CPRB News - May 2024

May 21, 2024
 
 

Student and Resident Networking Event

The CPRB hosted a Student and Resident Networking Event at the CSHP Professional Practice Conference on April 20, 2024, in Niagara Falls.  It was a very successful event with 52 residents, 3 students, and 55 volunteer practitioners in attendance.  Thank you to everyone who attended.  The Networking Event is held each year at the CSHP PPC Conference.
 




Aleisha Enemark, CPRB Chair and Host of the Event



Participants at the Student and Resident Networking Event

 
CPRB Members from left to right: Christine Landry, Debbie Kwan, Aleisha Enemark, Melanie Danilak,  Roxane Carr, Erika MacDonald, Debi Allen, Rita Dhami
 

2024/2025 Quebec Pharmacy Residency Stats

In the March 2024 CPRB news we published the Pharmacy Residency Application Matching Services (PRAMS) statistics, which includes data for all year 1 pharmacy residency programs in Canada, except Québec where admissions are conducted by universities.  The following data summarizes the admission statistics for the Québec Master’s in Advanced Pharmacotherapy programs (year 1 residency program) for the 2024/2025 academic year.
 
 

Nouvelles du CCRP – mai 2024  

21 mai, 2024  

Événement de réseautage des étudiants et résidents

Le CCRP a organisé un événement de réseautage pour les étudiants et résidents lors de la conférence sur la pratique professionnelle de la SCPH le 20 avril 2024 à Niagara Falls.  Ce fut un événement très réussi avec la participation de 52 résidents, 3 étudiants et 55 praticiens bénévoles. Merci à tous ceux qui ont participé. L'événement de réseautage a lieu chaque année lors de la conférence PPC de la SCPH.
 



Aleisha Enemark, présidente du CCRP et animatrice de l'événement



Participants à l'événement de réseautage des étudiants et résidents
 
Membres du CCRP présents de gauche à droite : Christine Landry, Debbie Kwan, Aleisha Enemark, Melanie Danilak, Roxane Carr, Erika MacDonald, Debi Allen, Rita Dhami
 

Statistiques de résidence en pharmacie du Québec 2024/2025

Dans les nouvelles du CCRP de mars 2024, nous avons publié les statistiques du Service de jumelage des résidents (Pharmacy Residency Application and Matching Service, PRAMS), qui comprennent des données pour tous les programmes de résidence en pharmacie de première année au Canada, à l'exception du Québec, où les admissions sont effectuées par les universités. Les données suivantes résument les statistiques d'admission pour les programmes québécois de Maîtrise en pharmacothérapie avancée (programme de résidence de première année) pour l'année universitaire 2024-2025.
 
 
April 12, 2024
CPRB News - May 2024

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. Kadaajah Johnson-Louis (Humber River 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. Kadaajah Johnson-Louis (Humber River 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: May 7

May 7, 2024
 
  

What's happened

April 19-21, 2024 Bilateral Meetings with Officers

CSHP's executive team, comprising President Ashley Walus, President Elect Katie Hollis, Past President Sean Spina, and Treasurer Megan Riordon, together with CEO Jody Ciufo and CPO Rita Dhami, engaged in discussions with several external organizations to explore matters concerning hospital pharmacy practice and potential avenues for collaboration while attending the Professional Practice Conference 2024 including:

  • American Society of Health-System Pharmacists: Nishaminy Kasbekar
  • Indigenous Pharmacy Professionals of Canada:  Jaris Swidrovich and Cassandra McClelland
  • Board of Pharmacy Specialties: Sejal Lewis 
  • Pharmacy Examining Board of Canada: John Pugsley, Terri Schindel, and Harriet Davies
  • Canadian Association of Pharmacy Students and Interns: Madison Wong
  • Association des pharmaciens des établissements de santé du Québec: Julie Racicot, Linda Vaillant, and Suzanne Atkinson

Head to the bottom of this page to see some of the photos taken at these meetings!

April 30, Drug Shortages Expert Panel Meeting on National ‘At-Risk Medicines’ List  

As part of a CIHR-funded project with Health Canada and Canada’s Drug Agency (formerly known as CADTH), CPO Rita Dhami joined an expert panel to discuss the clinical review of a national at-risk medicine list with the end goal of creating a systematic, adaptable, transparent, and regularly updated National Vulnerable Drugs List. The next steps in this process will include a public consultation. For information on the status of this project, please view CDA’s health technology review

Ongoing, Health Canada Drug Shortages Meetings

CSHP is continuing to monitor these ongoing drug shortages:
  • April 29: Cisatracurium Health Canada Notice of Risk
  • April 26 Tier Assignment Committee - Shortages of Bupivacaine 
  • April 3: Tier Assignment Committee - Supply disruptions of Ozempic 
  • March 3: Tier Assignment Committee - Supply disruptions of Thiamine 

What's happening

May 15, Choosing Wisely Canada Climate Conscious Recommendations 

Professional Practice Specialist Kiet-Nghi Cao will present CSHP and CPhA’s joint hospital pharmacy recommendations at the Choosing Wisely Talks on May 15. This presentation is just a part of 41 new Choosing Wisely Canada recommendations focused on sustainability, developed by multiple national societies and associations spanning 20 specialties. All these recommendations will provide practical ways to stop or reduce routine practices harming the environment without compromising patient care. To register for this event, click here

May, NAPRA Consultation on Modernization of Drug Schedules

CSHP was part of an expert panel contributing to the modernization of the NAPRA Drug Schedules. After initial discussions with expert groups, NAPRA has outlined two potential models for non-prescription drug (NPD) scheduling, along with their respective terms of sale, for potential inclusion in the updated program. In the coming weeks, CSHP will be involving its branches and members in formulating a response to these proposals.

June 6, Transforming Primary Care in Canada Summit

CSHP CEO Jody Ciufo and CPO Rita Dhami will be meeting with pharmacy leaders from across Canada- along with other prominent healthcare professionals, policymakers, and patient advocacy groups- at CPhA’s inaugural national summit. 

The Transforming Primary Care in Canada Summit aims to achieve consensus on the future roles of pharmacists and pharmacy teams in primary care. It will identify barriers and facilitators for integrating community pharmacies into primary care and outline priority areas for actionable initiatives. 




To catch up on CSHP advocacy news, click here.

Have a question about Advocacy in Action or CSHP's advocacy and consultation work?
Reach out to our professional practice team!   

March 12, 2024
Advocacy in Action: May 7

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.

Have a question about Advocacy in Action or CSHP's advocacy and consultation work?
Reach out to our professional practice team!   

March 12, 2024
Advocacy in Action: March 12

Latest News

Call for nominations: Fellows Recognition Committee

March 6, 2024

 

The Fellows (FCSHP) Recognition Committee is now calling for nominations for one Committee Member position. Joining this committee is an exciting way to celebrate Canadian hospital pharmacy excellence. If you know an eligible CSHP member who would thrive in this role, please consider nominating them for this position! 

How long is the term?
Committee members are appointed for a three-year term and are eligible for reappointment for one additional three-year term. The term for this position begins August 2024.

Who is eligible?
Nominees must have achieved Fellow status and hold current membership in CSHP.

How can I nominate someone?
Provide a short biography or statement including information on how the nominee qualifies for the position. Nominations for the Committee must be made in writing, signed by the nominee and a nominator, and be submitted to the Chair of the Fellows Nominating Committee, using the nomination form. Nominators must also hold the FCSHP designation. Click here for details and to access the nomination form.

Deadline
All nominations must be received by May 31, 2024.
March 06, 2024
Call for nominations: Fellows Recognition Committee

Latest News

CSHP is searching for our new Professional Practice Specialist (One-year Contract)

March 5, 2024
 

Professional Practice Specialist (One-year Contract)

Full-Time Position (0.8-1.0 FTE)

 Apply now
 

Position Overview

CSHP is seeking a dynamic and experienced pharmacist for a full-time staff position for a one-year contract to replace a leave of absence. We are looking for someone who is passionate about excellence and safety in pharmacy practice and enjoys inspiring and supporting others. Under the direction of the Chief Pharmacy Officer, the Professional Practice Specialist will contribute to the suite of professional development resources for CSHP members, oversee educational programs, and provide support to other areas of CSHP where the perspective or advice of a pharmacist would be valuable.

As the successful candidate, you will have a demonstrated record of understanding issues that are relevant to hospital pharmacy practice. You have knowledge of issues that are not only at the grassroots level of hospital pharmacy, but also of those that are found at level of the healthcare system. Your understanding and appreciation of the integration between knowledge translation and quality improvement helps you to mobilize knowledge by selecting appropriate strategies to connect CSHP’s members with information and tools. Your ability to concurrently manage several projects and work with staff and volunteers located across Canada will be a key factor to your success.

You have worked in hospital pharmacy and ideally, you will have experience as an employee of a pharmacy association, regulatory authority, government department or academic institution. Volunteer experience demonstrating your interest in giving back to the pharmacy profession is a definite asset.

Key Responsibilities

  • Lead and coordinate the development of practice resources for CSHP members
  • Manage multiple, key projects related to pharmacy practice, as assigned by the Chief Pharmacy Officer, or arising from committees or task forces
  • Coordinate and support committees or working groups of subject matter experts to complete projects—this includes recruiting subject matter experts from CSHP’s membership
  • Create organizational knowledge (e.g., by gathering and analyzing data and information, sharing knowledge, and problem-solving) for key projects on professional practice or enquiries from other organizations
  • Draft or revise documents required for assigned projects, stakeholder consultations or other work related to professional practice based on research conducted, input of committees, task forces, working groups, and CSHP members
  • Contribute to advocacy efforts, providing the relevant professional content and perspective
  • Contribute to CSHP’s engagement with government or other organizations by conducting research and analysis of the topics of interest
  • Contribute to consultations from external stakeholders
  • Respond to inquiries from CSHP current and potential members on professional practice issues and Society business
  • Assist in promoting the benefits of membership in CSHP
  • Participate actively in meetings and continuing education symposia of the Society at a national and branch level
  • Perform such other duties as are prescribed from time to time by the Chief Pharmacy Officer

Qualifications

  • You are a pharmacist with at least 5 years of pharmacy practice in a hospital setting and have some experience in associations, government, health administration or academic institutions.
  • You have successfully completed a hospital pharmacy practice residency or advanced degree in pharmacy-relevant field.
  • You are a self-directed, innovative thinker with a demonstrated ability to translate strategic thinking into effective action plans.
  • You are politically astute and have experience working with volunteers.
  • You are extremely organized and capable of concurrently managing multiple projects. 
  • You have exceptional written, oral, interpersonal, and presentation skills.
  • Experience in conducting research is an asset.
  • Superior communications skills in English are essential.
  • Proficiency in French is an asset.

How to apply

We hire top talent, recognizing that our accomplishments are achieved through the commitment of dedicated individuals. If you think your personality, skills, education, and experience make you the person for this position, we’d love to hear from you. 

This is a completely remote position with limited travel for in-person events and meetings. Please send your application to rdhami@cshp.ca by April 2, 2024 at noon Pacific Time. To be considered for this position, a cover letter must accompany your c.v. 
   

About CSHP

The Canadian Society of Hospital Pharmacists (CSHP) represents pharmacy professionals working in hospitals and other collaborative health care settings who seek excellence in patient care through the advancement of safe and effective medication use. A non-profit organization, CSHP offers its over 3,000 pharmacist and pharmacy technician members a national voice through advocacy, education, information sharing, promotion of best practices, conferences, facilitation of research, and recognition of excellence. The Society publishes the Canadian Journal of Hospital Pharmacy, conducts the Hospital Pharmacy in Canada Survey and accredits pharmacy residency programs across Canada.  

Please note: We thank all applicants for their interest in this position. However, only those selected for an interview will be contacted.   

 

March 05, 2024
CSHP is searching for our new Professional Practice Specialist (One-year Contract)

Latest News

2024 Student update: Hospital Pharmacy Student Award winner and CAPSI-CSHP joint officers meeting

January 30, 2024
 


Hospital Pharmacy Student Award winner

 

 

Earlier this month at CAPSI’s Professional Development Week Conference in Toronto, ON, CSHP CPO, Rita Dhami alongside CAPSI President, Madison Wong presented the Hospital Pharmacy Student Award to the 2023-24 winner, Emma Fedusiak. 

Emma, a pharmacy student at the University of Saskatchewan is acknowledged for her compassionate approach to patient care, research, and education. She has developed essential skills through various work placements in organized healthcare settings including the Saskatchewan Health Authority.  

Specifically, she steps outside of her comfort zone repeatedly to learn from diverse perspectives of clinicians and practice areas. One area that she has taken a specific interest in is opioid stewardship. She has educated patients on their prescription opioids, tested tools that seek to flag those at risk of opioid overdose, and has created resources for multiple wards across Regina hospitals to help alleviate stigma around opioid usage. According to Emma, “stewardship showed me how research advances knowledge and improves patient care.”  

She is also a keen leader in Equity, Diversity, Inclusion and Accessibility services at USask and in her broader community. This work has varied from being an Access and Equity Note Taker for multiple classes to connecting with new immigrants about pharmacy in Canada. 

Emma is a proud pharmacy advocate through CAPSI, having served on the national and local levels throughout her undergraduate career, in addition to her CSHP Saskatchewan Branch activities!  

Congratulations Emma – CSHP cannot wait to see what is next for you.  

 

 

CAPSI-CSHP Meeting


On January 9, CAPSI and CSHP held a joint officer meeting with CAPSI delegates, CSHP President Ashley Walus, and CSHP staff on the call. It is always a pleasure to engage in discussions with CAPSI on pharmacy student supports and programs. Some topics covered were student membership, making residency more accessible and equitable for all students, tweaks to the CAPSI-CSHP Evidence-Based Practice Competition, and CSHP’s involvement in Professional Development Week 2025 which will be taking place in Halifax, NS.  

 

Career insight webinar - We have chairs!

On January 23, Lorie Carter, President of the CSHP NL Branch, led a webinar for students and anyone interested in pursuing a career as a hospital pharmacist. The webinar highlighted the vital role hospital pharmacists play in patient care and provided information about how to get started in this field.   

Throughout the webinar, she delved into patient cases, shedding light on the fulfilling aspects of the profession, and providing guidance for those interested in pursuing a career in hospital pharmacy.  

Watch this free and open-access webinar here.

 

 

January 30, 2024
2024 Student update: Hospital Pharmacy Student Award winner and CAPSI-CSHP joint officers meeting

Latest News

CSHP welcomes Pharmacy Technician, Faith Norris, in new role 

January 30, 2024
JANUARY 30, 2024, OTTAWA — The Canadian Society of Hospital Pharmacists (CSHP) is pleased to welcome Faith Norris as the first Professional Practice Coordinator.  

 She’ll be coordinating the workflow and operations of the Hospital Pharmacy 101 Program, Pharmacy Specialty Networks, and educational events including the Professional Practice Conference as well as the CSHP Webinar Series. In addition, Faith is coordinating related Professional Practice operations, committees, and task forces
 
“I’m excited to dive into my new role as CSHP’s Professional Practice Coordinator! I look forward to taking my passion for pharmacy and collaborating with other healthcare professionals in this setting to advance patient care!”    

Throughout her professional career, Faith has worked as a Pharmacy Technician predominantly at London Health Sciences Centre in the Inpatient Pharmacy Department working on sterile preparation, entering Physician orders, and in unit dose. She also served as a superuser for the Swisslog Dispensing Robot and has experience in clinical trial pharmacy. Plus, Faith has been involved in multiple special projects including: 
  • Working with management to create and implement procedures to algin with NAPRA’s Model Standards for Pharmacy Compounding of Non-Hazardous Sterile Preparations  
  • Working with the LEAN Team to reconfigure the daily schedule in the Unit Dose Area in accordance with their recommendations   
  • Assisting the Pharmacy Pandemic Team to identify changes required to medication distribution schedules to support the changing patient needs 

She lives in Baltimore, ON with her partner and three children.  



Interested in learning more about professional practice programs? 

Contact Faith: 
 

 

January 30, 2024
CSHP welcomes Pharmacy Technician, Faith Norris, in new role

Education Spotlight - Nese Yuksel

January 24, 2024

Nese Yuksel, BScPharm, PharmD, FCSHP, NCMP
CSHP Foundation Education Grant Recipient

“The development of a combined hormonal contraceptive practice tool for pharmacists will provide an accessible, practical, and easy to use practice tool to support pharmacists at the point of care with patients.”

Nese was a 2017 CSHP Foundation Education Grant Recipient in the amount of $9,357

Co-applicants: Anne Marie Whelan, BScPharm, PharmD, FCSHP

Project Summary
Effective contraception, such as combined hormonal contraceptives (CHC’s), are underutilized in Canada for a variety of reasons. As a result, our team recognized the need to support our colleagues with the management of CHCs at the point of care with an accessible, practical and easy to use practice tool.

What gap did you see in your practice that led to this project? 
Pharmacists can now initiate a prescription of CHC’s in most Canadian provinces because of pharmacists expanding scope of practice. It is now recognized that pharmacists are a convenient, approachable and reliable healthcare provider to support women with their contraception decisions. 

There are currently several barriers for women to obtaining or continuing effective contraceptives, including women not being adequately informed and issues of access. The Practice Tool for CHC has been designed to support pharmacists with prescribing and initiating CHCs and managing ongoing therapy. The Practice Tool includes four sections: Step 1: Assess if CHC is appropriate; Step 2: Initiate a CHC product; Step 3: Patient education; Step 4: Follow-up monitoring. 

How will this project impact pharmacy practice and/or care of patients?
This Practice Tool offers a framework for pharmacists to manage CHC including assessing patients, decision making and choosing a CHC, patient education and follow-up. It is our hope that this tool will provide a guide for pharmacists when prescribing CHC and supporting patients with CHC.

What did you learn that you weren’t expecting? 
The process of development of the practice tool took time and patience and involved multiple drafts and revisions. The expert reviews, as well as the pilot evaluations with the pharmacists provided very helpful and insightful comments and suggestions, which we were able to incorporate into future drafts.  

The development team consisted of myself, Dr Anne Marie Whelan and Christine Maslanko. We also wanted to give a shout out to all the pharmacy students who were involved in the development of the CHC Practice Tool over the years. Special thank you as well to all of the expert reviewers and pharmacists who took part in the evaluation, Christine Maslanko, Dr Judith Soon for the initial review of the tool and Broken Arrow Solutions for the graphic design.

Where should people go to learn more about this topic if they are interested? 
Individuals interested in learning more about our practice tool are welcome to contact me at nese.yuksel@ualberta.ca. A recent publication in January 2024 in the Canadian Pharmacists Journal presented a case highlighting how to use the CHC Practice Tool. The publication can be found by visiting https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10729716/

The development of the CHC Practice Tool could not have been achieved without the support of the CSHP Foundation for their financial support. 

 

The role of the hospital pharmacist is changing; research and education will support the change.

CSHP Foundation grant and scholarship recipients are changing the face of pharmacy practice. 
Find out more at https://cshp-scph.ca/cshp-foundation.

Latest News

January 24, 2024
Education Spotlight - Nese Yuksel

Latest News

Call for Members: Awards Committee

January 22, 2024

 
 

Join the Awards Committee!

We are looking for broad geographical representation from across the country.  

The Committee administers CSHP’s annual awards program, including reviewing submissions and selecting winners. We’re also involved in planning awards presentations, developing criteria for new awards, and promoting the program to the membership. 

We are seeking new committee members in the following areas: 

  • Chair Elect: 
    • CSHP member with team leader experience 
    • Prior experience serving on an awards committee would be beneficial 
    • Term begins Spring 2024 
    • This is a partial term that transitions to Committee Chair in Fall 2024 
  • Core Members: 
    • CSHP member with an interest in the awards program 
    • No previous CSHP committee or task force experience required 
    • Term begins Spring 2024 
    • This is a two-year term, with an optional two-year term (four years maximum) 

Candidate criteria

  • Candidates must be able to commit to a minimum of 6 virtual meetings per year. Meetings are scheduled in 2-hour time blocks. 
  • An additional time commitment is required for reviewing award submissions. This review is generally performed independently, so that results can be shared at meetings. Candidates should also schedule time to consult with the Committee Chair as necessary to become familiar with the position. 

Instructions for applicants: 

  • Please submit the following documents:
    • A copy of your curriculum vitae
    • One-page statement describing your interest in volunteering for this position 
  • Submit the above noted documents to the CSHP office by e-mail to Robyn Rockwell, Membership and Awards Administrator.   

  
For more information on either position, please contact Rumi McGloin, Chair, Awards Committee.  

January 22, 2024
Call for members: Awards Committee

Latest News

CSHP's statement on FDA’s Approval of Canadian Drug Importation

January 16, 2024
 
 
 
On January 5, the U.S. Food and Drug Administration (FDA) authorized Florida’s plan to import prescription drugs from Canada in an effort to reduce the drug costs to the American consumer. The Canadian Society of Hospital Pharmacists (CSHP) remains opposed to any exportation of medicines from Canada and will ramp up our advocacy to the U.S. Federal and state governments, as well as the FDA, to address the underlying drivers of drug shortages and pricing in the U.S.

“Canada cannot stock America’s medicine cabinet,” says CSHP President Ashley Walus. “Our drug supply is not the answer to the problem of high drug prices in the United States.”

The American Society of Health-System Pharmacists (ASHP) also acknowledges that drug importation from Canada is not a real solution because it is not a meaningful response to drug pricing and has the potential to disrupt the pharmacist-patient relationship. 

While the details of Florida’s plan are still to be released, Canada took precautionary steps in August 2021 in response to various states exploring legislation to import prescription drugs. Health Canada bolstered the existing limitations in our healthcare legislation to stipulate that pharmaceuticals intended for the domestic market cannot be distributed outside of Canada if it will cause or exacerbate a shortage of a drug.

“The intention of some U.S. states to tap into Canada’s supply isn’t new,” says CSHP CEO Jody Ciufo. “In 2019, CSHP joined the Alliance for Safe Online Pharmacies Canada (ASOP Canada) along with 12 other organizations to advocate against the export of Canadian drugs. We appeared before various state legislatures, met with U.S. federalrepresentatives, and featured prominently in media stories about the issue – and will do this again to actively protect our drug supply.”

CSHP is engaged with Health Canada and applauds their notification to regulated parties of their legal obligations not to distribute drugs for consumption outside of Canada if the distribution will cause or worsen a shortage of the drug. Just as important is their plan to enforce existing regulations: “The Department will not hesitate to take immediate action to address non-compliance, ranging from requesting a plan for corrective measures, issuing a public advisory or other forms of communication, to taking action on the licenses of regulated parties who contravene the export prohibition if warranted.”

Along with these safeguards, CSHP believes in the importance of these collective efforts to address the complexities associated with drug importation and its potential impact on patient care. “We are aligned with our peers including CPhA, are a member of ASOP Canada, and we will continue to safeguard the supply chain intended for Canadian patients,” says CSHP President Ashley Walus.

For more information please contact: Dr. Rita Dhami, Chief Pharmacy Officer at rdhami@cshp.ca.
January 16, 2024
CSHP's statement on FDA’s Approval of Canadian Drug Importation

Latest News

Student Member Stories: Melanie King

January 2, 2023
 
 

About Melanie

Pronouns: She/Her
School, Program & Year: Memorial University, PharmD, fourth year 
Social media: Mellyjking on Twitter, Melanie King on LinkedIn

What is enticing to you about hospital pharmacy?

I love how pharmacists can play an essential role in managing drug therapy problems on an interdisciplinary team. I love how you are able to utilize your clinical knowledge and learn about specialized fields.

What drew you to join CSHP as a student?

I always found hospital pharmacy intriguing and thought it would be a great way to learn more. I started volunteering with our CSHP NL Branch on the education committee and then became the MUN junior student representative for the CSHP NL Branch and now am the senior representative.

How do you see yourself reflected by CSHP?

I love how there are so many student opportunities and resources. From webinars to journal clubs to provincial branches there are so many student events to learn more and meet others with similar interests. 

Have you ever attended or presented at a CSHP event?

I have attended the Together conferences virtually the past three years. I have also attended the Fall and Spring CE Days for the CSHP NL Branch for the past several years. I learned so much through these conferences and learning events such as interesting clinical topics that we have limited exposure to in school.

What is one CSHP resource or benefit that you couldn’t live without?

Webinars. Webinars are super valuable and being in Newfoundland, where travelling to events is more difficult, webinars have been a great way to advance my learning. 

What is one piece of advice you give soon-to-be pharmacy students?

 Get involved! You are only in pharmacy school once and you should make the most of it!

 

Want to share your student story?
Tell us about yourself here for a chance to be featured.

January 02, 2024
Student Member Stories: Melanie King

No content found

No content found

No content found

No content found

No content found

No content found

No content found