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CPRB News -  June 2024

June 18, 2024
 
 

Pfizer Award Winners – Year 2 Residencies

The Canadian Society of Hospital Pharmacists (CSHP) wishes to congratulate Hazal Babadagli (Alberta Health Services – Cardiology) and Shazia Damji (Lower Mainland Pharmacy Services,  Internal Medicine) the winners of the Advanced (Year 2) Pharmacy Residency Award sponsored by Pfizer Canada.  Their research manuscripts were: " Pharmacist-Led Follow-Up Program for RurAL Patients with Acute Coronary Syndrome Patients: The PLURAL-ACS Pilot Program” (Babadagli) and “Prioritizing Quality Over Quantity: Defining Optimal Pharmacist-to-Patient Ratios to Ensure Comprehensive Direct Patient Care in a Medical or Surgical Unit” (Damji).

The Advanced (Year 2) Pharmacy Residency Award recognizes pharmacy residents whose research projects are judged to be most deserving in terms of significant innovation, practical application, and/or development of pharmacy practice. The CSHP Pharmacy Residency Award consists of a $1,000 prize.
To be eligible, each candidate must:
  • Be a current member of CSHP;
  • Be currently enrolled in or one-year post-completion of a Canadian Pharmacy Residency Board (CPRB)-accredited (or accreditation-pending) Advanced (Year 2) Pharmacy Residency program;
  • Submit an award application to the CSHP, which includes the manuscript describing the residency project.  

Thank you to all who applied and to the National Awards Committee who adjudicated the award submissions. 

PRAMS 2025-2026 Application Cycle Updates and Key Dates

Thank you to those from across the country who responded to this year's PRAMS program survey. Your responses helped CPRB refine the application to make it easier for applicants to accurately provide the information requested and for programs to assess candidates.

Application form refinements include clearer instructions on what information to input into text boxes, dropdown menus for pharmacy education, and the reduction in the text fields for undergraduate education.  In addition, referees will receive an email confirming their submission has been sent.  

A sample application with all updates will be available in August to allow programs to prepare for applicant screening and interviewing.  

 The applicant fee structure will be $275 for 5 programs, and any additional program will cost $25 per program. 
 
Dates of note for the 2025/2026 application cycle are as follows:

  • July 22 – August 8, 2024 – Programs to provide updated information for PRAMS
  • August 12, 2024 – PRAMS opens to applicants 
  • October 10, 2024, 11:59AM EST – PRAMS closes to applicants and applications available to programs 
  • January 8, 2025 – Ranking deadline for applicants and programs 
  • January 15, 2025 – Match results available
  • January 24, 2025 – Final deadline date for applicants to accept a residency position.
  • January 27, 2025 – Programs with unfilled positions may contact unmatched applicants to fill open positions
 

Nouvelles du CCRP – mai 2024  

18 juin, 2024  

Lauréats des prix Pfizer – Résidences année 2

La Société canadienne des pharmaciens d'hôpitaux (SCPH) souhaite féliciter Hazal Babadagli (Alberta Health Services – Cardiologie) et Shazia Damji (Lower Mainland Pharmacy Services, Médecine interne), les personnes lauréates du prix de résidence en pratique avancée en pharmacie (2e année) parrainé par Pfizer Canada.  Les manuscrits de recherche étaient : " Pharmacist-Led Follow-Up Program for RurAL Patients with Acute Coronary Syndrome Patients: The PLURAL-ACS Pilot Program” (Babadagli) et “Prioritizing Quality Over Quantity: Defining Optimal Pharmacist-to-Patient Ratios to Ensure Comprehensive Direct Patient Care in a Medical or Surgical Unit” (Damji).

Le prix de résidence en pratique avancée (2e année) récompense les résidents en pharmacie dont les projets de recherche sont jugés les plus méritants en termes d’innovation significative, d’application pratique et/ou de développement de la pratique pharmaceutique. Le prix de résidence en pharmacie de la SCPH consiste en un prix de 1,000 $.
Pour être éligible, chaque candidat doit :
  • Être membre actuel de la SCPH;
  • Être actuellement inscrit ou avoir terminé depuis moins d'un an un programme de résidence en pratique avancée en pharmacie (2e année) agréé par le Conseil canadien de la résidence en pharmacie (CCRP) (ou en attente d'agrément);
  • Soumettre une demande de bourse à la SCPH, qui comprend le manuscrit décrivant le projet de résidence.

Merci à tous ceux qui ont postulé et au Comité national des prix qui a évalué les candidatures.

Cycle d'application PRAMS 2025-2026 et dates importantes

Merci à tous ayant répondu au sondage du programme PRAMS de cette année. Vos réponses ont aidé le CCRP à améliorer le formulaire de candidature en facilitant la saisie de données précises par les candidats et l'évaluation des candidats par les programmes.

Les améliorations apportées au formulaire de candidature incluent des instructions plus claires sur les informations à saisir dans les champs libres, des menus déroulants pour la formation en pharmacie et la diminution de champs pour la formation de premier cycle.  De plus, les personnes agissant comme références recevront un courriel confirmant que leur soumission a été envoyée.

Un exemple du formulaire de candidature avec toutes les mises à jour sera disponible en août pour permettre aux programmes de se préparer pour la sélection des candidats.

La structure des frais de candidature sera de 275 $ pour 5 programmes, et la sélection de tout programme supplémentaire coûtera 25 $ par programme.
 
Les dates importantes pour le cycle de candidature 2025/2026 sont les suivantes :

  • 22 juillet – 8 août 2024 – Remise d'informations mises à jour par les programmes pour PRAMS
  • 12 août 2024 – PRAMS ouvre aux candidats
  • 10 octobre 2024, 11 h 59 HNE – PRAMS ferme aux candidats, et candidatures disponibles pour les programmes
  • 8 janvier 2025 – Date limite pour le classement des candidats et des programmes
  • 15 janvier 2025 – Résultats de jumelage disponible
  • 24 janvier 2025 – Date limite finale pour que les candidats acceptent un poste de résidence
  • 27 janvier 2025 – Les programmes avec des postes non pourvus peuvent contacter les candidats non jumelés pour pourvoir les postes vacants.
June 18, 2024
CPRB News - June 2024

Latest News

Apply Now for the 2024 Pharmacy Leadership Academy Scholarship

June 5, 2024

FoundationLogo-Colour.png

CSHP FOUNDATION IS NOW ACCEPTING APPLICATIONS FOR THE
2024 Pharmacy Leadership Academy Scholarship

The CSHP Foundation is committed to offering educational opportunities that develop Canada’s hospital pharmacy leaders using innovative, evidence-based methods. The Pharmacy Leadership Academy® (PLA) is a 12-month on-line integrated program offered by the ASHP Foundation that will appeal to Canadian hospital pharmacy leaders or those aspiring to leadership positions who want additional training. 

This scholarship is for the July 14, 2024, program start date and is valued at $5,000 CDN towards the PLA tuition fee. Application information for the CSHP Foundation scholarship is available at CSHP Foundation.

Further information on the ASHP PLA program is available at https://www.ashpfoundation.org/leadership-development/pharmacy-leadership-academy.

The ASHP Pharmacy Leadership Academy has the following program objectives: 

  1. Provide a curriculum that enhances leadership competency and tackles contemporary issues in healthcare.
  2. Provide leadership education in a graduate credit-worthy platform applicable to practitioners in small to large hospitals and health systems. 
  3. Provide integrated, real-world pharmacy case studies to highlight and amplify critical thinking, integration of ideas and perspectives.
  4. Incorporate mentorship into the fabric of the program. 
  5. Maximize distance education of qualified persons through an advanced Learning Management System and technologies.

HOW TO APPLY:  

  1. Submit an ASHP Foundation Pharmacy Leadership Academy application by February 1, 2024.
    • ASHP will accept applications until March 31, 2024. However, to be considered for the CSHP Foundation Scholarship you must apply to the ASHP Foundation by February 1, 2024, to ensure notification of acceptance to the PLA program prior to submitting your CSHP Scholarship application.
  2. Submit a CSHP Foundation scholarship application with required documents by March 13, 2024.

The successful CSHP Foundation PLA Scholarship applicant will be notified by April 30, 2024.

 

June 10, 2024
Apply Now for the 2024 Pharmacy Leadership Academy Scholarship

Latest News

CSHP welcomes Dr. Angel Bhathal as Professional Practice Specialist

June 4, 2024
June 4, 2024, OTTAWA — The Canadian Society of Hospital Pharmacists (CSHP) is pleased to welcome Dr. Angel Bhathal as Professional Practice Specialist. Angel will work with CSHP for the next 14 months to fill in during a leave of absence within the National Office staff.

An integral part of the professional practice team, she will help CSHP develop its suite of professional resources, policy positions, continuing education, best practices, consultationsresearch and knowledge translation.
 
CSHP CEO Jody Ciufo says, “Angel’s experience in hospitals, health authorities, community pharmacies and non-profits across three provinces will enhance CSHP’s program offerings. And with her CSHP volunteer background, she knows what matters most to our members and how to channel that dedication in working groups.”

Throughout her professional career, Angel has over 13 years of pharmacy experiences in pharmacy leadership, education, hospital, and community pharmacy. She is a Doctor of Pharmacy graduate from the University of Alberta and a Bachelor of Pharmacy graduate from the University of Manitoba. During her tenure at the Winnipeg Regional Health Authority, Angel was the professional development and clinical pharmacist for the departments of Educational Services, Adult Inpatients, and Pediatrics. Most recently, she worked on digital health initiatives through the adoption of global standards and advocated for patient safety as the Senior Director of Pharmacy for GS1 Canada. 

Angel is no stranger to CSHP, she is a longstanding member and is also a former Education Chair for the Manitoba Branch of CSHP. Angel has been involved in multiple special projects, including:
 
  • Developing Hospital Policies collaboratively as a member of the Provincial NAPRA Working Group for Manitoba.
  • Serving as a Doctor of Pharmacy Mentor for the University of Alberta’s Faculty of Pharmacy and Pharmaceutical Sciences.
  • Securing sponsorships, speakers, and planning professional development events as an Education Chair for the Manitoba Branch of CSHP.

Angel lives in Toronto and enjoys mentoring, traveling, and raising funds for gender literacy through Plan International.  She says, “I am excited to begin my new role as CSHP’s Professional Practice Specialist. I look forward to applying my passion for pharmacy education and collaborating with healthcare professionals to advance patient care!”    



Interested in learning more about professional practice programs? 

Contact : 
 

 

June 04, 2024
CSHP welcomes Dr. Angel Bhathal as Professional Practice Specialist

Latest News

Advocacy in Action: June 18

June 18, 2024
 
  

What's happened

Ongoing, Health Canada Drug Shortages Meetings

Through participation at these meetings, CSHP is continuing to monitor these ongoing drug shortages 
  • June 5 Tier Assignment Committee: Shortages of Mepivacaine 2%  
  • June 6 Tier Assignment Committee: De-escalation of Dipyridamole

June 4, Choosing Wisely Canada Annual Meeting of the Societies 

CSHP participated in a multilateral meeting with Choosing Wisely Canada and other associations. The agenda covered discussions on the Choosing Wisely Climate Campaign and explored potential collaborations between the various organizations.

June 6, Transforming Primary Care in Canada Summit

CSHP CEO Jody Ciufo and CPO Rita Dhami travelled to Toronto to attend the Canadian Pharmacists Association (CPhA)’s inaugural national summit alongside other pharmacy leaders, healthcare professionals, policymakers, and patient advocacy groups.

The Transforming Primary Care in Canada Summit aimed to reach a shared vision on the future roles of pharmacists and pharmacy teams in primary care, identify barriers and facilitators for integrating community pharmacies, and outline priority areas for actionable initiatives. This vision includes a system where pharmacy is recognized as a first stop in the primary care journey for all. 
 
To learn more about the takeaways from this event, click here.

June 12, Multilateral Meeting with Health Canada 

CPO Rita Dhami participated in a multilateral meeting with Health Canada. While in attendance, she received updates from the various divisions of Health Canada including the Marketed Health Products Branch, the Pharmaceutical Drugs Directorate, the Health Product Compliance Directorate, and the Biologic and Radiopharmaceutical Directorate as well as some policy updates.  

What's happening

May to June, NAPRA Consultation on Modernization of Drug Schedules

After taking part in an expert panel to modernize the NAPRA Drug Schedules, CSHP has been invited to consult on two potential models for non-prescription drug (NPD) scheduling and their respective terms of sale for inclusion in the updated program. CSHP has been contacting various members to include their perspectives in this consultation.

June to July, Health Canada Consultation on Controlled Drugs and Substances Act

Health Canada has started a consultation on the proposed Controlled Substances Regulations and related amendments to other federal regulations, including the Cannabis Regulations, as published in the Canada Gazette, Part I. CSHP is currently drafting a response to the proposal and will be seeking input from Branches on this consultation.

What's worth repeating

May 29, Hospital News featured section

As part of CSHP’s 2024 featured section in Hospital News, seven authors delve deep into the critical topic of sustainability in pharmacy and healthcare. To access these insightful articles, click here


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!   

June 04, 2024
Advocacy in Action: June 18

Latest News

Call for Curriculum Vitae, Letter of Intent Reviewers and Mock Interviewers 

June 4, 2024


The Canadian Society of Hospital Pharmacists (CSHP) is relaunching its Pharmacy Residency Application Roadmap Program this year that is designed for prospective pharmacy residency candidates to provide them with additional knowledge and experience needed to competitively apply for Year 1 and Year 2 pharmacy residency programs.   

The program will consist of both didactic (on-line modules) and practical (CV/essay review and mock interviews). 

We are looking for CSHP members who were previous pharmacy residents or coordinators not currently actively involved in the interview and selection process of pharmacy residency programs (to avoid conflict of interest) to conduct CV/essay reviews and mock interviews.   

Conditions to participate as a mock interviewer/CV reviewer and LOI reviewer: 

  • CSHP member
  • Email practice@cshp.ca by Friday July 5, 2024 with your Curriculum Vitae 
  • Each mock interviewer/CV & LOI reviewer will perform 12 mock interviews and 12 CV&LOI reviews  
  • Review Module 3: Writing CV/Cover Letter/Letter of Intents AND Module 5:  Residency Interview Preparation  
  • Attend a one-hour training session for the CV and Letter of Intent and Mock Interview at a mutually agreed upon date and time. 
  • Be available on the weekend of November 2/3, 2024 to conduct a “live” virtual mock interview 

     

     
June 04, 2024
Call for Curriculum Vitae, Letter of Intent Reviewers and Mock Interviewers

Latest News

Advocacy in Action: June 4

June 4, 2024
 
  

What's happened

Ongoing, Health Canada Drug Shortages Meetings

CSHP is continuing to monitor these ongoing drug shortages:
  • May 17 Tier Assignment Committee: Shortages of Loxapine  
  • May 23 Tier Assignment Committe: Shortages of Irinotecan
  • May 30 Tier Assignment Committee: De-escalation of Calcitonin 

What's happening

May to June, NAPRA Consultation on Modernization of Drug Schedules

After participating in an expert panel to modernize the NAPRA Drug Schedules, CSHP has been invited to consult on two potential models for non-prescription drug (NPD) scheduling and their respective terms of sale for inclusion in the updated program. CSHP will be contacting various members to include their perspectives in this consultation.

June 4, Choosing Wisely Canada Annual Meeting of the Societies 

CSHP is attending a multilateral meeting with Choosing Wisely Canada alongside all stakeholders. The agenda includes discussions on the Choosing Wisely Climate Campaign and exploration of potential collaborations between the various organizations. 

June 6, Transforming Primary Care in Canada Summit

CSHP CEO Jody Ciufo and CPO Rita Dhami will meet with pharmacy leaders, healthcare professionals, policymakers, and patient advocacy groups at CPhA’s inaugural national summit. The Transforming Primary Care in Canada Summit aims to reach a shared vision on the future roles of pharmacists and pharmacy teams in primary care, identify barriers and facilitators for integrating community pharmacies, and outline priority areas for actionable initiatives. 

What's worth repeating

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.


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!   

June 04, 2024
Advocacy in Action: June 4

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 Industry Corporate Supporter.
  • 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

Pride in Pharmacy: Comprehensive Resources for 2SLGBTQIA+ Patient Care 

June 1, 2024
 
During Pride Month in June, it's important to reflect on its history and significance. For pharmacy professionals, this includes considering how to best serve 2SLGBTQIA+ patients by providing equitable and inclusive care. Staying informed about the unique health needs of this community is essential.  
 
Explore valuable resources that can help pharmacy professionals provide equitable patient care for all.

Internal Resources

CSHP Ontario Branch - May Journal Club: Where to Start? Considering Sex and Gender in Research and Practice

In this session speaker Mira Maximos describes how sex and gender related factors may influence therapeutic efficacy and safety. She also explores how research led by and involving pharmacy professionals can begin to consider sex and gender related factors.

Clinical Pearl: Student reflection on Pride Month & 2SLGBTQIA+ advocacy during pharmacy school and Resource Spotlight: Pride and 2SLGBTQIA+ advocacy  

 Read last year’s Pride month student perspective on how pharmacy students can advocate for the 2SLGBTQIA+ population all year round then brush up on 2SLGBTQIA+ inclusive care resources available for patients and pharmacy professionals, both by Holly Wingate. 
 

The Hospital Pharmacist’s Role In 2SLGBTQ+ Inclusive Patient Care 

Jessica Sheard’s article covers how hospital pharmacy professionals are well-positioned to provide equitable and inclusive care to 2SLGBTQ+ patients during their hospital stay.
 

Pharmacists as EDI Champions: Reflections of a Pharmacy Resident on the Role of Pharmacists in Minimizing Health Inequities for Underserved Populations 

Written while a resident,  Zach Kennedy reflects on how pharmacists can be great advocates for their patients in EDIA, particularly when nobody else takes up that role.  

Equity, Diversity, and Inclusion in HIV care: an approach to stigma 

Caitlin Olatunbosun offers insights into how EDIA principles can ensure access to care for everyone, especially in HIV treatment and beyond.

External Resources 

prideHealth 

Nova Scotia Health established prideHealth to enhance access to health services that are safe, coordinated, comprehensive, and culturally appropriate for 2SLGBTQIA+ community members. PrideHealth houses an interactive online tool which includes guidance on navigating Trans and Gender-diverse healthcare, informational brochuresposters, and much more!
 

CPhA Updated practice tools to help your LGBT2SQ+ patients

Our peers at CPhA have a few great, updated resources for healthcare providers to better help 2SLGBTQIA+ patients including 10 actions for creating an inclusive pharmacy space, a guide to 2SLGBTQIA+-friendly language, as well as other posters and webinars! 
 

ASHP pride month podcasts

As part of their pride month celebrations our American counterparts at ASHP host a series of podcasts with LGBTQ pharmacy leaders.  

Rainbow Health Ontario Resource Library

This resource library by Sherbourne Health gathers and distributes the latest, credible health resources tailored to the 2SLGBTQIA+ communities across Ontario.  

Trans Care BC – Health Professionals resources

This resource page Provincial Health Services Authority’s Trans Care BC was designed to help healthcare professionals provide optimal care to trans, Two-Spirit, and non-binary patients. It features a primer on gender-affirming care, professional development courses, and a primary care toolkit for initiating or maintaining hormone therapy, and additional reading materials to enhance practice. 

The College of Pharmacists of BC Joins the 2SLGBTQ+ Community in Celebrating PRIDE

In 2021, the College of Pharmacists of British Columbia published an article emphasizing the crucial role pharmacists play in providing safe, effective, and ethical care to 2SLGBTQ+ individuals throughout the healthcare system. The article calls for the use of inclusive language and highlights the impact of 2SLGBTQIA+ identification on patient safety and experiences. 

Alberta Health Services: LGBTQ2S+ / Sexual and Gender Diversity – Resources

This resource offers comprehensive support, including educational materials and awareness programs aimed at building safe spaces. It also features a section dedicated to transgender health, providing valuable information and guidance for healthcare professionals. 

Anti-Trans Risk Map

The Anti-Trans Risk Map is an essential tool that identifies regions where transgender individuals face increased risks due to discriminatory laws, policies, and social climates. Given that such legislation can significantly impact the physical and mental health of affected individuals1,2, this tool can help pharmacy professionals stay informed about current legal conditions and advocate for trans, gender-diverse, and other 2SLGBTQIA+ communities. 

Human Rights Campaign: Providing LGBTQ-Inclusive Care and Services at your Pharmacy

This guide created by the Human Rights Campaign was developed to help pharmacy professionals provide an inclusive and welcoming environment for their 2SLGBTQIA+ patients. 

National LGBTQIA+ Health Education Center

The US-based National LGBTQIA+ Health Education Center offers a wide array of learning resources, including educational modules, toolkits, and webinars on various health-related topics. 

References

  1. Andreou A. Anti-trans laws will have a chilling effect on medicine [Internet]. Scientific American; 2022 [cited 2024 May]. Available from: https://www.scientificamerican.com/article/anti-trans-laws-will-have-a-chilling-effect-on-medicine/ 
  2. Barbee H, Deal C, Gonzales G [Internet]. U.S. National Library of Medicine; 2022 [cited 2024 May]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10204642/  
June 01, 2024
Pride in Pharmacy: Comprehensive Resources for 2SLGBTQIA+ Patient Care

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

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