Past Winners - Pharmacotherapy Best Practices Award

2019 award recipient 

Voriconazole Prophylaxis in Leukemic Patients: A Retrospective Single Centre Study

Vivian Bui, Sandra A N Walker, Marion Elligsen

Sunnybrook Health Sciences Centre, Toronto, Ontario

Background: Invasive fungal infections (IFIs) commonly occur in acute myeloid and lymphoblastic leukemia (AML and ALL) patients receiving chemotherapy. In these patients, posaconazole prophylaxis is recommended; however, voriconazole may be a less costly alternative. The objective of this study was to evaluate the efficacy and safety of voriconazole prophylaxis in acute leukemia patients.

Methods: A retrospective chart review of inpatients at Sunnybrook Health Sciences Centre between 2005 and 2017 was completed. Hospitalized adult AML and ALL patients who received voriconazole prophylaxis (cases) were compared to patients who received fluconazole or no prophylaxis during chemotherapy (controls). Statistical analyses comparing baseline characteristics, safety, and efficacy outcomes between the study cohorts were completed; and a generalized estimating equation (GEE) was used to balance for any observed baseline differences and / or the effect of repeat patient admissions. A posaconazole literature-based weighted mean risk was compared to the voriconazole risk of IFI identified in this study with patients who had similar characteristics, including: age and primary diagnosis.

Results: Of 490 AML or ALL patients, 83 controls and 92 cases were eligible. Case patients received an average of 24.4 ± 10.8 days of voriconazole prophylaxis. The GEE confirmed incidence of proven or probable IFIs with voriconazole was 3.3% (3/92) versus 7.2% (6/83) in the control cohort (GEE OR 0.43; 95% CI -2.3-0.6; p>0.05) and was comparable to the literature reported weighted incidence of IFI with posaconazole (2.4 ± 2.1%; 95% CI 1.3-3.4%; p>0.05). Voriconazole was well tolerated by patients (91%; 84/91; 7 discontinued due to asymptomatic elevated liver function tests).

Conclusions: Voriconazole prophylaxis was found to be safe, effective, and comparable to literature based efficacy data for risk of IFI with posaconazole antifungal prophylaxis in patients with acute leukemia undergoing chemotherapy; and could represent a significant cost advantage.

Sponsored by Pfizer Canada
 
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Past award recipients

Abstracts for the projects listed below can be viewed in the Canadian Journal of Hospital Pharmacy (CJHP). Award-winning abstracts are generally published in the first or second issue of each volume.

2018

Sponsored by Pfizer Canada Inc.

Lesley Palmay, Tiffany Kan 

Point-of-Care Beta-lactam Allergy Skin Testing by Antimicrobial Stewardship Programs: A Pragmatic Multicenter Prospective Evaluation (completed at Sunnybrook Health Sciences Centre, Toronto, Ontario)

2017

Sponsored by Pfizer Canada Inc.

Melanie Cormier, Sandra A N Walker, Marion Elligsen, Dolores Iaboni

Development, Evaluation and Validation of a Screening Tool for Late Onset Bacteremia in Neonates (completed at Sunnybrook Health Sciences Centre, Toronto, Ontario)

2017

Sponsored by Sandoz Canada Inc.

Patwant Dhillon, Pamela Ng

A Case-Control Study Analyzing Mannitol Dosing for Prevention of Cisplatin-Induced Acute Nephrotoxicity (completed at University Health Network, Toronto, Ontario)

2016

Sponsored by Pfizer Canada Inc.

Olavo Fernandes, Sean K Gorman, Richard S Slavik, William M Semchuk, Stephen Shalansky, Jean-François Bussières, Douglas Doucette, Jennifer Lo, Winnie W Y Chan, Natalie Benninger, Neil J MacKinnon, Jeremy Slobodan, Catherine Lyder, Peter J Zed, Kent Toombs

Development of Clinical Pharmacy Key Performance Indicators for Hospital Pharmacists Using a Modified Delphi Approach (completed at University Health Network, Toronto, Ontario)

2016

Sponsored by Sandoz Canada Inc.

Kyle Collins, Mary H H Ensom, Daniel Rainkie, Roxane Carr

Pediatric Assessment of Vancomycin Empiric Dosing 2 (PAVED2) (completed at British Columbia Children's Hospital, Vancouver, British Columbia)

2015

Sponsored by Pfizer Canada Inc.

Caitlin Meyer, Colette Raymond, Pamela Ng

Evaluation of Hypersensitivity Reactions Following the Discontinuation of Prophylactic Pre-medications (completed at University Health Network, Toronto, Ontario)

2014

Sponsored by Merck Canada Inc.

Daniel Rainkie, Mary H H Ensom

Pediatric Assessment of Vancomycin Empiric Dosing (PAVED) (completed at the Children's and Women's Health Centre of British Columbia, Vancouver, British Columbia)

2014

Sponsored by Pfizer Canada Inc.

Michelle Baker, Derek Leong, Gary Wong, Emily Musing, Olavo Fernandes

Does Interprofessional Medication Reconciliation from Admission to Discharge Reduce Post-Discharge Patient Emergency Department Visits and Hospital Readmissions? (completed at the Toronto General Hospital and Toronto Western Hospital sites of the University Health Network, Toronto, Ontario)

2013

Sponsored by Merck Canada Inc.

Arden Barry, Sheri Koshman, Glen Pearson

Evaluation of In-hospital and Post-Discharge Utilization of Preventative Cardiovascular Pharmacotherapy in Patients who have Undergone Coronary Artery Bypass Graft Surgery (completed at Mazankowski Alberta Heart Institute, Edmonton, Alberta)

2013

Sponsored by Pfizer Canada Inc.

Laura Carney, Roxane Carr, Jennifer Kendrick

The Safety and Effectiveness of Dexmedetomidine in the Pediatric Intensive Care Unit (SAD-PICU) (completed at BC Children's Hospital,
Vancouver, British Columbia)

2012

Sponsored by Merck Canada Inc.

Melissa Hawkins, Michael LeBlanc, Gisia Pisegna

A Pharmacist-Directed Toxicity Management Program for Patients Receiving Capecitabine: Implementation and Evaluation (completed at Horizon Health Network - The Moncton Hospital, Moncton, New Brunswick)

2012

Sponsored by Pfizer Canada Inc.

Marion Elligsen, Sandra A N Walker

Evaluation of a Prospective Audit and Feedback Program in Critical Care: A Controlled Interrupted Time Series Analysis (completed at Sunnybrook Health Sciences Centre, Toronto, Ontario)

2011

Sponsored by Merck Frosst Canada Ltd.

Anne Marie Whelan

Development and Evaluation of an Instrument for the Critical Appraisal of Randomized Controlled Trials of Natural Products (completed at College of Pharmacy, Dalhousie University, Halifax, Nova Scotia)

2011

Sponsored by Pfizer Canada Inc.

Shane Pawluk, Roberta Esau, Roxanne Carr

Single versus Double Gram Negative Coverage Empiric Antibiotic Therapy of Febrile Neutropenia in Pediatric Patients (completed at BC Children’s Hospital, Vancouver, British Columbia)

2010

Sponsored by Merck Frosst Canada Ltd.

Miriam Inparajah, L Lee Dupuis, Sabrina Boodhan

Once Daily Gentamicin Dosing in Febrile Neutropenic Children (completed at The Hospital for Sick Children, Toronto Ontario)

2010

Sponsored by Pfizer Canada Inc.

Vincent H Mabasa, Douglas L Malyuk, Alice Chan, Elisa-Marie Weatherby

A Practical Method of Providing Pharmaceutical Care in the Intensive Care Unit: FASTHUG-MAIDENS (completed at Royal Columbian Hospital, Burnaby, British Columbia)

2009

Sponsored by Merck Frosst Canada Ltd.

Winnie W Y Chan, Peter J Zed

Efficacy, Safety and Patient Satisfaction of Propofol for Procedural Sedation and Analgesia in the Emergency Department (completed at Vancouver General Hospital, Vancouver, British Columbia)

2009

Sponsored by Pfizer Canada Inc.

Adil Virani

Innovative Role or Overkill? (completed at Fraser Health Community Programs, Langley, British Columbia)

Inquiries should be directed to :

Robyn Rockwell, Membership & Awards Administrator
awards@cshp.pharmacy
Toll Free: 1 (877) 340-2756, ext. 222
Direct: (613) 736-9733, ext. 222