| 2019 Recipients |
 |
| Dan Burton |
 |
| Laura Murphy |
 |
| Olavo Fernandes |
 |
| Philippe Vincent |
Since 2007 CFP has transformed more than $2 million in individual and corporate donations into awards, bursaries and scholarships for pharmacy researchers, innovators and leaders across the country. Grants from the Innovation Fund are a core component of CFP's commitment to support pharmacy for a healthier Canada.
Click here for general information about criteria and the online application process. You can also contact CFP Executive Director Dayle Acorn at dacorn@cfpnet.ca or 905.997.3238.
Next year's application process will begin early in 2020. Check this page for updates.
A Summary of the Projects that Received Innovation Fund Grants in 2019:
Expanding the Circle of Care for Mental Health
The "Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)" research study led by Daniel Burton and the research team at University of Alberta seeks to evaluate the effect of a community-pharmacist monitoring and intervention program with patients diagnosed with major depressive disorder and/or general anxiety disorder, in comparison to usual care managed exclusively by the patient's primary care provider. Pharmacists' interventions may include prescribing, and the pharmacists will enage with patients' family physicians. The randomized controlled trial is funded with a CFP Innovation Fund grant of $50,000.
CannabisCareRx: The Pharmacist's Role in Medical Cannabis
Laura Murphy and Olavo Fernandes at the University Health Network have received $25,000 from CFP's Innovation Fund to develop Canada's first structured program to assist pharmacists with screening patients on their possible use of medical cannabis, and from there, if applicable, provide tools for assessment, documentation and referral. The program includes pharmacist education that emphasizes the development of communication skills specific to issues surrounding medical cannabis, including stigma. The researcherse will pilot the "CannabisCareRx" program in Ontario, with the intent to make it available to pharmacies across Canada.
Coaching and custom app for patients with depression
Philippe Vincent of the University of Montreal and his research team are developing and piloting a smartphone app that's supported by pharmacist coaching in an effort to achieve a quicker treatment response for patients experiencing a new episode of major depressive disorder. The randomized, unblinded, multicenter intervention trial (entitled "SAD-APP: Self-rating App for Depression Aided by Proactive Pharmacists") will involve 300 patients at 30 community pharmacies. The app will regularly remind patients to use its self-assessment tools, and the results will be accessible to pharmacists in the coaching group. CFP is one of two funders for the project, contributing $50,000 from its Innovation Fund.
For more details on all of our grant recipients, see below.
"Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)"
With $50,000 in funding from the Canadian Foundation for Pharmacy’s Innovation Fund, a University of Alberta team of researchers and front-line pharmacists are implementing a pharmacist-initiated mental health monitoring and intervention program based in the community setting. “We are grateful to have the opportunity to partner with CFP as an unbiased organization that supports pharmacy initiatives,” says lead researcher/pharmacist Dan Burton.
For the study, up to 10 pharmacies in Calgary and surrounding areas will be involved with some 120 participating patients over a six-month period. The intervention group will be recruiting and monitoring patients with major depressive disorder and general anxiety disorder, providing interventions as needed and collaborating with patients’ physicians. The control group will receive usual pharmacy care.
Participating pharmacists will receive mental health training materials and have support throughout the pilot and are expected to begin recruiting patients by March 2020.
“Given community pharmacists’ training and access, they are in a great position to help the healthcare field better manage depression and anxiety,” says Burton. “They could take the burden off physicians and other providers by stabilizing patients on medication—plus sometimes these patients need more frequent touch points of support and we have that opportunity in the community.”
Burton says he and his team were inspired to develop the study by the recent Bloom Program pilot in Nova Scotia, which showed the positive benefits community pharmacists can have in helping patients with mental health issues. “With additional prescribing authority in Alberta there’s potential for us to do even more,” he says. For example, Alberta pharmacists can titrate and augment therapies by prescribing higher doses, or add on medications to help patients reach maximum treatment benefits. They can also switch therapies if patients aren’t responding or have uncomfortable side effects. “That’s a huge opportunity for pharmacists,” he says.
Burton hopes that positive study results will also encourage other pharmacists to get more involved in helping patients with mental health disorders. “There is still a significant amount of stigma out there around mental health. Pharmacists are also very type A personalities and sometimes we need concrete data before we believe we can do it,” he says. “If the study goes well, it will be a good starting point to build from.”
"Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)"
With $50,000 in funding from the Canadian Foundation for Pharmacy’s Innovation Fund, a University of Alberta team of researchers and front-line pharmacists are implementing a pharmacist-initiated mental health monitoring and intervention program based in the community setting. “We are grateful to have the opportunity to partner with CFP as an unbiased organization that supports pharmacy initiatives,” says lead researcher/pharmacist Dan Burton.
For the study, up to 10 pharmacies in Calgary and surrounding areas will be involved with some 120 participating patients over a six-month period. The intervention group will be recruiting and monitoring patients with major depressive disorder and general anxiety disorder, providing interventions as needed and collaborating with patients’ physicians. The control group will receive usual pharmacy care.
Participating pharmacists will receive mental health training materials and have support throughout the pilot and are expected to begin recruiting patients by March 2020.
“Given community pharmacists’ training and access, they are in a great position to help the healthcare field better manage depression and anxiety,” says Burton. “They could take the burden off physicians and other providers by stabilizing patients on medication—plus sometimes these patients need more frequent touch points of support and we have that opportunity in the community.”
Burton says he and his team were inspired to develop the study by the recent Bloom Program pilot in Nova Scotia, which showed the positive benefits community pharmacists can have in helping patients with mental health issues. “With additional prescribing authority in Alberta there’s potential for us to do even more,” he says. For example, Alberta pharmacists can titrate and augment therapies by prescribing higher doses, or add on medications to help patients reach maximum treatment benefits. They can also switch therapies if patients aren’t responding or have uncomfortable side effects. “That’s a huge opportunity for pharmacists,” he says.
Burton hopes that positive study results will also encourage other pharmacists to get more involved in helping patients with mental health disorders. “There is still a significant amount of stigma out there around mental health. Pharmacists are also very type A personalities and sometimes we need concrete data before we believe we can do it,” he says. “If the study goes well, it will be a good starting point to build from.”
|
| Laura Murphy |
|
| Olavo Fernandes |
"CannabisCareRx"
A $25,000 grant from the Canadian Foundation for Pharmacy’s Innovation Fund will see the development and study of a program to help community pharmacists identify and support patients using medical cannabis, as part of routine care.
The pilot-based research study out of Ontario is looking to bridge the gap between legal medical cannabis distribution, which currently bypasses community pharmacies, and the expectation that community pharmacists competently provide information and advice to patients who use medical cannabis. Pharmacists in Ontario who provide direct patient care must complete mandatory cannabis training by 2020, yet there is a noticeable lack of a training program that involves pharmacists in screening for cannabis use.
Lead investigators Laura Murphy and Olavo Fernandes, researchers at the University Health Network, will conduct a prospective observational study of a pilot implementation of a structured program, entitled CannabisCareRx. The program will be comprised of screening questions, a structured process for assessment and a template for documentation and referral to other healthcare providers. The program also includes pharmacist education that emphasizes the development of communication skills to engage patients and decrease stigma. The materials and tools developed will be scalable for implementation across Canada.
Overall, the project is set to occur over three years, starting in September of 2020. It is broken up into three steps: set-up, pilot implementation and dissemination. The set-up stage includes development of the pharmacy education and consultation guide, building the research database, and recruiting five pharmacists from the Greater Toronto Area for the pilot occurring throughout year two.
CannabisCareRx will be piloted as part of usual care provided by the participating pharmacists. After completing the Cannabis Education program, the pharmacists will implement the use of the screening questions with all of their adult patients during routine interactions throughout the 12 months of the pilot.
From there, a member of the research team will conduct a follow-up survey with the pharmacists involved and patients who provide their contact information and permission. The feasibility outcomes will include the number of patients who use cannabis for therapeutic reasons, the number of patients who complete the questionnaire, and the amount of pharmacist time required to conduct CannabisCareRx.
The aim is not only to be successful at the end of the three years but also to create a blueprint for pharmacists across Canada. “The outcomes of the pilot implementation of the CannabisCareRx program will provide patient-centred, pharmacist-driven education materials that will not only support the promotion of safe and effective use of cannabis and harm reduction but will also provide a tangible, patient-facing guide that can facilitate brief and effective consultation,” said Murphy.
"Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)"
With $50,000 in funding from the Canadian Foundation for Pharmacy’s Innovation Fund, a University of Alberta team of researchers and front-line pharmacists are implementing a pharmacist-initiated mental health monitoring and intervention program based in the community setting. “We are grateful to have the opportunity to partner with CFP as an unbiased organization that supports pharmacy initiatives,” says lead researcher/pharmacist Dan Burton.
For the study, up to 10 pharmacies in Calgary and surrounding areas will be involved with some 120 participating patients over a six-month period. The intervention group will be recruiting and monitoring patients with major depressive disorder and general anxiety disorder, providing interventions as needed and collaborating with patients’ physicians. The control group will receive usual pharmacy care.
Participating pharmacists will receive mental health training materials and have support throughout the pilot and are expected to begin recruiting patients by March 2020.
“Given community pharmacists’ training and access, they are in a great position to help the healthcare field better manage depression and anxiety,” says Burton. “They could take the burden off physicians and other providers by stabilizing patients on medication—plus sometimes these patients need more frequent touch points of support and we have that opportunity in the community.”
Burton says he and his team were inspired to develop the study by the recent Bloom Program pilot in Nova Scotia, which showed the positive benefits community pharmacists can have in helping patients with mental health issues. “With additional prescribing authority in Alberta there’s potential for us to do even more,” he says. For example, Alberta pharmacists can titrate and augment therapies by prescribing higher doses, or add on medications to help patients reach maximum treatment benefits. They can also switch therapies if patients aren’t responding or have uncomfortable side effects. “That’s a huge opportunity for pharmacists,” he says.
Burton hopes that positive study results will also encourage other pharmacists to get more involved in helping patients with mental health disorders. “There is still a significant amount of stigma out there around mental health. Pharmacists are also very type A personalities and sometimes we need concrete data before we believe we can do it,” he says. “If the study goes well, it will be a good starting point to build from.”
|
| Laura Murphy |
|
| Olavo Fernandes |
"CannabisCareRx"
A $25,000 grant from the Canadian Foundation for Pharmacy’s Innovation Fund will see the development and study of a program to help community pharmacists identify and support patients using medical cannabis, as part of routine care.
The pilot-based research study out of Ontario is looking to bridge the gap between legal medical cannabis distribution, which currently bypasses community pharmacies, and the expectation that community pharmacists competently provide information and advice to patients who use medical cannabis. Pharmacists in Ontario who provide direct patient care must complete mandatory cannabis training by 2020, yet there is a noticeable lack of a training program that involves pharmacists in screening for cannabis use.
Lead investigators Laura Murphy and Olavo Fernandes, researchers at the University Health Network, will conduct a prospective observational study of a pilot implementation of a structured program, entitled CannabisCareRx. The program will be comprised of screening questions, a structured process for assessment and a template for documentation and referral to other healthcare providers. The program also includes pharmacist education that emphasizes the development of communication skills to engage patients and decrease stigma. The materials and tools developed will be scalable for implementation across Canada.
Overall, the project is set to occur over three years, starting in September of 2020. It is broken up into three steps: set-up, pilot implementation and dissemination. The set-up stage includes development of the pharmacy education and consultation guide, building the research database, and recruiting five pharmacists from the Greater Toronto Area for the pilot occurring throughout year two.
CannabisCareRx will be piloted as part of usual care provided by the participating pharmacists. After completing the Cannabis Education program, the pharmacists will implement the use of the screening questions with all of their adult patients during routine interactions throughout the 12 months of the pilot.
From there, a member of the research team will conduct a follow-up survey with the pharmacists involved and patients who provide their contact information and permission. The feasibility outcomes will include the number of patients who use cannabis for therapeutic reasons, the number of patients who complete the questionnaire, and the amount of pharmacist time required to conduct CannabisCareRx.
The aim is not only to be successful at the end of the three years but also to create a blueprint for pharmacists across Canada. “The outcomes of the pilot implementation of the CannabisCareRx program will provide patient-centred, pharmacist-driven education materials that will not only support the promotion of safe and effective use of cannabis and harm reduction but will also provide a tangible, patient-facing guide that can facilitate brief and effective consultation,” said Murphy.
"SAD-APP: Self-rating App for Depression Aided by Proactive Pharmacists"
Researcher Philippe Vincent and pharmacists at 30 community pharmacies hope to smooth the path to recovery for patients with depression through a ground-breaking research study funded in part with a $50,000 grant from the Canadian Foundation for Pharmacy’s (CFP’s) Innovation Fund.
The research is unique in that it combines pharmacist coaching with a smartphone app. The app will also differentiate itself within the virtual sea of mental health apps in that it will be built around the PHQ-9 and GAD-7 self-assessment questionnaires, two standardised, validated tools to assess depression and anxiety, respectively. Participating pharmacists will be able to access a patient’s results using a secure, online dashboard.
The study’s primary objective is to shorten the time to recovery by helping patients achieve treatment response as quickly as possible and by supporting adherence.
“Our project seeks to bring patients who suffer in silence and pharmacists together into a meaningful relationship. The self-rating scales and smartphone app are mediators of a safe space for private, sometimes emotional conversations and goal-setting,” says Vincent, Associate Professor of Clinical Pharmacy at University of Montreal and a researcher with the university-affiliated Institute universitaire en sante mentale de Montreal (a psychiatric hospital).
A secondary goal is to prove the value of pharmacists’ interventions. “If we can show that the time pharmacists put into monitoring and coaching is directly proportional to the remission of patients, so people can go back to meaningful occupations and live fuller lives, then insurance, government and other stakeholders will understand that the pharmacists’ time is worth something,” says Vincent.
As well, the stage is already set for possible adoption of the research model into regular pharmacy practice, and possibly on a national scale. All 30 participating pharmacies are part of the Pharmaprix banner, a division of Shoppers Drug Mart and Loblaw companies. Pharmaprix is co-funding the project with CFP.
The study is a randomized, unblinded, multicenter intervention trial that will follow patients over six months. The 30 participating pharmacies will each enrol 10 patients who have been diagnosed with a new episode of major depression, broken down as follows:
Pharmacists in the coaching group will receive training based on best practices in clinical psychiatry. They will call their participating patients every week during the dose-finding period and conduct a 5-minute semi-structured interview that seeks to create rapport, agree on treatment goals and agree on tasks. Pharmacists will also ask about side effects, which will be addressed as required through separate interventions that will be documented in the dashboard.
Throughout the six months of the study, the app will send notifications to patients every two weeks to remind them to complete the PHQ-9 and GAD-7 questionnaires. The app will also prompt patients to complete the PHQ-2 questionnaire every day for the first 15 days, every two days for the next 15 days, and every three days thereafter. “In a pharmacy setting where everything is so busy, you need to have useful, fast and complete information. This model enables systematic monitoring and a communication bridge between patients and pharmacists,” says Vincent.
The estimated project completion date, including data analysis, is mid 2021.
"Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)"
With $50,000 in funding from the Canadian Foundation for Pharmacy’s Innovation Fund, a University of Alberta team of researchers and front-line pharmacists are implementing a pharmacist-initiated mental health monitoring and intervention program based in the community setting. “We are grateful to have the opportunity to partner with CFP as an unbiased organization that supports pharmacy initiatives,” says lead researcher/pharmacist Dan Burton.
For the study, up to 10 pharmacies in Calgary and surrounding areas will be involved with some 120 participating patients over a six-month period. The intervention group will be recruiting and monitoring patients with major depressive disorder and general anxiety disorder, providing interventions as needed and collaborating with patients’ physicians. The control group will receive usual pharmacy care.
Participating pharmacists will receive mental health training materials and have support throughout the pilot and are expected to begin recruiting patients by March 2020.
“Given community pharmacists’ training and access, they are in a great position to help the healthcare field better manage depression and anxiety,” says Burton. “They could take the burden off physicians and other providers by stabilizing patients on medication—plus sometimes these patients need more frequent touch points of support and we have that opportunity in the community.”
Burton says he and his team were inspired to develop the study by the recent Bloom Program pilot in Nova Scotia, which showed the positive benefits community pharmacists can have in helping patients with mental health issues. “With additional prescribing authority in Alberta there’s potential for us to do even more,” he says. For example, Alberta pharmacists can titrate and augment therapies by prescribing higher doses, or add on medications to help patients reach maximum treatment benefits. They can also switch therapies if patients aren’t responding or have uncomfortable side effects. “That’s a huge opportunity for pharmacists,” he says.
Burton hopes that positive study results will also encourage other pharmacists to get more involved in helping patients with mental health disorders. “There is still a significant amount of stigma out there around mental health. Pharmacists are also very type A personalities and sometimes we need concrete data before we believe we can do it,” he says. “If the study goes well, it will be a good starting point to build from.”
|
| Laura Murphy |
|
| Olavo Fernandes |
"CannabisCareRx"
A $25,000 grant from the Canadian Foundation for Pharmacy’s Innovation Fund will see the development and study of a program to help community pharmacists identify and support patients using medical cannabis, as part of routine care.
The pilot-based research study out of Ontario is looking to bridge the gap between legal medical cannabis distribution, which currently bypasses community pharmacies, and the expectation that community pharmacists competently provide information and advice to patients who use medical cannabis. Pharmacists in Ontario who provide direct patient care must complete mandatory cannabis training by 2020, yet there is a noticeable lack of a training program that involves pharmacists in screening for cannabis use.
Lead investigators Laura Murphy and Olavo Fernandes, researchers at the University Health Network, will conduct a prospective observational study of a pilot implementation of a structured program, entitled CannabisCareRx. The program will be comprised of screening questions, a structured process for assessment and a template for documentation and referral to other healthcare providers. The program also includes pharmacist education that emphasizes the development of communication skills to engage patients and decrease stigma. The materials and tools developed will be scalable for implementation across Canada.
Overall, the project is set to occur over three years, starting in September of 2020. It is broken up into three steps: set-up, pilot implementation and dissemination. The set-up stage includes development of the pharmacy education and consultation guide, building the research database, and recruiting five pharmacists from the Greater Toronto Area for the pilot occurring throughout year two.
CannabisCareRx will be piloted as part of usual care provided by the participating pharmacists. After completing the Cannabis Education program, the pharmacists will implement the use of the screening questions with all of their adult patients during routine interactions throughout the 12 months of the pilot.
From there, a member of the research team will conduct a follow-up survey with the pharmacists involved and patients who provide their contact information and permission. The feasibility outcomes will include the number of patients who use cannabis for therapeutic reasons, the number of patients who complete the questionnaire, and the amount of pharmacist time required to conduct CannabisCareRx.
The aim is not only to be successful at the end of the three years but also to create a blueprint for pharmacists across Canada. “The outcomes of the pilot implementation of the CannabisCareRx program will provide patient-centred, pharmacist-driven education materials that will not only support the promotion of safe and effective use of cannabis and harm reduction but will also provide a tangible, patient-facing guide that can facilitate brief and effective consultation,” said Murphy.
"SAD-APP: Self-rating App for Depression Aided by Proactive Pharmacists"
Researcher Philippe Vincent and pharmacists at 30 community pharmacies hope to smooth the path to recovery for patients with depression through a ground-breaking research study funded in part with a $50,000 grant from the Canadian Foundation for Pharmacy’s (CFP’s) Innovation Fund.
The research is unique in that it combines pharmacist coaching with a smartphone app. The app will also differentiate itself within the virtual sea of mental health apps in that it will be built around the PHQ-9 and GAD-7 self-assessment questionnaires, two standardised, validated tools to assess depression and anxiety, respectively. Participating pharmacists will be able to access a patient’s results using a secure, online dashboard.
The study’s primary objective is to shorten the time to recovery by helping patients achieve treatment response as quickly as possible and by supporting adherence.
“Our project seeks to bring patients who suffer in silence and pharmacists together into a meaningful relationship. The self-rating scales and smartphone app are mediators of a safe space for private, sometimes emotional conversations and goal-setting,” says Vincent, Associate Professor of Clinical Pharmacy at University of Montreal and a researcher with the university-affiliated Institute universitaire en sante mentale de Montreal (a psychiatric hospital).
A secondary goal is to prove the value of pharmacists’ interventions. “If we can show that the time pharmacists put into monitoring and coaching is directly proportional to the remission of patients, so people can go back to meaningful occupations and live fuller lives, then insurance, government and other stakeholders will understand that the pharmacists’ time is worth something,” says Vincent.
As well, the stage is already set for possible adoption of the research model into regular pharmacy practice, and possibly on a national scale. All 30 participating pharmacies are part of the Pharmaprix banner, a division of Shoppers Drug Mart and Loblaw companies. Pharmaprix is co-funding the project with CFP.
The study is a randomized, unblinded, multicenter intervention trial that will follow patients over six months. The 30 participating pharmacies will each enrol 10 patients who have been diagnosed with a new episode of major depression, broken down as follows:
Pharmacists in the coaching group will receive training based on best practices in clinical psychiatry. They will call their participating patients every week during the dose-finding period and conduct a 5-minute semi-structured interview that seeks to create rapport, agree on treatment goals and agree on tasks. Pharmacists will also ask about side effects, which will be addressed as required through separate interventions that will be documented in the dashboard.
Throughout the six months of the study, the app will send notifications to patients every two weeks to remind them to complete the PHQ-9 and GAD-7 questionnaires. The app will also prompt patients to complete the PHQ-2 questionnaire every day for the first 15 days, every two days for the next 15 days, and every three days thereafter. “In a pharmacy setting where everything is so busy, you need to have useful, fast and complete information. This model enables systematic monitoring and a communication bridge between patients and pharmacists,” says Vincent.
The estimated project completion date, including data analysis, is mid 2021.
John Papastergiou, practising community pharmacist, and the research team at University of Toronto is using CFP's grant of $15,000 to quantify adherence rates to adult immunizations, where a series of vaccines or booster vaccines are required, when these vaccines are administered by community pharmacists. It's hoped that the study results will help pharmacists obtain prescribing rights for vaccines.
"Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)"
With $50,000 in funding from the Canadian Foundation for Pharmacy’s Innovation Fund, a University of Alberta team of researchers and front-line pharmacists are implementing a pharmacist-initiated mental health monitoring and intervention program based in the community setting. “We are grateful to have the opportunity to partner with CFP as an unbiased organization that supports pharmacy initiatives,” says lead researcher/pharmacist Dan Burton.
For the study, up to 10 pharmacies in Calgary and surrounding areas will be involved with some 120 participating patients over a six-month period. The intervention group will be recruiting and monitoring patients with major depressive disorder and general anxiety disorder, providing interventions as needed and collaborating with patients’ physicians. The control group will receive usual pharmacy care.
Participating pharmacists will receive mental health training materials and have support throughout the pilot and are expected to begin recruiting patients by March 2020.
“Given community pharmacists’ training and access, they are in a great position to help the healthcare field better manage depression and anxiety,” says Burton. “They could take the burden off physicians and other providers by stabilizing patients on medication—plus sometimes these patients need more frequent touch points of support and we have that opportunity in the community.”
Burton says he and his team were inspired to develop the study by the recent Bloom Program pilot in Nova Scotia, which showed the positive benefits community pharmacists can have in helping patients with mental health issues. “With additional prescribing authority in Alberta there’s potential for us to do even more,” he says. For example, Alberta pharmacists can titrate and augment therapies by prescribing higher doses, or add on medications to help patients reach maximum treatment benefits. They can also switch therapies if patients aren’t responding or have uncomfortable side effects. “That’s a huge opportunity for pharmacists,” he says.
Burton hopes that positive study results will also encourage other pharmacists to get more involved in helping patients with mental health disorders. “There is still a significant amount of stigma out there around mental health. Pharmacists are also very type A personalities and sometimes we need concrete data before we believe we can do it,” he says. “If the study goes well, it will be a good starting point to build from.”
|
| Laura Murphy |
|
| Olavo Fernandes |
"CannabisCareRx"
A $25,000 grant from the Canadian Foundation for Pharmacy’s Innovation Fund will see the development and study of a program to help community pharmacists identify and support patients using medical cannabis, as part of routine care.
The pilot-based research study out of Ontario is looking to bridge the gap between legal medical cannabis distribution, which currently bypasses community pharmacies, and the expectation that community pharmacists competently provide information and advice to patients who use medical cannabis. Pharmacists in Ontario who provide direct patient care must complete mandatory cannabis training by 2020, yet there is a noticeable lack of a training program that involves pharmacists in screening for cannabis use.
Lead investigators Laura Murphy and Olavo Fernandes, researchers at the University Health Network, will conduct a prospective observational study of a pilot implementation of a structured program, entitled CannabisCareRx. The program will be comprised of screening questions, a structured process for assessment and a template for documentation and referral to other healthcare providers. The program also includes pharmacist education that emphasizes the development of communication skills to engage patients and decrease stigma. The materials and tools developed will be scalable for implementation across Canada.
Overall, the project is set to occur over three years, starting in September of 2020. It is broken up into three steps: set-up, pilot implementation and dissemination. The set-up stage includes development of the pharmacy education and consultation guide, building the research database, and recruiting five pharmacists from the Greater Toronto Area for the pilot occurring throughout year two.
CannabisCareRx will be piloted as part of usual care provided by the participating pharmacists. After completing the Cannabis Education program, the pharmacists will implement the use of the screening questions with all of their adult patients during routine interactions throughout the 12 months of the pilot.
From there, a member of the research team will conduct a follow-up survey with the pharmacists involved and patients who provide their contact information and permission. The feasibility outcomes will include the number of patients who use cannabis for therapeutic reasons, the number of patients who complete the questionnaire, and the amount of pharmacist time required to conduct CannabisCareRx.
The aim is not only to be successful at the end of the three years but also to create a blueprint for pharmacists across Canada. “The outcomes of the pilot implementation of the CannabisCareRx program will provide patient-centred, pharmacist-driven education materials that will not only support the promotion of safe and effective use of cannabis and harm reduction but will also provide a tangible, patient-facing guide that can facilitate brief and effective consultation,” said Murphy.
"SAD-APP: Self-rating App for Depression Aided by Proactive Pharmacists"
Researcher Philippe Vincent and pharmacists at 30 community pharmacies hope to smooth the path to recovery for patients with depression through a ground-breaking research study funded in part with a $50,000 grant from the Canadian Foundation for Pharmacy’s (CFP’s) Innovation Fund.
The research is unique in that it combines pharmacist coaching with a smartphone app. The app will also differentiate itself within the virtual sea of mental health apps in that it will be built around the PHQ-9 and GAD-7 self-assessment questionnaires, two standardised, validated tools to assess depression and anxiety, respectively. Participating pharmacists will be able to access a patient’s results using a secure, online dashboard.
The study’s primary objective is to shorten the time to recovery by helping patients achieve treatment response as quickly as possible and by supporting adherence.
“Our project seeks to bring patients who suffer in silence and pharmacists together into a meaningful relationship. The self-rating scales and smartphone app are mediators of a safe space for private, sometimes emotional conversations and goal-setting,” says Vincent, Associate Professor of Clinical Pharmacy at University of Montreal and a researcher with the university-affiliated Institute universitaire en sante mentale de Montreal (a psychiatric hospital).
A secondary goal is to prove the value of pharmacists’ interventions. “If we can show that the time pharmacists put into monitoring and coaching is directly proportional to the remission of patients, so people can go back to meaningful occupations and live fuller lives, then insurance, government and other stakeholders will understand that the pharmacists’ time is worth something,” says Vincent.
As well, the stage is already set for possible adoption of the research model into regular pharmacy practice, and possibly on a national scale. All 30 participating pharmacies are part of the Pharmaprix banner, a division of Shoppers Drug Mart and Loblaw companies. Pharmaprix is co-funding the project with CFP.
The study is a randomized, unblinded, multicenter intervention trial that will follow patients over six months. The 30 participating pharmacies will each enrol 10 patients who have been diagnosed with a new episode of major depression, broken down as follows:
Pharmacists in the coaching group will receive training based on best practices in clinical psychiatry. They will call their participating patients every week during the dose-finding period and conduct a 5-minute semi-structured interview that seeks to create rapport, agree on treatment goals and agree on tasks. Pharmacists will also ask about side effects, which will be addressed as required through separate interventions that will be documented in the dashboard.
Throughout the six months of the study, the app will send notifications to patients every two weeks to remind them to complete the PHQ-9 and GAD-7 questionnaires. The app will also prompt patients to complete the PHQ-2 questionnaire every day for the first 15 days, every two days for the next 15 days, and every three days thereafter. “In a pharmacy setting where everything is so busy, you need to have useful, fast and complete information. This model enables systematic monitoring and a communication bridge between patients and pharmacists,” says Vincent.
The estimated project completion date, including data analysis, is mid 2021.
John Papastergiou, practising community pharmacist, and the research team at University of Toronto is using CFP's grant of $15,000 to quantify adherence rates to adult immunizations, where a series of vaccines or booster vaccines are required, when these vaccines are administered by community pharmacists. It's hoped that the study results will help pharmacists obtain prescribing rights for vaccines.
CFP has awarded Paula Newman and her team at Northwest Telepharmacy Solutions $22,500 to determine the feasibility and effectiveness of a pharmacist-led opioid stewardship program for chronic non-cancer pain, using videoconferencing technology. The project includes prescriber and patient education, risk stratification and screening for potential harm, as well as patient monitoriing with follow-up and continuity of care.
"Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)"
With $50,000 in funding from the Canadian Foundation for Pharmacy’s Innovation Fund, a University of Alberta team of researchers and front-line pharmacists are implementing a pharmacist-initiated mental health monitoring and intervention program based in the community setting. “We are grateful to have the opportunity to partner with CFP as an unbiased organization that supports pharmacy initiatives,” says lead researcher/pharmacist Dan Burton.
For the study, up to 10 pharmacies in Calgary and surrounding areas will be involved with some 120 participating patients over a six-month period. The intervention group will be recruiting and monitoring patients with major depressive disorder and general anxiety disorder, providing interventions as needed and collaborating with patients’ physicians. The control group will receive usual pharmacy care.
Participating pharmacists will receive mental health training materials and have support throughout the pilot and are expected to begin recruiting patients by March 2020.
“Given community pharmacists’ training and access, they are in a great position to help the healthcare field better manage depression and anxiety,” says Burton. “They could take the burden off physicians and other providers by stabilizing patients on medication—plus sometimes these patients need more frequent touch points of support and we have that opportunity in the community.”
Burton says he and his team were inspired to develop the study by the recent Bloom Program pilot in Nova Scotia, which showed the positive benefits community pharmacists can have in helping patients with mental health issues. “With additional prescribing authority in Alberta there’s potential for us to do even more,” he says. For example, Alberta pharmacists can titrate and augment therapies by prescribing higher doses, or add on medications to help patients reach maximum treatment benefits. They can also switch therapies if patients aren’t responding or have uncomfortable side effects. “That’s a huge opportunity for pharmacists,” he says.
Burton hopes that positive study results will also encourage other pharmacists to get more involved in helping patients with mental health disorders. “There is still a significant amount of stigma out there around mental health. Pharmacists are also very type A personalities and sometimes we need concrete data before we believe we can do it,” he says. “If the study goes well, it will be a good starting point to build from.”
|
| Laura Murphy |
|
| Olavo Fernandes |
"CannabisCareRx"
A $25,000 grant from the Canadian Foundation for Pharmacy’s Innovation Fund will see the development and study of a program to help community pharmacists identify and support patients using medical cannabis, as part of routine care.
The pilot-based research study out of Ontario is looking to bridge the gap between legal medical cannabis distribution, which currently bypasses community pharmacies, and the expectation that community pharmacists competently provide information and advice to patients who use medical cannabis. Pharmacists in Ontario who provide direct patient care must complete mandatory cannabis training by 2020, yet there is a noticeable lack of a training program that involves pharmacists in screening for cannabis use.
Lead investigators Laura Murphy and Olavo Fernandes, researchers at the University Health Network, will conduct a prospective observational study of a pilot implementation of a structured program, entitled CannabisCareRx. The program will be comprised of screening questions, a structured process for assessment and a template for documentation and referral to other healthcare providers. The program also includes pharmacist education that emphasizes the development of communication skills to engage patients and decrease stigma. The materials and tools developed will be scalable for implementation across Canada.
Overall, the project is set to occur over three years, starting in September of 2020. It is broken up into three steps: set-up, pilot implementation and dissemination. The set-up stage includes development of the pharmacy education and consultation guide, building the research database, and recruiting five pharmacists from the Greater Toronto Area for the pilot occurring throughout year two.
CannabisCareRx will be piloted as part of usual care provided by the participating pharmacists. After completing the Cannabis Education program, the pharmacists will implement the use of the screening questions with all of their adult patients during routine interactions throughout the 12 months of the pilot.
From there, a member of the research team will conduct a follow-up survey with the pharmacists involved and patients who provide their contact information and permission. The feasibility outcomes will include the number of patients who use cannabis for therapeutic reasons, the number of patients who complete the questionnaire, and the amount of pharmacist time required to conduct CannabisCareRx.
The aim is not only to be successful at the end of the three years but also to create a blueprint for pharmacists across Canada. “The outcomes of the pilot implementation of the CannabisCareRx program will provide patient-centred, pharmacist-driven education materials that will not only support the promotion of safe and effective use of cannabis and harm reduction but will also provide a tangible, patient-facing guide that can facilitate brief and effective consultation,” said Murphy.
"SAD-APP: Self-rating App for Depression Aided by Proactive Pharmacists"
Researcher Philippe Vincent and pharmacists at 30 community pharmacies hope to smooth the path to recovery for patients with depression through a ground-breaking research study funded in part with a $50,000 grant from the Canadian Foundation for Pharmacy’s (CFP’s) Innovation Fund.
The research is unique in that it combines pharmacist coaching with a smartphone app. The app will also differentiate itself within the virtual sea of mental health apps in that it will be built around the PHQ-9 and GAD-7 self-assessment questionnaires, two standardised, validated tools to assess depression and anxiety, respectively. Participating pharmacists will be able to access a patient’s results using a secure, online dashboard.
The study’s primary objective is to shorten the time to recovery by helping patients achieve treatment response as quickly as possible and by supporting adherence.
“Our project seeks to bring patients who suffer in silence and pharmacists together into a meaningful relationship. The self-rating scales and smartphone app are mediators of a safe space for private, sometimes emotional conversations and goal-setting,” says Vincent, Associate Professor of Clinical Pharmacy at University of Montreal and a researcher with the university-affiliated Institute universitaire en sante mentale de Montreal (a psychiatric hospital).
A secondary goal is to prove the value of pharmacists’ interventions. “If we can show that the time pharmacists put into monitoring and coaching is directly proportional to the remission of patients, so people can go back to meaningful occupations and live fuller lives, then insurance, government and other stakeholders will understand that the pharmacists’ time is worth something,” says Vincent.
As well, the stage is already set for possible adoption of the research model into regular pharmacy practice, and possibly on a national scale. All 30 participating pharmacies are part of the Pharmaprix banner, a division of Shoppers Drug Mart and Loblaw companies. Pharmaprix is co-funding the project with CFP.
The study is a randomized, unblinded, multicenter intervention trial that will follow patients over six months. The 30 participating pharmacies will each enrol 10 patients who have been diagnosed with a new episode of major depression, broken down as follows:
Pharmacists in the coaching group will receive training based on best practices in clinical psychiatry. They will call their participating patients every week during the dose-finding period and conduct a 5-minute semi-structured interview that seeks to create rapport, agree on treatment goals and agree on tasks. Pharmacists will also ask about side effects, which will be addressed as required through separate interventions that will be documented in the dashboard.
Throughout the six months of the study, the app will send notifications to patients every two weeks to remind them to complete the PHQ-9 and GAD-7 questionnaires. The app will also prompt patients to complete the PHQ-2 questionnaire every day for the first 15 days, every two days for the next 15 days, and every three days thereafter. “In a pharmacy setting where everything is so busy, you need to have useful, fast and complete information. This model enables systematic monitoring and a communication bridge between patients and pharmacists,” says Vincent.
The estimated project completion date, including data analysis, is mid 2021.
John Papastergiou, practising community pharmacist, and the research team at University of Toronto is using CFP's grant of $15,000 to quantify adherence rates to adult immunizations, where a series of vaccines or booster vaccines are required, when these vaccines are administered by community pharmacists. It's hoped that the study results will help pharmacists obtain prescribing rights for vaccines.
CFP has awarded Paula Newman and her team at Northwest Telepharmacy Solutions $22,500 to determine the feasibility and effectiveness of a pharmacist-led opioid stewardship program for chronic non-cancer pain, using videoconferencing technology. The project includes prescriber and patient education, risk stratification and screening for potential harm, as well as patient monitoriing with follow-up and continuity of care.
The Presciption to Thrive project, funded by multiple stakeholders including Canada's two national pharmacy associations and the Nova Scotia Department of Health and Wellness, seeks to establish a model for practice change in community pharmacy. Expert facilitators will work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.
"Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)"
With $50,000 in funding from the Canadian Foundation for Pharmacy’s Innovation Fund, a University of Alberta team of researchers and front-line pharmacists are implementing a pharmacist-initiated mental health monitoring and intervention program based in the community setting. “We are grateful to have the opportunity to partner with CFP as an unbiased organization that supports pharmacy initiatives,” says lead researcher/pharmacist Dan Burton.
For the study, up to 10 pharmacies in Calgary and surrounding areas will be involved with some 120 participating patients over a six-month period. The intervention group will be recruiting and monitoring patients with major depressive disorder and general anxiety disorder, providing interventions as needed and collaborating with patients’ physicians. The control group will receive usual pharmacy care.
Participating pharmacists will receive mental health training materials and have support throughout the pilot and are expected to begin recruiting patients by March 2020.
“Given community pharmacists’ training and access, they are in a great position to help the healthcare field better manage depression and anxiety,” says Burton. “They could take the burden off physicians and other providers by stabilizing patients on medication—plus sometimes these patients need more frequent touch points of support and we have that opportunity in the community.”
Burton says he and his team were inspired to develop the study by the recent Bloom Program pilot in Nova Scotia, which showed the positive benefits community pharmacists can have in helping patients with mental health issues. “With additional prescribing authority in Alberta there’s potential for us to do even more,” he says. For example, Alberta pharmacists can titrate and augment therapies by prescribing higher doses, or add on medications to help patients reach maximum treatment benefits. They can also switch therapies if patients aren’t responding or have uncomfortable side effects. “That’s a huge opportunity for pharmacists,” he says.
Burton hopes that positive study results will also encourage other pharmacists to get more involved in helping patients with mental health disorders. “There is still a significant amount of stigma out there around mental health. Pharmacists are also very type A personalities and sometimes we need concrete data before we believe we can do it,” he says. “If the study goes well, it will be a good starting point to build from.”
|
| Laura Murphy |
|
| Olavo Fernandes |
"CannabisCareRx"
A $25,000 grant from the Canadian Foundation for Pharmacy’s Innovation Fund will see the development and study of a program to help community pharmacists identify and support patients using medical cannabis, as part of routine care.
The pilot-based research study out of Ontario is looking to bridge the gap between legal medical cannabis distribution, which currently bypasses community pharmacies, and the expectation that community pharmacists competently provide information and advice to patients who use medical cannabis. Pharmacists in Ontario who provide direct patient care must complete mandatory cannabis training by 2020, yet there is a noticeable lack of a training program that involves pharmacists in screening for cannabis use.
Lead investigators Laura Murphy and Olavo Fernandes, researchers at the University Health Network, will conduct a prospective observational study of a pilot implementation of a structured program, entitled CannabisCareRx. The program will be comprised of screening questions, a structured process for assessment and a template for documentation and referral to other healthcare providers. The program also includes pharmacist education that emphasizes the development of communication skills to engage patients and decrease stigma. The materials and tools developed will be scalable for implementation across Canada.
Overall, the project is set to occur over three years, starting in September of 2020. It is broken up into three steps: set-up, pilot implementation and dissemination. The set-up stage includes development of the pharmacy education and consultation guide, building the research database, and recruiting five pharmacists from the Greater Toronto Area for the pilot occurring throughout year two.
CannabisCareRx will be piloted as part of usual care provided by the participating pharmacists. After completing the Cannabis Education program, the pharmacists will implement the use of the screening questions with all of their adult patients during routine interactions throughout the 12 months of the pilot.
From there, a member of the research team will conduct a follow-up survey with the pharmacists involved and patients who provide their contact information and permission. The feasibility outcomes will include the number of patients who use cannabis for therapeutic reasons, the number of patients who complete the questionnaire, and the amount of pharmacist time required to conduct CannabisCareRx.
The aim is not only to be successful at the end of the three years but also to create a blueprint for pharmacists across Canada. “The outcomes of the pilot implementation of the CannabisCareRx program will provide patient-centred, pharmacist-driven education materials that will not only support the promotion of safe and effective use of cannabis and harm reduction but will also provide a tangible, patient-facing guide that can facilitate brief and effective consultation,” said Murphy.
"SAD-APP: Self-rating App for Depression Aided by Proactive Pharmacists"
Researcher Philippe Vincent and pharmacists at 30 community pharmacies hope to smooth the path to recovery for patients with depression through a ground-breaking research study funded in part with a $50,000 grant from the Canadian Foundation for Pharmacy’s (CFP’s) Innovation Fund.
The research is unique in that it combines pharmacist coaching with a smartphone app. The app will also differentiate itself within the virtual sea of mental health apps in that it will be built around the PHQ-9 and GAD-7 self-assessment questionnaires, two standardised, validated tools to assess depression and anxiety, respectively. Participating pharmacists will be able to access a patient’s results using a secure, online dashboard.
The study’s primary objective is to shorten the time to recovery by helping patients achieve treatment response as quickly as possible and by supporting adherence.
“Our project seeks to bring patients who suffer in silence and pharmacists together into a meaningful relationship. The self-rating scales and smartphone app are mediators of a safe space for private, sometimes emotional conversations and goal-setting,” says Vincent, Associate Professor of Clinical Pharmacy at University of Montreal and a researcher with the university-affiliated Institute universitaire en sante mentale de Montreal (a psychiatric hospital).
A secondary goal is to prove the value of pharmacists’ interventions. “If we can show that the time pharmacists put into monitoring and coaching is directly proportional to the remission of patients, so people can go back to meaningful occupations and live fuller lives, then insurance, government and other stakeholders will understand that the pharmacists’ time is worth something,” says Vincent.
As well, the stage is already set for possible adoption of the research model into regular pharmacy practice, and possibly on a national scale. All 30 participating pharmacies are part of the Pharmaprix banner, a division of Shoppers Drug Mart and Loblaw companies. Pharmaprix is co-funding the project with CFP.
The study is a randomized, unblinded, multicenter intervention trial that will follow patients over six months. The 30 participating pharmacies will each enrol 10 patients who have been diagnosed with a new episode of major depression, broken down as follows:
Pharmacists in the coaching group will receive training based on best practices in clinical psychiatry. They will call their participating patients every week during the dose-finding period and conduct a 5-minute semi-structured interview that seeks to create rapport, agree on treatment goals and agree on tasks. Pharmacists will also ask about side effects, which will be addressed as required through separate interventions that will be documented in the dashboard.
Throughout the six months of the study, the app will send notifications to patients every two weeks to remind them to complete the PHQ-9 and GAD-7 questionnaires. The app will also prompt patients to complete the PHQ-2 questionnaire every day for the first 15 days, every two days for the next 15 days, and every three days thereafter. “In a pharmacy setting where everything is so busy, you need to have useful, fast and complete information. This model enables systematic monitoring and a communication bridge between patients and pharmacists,” says Vincent.
The estimated project completion date, including data analysis, is mid 2021.
John Papastergiou, practising community pharmacist, and the research team at University of Toronto is using CFP's grant of $15,000 to quantify adherence rates to adult immunizations, where a series of vaccines or booster vaccines are required, when these vaccines are administered by community pharmacists. It's hoped that the study results will help pharmacists obtain prescribing rights for vaccines.
CFP has awarded Paula Newman and her team at Northwest Telepharmacy Solutions $22,500 to determine the feasibility and effectiveness of a pharmacist-led opioid stewardship program for chronic non-cancer pain, using videoconferencing technology. The project includes prescriber and patient education, risk stratification and screening for potential harm, as well as patient monitoriing with follow-up and continuity of care.
The Presciption to Thrive project, funded by multiple stakeholders including Canada's two national pharmacy associations and the Nova Scotia Department of Health and Wellness, seeks to establish a model for practice change in community pharmacy. Expert facilitators will work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.
Saleema Bhaidani, Director, Pharmacy Innovation & Professional Affairs at Whole Health Pharmacy Partners, and researcher Lisa Dolovich at the University of Toronto are conducting a retrospective analysis of the impact of an appointment-based model (ABM) for pharmacy practice based on data obtained from six independent pharmacies, part of the Whole Health Pharmacy banner, which implemented ABM in September 2017. ABM uses medication synchronization to coordinate refills into one pick-up, which enables pharmacists to conduct appointments where they can review, address and follow up on medication issues on a monthly or regular basis. The study will seek to evaluate clinical outcomes and the impact on adherence, as well as ABM's impact on workflow and pharmacy staff.
"Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)"
With $50,000 in funding from the Canadian Foundation for Pharmacy’s Innovation Fund, a University of Alberta team of researchers and front-line pharmacists are implementing a pharmacist-initiated mental health monitoring and intervention program based in the community setting. “We are grateful to have the opportunity to partner with CFP as an unbiased organization that supports pharmacy initiatives,” says lead researcher/pharmacist Dan Burton.
For the study, up to 10 pharmacies in Calgary and surrounding areas will be involved with some 120 participating patients over a six-month period. The intervention group will be recruiting and monitoring patients with major depressive disorder and general anxiety disorder, providing interventions as needed and collaborating with patients’ physicians. The control group will receive usual pharmacy care.
Participating pharmacists will receive mental health training materials and have support throughout the pilot and are expected to begin recruiting patients by March 2020.
“Given community pharmacists’ training and access, they are in a great position to help the healthcare field better manage depression and anxiety,” says Burton. “They could take the burden off physicians and other providers by stabilizing patients on medication—plus sometimes these patients need more frequent touch points of support and we have that opportunity in the community.”
Burton says he and his team were inspired to develop the study by the recent Bloom Program pilot in Nova Scotia, which showed the positive benefits community pharmacists can have in helping patients with mental health issues. “With additional prescribing authority in Alberta there’s potential for us to do even more,” he says. For example, Alberta pharmacists can titrate and augment therapies by prescribing higher doses, or add on medications to help patients reach maximum treatment benefits. They can also switch therapies if patients aren’t responding or have uncomfortable side effects. “That’s a huge opportunity for pharmacists,” he says.
Burton hopes that positive study results will also encourage other pharmacists to get more involved in helping patients with mental health disorders. “There is still a significant amount of stigma out there around mental health. Pharmacists are also very type A personalities and sometimes we need concrete data before we believe we can do it,” he says. “If the study goes well, it will be a good starting point to build from.”
|
| Laura Murphy |
|
| Olavo Fernandes |
"CannabisCareRx"
A $25,000 grant from the Canadian Foundation for Pharmacy’s Innovation Fund will see the development and study of a program to help community pharmacists identify and support patients using medical cannabis, as part of routine care.
The pilot-based research study out of Ontario is looking to bridge the gap between legal medical cannabis distribution, which currently bypasses community pharmacies, and the expectation that community pharmacists competently provide information and advice to patients who use medical cannabis. Pharmacists in Ontario who provide direct patient care must complete mandatory cannabis training by 2020, yet there is a noticeable lack of a training program that involves pharmacists in screening for cannabis use.
Lead investigators Laura Murphy and Olavo Fernandes, researchers at the University Health Network, will conduct a prospective observational study of a pilot implementation of a structured program, entitled CannabisCareRx. The program will be comprised of screening questions, a structured process for assessment and a template for documentation and referral to other healthcare providers. The program also includes pharmacist education that emphasizes the development of communication skills to engage patients and decrease stigma. The materials and tools developed will be scalable for implementation across Canada.
Overall, the project is set to occur over three years, starting in September of 2020. It is broken up into three steps: set-up, pilot implementation and dissemination. The set-up stage includes development of the pharmacy education and consultation guide, building the research database, and recruiting five pharmacists from the Greater Toronto Area for the pilot occurring throughout year two.
CannabisCareRx will be piloted as part of usual care provided by the participating pharmacists. After completing the Cannabis Education program, the pharmacists will implement the use of the screening questions with all of their adult patients during routine interactions throughout the 12 months of the pilot.
From there, a member of the research team will conduct a follow-up survey with the pharmacists involved and patients who provide their contact information and permission. The feasibility outcomes will include the number of patients who use cannabis for therapeutic reasons, the number of patients who complete the questionnaire, and the amount of pharmacist time required to conduct CannabisCareRx.
The aim is not only to be successful at the end of the three years but also to create a blueprint for pharmacists across Canada. “The outcomes of the pilot implementation of the CannabisCareRx program will provide patient-centred, pharmacist-driven education materials that will not only support the promotion of safe and effective use of cannabis and harm reduction but will also provide a tangible, patient-facing guide that can facilitate brief and effective consultation,” said Murphy.
"SAD-APP: Self-rating App for Depression Aided by Proactive Pharmacists"
Researcher Philippe Vincent and pharmacists at 30 community pharmacies hope to smooth the path to recovery for patients with depression through a ground-breaking research study funded in part with a $50,000 grant from the Canadian Foundation for Pharmacy’s (CFP’s) Innovation Fund.
The research is unique in that it combines pharmacist coaching with a smartphone app. The app will also differentiate itself within the virtual sea of mental health apps in that it will be built around the PHQ-9 and GAD-7 self-assessment questionnaires, two standardised, validated tools to assess depression and anxiety, respectively. Participating pharmacists will be able to access a patient’s results using a secure, online dashboard.
The study’s primary objective is to shorten the time to recovery by helping patients achieve treatment response as quickly as possible and by supporting adherence.
“Our project seeks to bring patients who suffer in silence and pharmacists together into a meaningful relationship. The self-rating scales and smartphone app are mediators of a safe space for private, sometimes emotional conversations and goal-setting,” says Vincent, Associate Professor of Clinical Pharmacy at University of Montreal and a researcher with the university-affiliated Institute universitaire en sante mentale de Montreal (a psychiatric hospital).
A secondary goal is to prove the value of pharmacists’ interventions. “If we can show that the time pharmacists put into monitoring and coaching is directly proportional to the remission of patients, so people can go back to meaningful occupations and live fuller lives, then insurance, government and other stakeholders will understand that the pharmacists’ time is worth something,” says Vincent.
As well, the stage is already set for possible adoption of the research model into regular pharmacy practice, and possibly on a national scale. All 30 participating pharmacies are part of the Pharmaprix banner, a division of Shoppers Drug Mart and Loblaw companies. Pharmaprix is co-funding the project with CFP.
The study is a randomized, unblinded, multicenter intervention trial that will follow patients over six months. The 30 participating pharmacies will each enrol 10 patients who have been diagnosed with a new episode of major depression, broken down as follows:
Pharmacists in the coaching group will receive training based on best practices in clinical psychiatry. They will call their participating patients every week during the dose-finding period and conduct a 5-minute semi-structured interview that seeks to create rapport, agree on treatment goals and agree on tasks. Pharmacists will also ask about side effects, which will be addressed as required through separate interventions that will be documented in the dashboard.
Throughout the six months of the study, the app will send notifications to patients every two weeks to remind them to complete the PHQ-9 and GAD-7 questionnaires. The app will also prompt patients to complete the PHQ-2 questionnaire every day for the first 15 days, every two days for the next 15 days, and every three days thereafter. “In a pharmacy setting where everything is so busy, you need to have useful, fast and complete information. This model enables systematic monitoring and a communication bridge between patients and pharmacists,” says Vincent.
The estimated project completion date, including data analysis, is mid 2021.
John Papastergiou, practising community pharmacist, and the research team at University of Toronto is using CFP's grant of $15,000 to quantify adherence rates to adult immunizations, where a series of vaccines or booster vaccines are required, when these vaccines are administered by community pharmacists. It's hoped that the study results will help pharmacists obtain prescribing rights for vaccines.
CFP has awarded Paula Newman and her team at Northwest Telepharmacy Solutions $22,500 to determine the feasibility and effectiveness of a pharmacist-led opioid stewardship program for chronic non-cancer pain, using videoconferencing technology. The project includes prescriber and patient education, risk stratification and screening for potential harm, as well as patient monitoriing with follow-up and continuity of care.
The Presciption to Thrive project, funded by multiple stakeholders including Canada's two national pharmacy associations and the Nova Scotia Department of Health and Wellness, seeks to establish a model for practice change in community pharmacy. Expert facilitators will work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.
Saleema Bhaidani, Director, Pharmacy Innovation & Professional Affairs at Whole Health Pharmacy Partners, and researcher Lisa Dolovich at the University of Toronto are conducting a retrospective analysis of the impact of an appointment-based model (ABM) for pharmacy practice based on data obtained from six independent pharmacies, part of the Whole Health Pharmacy banner, which implemented ABM in September 2017. ABM uses medication synchronization to coordinate refills into one pick-up, which enables pharmacists to conduct appointments where they can review, address and follow up on medication issues on a monthly or regular basis. The study will seek to evaluate clinical outcomes and the impact on adherence, as well as ABM's impact on workflow and pharmacy staff.
Dr. Chang and her team will examine the feasibility and effectiveness of a pharmacist intervention targeting high-dose, high-risk prescription opioids. The study will complement previous research in the area funded by the Ontario Ministry of Health and Long-Term Care, as well as Health Canada Anti-Drug Strategy Initiatives.
"Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)"
With $50,000 in funding from the Canadian Foundation for Pharmacy’s Innovation Fund, a University of Alberta team of researchers and front-line pharmacists are implementing a pharmacist-initiated mental health monitoring and intervention program based in the community setting. “We are grateful to have the opportunity to partner with CFP as an unbiased organization that supports pharmacy initiatives,” says lead researcher/pharmacist Dan Burton.
For the study, up to 10 pharmacies in Calgary and surrounding areas will be involved with some 120 participating patients over a six-month period. The intervention group will be recruiting and monitoring patients with major depressive disorder and general anxiety disorder, providing interventions as needed and collaborating with patients’ physicians. The control group will receive usual pharmacy care.
Participating pharmacists will receive mental health training materials and have support throughout the pilot and are expected to begin recruiting patients by March 2020.
“Given community pharmacists’ training and access, they are in a great position to help the healthcare field better manage depression and anxiety,” says Burton. “They could take the burden off physicians and other providers by stabilizing patients on medication—plus sometimes these patients need more frequent touch points of support and we have that opportunity in the community.”
Burton says he and his team were inspired to develop the study by the recent Bloom Program pilot in Nova Scotia, which showed the positive benefits community pharmacists can have in helping patients with mental health issues. “With additional prescribing authority in Alberta there’s potential for us to do even more,” he says. For example, Alberta pharmacists can titrate and augment therapies by prescribing higher doses, or add on medications to help patients reach maximum treatment benefits. They can also switch therapies if patients aren’t responding or have uncomfortable side effects. “That’s a huge opportunity for pharmacists,” he says.
Burton hopes that positive study results will also encourage other pharmacists to get more involved in helping patients with mental health disorders. “There is still a significant amount of stigma out there around mental health. Pharmacists are also very type A personalities and sometimes we need concrete data before we believe we can do it,” he says. “If the study goes well, it will be a good starting point to build from.”
|
| Laura Murphy |
|
| Olavo Fernandes |
"CannabisCareRx"
A $25,000 grant from the Canadian Foundation for Pharmacy’s Innovation Fund will see the development and study of a program to help community pharmacists identify and support patients using medical cannabis, as part of routine care.
The pilot-based research study out of Ontario is looking to bridge the gap between legal medical cannabis distribution, which currently bypasses community pharmacies, and the expectation that community pharmacists competently provide information and advice to patients who use medical cannabis. Pharmacists in Ontario who provide direct patient care must complete mandatory cannabis training by 2020, yet there is a noticeable lack of a training program that involves pharmacists in screening for cannabis use.
Lead investigators Laura Murphy and Olavo Fernandes, researchers at the University Health Network, will conduct a prospective observational study of a pilot implementation of a structured program, entitled CannabisCareRx. The program will be comprised of screening questions, a structured process for assessment and a template for documentation and referral to other healthcare providers. The program also includes pharmacist education that emphasizes the development of communication skills to engage patients and decrease stigma. The materials and tools developed will be scalable for implementation across Canada.
Overall, the project is set to occur over three years, starting in September of 2020. It is broken up into three steps: set-up, pilot implementation and dissemination. The set-up stage includes development of the pharmacy education and consultation guide, building the research database, and recruiting five pharmacists from the Greater Toronto Area for the pilot occurring throughout year two.
CannabisCareRx will be piloted as part of usual care provided by the participating pharmacists. After completing the Cannabis Education program, the pharmacists will implement the use of the screening questions with all of their adult patients during routine interactions throughout the 12 months of the pilot.
From there, a member of the research team will conduct a follow-up survey with the pharmacists involved and patients who provide their contact information and permission. The feasibility outcomes will include the number of patients who use cannabis for therapeutic reasons, the number of patients who complete the questionnaire, and the amount of pharmacist time required to conduct CannabisCareRx.
The aim is not only to be successful at the end of the three years but also to create a blueprint for pharmacists across Canada. “The outcomes of the pilot implementation of the CannabisCareRx program will provide patient-centred, pharmacist-driven education materials that will not only support the promotion of safe and effective use of cannabis and harm reduction but will also provide a tangible, patient-facing guide that can facilitate brief and effective consultation,” said Murphy.
"SAD-APP: Self-rating App for Depression Aided by Proactive Pharmacists"
Researcher Philippe Vincent and pharmacists at 30 community pharmacies hope to smooth the path to recovery for patients with depression through a ground-breaking research study funded in part with a $50,000 grant from the Canadian Foundation for Pharmacy’s (CFP’s) Innovation Fund.
The research is unique in that it combines pharmacist coaching with a smartphone app. The app will also differentiate itself within the virtual sea of mental health apps in that it will be built around the PHQ-9 and GAD-7 self-assessment questionnaires, two standardised, validated tools to assess depression and anxiety, respectively. Participating pharmacists will be able to access a patient’s results using a secure, online dashboard.
The study’s primary objective is to shorten the time to recovery by helping patients achieve treatment response as quickly as possible and by supporting adherence.
“Our project seeks to bring patients who suffer in silence and pharmacists together into a meaningful relationship. The self-rating scales and smartphone app are mediators of a safe space for private, sometimes emotional conversations and goal-setting,” says Vincent, Associate Professor of Clinical Pharmacy at University of Montreal and a researcher with the university-affiliated Institute universitaire en sante mentale de Montreal (a psychiatric hospital).
A secondary goal is to prove the value of pharmacists’ interventions. “If we can show that the time pharmacists put into monitoring and coaching is directly proportional to the remission of patients, so people can go back to meaningful occupations and live fuller lives, then insurance, government and other stakeholders will understand that the pharmacists’ time is worth something,” says Vincent.
As well, the stage is already set for possible adoption of the research model into regular pharmacy practice, and possibly on a national scale. All 30 participating pharmacies are part of the Pharmaprix banner, a division of Shoppers Drug Mart and Loblaw companies. Pharmaprix is co-funding the project with CFP.
The study is a randomized, unblinded, multicenter intervention trial that will follow patients over six months. The 30 participating pharmacies will each enrol 10 patients who have been diagnosed with a new episode of major depression, broken down as follows:
Pharmacists in the coaching group will receive training based on best practices in clinical psychiatry. They will call their participating patients every week during the dose-finding period and conduct a 5-minute semi-structured interview that seeks to create rapport, agree on treatment goals and agree on tasks. Pharmacists will also ask about side effects, which will be addressed as required through separate interventions that will be documented in the dashboard.
Throughout the six months of the study, the app will send notifications to patients every two weeks to remind them to complete the PHQ-9 and GAD-7 questionnaires. The app will also prompt patients to complete the PHQ-2 questionnaire every day for the first 15 days, every two days for the next 15 days, and every three days thereafter. “In a pharmacy setting where everything is so busy, you need to have useful, fast and complete information. This model enables systematic monitoring and a communication bridge between patients and pharmacists,” says Vincent.
The estimated project completion date, including data analysis, is mid 2021.
John Papastergiou, practising community pharmacist, and the research team at University of Toronto is using CFP's grant of $15,000 to quantify adherence rates to adult immunizations, where a series of vaccines or booster vaccines are required, when these vaccines are administered by community pharmacists. It's hoped that the study results will help pharmacists obtain prescribing rights for vaccines.
CFP has awarded Paula Newman and her team at Northwest Telepharmacy Solutions $22,500 to determine the feasibility and effectiveness of a pharmacist-led opioid stewardship program for chronic non-cancer pain, using videoconferencing technology. The project includes prescriber and patient education, risk stratification and screening for potential harm, as well as patient monitoriing with follow-up and continuity of care.
The Presciption to Thrive project, funded by multiple stakeholders including Canada's two national pharmacy associations and the Nova Scotia Department of Health and Wellness, seeks to establish a model for practice change in community pharmacy. Expert facilitators will work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.
Saleema Bhaidani, Director, Pharmacy Innovation & Professional Affairs at Whole Health Pharmacy Partners, and researcher Lisa Dolovich at the University of Toronto are conducting a retrospective analysis of the impact of an appointment-based model (ABM) for pharmacy practice based on data obtained from six independent pharmacies, part of the Whole Health Pharmacy banner, which implemented ABM in September 2017. ABM uses medication synchronization to coordinate refills into one pick-up, which enables pharmacists to conduct appointments where they can review, address and follow up on medication issues on a monthly or regular basis. The study will seek to evaluate clinical outcomes and the impact on adherence, as well as ABM's impact on workflow and pharmacy staff.
Dr. Chang and her team will examine the feasibility and effectiveness of a pharmacist intervention targeting high-dose, high-risk prescription opioids. The study will complement previous research in the area funded by the Ontario Ministry of Health and Long-Term Care, as well as Health Canada Anti-Drug Strategy Initiatives.
Dr. MacCallum and her team are researching strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes.As part of that, the team will also determine how routine monitoring and follow-up is linked to other expanded professional services.
The project began with a survey of about 8,000 pharmacists in early 2018. During phase two, launched in fall 2018, researchers are working with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.
"Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)"
With $50,000 in funding from the Canadian Foundation for Pharmacy’s Innovation Fund, a University of Alberta team of researchers and front-line pharmacists are implementing a pharmacist-initiated mental health monitoring and intervention program based in the community setting. “We are grateful to have the opportunity to partner with CFP as an unbiased organization that supports pharmacy initiatives,” says lead researcher/pharmacist Dan Burton.
For the study, up to 10 pharmacies in Calgary and surrounding areas will be involved with some 120 participating patients over a six-month period. The intervention group will be recruiting and monitoring patients with major depressive disorder and general anxiety disorder, providing interventions as needed and collaborating with patients’ physicians. The control group will receive usual pharmacy care.
Participating pharmacists will receive mental health training materials and have support throughout the pilot and are expected to begin recruiting patients by March 2020.
“Given community pharmacists’ training and access, they are in a great position to help the healthcare field better manage depression and anxiety,” says Burton. “They could take the burden off physicians and other providers by stabilizing patients on medication—plus sometimes these patients need more frequent touch points of support and we have that opportunity in the community.”
Burton says he and his team were inspired to develop the study by the recent Bloom Program pilot in Nova Scotia, which showed the positive benefits community pharmacists can have in helping patients with mental health issues. “With additional prescribing authority in Alberta there’s potential for us to do even more,” he says. For example, Alberta pharmacists can titrate and augment therapies by prescribing higher doses, or add on medications to help patients reach maximum treatment benefits. They can also switch therapies if patients aren’t responding or have uncomfortable side effects. “That’s a huge opportunity for pharmacists,” he says.
Burton hopes that positive study results will also encourage other pharmacists to get more involved in helping patients with mental health disorders. “There is still a significant amount of stigma out there around mental health. Pharmacists are also very type A personalities and sometimes we need concrete data before we believe we can do it,” he says. “If the study goes well, it will be a good starting point to build from.”
|
| Laura Murphy |
|
| Olavo Fernandes |
"CannabisCareRx"
A $25,000 grant from the Canadian Foundation for Pharmacy’s Innovation Fund will see the development and study of a program to help community pharmacists identify and support patients using medical cannabis, as part of routine care.
The pilot-based research study out of Ontario is looking to bridge the gap between legal medical cannabis distribution, which currently bypasses community pharmacies, and the expectation that community pharmacists competently provide information and advice to patients who use medical cannabis. Pharmacists in Ontario who provide direct patient care must complete mandatory cannabis training by 2020, yet there is a noticeable lack of a training program that involves pharmacists in screening for cannabis use.
Lead investigators Laura Murphy and Olavo Fernandes, researchers at the University Health Network, will conduct a prospective observational study of a pilot implementation of a structured program, entitled CannabisCareRx. The program will be comprised of screening questions, a structured process for assessment and a template for documentation and referral to other healthcare providers. The program also includes pharmacist education that emphasizes the development of communication skills to engage patients and decrease stigma. The materials and tools developed will be scalable for implementation across Canada.
Overall, the project is set to occur over three years, starting in September of 2020. It is broken up into three steps: set-up, pilot implementation and dissemination. The set-up stage includes development of the pharmacy education and consultation guide, building the research database, and recruiting five pharmacists from the Greater Toronto Area for the pilot occurring throughout year two.
CannabisCareRx will be piloted as part of usual care provided by the participating pharmacists. After completing the Cannabis Education program, the pharmacists will implement the use of the screening questions with all of their adult patients during routine interactions throughout the 12 months of the pilot.
From there, a member of the research team will conduct a follow-up survey with the pharmacists involved and patients who provide their contact information and permission. The feasibility outcomes will include the number of patients who use cannabis for therapeutic reasons, the number of patients who complete the questionnaire, and the amount of pharmacist time required to conduct CannabisCareRx.
The aim is not only to be successful at the end of the three years but also to create a blueprint for pharmacists across Canada. “The outcomes of the pilot implementation of the CannabisCareRx program will provide patient-centred, pharmacist-driven education materials that will not only support the promotion of safe and effective use of cannabis and harm reduction but will also provide a tangible, patient-facing guide that can facilitate brief and effective consultation,” said Murphy.
"SAD-APP: Self-rating App for Depression Aided by Proactive Pharmacists"
Researcher Philippe Vincent and pharmacists at 30 community pharmacies hope to smooth the path to recovery for patients with depression through a ground-breaking research study funded in part with a $50,000 grant from the Canadian Foundation for Pharmacy’s (CFP’s) Innovation Fund.
The research is unique in that it combines pharmacist coaching with a smartphone app. The app will also differentiate itself within the virtual sea of mental health apps in that it will be built around the PHQ-9 and GAD-7 self-assessment questionnaires, two standardised, validated tools to assess depression and anxiety, respectively. Participating pharmacists will be able to access a patient’s results using a secure, online dashboard.
The study’s primary objective is to shorten the time to recovery by helping patients achieve treatment response as quickly as possible and by supporting adherence.
“Our project seeks to bring patients who suffer in silence and pharmacists together into a meaningful relationship. The self-rating scales and smartphone app are mediators of a safe space for private, sometimes emotional conversations and goal-setting,” says Vincent, Associate Professor of Clinical Pharmacy at University of Montreal and a researcher with the university-affiliated Institute universitaire en sante mentale de Montreal (a psychiatric hospital).
A secondary goal is to prove the value of pharmacists’ interventions. “If we can show that the time pharmacists put into monitoring and coaching is directly proportional to the remission of patients, so people can go back to meaningful occupations and live fuller lives, then insurance, government and other stakeholders will understand that the pharmacists’ time is worth something,” says Vincent.
As well, the stage is already set for possible adoption of the research model into regular pharmacy practice, and possibly on a national scale. All 30 participating pharmacies are part of the Pharmaprix banner, a division of Shoppers Drug Mart and Loblaw companies. Pharmaprix is co-funding the project with CFP.
The study is a randomized, unblinded, multicenter intervention trial that will follow patients over six months. The 30 participating pharmacies will each enrol 10 patients who have been diagnosed with a new episode of major depression, broken down as follows:
Pharmacists in the coaching group will receive training based on best practices in clinical psychiatry. They will call their participating patients every week during the dose-finding period and conduct a 5-minute semi-structured interview that seeks to create rapport, agree on treatment goals and agree on tasks. Pharmacists will also ask about side effects, which will be addressed as required through separate interventions that will be documented in the dashboard.
Throughout the six months of the study, the app will send notifications to patients every two weeks to remind them to complete the PHQ-9 and GAD-7 questionnaires. The app will also prompt patients to complete the PHQ-2 questionnaire every day for the first 15 days, every two days for the next 15 days, and every three days thereafter. “In a pharmacy setting where everything is so busy, you need to have useful, fast and complete information. This model enables systematic monitoring and a communication bridge between patients and pharmacists,” says Vincent.
The estimated project completion date, including data analysis, is mid 2021.
John Papastergiou, practising community pharmacist, and the research team at University of Toronto is using CFP's grant of $15,000 to quantify adherence rates to adult immunizations, where a series of vaccines or booster vaccines are required, when these vaccines are administered by community pharmacists. It's hoped that the study results will help pharmacists obtain prescribing rights for vaccines.
CFP has awarded Paula Newman and her team at Northwest Telepharmacy Solutions $22,500 to determine the feasibility and effectiveness of a pharmacist-led opioid stewardship program for chronic non-cancer pain, using videoconferencing technology. The project includes prescriber and patient education, risk stratification and screening for potential harm, as well as patient monitoriing with follow-up and continuity of care.
The Presciption to Thrive project, funded by multiple stakeholders including Canada's two national pharmacy associations and the Nova Scotia Department of Health and Wellness, seeks to establish a model for practice change in community pharmacy. Expert facilitators will work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.
Saleema Bhaidani, Director, Pharmacy Innovation & Professional Affairs at Whole Health Pharmacy Partners, and researcher Lisa Dolovich at the University of Toronto are conducting a retrospective analysis of the impact of an appointment-based model (ABM) for pharmacy practice based on data obtained from six independent pharmacies, part of the Whole Health Pharmacy banner, which implemented ABM in September 2017. ABM uses medication synchronization to coordinate refills into one pick-up, which enables pharmacists to conduct appointments where they can review, address and follow up on medication issues on a monthly or regular basis. The study will seek to evaluate clinical outcomes and the impact on adherence, as well as ABM's impact on workflow and pharmacy staff.
Dr. Chang and her team will examine the feasibility and effectiveness of a pharmacist intervention targeting high-dose, high-risk prescription opioids. The study will complement previous research in the area funded by the Ontario Ministry of Health and Long-Term Care, as well as Health Canada Anti-Drug Strategy Initiatives.
Dr. MacCallum and her team are researching strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes.As part of that, the team will also determine how routine monitoring and follow-up is linked to other expanded professional services.
The project began with a survey of about 8,000 pharmacists in early 2018. During phase two, launched in fall 2018, researchers are working with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.
With the support of the Innovation grant and additional funding from the New Brunswick Pharmacists' Association, Dr. Tsuyuki and his team tracked and quantified the impact of pharmacist management of patients with uncomplicated urinary tract infection.
As follow-up to the study, the research team is looking at antibiotic usage and conducting an economic analysis. The group is also developing an online registry and practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.
News article - "Pharmacists for UTI management a 'no-brainer'"
Published study - "Outcomes of Urinary Tract Infection Management by Pharmacists (RxOUTMAP)"
"Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)"
With $50,000 in funding from the Canadian Foundation for Pharmacy’s Innovation Fund, a University of Alberta team of researchers and front-line pharmacists are implementing a pharmacist-initiated mental health monitoring and intervention program based in the community setting. “We are grateful to have the opportunity to partner with CFP as an unbiased organization that supports pharmacy initiatives,” says lead researcher/pharmacist Dan Burton.
For the study, up to 10 pharmacies in Calgary and surrounding areas will be involved with some 120 participating patients over a six-month period. The intervention group will be recruiting and monitoring patients with major depressive disorder and general anxiety disorder, providing interventions as needed and collaborating with patients’ physicians. The control group will receive usual pharmacy care.
Participating pharmacists will receive mental health training materials and have support throughout the pilot and are expected to begin recruiting patients by March 2020.
“Given community pharmacists’ training and access, they are in a great position to help the healthcare field better manage depression and anxiety,” says Burton. “They could take the burden off physicians and other providers by stabilizing patients on medication—plus sometimes these patients need more frequent touch points of support and we have that opportunity in the community.”
Burton says he and his team were inspired to develop the study by the recent Bloom Program pilot in Nova Scotia, which showed the positive benefits community pharmacists can have in helping patients with mental health issues. “With additional prescribing authority in Alberta there’s potential for us to do even more,” he says. For example, Alberta pharmacists can titrate and augment therapies by prescribing higher doses, or add on medications to help patients reach maximum treatment benefits. They can also switch therapies if patients aren’t responding or have uncomfortable side effects. “That’s a huge opportunity for pharmacists,” he says.
Burton hopes that positive study results will also encourage other pharmacists to get more involved in helping patients with mental health disorders. “There is still a significant amount of stigma out there around mental health. Pharmacists are also very type A personalities and sometimes we need concrete data before we believe we can do it,” he says. “If the study goes well, it will be a good starting point to build from.”
|
| Laura Murphy |
|
| Olavo Fernandes |
"CannabisCareRx"
A $25,000 grant from the Canadian Foundation for Pharmacy’s Innovation Fund will see the development and study of a program to help community pharmacists identify and support patients using medical cannabis, as part of routine care.
The pilot-based research study out of Ontario is looking to bridge the gap between legal medical cannabis distribution, which currently bypasses community pharmacies, and the expectation that community pharmacists competently provide information and advice to patients who use medical cannabis. Pharmacists in Ontario who provide direct patient care must complete mandatory cannabis training by 2020, yet there is a noticeable lack of a training program that involves pharmacists in screening for cannabis use.
Lead investigators Laura Murphy and Olavo Fernandes, researchers at the University Health Network, will conduct a prospective observational study of a pilot implementation of a structured program, entitled CannabisCareRx. The program will be comprised of screening questions, a structured process for assessment and a template for documentation and referral to other healthcare providers. The program also includes pharmacist education that emphasizes the development of communication skills to engage patients and decrease stigma. The materials and tools developed will be scalable for implementation across Canada.
Overall, the project is set to occur over three years, starting in September of 2020. It is broken up into three steps: set-up, pilot implementation and dissemination. The set-up stage includes development of the pharmacy education and consultation guide, building the research database, and recruiting five pharmacists from the Greater Toronto Area for the pilot occurring throughout year two.
CannabisCareRx will be piloted as part of usual care provided by the participating pharmacists. After completing the Cannabis Education program, the pharmacists will implement the use of the screening questions with all of their adult patients during routine interactions throughout the 12 months of the pilot.
From there, a member of the research team will conduct a follow-up survey with the pharmacists involved and patients who provide their contact information and permission. The feasibility outcomes will include the number of patients who use cannabis for therapeutic reasons, the number of patients who complete the questionnaire, and the amount of pharmacist time required to conduct CannabisCareRx.
The aim is not only to be successful at the end of the three years but also to create a blueprint for pharmacists across Canada. “The outcomes of the pilot implementation of the CannabisCareRx program will provide patient-centred, pharmacist-driven education materials that will not only support the promotion of safe and effective use of cannabis and harm reduction but will also provide a tangible, patient-facing guide that can facilitate brief and effective consultation,” said Murphy.
"SAD-APP: Self-rating App for Depression Aided by Proactive Pharmacists"
Researcher Philippe Vincent and pharmacists at 30 community pharmacies hope to smooth the path to recovery for patients with depression through a ground-breaking research study funded in part with a $50,000 grant from the Canadian Foundation for Pharmacy’s (CFP’s) Innovation Fund.
The research is unique in that it combines pharmacist coaching with a smartphone app. The app will also differentiate itself within the virtual sea of mental health apps in that it will be built around the PHQ-9 and GAD-7 self-assessment questionnaires, two standardised, validated tools to assess depression and anxiety, respectively. Participating pharmacists will be able to access a patient’s results using a secure, online dashboard.
The study’s primary objective is to shorten the time to recovery by helping patients achieve treatment response as quickly as possible and by supporting adherence.
“Our project seeks to bring patients who suffer in silence and pharmacists together into a meaningful relationship. The self-rating scales and smartphone app are mediators of a safe space for private, sometimes emotional conversations and goal-setting,” says Vincent, Associate Professor of Clinical Pharmacy at University of Montreal and a researcher with the university-affiliated Institute universitaire en sante mentale de Montreal (a psychiatric hospital).
A secondary goal is to prove the value of pharmacists’ interventions. “If we can show that the time pharmacists put into monitoring and coaching is directly proportional to the remission of patients, so people can go back to meaningful occupations and live fuller lives, then insurance, government and other stakeholders will understand that the pharmacists’ time is worth something,” says Vincent.
As well, the stage is already set for possible adoption of the research model into regular pharmacy practice, and possibly on a national scale. All 30 participating pharmacies are part of the Pharmaprix banner, a division of Shoppers Drug Mart and Loblaw companies. Pharmaprix is co-funding the project with CFP.
The study is a randomized, unblinded, multicenter intervention trial that will follow patients over six months. The 30 participating pharmacies will each enrol 10 patients who have been diagnosed with a new episode of major depression, broken down as follows:
Pharmacists in the coaching group will receive training based on best practices in clinical psychiatry. They will call their participating patients every week during the dose-finding period and conduct a 5-minute semi-structured interview that seeks to create rapport, agree on treatment goals and agree on tasks. Pharmacists will also ask about side effects, which will be addressed as required through separate interventions that will be documented in the dashboard.
Throughout the six months of the study, the app will send notifications to patients every two weeks to remind them to complete the PHQ-9 and GAD-7 questionnaires. The app will also prompt patients to complete the PHQ-2 questionnaire every day for the first 15 days, every two days for the next 15 days, and every three days thereafter. “In a pharmacy setting where everything is so busy, you need to have useful, fast and complete information. This model enables systematic monitoring and a communication bridge between patients and pharmacists,” says Vincent.
The estimated project completion date, including data analysis, is mid 2021.
John Papastergiou, practising community pharmacist, and the research team at University of Toronto is using CFP's grant of $15,000 to quantify adherence rates to adult immunizations, where a series of vaccines or booster vaccines are required, when these vaccines are administered by community pharmacists. It's hoped that the study results will help pharmacists obtain prescribing rights for vaccines.
CFP has awarded Paula Newman and her team at Northwest Telepharmacy Solutions $22,500 to determine the feasibility and effectiveness of a pharmacist-led opioid stewardship program for chronic non-cancer pain, using videoconferencing technology. The project includes prescriber and patient education, risk stratification and screening for potential harm, as well as patient monitoriing with follow-up and continuity of care.
The Presciption to Thrive project, funded by multiple stakeholders including Canada's two national pharmacy associations and the Nova Scotia Department of Health and Wellness, seeks to establish a model for practice change in community pharmacy. Expert facilitators will work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.
Saleema Bhaidani, Director, Pharmacy Innovation & Professional Affairs at Whole Health Pharmacy Partners, and researcher Lisa Dolovich at the University of Toronto are conducting a retrospective analysis of the impact of an appointment-based model (ABM) for pharmacy practice based on data obtained from six independent pharmacies, part of the Whole Health Pharmacy banner, which implemented ABM in September 2017. ABM uses medication synchronization to coordinate refills into one pick-up, which enables pharmacists to conduct appointments where they can review, address and follow up on medication issues on a monthly or regular basis. The study will seek to evaluate clinical outcomes and the impact on adherence, as well as ABM's impact on workflow and pharmacy staff.
Dr. Chang and her team will examine the feasibility and effectiveness of a pharmacist intervention targeting high-dose, high-risk prescription opioids. The study will complement previous research in the area funded by the Ontario Ministry of Health and Long-Term Care, as well as Health Canada Anti-Drug Strategy Initiatives.
Dr. MacCallum and her team are researching strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes.As part of that, the team will also determine how routine monitoring and follow-up is linked to other expanded professional services.
The project began with a survey of about 8,000 pharmacists in early 2018. During phase two, launched in fall 2018, researchers are working with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.
With the support of the Innovation grant and additional funding from the New Brunswick Pharmacists' Association, Dr. Tsuyuki and his team tracked and quantified the impact of pharmacist management of patients with uncomplicated urinary tract infection.
As follow-up to the study, the research team is looking at antibiotic usage and conducting an economic analysis. The group is also developing an online registry and practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.
News article - "Pharmacists for UTI management a 'no-brainer'"
Published study - "Outcomes of Urinary Tract Infection Management by Pharmacists (RxOUTMAP)"
Dr. Barbara Farrell of the Bruyère Research Institute in Ottawa has been awarded $50,000 to support her research project on “Mobilizing Community Pharmacists as Catalysts for Deprescribing.” Based at the Institute, Farrell and her team will work with community pharmacy practices and a national advisory group (with provider and private payer representation) over a one-year period to develop acceptable workflow strategies for deprescribing guideline use.
Research associates will work with each pharmacy to quantify opportunities for deprescribing, describe activities and processes associated with guideline use—including how long such activities take—and highlight enablers and barriers that pharmacists encounter. This project is expected to lay the foundation for a larger demonstration project examining reach, adoption and implementation of deprescribing strategies, and ultimately a randomized controlled trial of deprescribing interventions that explores patient and health system outcomes, including related cost savings.
News article - "Deprescribing, within a pharmacist's domain"
"Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)"
With $50,000 in funding from the Canadian Foundation for Pharmacy’s Innovation Fund, a University of Alberta team of researchers and front-line pharmacists are implementing a pharmacist-initiated mental health monitoring and intervention program based in the community setting. “We are grateful to have the opportunity to partner with CFP as an unbiased organization that supports pharmacy initiatives,” says lead researcher/pharmacist Dan Burton.
For the study, up to 10 pharmacies in Calgary and surrounding areas will be involved with some 120 participating patients over a six-month period. The intervention group will be recruiting and monitoring patients with major depressive disorder and general anxiety disorder, providing interventions as needed and collaborating with patients’ physicians. The control group will receive usual pharmacy care.
Participating pharmacists will receive mental health training materials and have support throughout the pilot and are expected to begin recruiting patients by March 2020.
“Given community pharmacists’ training and access, they are in a great position to help the healthcare field better manage depression and anxiety,” says Burton. “They could take the burden off physicians and other providers by stabilizing patients on medication—plus sometimes these patients need more frequent touch points of support and we have that opportunity in the community.”
Burton says he and his team were inspired to develop the study by the recent Bloom Program pilot in Nova Scotia, which showed the positive benefits community pharmacists can have in helping patients with mental health issues. “With additional prescribing authority in Alberta there’s potential for us to do even more,” he says. For example, Alberta pharmacists can titrate and augment therapies by prescribing higher doses, or add on medications to help patients reach maximum treatment benefits. They can also switch therapies if patients aren’t responding or have uncomfortable side effects. “That’s a huge opportunity for pharmacists,” he says.
Burton hopes that positive study results will also encourage other pharmacists to get more involved in helping patients with mental health disorders. “There is still a significant amount of stigma out there around mental health. Pharmacists are also very type A personalities and sometimes we need concrete data before we believe we can do it,” he says. “If the study goes well, it will be a good starting point to build from.”
|
| Laura Murphy |
|
| Olavo Fernandes |
"CannabisCareRx"
A $25,000 grant from the Canadian Foundation for Pharmacy’s Innovation Fund will see the development and study of a program to help community pharmacists identify and support patients using medical cannabis, as part of routine care.
The pilot-based research study out of Ontario is looking to bridge the gap between legal medical cannabis distribution, which currently bypasses community pharmacies, and the expectation that community pharmacists competently provide information and advice to patients who use medical cannabis. Pharmacists in Ontario who provide direct patient care must complete mandatory cannabis training by 2020, yet there is a noticeable lack of a training program that involves pharmacists in screening for cannabis use.
Lead investigators Laura Murphy and Olavo Fernandes, researchers at the University Health Network, will conduct a prospective observational study of a pilot implementation of a structured program, entitled CannabisCareRx. The program will be comprised of screening questions, a structured process for assessment and a template for documentation and referral to other healthcare providers. The program also includes pharmacist education that emphasizes the development of communication skills to engage patients and decrease stigma. The materials and tools developed will be scalable for implementation across Canada.
Overall, the project is set to occur over three years, starting in September of 2020. It is broken up into three steps: set-up, pilot implementation and dissemination. The set-up stage includes development of the pharmacy education and consultation guide, building the research database, and recruiting five pharmacists from the Greater Toronto Area for the pilot occurring throughout year two.
CannabisCareRx will be piloted as part of usual care provided by the participating pharmacists. After completing the Cannabis Education program, the pharmacists will implement the use of the screening questions with all of their adult patients during routine interactions throughout the 12 months of the pilot.
From there, a member of the research team will conduct a follow-up survey with the pharmacists involved and patients who provide their contact information and permission. The feasibility outcomes will include the number of patients who use cannabis for therapeutic reasons, the number of patients who complete the questionnaire, and the amount of pharmacist time required to conduct CannabisCareRx.
The aim is not only to be successful at the end of the three years but also to create a blueprint for pharmacists across Canada. “The outcomes of the pilot implementation of the CannabisCareRx program will provide patient-centred, pharmacist-driven education materials that will not only support the promotion of safe and effective use of cannabis and harm reduction but will also provide a tangible, patient-facing guide that can facilitate brief and effective consultation,” said Murphy.
"SAD-APP: Self-rating App for Depression Aided by Proactive Pharmacists"
Researcher Philippe Vincent and pharmacists at 30 community pharmacies hope to smooth the path to recovery for patients with depression through a ground-breaking research study funded in part with a $50,000 grant from the Canadian Foundation for Pharmacy’s (CFP’s) Innovation Fund.
The research is unique in that it combines pharmacist coaching with a smartphone app. The app will also differentiate itself within the virtual sea of mental health apps in that it will be built around the PHQ-9 and GAD-7 self-assessment questionnaires, two standardised, validated tools to assess depression and anxiety, respectively. Participating pharmacists will be able to access a patient’s results using a secure, online dashboard.
The study’s primary objective is to shorten the time to recovery by helping patients achieve treatment response as quickly as possible and by supporting adherence.
“Our project seeks to bring patients who suffer in silence and pharmacists together into a meaningful relationship. The self-rating scales and smartphone app are mediators of a safe space for private, sometimes emotional conversations and goal-setting,” says Vincent, Associate Professor of Clinical Pharmacy at University of Montreal and a researcher with the university-affiliated Institute universitaire en sante mentale de Montreal (a psychiatric hospital).
A secondary goal is to prove the value of pharmacists’ interventions. “If we can show that the time pharmacists put into monitoring and coaching is directly proportional to the remission of patients, so people can go back to meaningful occupations and live fuller lives, then insurance, government and other stakeholders will understand that the pharmacists’ time is worth something,” says Vincent.
As well, the stage is already set for possible adoption of the research model into regular pharmacy practice, and possibly on a national scale. All 30 participating pharmacies are part of the Pharmaprix banner, a division of Shoppers Drug Mart and Loblaw companies. Pharmaprix is co-funding the project with CFP.
The study is a randomized, unblinded, multicenter intervention trial that will follow patients over six months. The 30 participating pharmacies will each enrol 10 patients who have been diagnosed with a new episode of major depression, broken down as follows:
Pharmacists in the coaching group will receive training based on best practices in clinical psychiatry. They will call their participating patients every week during the dose-finding period and conduct a 5-minute semi-structured interview that seeks to create rapport, agree on treatment goals and agree on tasks. Pharmacists will also ask about side effects, which will be addressed as required through separate interventions that will be documented in the dashboard.
Throughout the six months of the study, the app will send notifications to patients every two weeks to remind them to complete the PHQ-9 and GAD-7 questionnaires. The app will also prompt patients to complete the PHQ-2 questionnaire every day for the first 15 days, every two days for the next 15 days, and every three days thereafter. “In a pharmacy setting where everything is so busy, you need to have useful, fast and complete information. This model enables systematic monitoring and a communication bridge between patients and pharmacists,” says Vincent.
The estimated project completion date, including data analysis, is mid 2021.
John Papastergiou, practising community pharmacist, and the research team at University of Toronto is using CFP's grant of $15,000 to quantify adherence rates to adult immunizations, where a series of vaccines or booster vaccines are required, when these vaccines are administered by community pharmacists. It's hoped that the study results will help pharmacists obtain prescribing rights for vaccines.
CFP has awarded Paula Newman and her team at Northwest Telepharmacy Solutions $22,500 to determine the feasibility and effectiveness of a pharmacist-led opioid stewardship program for chronic non-cancer pain, using videoconferencing technology. The project includes prescriber and patient education, risk stratification and screening for potential harm, as well as patient monitoriing with follow-up and continuity of care.
The Presciption to Thrive project, funded by multiple stakeholders including Canada's two national pharmacy associations and the Nova Scotia Department of Health and Wellness, seeks to establish a model for practice change in community pharmacy. Expert facilitators will work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.
Saleema Bhaidani, Director, Pharmacy Innovation & Professional Affairs at Whole Health Pharmacy Partners, and researcher Lisa Dolovich at the University of Toronto are conducting a retrospective analysis of the impact of an appointment-based model (ABM) for pharmacy practice based on data obtained from six independent pharmacies, part of the Whole Health Pharmacy banner, which implemented ABM in September 2017. ABM uses medication synchronization to coordinate refills into one pick-up, which enables pharmacists to conduct appointments where they can review, address and follow up on medication issues on a monthly or regular basis. The study will seek to evaluate clinical outcomes and the impact on adherence, as well as ABM's impact on workflow and pharmacy staff.
Dr. Chang and her team will examine the feasibility and effectiveness of a pharmacist intervention targeting high-dose, high-risk prescription opioids. The study will complement previous research in the area funded by the Ontario Ministry of Health and Long-Term Care, as well as Health Canada Anti-Drug Strategy Initiatives.
Dr. MacCallum and her team are researching strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes.As part of that, the team will also determine how routine monitoring and follow-up is linked to other expanded professional services.
The project began with a survey of about 8,000 pharmacists in early 2018. During phase two, launched in fall 2018, researchers are working with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.
With the support of the Innovation grant and additional funding from the New Brunswick Pharmacists' Association, Dr. Tsuyuki and his team tracked and quantified the impact of pharmacist management of patients with uncomplicated urinary tract infection.
As follow-up to the study, the research team is looking at antibiotic usage and conducting an economic analysis. The group is also developing an online registry and practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.
News article - "Pharmacists for UTI management a 'no-brainer'"
Published study - "Outcomes of Urinary Tract Infection Management by Pharmacists (RxOUTMAP)"
Dr. Barbara Farrell of the Bruyère Research Institute in Ottawa has been awarded $50,000 to support her research project on “Mobilizing Community Pharmacists as Catalysts for Deprescribing.” Based at the Institute, Farrell and her team will work with community pharmacy practices and a national advisory group (with provider and private payer representation) over a one-year period to develop acceptable workflow strategies for deprescribing guideline use.
Research associates will work with each pharmacy to quantify opportunities for deprescribing, describe activities and processes associated with guideline use—including how long such activities take—and highlight enablers and barriers that pharmacists encounter. This project is expected to lay the foundation for a larger demonstration project examining reach, adoption and implementation of deprescribing strategies, and ultimately a randomized controlled trial of deprescribing interventions that explores patient and health system outcomes, including related cost savings.
News article - "Deprescribing, within a pharmacist's domain"
.jpg "Dr. Line Guenette")
Dr. Line Guénette of the Faculty of Pharmacy at Laval University and her team have received $26,800 to develop evidence-based electronic tools for community pharmacists to detect and improve medication non-adherence. Drawing on their previous research in medication adherence measures, the team aims to develop five electronic tools to target four common chronic disease areas (type 2 diabetes, hypertension, asthma and depression).
“We are committed to building tools that have acceptability, usability, utility, implementation and ways to improve e-tools for supporting pharmacy practice,” says Guénette, noting that the initial focus will be on diabetes and depression. “By developing and providing new tools to better identify patients having adherence problems, we will engage and support pharmacists with their crucial role regarding …medication efficacy/safety."
"Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)"
With $50,000 in funding from the Canadian Foundation for Pharmacy’s Innovation Fund, a University of Alberta team of researchers and front-line pharmacists are implementing a pharmacist-initiated mental health monitoring and intervention program based in the community setting. “We are grateful to have the opportunity to partner with CFP as an unbiased organization that supports pharmacy initiatives,” says lead researcher/pharmacist Dan Burton.
For the study, up to 10 pharmacies in Calgary and surrounding areas will be involved with some 120 participating patients over a six-month period. The intervention group will be recruiting and monitoring patients with major depressive disorder and general anxiety disorder, providing interventions as needed and collaborating with patients’ physicians. The control group will receive usual pharmacy care.
Participating pharmacists will receive mental health training materials and have support throughout the pilot and are expected to begin recruiting patients by March 2020.
“Given community pharmacists’ training and access, they are in a great position to help the healthcare field better manage depression and anxiety,” says Burton. “They could take the burden off physicians and other providers by stabilizing patients on medication—plus sometimes these patients need more frequent touch points of support and we have that opportunity in the community.”
Burton says he and his team were inspired to develop the study by the recent Bloom Program pilot in Nova Scotia, which showed the positive benefits community pharmacists can have in helping patients with mental health issues. “With additional prescribing authority in Alberta there’s potential for us to do even more,” he says. For example, Alberta pharmacists can titrate and augment therapies by prescribing higher doses, or add on medications to help patients reach maximum treatment benefits. They can also switch therapies if patients aren’t responding or have uncomfortable side effects. “That’s a huge opportunity for pharmacists,” he says.
Burton hopes that positive study results will also encourage other pharmacists to get more involved in helping patients with mental health disorders. “There is still a significant amount of stigma out there around mental health. Pharmacists are also very type A personalities and sometimes we need concrete data before we believe we can do it,” he says. “If the study goes well, it will be a good starting point to build from.”
|
| Laura Murphy |
|
| Olavo Fernandes |
"CannabisCareRx"
A $25,000 grant from the Canadian Foundation for Pharmacy’s Innovation Fund will see the development and study of a program to help community pharmacists identify and support patients using medical cannabis, as part of routine care.
The pilot-based research study out of Ontario is looking to bridge the gap between legal medical cannabis distribution, which currently bypasses community pharmacies, and the expectation that community pharmacists competently provide information and advice to patients who use medical cannabis. Pharmacists in Ontario who provide direct patient care must complete mandatory cannabis training by 2020, yet there is a noticeable lack of a training program that involves pharmacists in screening for cannabis use.
Lead investigators Laura Murphy and Olavo Fernandes, researchers at the University Health Network, will conduct a prospective observational study of a pilot implementation of a structured program, entitled CannabisCareRx. The program will be comprised of screening questions, a structured process for assessment and a template for documentation and referral to other healthcare providers. The program also includes pharmacist education that emphasizes the development of communication skills to engage patients and decrease stigma. The materials and tools developed will be scalable for implementation across Canada.
Overall, the project is set to occur over three years, starting in September of 2020. It is broken up into three steps: set-up, pilot implementation and dissemination. The set-up stage includes development of the pharmacy education and consultation guide, building the research database, and recruiting five pharmacists from the Greater Toronto Area for the pilot occurring throughout year two.
CannabisCareRx will be piloted as part of usual care provided by the participating pharmacists. After completing the Cannabis Education program, the pharmacists will implement the use of the screening questions with all of their adult patients during routine interactions throughout the 12 months of the pilot.
From there, a member of the research team will conduct a follow-up survey with the pharmacists involved and patients who provide their contact information and permission. The feasibility outcomes will include the number of patients who use cannabis for therapeutic reasons, the number of patients who complete the questionnaire, and the amount of pharmacist time required to conduct CannabisCareRx.
The aim is not only to be successful at the end of the three years but also to create a blueprint for pharmacists across Canada. “The outcomes of the pilot implementation of the CannabisCareRx program will provide patient-centred, pharmacist-driven education materials that will not only support the promotion of safe and effective use of cannabis and harm reduction but will also provide a tangible, patient-facing guide that can facilitate brief and effective consultation,” said Murphy.
"SAD-APP: Self-rating App for Depression Aided by Proactive Pharmacists"
Researcher Philippe Vincent and pharmacists at 30 community pharmacies hope to smooth the path to recovery for patients with depression through a ground-breaking research study funded in part with a $50,000 grant from the Canadian Foundation for Pharmacy’s (CFP’s) Innovation Fund.
The research is unique in that it combines pharmacist coaching with a smartphone app. The app will also differentiate itself within the virtual sea of mental health apps in that it will be built around the PHQ-9 and GAD-7 self-assessment questionnaires, two standardised, validated tools to assess depression and anxiety, respectively. Participating pharmacists will be able to access a patient’s results using a secure, online dashboard.
The study’s primary objective is to shorten the time to recovery by helping patients achieve treatment response as quickly as possible and by supporting adherence.
“Our project seeks to bring patients who suffer in silence and pharmacists together into a meaningful relationship. The self-rating scales and smartphone app are mediators of a safe space for private, sometimes emotional conversations and goal-setting,” says Vincent, Associate Professor of Clinical Pharmacy at University of Montreal and a researcher with the university-affiliated Institute universitaire en sante mentale de Montreal (a psychiatric hospital).
A secondary goal is to prove the value of pharmacists’ interventions. “If we can show that the time pharmacists put into monitoring and coaching is directly proportional to the remission of patients, so people can go back to meaningful occupations and live fuller lives, then insurance, government and other stakeholders will understand that the pharmacists’ time is worth something,” says Vincent.
As well, the stage is already set for possible adoption of the research model into regular pharmacy practice, and possibly on a national scale. All 30 participating pharmacies are part of the Pharmaprix banner, a division of Shoppers Drug Mart and Loblaw companies. Pharmaprix is co-funding the project with CFP.
The study is a randomized, unblinded, multicenter intervention trial that will follow patients over six months. The 30 participating pharmacies will each enrol 10 patients who have been diagnosed with a new episode of major depression, broken down as follows:
Pharmacists in the coaching group will receive training based on best practices in clinical psychiatry. They will call their participating patients every week during the dose-finding period and conduct a 5-minute semi-structured interview that seeks to create rapport, agree on treatment goals and agree on tasks. Pharmacists will also ask about side effects, which will be addressed as required through separate interventions that will be documented in the dashboard.
Throughout the six months of the study, the app will send notifications to patients every two weeks to remind them to complete the PHQ-9 and GAD-7 questionnaires. The app will also prompt patients to complete the PHQ-2 questionnaire every day for the first 15 days, every two days for the next 15 days, and every three days thereafter. “In a pharmacy setting where everything is so busy, you need to have useful, fast and complete information. This model enables systematic monitoring and a communication bridge between patients and pharmacists,” says Vincent.
The estimated project completion date, including data analysis, is mid 2021.
John Papastergiou, practising community pharmacist, and the research team at University of Toronto is using CFP's grant of $15,000 to quantify adherence rates to adult immunizations, where a series of vaccines or booster vaccines are required, when these vaccines are administered by community pharmacists. It's hoped that the study results will help pharmacists obtain prescribing rights for vaccines.
CFP has awarded Paula Newman and her team at Northwest Telepharmacy Solutions $22,500 to determine the feasibility and effectiveness of a pharmacist-led opioid stewardship program for chronic non-cancer pain, using videoconferencing technology. The project includes prescriber and patient education, risk stratification and screening for potential harm, as well as patient monitoriing with follow-up and continuity of care.
The Presciption to Thrive project, funded by multiple stakeholders including Canada's two national pharmacy associations and the Nova Scotia Department of Health and Wellness, seeks to establish a model for practice change in community pharmacy. Expert facilitators will work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.
Saleema Bhaidani, Director, Pharmacy Innovation & Professional Affairs at Whole Health Pharmacy Partners, and researcher Lisa Dolovich at the University of Toronto are conducting a retrospective analysis of the impact of an appointment-based model (ABM) for pharmacy practice based on data obtained from six independent pharmacies, part of the Whole Health Pharmacy banner, which implemented ABM in September 2017. ABM uses medication synchronization to coordinate refills into one pick-up, which enables pharmacists to conduct appointments where they can review, address and follow up on medication issues on a monthly or regular basis. The study will seek to evaluate clinical outcomes and the impact on adherence, as well as ABM's impact on workflow and pharmacy staff.
Dr. Chang and her team will examine the feasibility and effectiveness of a pharmacist intervention targeting high-dose, high-risk prescription opioids. The study will complement previous research in the area funded by the Ontario Ministry of Health and Long-Term Care, as well as Health Canada Anti-Drug Strategy Initiatives.
Dr. MacCallum and her team are researching strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes.As part of that, the team will also determine how routine monitoring and follow-up is linked to other expanded professional services.
The project began with a survey of about 8,000 pharmacists in early 2018. During phase two, launched in fall 2018, researchers are working with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.
With the support of the Innovation grant and additional funding from the New Brunswick Pharmacists' Association, Dr. Tsuyuki and his team tracked and quantified the impact of pharmacist management of patients with uncomplicated urinary tract infection.
As follow-up to the study, the research team is looking at antibiotic usage and conducting an economic analysis. The group is also developing an online registry and practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.
News article - "Pharmacists for UTI management a 'no-brainer'"
Published study - "Outcomes of Urinary Tract Infection Management by Pharmacists (RxOUTMAP)"
Dr. Barbara Farrell of the Bruyère Research Institute in Ottawa has been awarded $50,000 to support her research project on “Mobilizing Community Pharmacists as Catalysts for Deprescribing.” Based at the Institute, Farrell and her team will work with community pharmacy practices and a national advisory group (with provider and private payer representation) over a one-year period to develop acceptable workflow strategies for deprescribing guideline use.
Research associates will work with each pharmacy to quantify opportunities for deprescribing, describe activities and processes associated with guideline use—including how long such activities take—and highlight enablers and barriers that pharmacists encounter. This project is expected to lay the foundation for a larger demonstration project examining reach, adoption and implementation of deprescribing strategies, and ultimately a randomized controlled trial of deprescribing interventions that explores patient and health system outcomes, including related cost savings.
News article - "Deprescribing, within a pharmacist's domain"
Dr. Line Guénette of the Faculty of Pharmacy at Laval University and her team have received $26,800 to develop evidence-based electronic tools for community pharmacists to detect and improve medication non-adherence. Drawing on their previous research in medication adherence measures, the team aims to develop five electronic tools to target four common chronic disease areas (type 2 diabetes, hypertension, asthma and depression).
“We are committed to building tools that have acceptability, usability, utility, implementation and ways to improve e-tools for supporting pharmacy practice,” says Guénette, noting that the initial focus will be on diabetes and depression. “By developing and providing new tools to better identify patients having adherence problems, we will engage and support pharmacists with their crucial role regarding …medication efficacy/safety."
University of Toronto’s Sara Guilcher and her team were also honoured with a 2016 Innovation Fund grant worth $38,000 to establish and evaluate the feasibility of an Acute care to Community Pharmacy Communication Link (ACC-Link) to improve medication management across transitions of care.
Building on existing best evidence around successful medication management interventions, the ACC-Link provides communication between hospital and community pharmacists to actively equip the latter with information needed to guide patients and their families at the point of hospital discharge. By evaluating the feasibility of the intervention and understanding the factors that may influence implementation, the researchers are expecting the program can be scaled to fit other clinical settings.
“Ultimately, ACC-Link has the potential to improve patients’ medication experiences, safety, overall health, and quality of life for themselves and their caregivers while reducing health-system costs and demand,” noted the research team in their submission.
"Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)"
With $50,000 in funding from the Canadian Foundation for Pharmacy’s Innovation Fund, a University of Alberta team of researchers and front-line pharmacists are implementing a pharmacist-initiated mental health monitoring and intervention program based in the community setting. “We are grateful to have the opportunity to partner with CFP as an unbiased organization that supports pharmacy initiatives,” says lead researcher/pharmacist Dan Burton.
For the study, up to 10 pharmacies in Calgary and surrounding areas will be involved with some 120 participating patients over a six-month period. The intervention group will be recruiting and monitoring patients with major depressive disorder and general anxiety disorder, providing interventions as needed and collaborating with patients’ physicians. The control group will receive usual pharmacy care.
Participating pharmacists will receive mental health training materials and have support throughout the pilot and are expected to begin recruiting patients by March 2020.
“Given community pharmacists’ training and access, they are in a great position to help the healthcare field better manage depression and anxiety,” says Burton. “They could take the burden off physicians and other providers by stabilizing patients on medication—plus sometimes these patients need more frequent touch points of support and we have that opportunity in the community.”
Burton says he and his team were inspired to develop the study by the recent Bloom Program pilot in Nova Scotia, which showed the positive benefits community pharmacists can have in helping patients with mental health issues. “With additional prescribing authority in Alberta there’s potential for us to do even more,” he says. For example, Alberta pharmacists can titrate and augment therapies by prescribing higher doses, or add on medications to help patients reach maximum treatment benefits. They can also switch therapies if patients aren’t responding or have uncomfortable side effects. “That’s a huge opportunity for pharmacists,” he says.
Burton hopes that positive study results will also encourage other pharmacists to get more involved in helping patients with mental health disorders. “There is still a significant amount of stigma out there around mental health. Pharmacists are also very type A personalities and sometimes we need concrete data before we believe we can do it,” he says. “If the study goes well, it will be a good starting point to build from.”
|
| Laura Murphy |
|
| Olavo Fernandes |
"CannabisCareRx"
A $25,000 grant from the Canadian Foundation for Pharmacy’s Innovation Fund will see the development and study of a program to help community pharmacists identify and support patients using medical cannabis, as part of routine care.
The pilot-based research study out of Ontario is looking to bridge the gap between legal medical cannabis distribution, which currently bypasses community pharmacies, and the expectation that community pharmacists competently provide information and advice to patients who use medical cannabis. Pharmacists in Ontario who provide direct patient care must complete mandatory cannabis training by 2020, yet there is a noticeable lack of a training program that involves pharmacists in screening for cannabis use.
Lead investigators Laura Murphy and Olavo Fernandes, researchers at the University Health Network, will conduct a prospective observational study of a pilot implementation of a structured program, entitled CannabisCareRx. The program will be comprised of screening questions, a structured process for assessment and a template for documentation and referral to other healthcare providers. The program also includes pharmacist education that emphasizes the development of communication skills to engage patients and decrease stigma. The materials and tools developed will be scalable for implementation across Canada.
Overall, the project is set to occur over three years, starting in September of 2020. It is broken up into three steps: set-up, pilot implementation and dissemination. The set-up stage includes development of the pharmacy education and consultation guide, building the research database, and recruiting five pharmacists from the Greater Toronto Area for the pilot occurring throughout year two.
CannabisCareRx will be piloted as part of usual care provided by the participating pharmacists. After completing the Cannabis Education program, the pharmacists will implement the use of the screening questions with all of their adult patients during routine interactions throughout the 12 months of the pilot.
From there, a member of the research team will conduct a follow-up survey with the pharmacists involved and patients who provide their contact information and permission. The feasibility outcomes will include the number of patients who use cannabis for therapeutic reasons, the number of patients who complete the questionnaire, and the amount of pharmacist time required to conduct CannabisCareRx.
The aim is not only to be successful at the end of the three years but also to create a blueprint for pharmacists across Canada. “The outcomes of the pilot implementation of the CannabisCareRx program will provide patient-centred, pharmacist-driven education materials that will not only support the promotion of safe and effective use of cannabis and harm reduction but will also provide a tangible, patient-facing guide that can facilitate brief and effective consultation,” said Murphy.
"SAD-APP: Self-rating App for Depression Aided by Proactive Pharmacists"
Researcher Philippe Vincent and pharmacists at 30 community pharmacies hope to smooth the path to recovery for patients with depression through a ground-breaking research study funded in part with a $50,000 grant from the Canadian Foundation for Pharmacy’s (CFP’s) Innovation Fund.
The research is unique in that it combines pharmacist coaching with a smartphone app. The app will also differentiate itself within the virtual sea of mental health apps in that it will be built around the PHQ-9 and GAD-7 self-assessment questionnaires, two standardised, validated tools to assess depression and anxiety, respectively. Participating pharmacists will be able to access a patient’s results using a secure, online dashboard.
The study’s primary objective is to shorten the time to recovery by helping patients achieve treatment response as quickly as possible and by supporting adherence.
“Our project seeks to bring patients who suffer in silence and pharmacists together into a meaningful relationship. The self-rating scales and smartphone app are mediators of a safe space for private, sometimes emotional conversations and goal-setting,” says Vincent, Associate Professor of Clinical Pharmacy at University of Montreal and a researcher with the university-affiliated Institute universitaire en sante mentale de Montreal (a psychiatric hospital).
A secondary goal is to prove the value of pharmacists’ interventions. “If we can show that the time pharmacists put into monitoring and coaching is directly proportional to the remission of patients, so people can go back to meaningful occupations and live fuller lives, then insurance, government and other stakeholders will understand that the pharmacists’ time is worth something,” says Vincent.
As well, the stage is already set for possible adoption of the research model into regular pharmacy practice, and possibly on a national scale. All 30 participating pharmacies are part of the Pharmaprix banner, a division of Shoppers Drug Mart and Loblaw companies. Pharmaprix is co-funding the project with CFP.
The study is a randomized, unblinded, multicenter intervention trial that will follow patients over six months. The 30 participating pharmacies will each enrol 10 patients who have been diagnosed with a new episode of major depression, broken down as follows:
Pharmacists in the coaching group will receive training based on best practices in clinical psychiatry. They will call their participating patients every week during the dose-finding period and conduct a 5-minute semi-structured interview that seeks to create rapport, agree on treatment goals and agree on tasks. Pharmacists will also ask about side effects, which will be addressed as required through separate interventions that will be documented in the dashboard.
Throughout the six months of the study, the app will send notifications to patients every two weeks to remind them to complete the PHQ-9 and GAD-7 questionnaires. The app will also prompt patients to complete the PHQ-2 questionnaire every day for the first 15 days, every two days for the next 15 days, and every three days thereafter. “In a pharmacy setting where everything is so busy, you need to have useful, fast and complete information. This model enables systematic monitoring and a communication bridge between patients and pharmacists,” says Vincent.
The estimated project completion date, including data analysis, is mid 2021.
John Papastergiou, practising community pharmacist, and the research team at University of Toronto is using CFP's grant of $15,000 to quantify adherence rates to adult immunizations, where a series of vaccines or booster vaccines are required, when these vaccines are administered by community pharmacists. It's hoped that the study results will help pharmacists obtain prescribing rights for vaccines.
CFP has awarded Paula Newman and her team at Northwest Telepharmacy Solutions $22,500 to determine the feasibility and effectiveness of a pharmacist-led opioid stewardship program for chronic non-cancer pain, using videoconferencing technology. The project includes prescriber and patient education, risk stratification and screening for potential harm, as well as patient monitoriing with follow-up and continuity of care.
The Presciption to Thrive project, funded by multiple stakeholders including Canada's two national pharmacy associations and the Nova Scotia Department of Health and Wellness, seeks to establish a model for practice change in community pharmacy. Expert facilitators will work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.
Saleema Bhaidani, Director, Pharmacy Innovation & Professional Affairs at Whole Health Pharmacy Partners, and researcher Lisa Dolovich at the University of Toronto are conducting a retrospective analysis of the impact of an appointment-based model (ABM) for pharmacy practice based on data obtained from six independent pharmacies, part of the Whole Health Pharmacy banner, which implemented ABM in September 2017. ABM uses medication synchronization to coordinate refills into one pick-up, which enables pharmacists to conduct appointments where they can review, address and follow up on medication issues on a monthly or regular basis. The study will seek to evaluate clinical outcomes and the impact on adherence, as well as ABM's impact on workflow and pharmacy staff.
Dr. Chang and her team will examine the feasibility and effectiveness of a pharmacist intervention targeting high-dose, high-risk prescription opioids. The study will complement previous research in the area funded by the Ontario Ministry of Health and Long-Term Care, as well as Health Canada Anti-Drug Strategy Initiatives.
Dr. MacCallum and her team are researching strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes.As part of that, the team will also determine how routine monitoring and follow-up is linked to other expanded professional services.
The project began with a survey of about 8,000 pharmacists in early 2018. During phase two, launched in fall 2018, researchers are working with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.
With the support of the Innovation grant and additional funding from the New Brunswick Pharmacists' Association, Dr. Tsuyuki and his team tracked and quantified the impact of pharmacist management of patients with uncomplicated urinary tract infection.
As follow-up to the study, the research team is looking at antibiotic usage and conducting an economic analysis. The group is also developing an online registry and practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.
News article - "Pharmacists for UTI management a 'no-brainer'"
Published study - "Outcomes of Urinary Tract Infection Management by Pharmacists (RxOUTMAP)"
Dr. Barbara Farrell of the Bruyère Research Institute in Ottawa has been awarded $50,000 to support her research project on “Mobilizing Community Pharmacists as Catalysts for Deprescribing.” Based at the Institute, Farrell and her team will work with community pharmacy practices and a national advisory group (with provider and private payer representation) over a one-year period to develop acceptable workflow strategies for deprescribing guideline use.
Research associates will work with each pharmacy to quantify opportunities for deprescribing, describe activities and processes associated with guideline use—including how long such activities take—and highlight enablers and barriers that pharmacists encounter. This project is expected to lay the foundation for a larger demonstration project examining reach, adoption and implementation of deprescribing strategies, and ultimately a randomized controlled trial of deprescribing interventions that explores patient and health system outcomes, including related cost savings.
News article - "Deprescribing, within a pharmacist's domain"
Dr. Line Guénette of the Faculty of Pharmacy at Laval University and her team have received $26,800 to develop evidence-based electronic tools for community pharmacists to detect and improve medication non-adherence. Drawing on their previous research in medication adherence measures, the team aims to develop five electronic tools to target four common chronic disease areas (type 2 diabetes, hypertension, asthma and depression).
“We are committed to building tools that have acceptability, usability, utility, implementation and ways to improve e-tools for supporting pharmacy practice,” says Guénette, noting that the initial focus will be on diabetes and depression. “By developing and providing new tools to better identify patients having adherence problems, we will engage and support pharmacists with their crucial role regarding …medication efficacy/safety."
University of Toronto’s Sara Guilcher and her team were also honoured with a 2016 Innovation Fund grant worth $38,000 to establish and evaluate the feasibility of an Acute care to Community Pharmacy Communication Link (ACC-Link) to improve medication management across transitions of care.
Building on existing best evidence around successful medication management interventions, the ACC-Link provides communication between hospital and community pharmacists to actively equip the latter with information needed to guide patients and their families at the point of hospital discharge. By evaluating the feasibility of the intervention and understanding the factors that may influence implementation, the researchers are expecting the program can be scaled to fit other clinical settings.
“Ultimately, ACC-Link has the potential to improve patients’ medication experiences, safety, overall health, and quality of life for themselves and their caregivers while reducing health-system costs and demand,” noted the research team in their submission.
Researchers Christine Hughes, Terri Schindel and Rene Breault set out to determine how Alberta pharmacists are providing care under the Alberta Pharmacy Services Framework, and how patients are experiencing care planning services in the “real world.”
With funding from the Canadian Foundation for Pharmacy and the Alberta Pharmacists’ Association (RxA), the investigators recruited four different cases, or community pharmacies, in the province and collected data over 12 months per site. Over the course of 83 interviews and 94 hours of observation, they explored the value of pharmacy services to patients, pharmacists, other healthcare providers and policy makers.
"Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)"
With $50,000 in funding from the Canadian Foundation for Pharmacy’s Innovation Fund, a University of Alberta team of researchers and front-line pharmacists are implementing a pharmacist-initiated mental health monitoring and intervention program based in the community setting. “We are grateful to have the opportunity to partner with CFP as an unbiased organization that supports pharmacy initiatives,” says lead researcher/pharmacist Dan Burton.
For the study, up to 10 pharmacies in Calgary and surrounding areas will be involved with some 120 participating patients over a six-month period. The intervention group will be recruiting and monitoring patients with major depressive disorder and general anxiety disorder, providing interventions as needed and collaborating with patients’ physicians. The control group will receive usual pharmacy care.
Participating pharmacists will receive mental health training materials and have support throughout the pilot and are expected to begin recruiting patients by March 2020.
“Given community pharmacists’ training and access, they are in a great position to help the healthcare field better manage depression and anxiety,” says Burton. “They could take the burden off physicians and other providers by stabilizing patients on medication—plus sometimes these patients need more frequent touch points of support and we have that opportunity in the community.”
Burton says he and his team were inspired to develop the study by the recent Bloom Program pilot in Nova Scotia, which showed the positive benefits community pharmacists can have in helping patients with mental health issues. “With additional prescribing authority in Alberta there’s potential for us to do even more,” he says. For example, Alberta pharmacists can titrate and augment therapies by prescribing higher doses, or add on medications to help patients reach maximum treatment benefits. They can also switch therapies if patients aren’t responding or have uncomfortable side effects. “That’s a huge opportunity for pharmacists,” he says.
Burton hopes that positive study results will also encourage other pharmacists to get more involved in helping patients with mental health disorders. “There is still a significant amount of stigma out there around mental health. Pharmacists are also very type A personalities and sometimes we need concrete data before we believe we can do it,” he says. “If the study goes well, it will be a good starting point to build from.”
|
| Laura Murphy |
|
| Olavo Fernandes |
"CannabisCareRx"
A $25,000 grant from the Canadian Foundation for Pharmacy’s Innovation Fund will see the development and study of a program to help community pharmacists identify and support patients using medical cannabis, as part of routine care.
The pilot-based research study out of Ontario is looking to bridge the gap between legal medical cannabis distribution, which currently bypasses community pharmacies, and the expectation that community pharmacists competently provide information and advice to patients who use medical cannabis. Pharmacists in Ontario who provide direct patient care must complete mandatory cannabis training by 2020, yet there is a noticeable lack of a training program that involves pharmacists in screening for cannabis use.
Lead investigators Laura Murphy and Olavo Fernandes, researchers at the University Health Network, will conduct a prospective observational study of a pilot implementation of a structured program, entitled CannabisCareRx. The program will be comprised of screening questions, a structured process for assessment and a template for documentation and referral to other healthcare providers. The program also includes pharmacist education that emphasizes the development of communication skills to engage patients and decrease stigma. The materials and tools developed will be scalable for implementation across Canada.
Overall, the project is set to occur over three years, starting in September of 2020. It is broken up into three steps: set-up, pilot implementation and dissemination. The set-up stage includes development of the pharmacy education and consultation guide, building the research database, and recruiting five pharmacists from the Greater Toronto Area for the pilot occurring throughout year two.
CannabisCareRx will be piloted as part of usual care provided by the participating pharmacists. After completing the Cannabis Education program, the pharmacists will implement the use of the screening questions with all of their adult patients during routine interactions throughout the 12 months of the pilot.
From there, a member of the research team will conduct a follow-up survey with the pharmacists involved and patients who provide their contact information and permission. The feasibility outcomes will include the number of patients who use cannabis for therapeutic reasons, the number of patients who complete the questionnaire, and the amount of pharmacist time required to conduct CannabisCareRx.
The aim is not only to be successful at the end of the three years but also to create a blueprint for pharmacists across Canada. “The outcomes of the pilot implementation of the CannabisCareRx program will provide patient-centred, pharmacist-driven education materials that will not only support the promotion of safe and effective use of cannabis and harm reduction but will also provide a tangible, patient-facing guide that can facilitate brief and effective consultation,” said Murphy.
"SAD-APP: Self-rating App for Depression Aided by Proactive Pharmacists"
Researcher Philippe Vincent and pharmacists at 30 community pharmacies hope to smooth the path to recovery for patients with depression through a ground-breaking research study funded in part with a $50,000 grant from the Canadian Foundation for Pharmacy’s (CFP’s) Innovation Fund.
The research is unique in that it combines pharmacist coaching with a smartphone app. The app will also differentiate itself within the virtual sea of mental health apps in that it will be built around the PHQ-9 and GAD-7 self-assessment questionnaires, two standardised, validated tools to assess depression and anxiety, respectively. Participating pharmacists will be able to access a patient’s results using a secure, online dashboard.
The study’s primary objective is to shorten the time to recovery by helping patients achieve treatment response as quickly as possible and by supporting adherence.
“Our project seeks to bring patients who suffer in silence and pharmacists together into a meaningful relationship. The self-rating scales and smartphone app are mediators of a safe space for private, sometimes emotional conversations and goal-setting,” says Vincent, Associate Professor of Clinical Pharmacy at University of Montreal and a researcher with the university-affiliated Institute universitaire en sante mentale de Montreal (a psychiatric hospital).
A secondary goal is to prove the value of pharmacists’ interventions. “If we can show that the time pharmacists put into monitoring and coaching is directly proportional to the remission of patients, so people can go back to meaningful occupations and live fuller lives, then insurance, government and other stakeholders will understand that the pharmacists’ time is worth something,” says Vincent.
As well, the stage is already set for possible adoption of the research model into regular pharmacy practice, and possibly on a national scale. All 30 participating pharmacies are part of the Pharmaprix banner, a division of Shoppers Drug Mart and Loblaw companies. Pharmaprix is co-funding the project with CFP.
The study is a randomized, unblinded, multicenter intervention trial that will follow patients over six months. The 30 participating pharmacies will each enrol 10 patients who have been diagnosed with a new episode of major depression, broken down as follows:
Pharmacists in the coaching group will receive training based on best practices in clinical psychiatry. They will call their participating patients every week during the dose-finding period and conduct a 5-minute semi-structured interview that seeks to create rapport, agree on treatment goals and agree on tasks. Pharmacists will also ask about side effects, which will be addressed as required through separate interventions that will be documented in the dashboard.
Throughout the six months of the study, the app will send notifications to patients every two weeks to remind them to complete the PHQ-9 and GAD-7 questionnaires. The app will also prompt patients to complete the PHQ-2 questionnaire every day for the first 15 days, every two days for the next 15 days, and every three days thereafter. “In a pharmacy setting where everything is so busy, you need to have useful, fast and complete information. This model enables systematic monitoring and a communication bridge between patients and pharmacists,” says Vincent.
The estimated project completion date, including data analysis, is mid 2021.
John Papastergiou, practising community pharmacist, and the research team at University of Toronto is using CFP's grant of $15,000 to quantify adherence rates to adult immunizations, where a series of vaccines or booster vaccines are required, when these vaccines are administered by community pharmacists. It's hoped that the study results will help pharmacists obtain prescribing rights for vaccines.
CFP has awarded Paula Newman and her team at Northwest Telepharmacy Solutions $22,500 to determine the feasibility and effectiveness of a pharmacist-led opioid stewardship program for chronic non-cancer pain, using videoconferencing technology. The project includes prescriber and patient education, risk stratification and screening for potential harm, as well as patient monitoriing with follow-up and continuity of care.
The Presciption to Thrive project, funded by multiple stakeholders including Canada's two national pharmacy associations and the Nova Scotia Department of Health and Wellness, seeks to establish a model for practice change in community pharmacy. Expert facilitators will work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.
Saleema Bhaidani, Director, Pharmacy Innovation & Professional Affairs at Whole Health Pharmacy Partners, and researcher Lisa Dolovich at the University of Toronto are conducting a retrospective analysis of the impact of an appointment-based model (ABM) for pharmacy practice based on data obtained from six independent pharmacies, part of the Whole Health Pharmacy banner, which implemented ABM in September 2017. ABM uses medication synchronization to coordinate refills into one pick-up, which enables pharmacists to conduct appointments where they can review, address and follow up on medication issues on a monthly or regular basis. The study will seek to evaluate clinical outcomes and the impact on adherence, as well as ABM's impact on workflow and pharmacy staff.
Dr. Chang and her team will examine the feasibility and effectiveness of a pharmacist intervention targeting high-dose, high-risk prescription opioids. The study will complement previous research in the area funded by the Ontario Ministry of Health and Long-Term Care, as well as Health Canada Anti-Drug Strategy Initiatives.
Dr. MacCallum and her team are researching strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes.As part of that, the team will also determine how routine monitoring and follow-up is linked to other expanded professional services.
The project began with a survey of about 8,000 pharmacists in early 2018. During phase two, launched in fall 2018, researchers are working with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.
With the support of the Innovation grant and additional funding from the New Brunswick Pharmacists' Association, Dr. Tsuyuki and his team tracked and quantified the impact of pharmacist management of patients with uncomplicated urinary tract infection.
As follow-up to the study, the research team is looking at antibiotic usage and conducting an economic analysis. The group is also developing an online registry and practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.
News article - "Pharmacists for UTI management a 'no-brainer'"
Published study - "Outcomes of Urinary Tract Infection Management by Pharmacists (RxOUTMAP)"
Dr. Barbara Farrell of the Bruyère Research Institute in Ottawa has been awarded $50,000 to support her research project on “Mobilizing Community Pharmacists as Catalysts for Deprescribing.” Based at the Institute, Farrell and her team will work with community pharmacy practices and a national advisory group (with provider and private payer representation) over a one-year period to develop acceptable workflow strategies for deprescribing guideline use.
Research associates will work with each pharmacy to quantify opportunities for deprescribing, describe activities and processes associated with guideline use—including how long such activities take—and highlight enablers and barriers that pharmacists encounter. This project is expected to lay the foundation for a larger demonstration project examining reach, adoption and implementation of deprescribing strategies, and ultimately a randomized controlled trial of deprescribing interventions that explores patient and health system outcomes, including related cost savings.
News article - "Deprescribing, within a pharmacist's domain"
Dr. Line Guénette of the Faculty of Pharmacy at Laval University and her team have received $26,800 to develop evidence-based electronic tools for community pharmacists to detect and improve medication non-adherence. Drawing on their previous research in medication adherence measures, the team aims to develop five electronic tools to target four common chronic disease areas (type 2 diabetes, hypertension, asthma and depression).
“We are committed to building tools that have acceptability, usability, utility, implementation and ways to improve e-tools for supporting pharmacy practice,” says Guénette, noting that the initial focus will be on diabetes and depression. “By developing and providing new tools to better identify patients having adherence problems, we will engage and support pharmacists with their crucial role regarding …medication efficacy/safety."
University of Toronto’s Sara Guilcher and her team were also honoured with a 2016 Innovation Fund grant worth $38,000 to establish and evaluate the feasibility of an Acute care to Community Pharmacy Communication Link (ACC-Link) to improve medication management across transitions of care.
Building on existing best evidence around successful medication management interventions, the ACC-Link provides communication between hospital and community pharmacists to actively equip the latter with information needed to guide patients and their families at the point of hospital discharge. By evaluating the feasibility of the intervention and understanding the factors that may influence implementation, the researchers are expecting the program can be scaled to fit other clinical settings.
“Ultimately, ACC-Link has the potential to improve patients’ medication experiences, safety, overall health, and quality of life for themselves and their caregivers while reducing health-system costs and demand,” noted the research team in their submission.
Researchers Christine Hughes, Terri Schindel and Rene Breault set out to determine how Alberta pharmacists are providing care under the Alberta Pharmacy Services Framework, and how patients are experiencing care planning services in the “real world.”
With funding from the Canadian Foundation for Pharmacy and the Alberta Pharmacists’ Association (RxA), the investigators recruited four different cases, or community pharmacies, in the province and collected data over 12 months per site. Over the course of 83 interviews and 94 hours of observation, they explored the value of pharmacy services to patients, pharmacists, other healthcare providers and policy makers.
Sherilyn Houle and her research team at University of Waterloo studied the clinical effectiveness and patients' satisfaction with travel medicine services provided by pharmacists with independent prescribing authority. Results were very positive. “We hope pharmacists are encouraged by these results, which show that they can safely and effectively prescribe and inject travel vaccines independently, and it’s a service that patients really appreciate,” says Houle.
2018 news article - Pharmacists’ fit in travel medicine
2018 news article - Happy, healthy travels
"Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)"
With $50,000 in funding from the Canadian Foundation for Pharmacy’s Innovation Fund, a University of Alberta team of researchers and front-line pharmacists are implementing a pharmacist-initiated mental health monitoring and intervention program based in the community setting. “We are grateful to have the opportunity to partner with CFP as an unbiased organization that supports pharmacy initiatives,” says lead researcher/pharmacist Dan Burton.
For the study, up to 10 pharmacies in Calgary and surrounding areas will be involved with some 120 participating patients over a six-month period. The intervention group will be recruiting and monitoring patients with major depressive disorder and general anxiety disorder, providing interventions as needed and collaborating with patients’ physicians. The control group will receive usual pharmacy care.
Participating pharmacists will receive mental health training materials and have support throughout the pilot and are expected to begin recruiting patients by March 2020.
“Given community pharmacists’ training and access, they are in a great position to help the healthcare field better manage depression and anxiety,” says Burton. “They could take the burden off physicians and other providers by stabilizing patients on medication—plus sometimes these patients need more frequent touch points of support and we have that opportunity in the community.”
Burton says he and his team were inspired to develop the study by the recent Bloom Program pilot in Nova Scotia, which showed the positive benefits community pharmacists can have in helping patients with mental health issues. “With additional prescribing authority in Alberta there’s potential for us to do even more,” he says. For example, Alberta pharmacists can titrate and augment therapies by prescribing higher doses, or add on medications to help patients reach maximum treatment benefits. They can also switch therapies if patients aren’t responding or have uncomfortable side effects. “That’s a huge opportunity for pharmacists,” he says.
Burton hopes that positive study results will also encourage other pharmacists to get more involved in helping patients with mental health disorders. “There is still a significant amount of stigma out there around mental health. Pharmacists are also very type A personalities and sometimes we need concrete data before we believe we can do it,” he says. “If the study goes well, it will be a good starting point to build from.”
|
| Laura Murphy |
|
| Olavo Fernandes |
"CannabisCareRx"
A $25,000 grant from the Canadian Foundation for Pharmacy’s Innovation Fund will see the development and study of a program to help community pharmacists identify and support patients using medical cannabis, as part of routine care.
The pilot-based research study out of Ontario is looking to bridge the gap between legal medical cannabis distribution, which currently bypasses community pharmacies, and the expectation that community pharmacists competently provide information and advice to patients who use medical cannabis. Pharmacists in Ontario who provide direct patient care must complete mandatory cannabis training by 2020, yet there is a noticeable lack of a training program that involves pharmacists in screening for cannabis use.
Lead investigators Laura Murphy and Olavo Fernandes, researchers at the University Health Network, will conduct a prospective observational study of a pilot implementation of a structured program, entitled CannabisCareRx. The program will be comprised of screening questions, a structured process for assessment and a template for documentation and referral to other healthcare providers. The program also includes pharmacist education that emphasizes the development of communication skills to engage patients and decrease stigma. The materials and tools developed will be scalable for implementation across Canada.
Overall, the project is set to occur over three years, starting in September of 2020. It is broken up into three steps: set-up, pilot implementation and dissemination. The set-up stage includes development of the pharmacy education and consultation guide, building the research database, and recruiting five pharmacists from the Greater Toronto Area for the pilot occurring throughout year two.
CannabisCareRx will be piloted as part of usual care provided by the participating pharmacists. After completing the Cannabis Education program, the pharmacists will implement the use of the screening questions with all of their adult patients during routine interactions throughout the 12 months of the pilot.
From there, a member of the research team will conduct a follow-up survey with the pharmacists involved and patients who provide their contact information and permission. The feasibility outcomes will include the number of patients who use cannabis for therapeutic reasons, the number of patients who complete the questionnaire, and the amount of pharmacist time required to conduct CannabisCareRx.
The aim is not only to be successful at the end of the three years but also to create a blueprint for pharmacists across Canada. “The outcomes of the pilot implementation of the CannabisCareRx program will provide patient-centred, pharmacist-driven education materials that will not only support the promotion of safe and effective use of cannabis and harm reduction but will also provide a tangible, patient-facing guide that can facilitate brief and effective consultation,” said Murphy.
"SAD-APP: Self-rating App for Depression Aided by Proactive Pharmacists"
Researcher Philippe Vincent and pharmacists at 30 community pharmacies hope to smooth the path to recovery for patients with depression through a ground-breaking research study funded in part with a $50,000 grant from the Canadian Foundation for Pharmacy’s (CFP’s) Innovation Fund.
The research is unique in that it combines pharmacist coaching with a smartphone app. The app will also differentiate itself within the virtual sea of mental health apps in that it will be built around the PHQ-9 and GAD-7 self-assessment questionnaires, two standardised, validated tools to assess depression and anxiety, respectively. Participating pharmacists will be able to access a patient’s results using a secure, online dashboard.
The study’s primary objective is to shorten the time to recovery by helping patients achieve treatment response as quickly as possible and by supporting adherence.
“Our project seeks to bring patients who suffer in silence and pharmacists together into a meaningful relationship. The self-rating scales and smartphone app are mediators of a safe space for private, sometimes emotional conversations and goal-setting,” says Vincent, Associate Professor of Clinical Pharmacy at University of Montreal and a researcher with the university-affiliated Institute universitaire en sante mentale de Montreal (a psychiatric hospital).
A secondary goal is to prove the value of pharmacists’ interventions. “If we can show that the time pharmacists put into monitoring and coaching is directly proportional to the remission of patients, so people can go back to meaningful occupations and live fuller lives, then insurance, government and other stakeholders will understand that the pharmacists’ time is worth something,” says Vincent.
As well, the stage is already set for possible adoption of the research model into regular pharmacy practice, and possibly on a national scale. All 30 participating pharmacies are part of the Pharmaprix banner, a division of Shoppers Drug Mart and Loblaw companies. Pharmaprix is co-funding the project with CFP.
The study is a randomized, unblinded, multicenter intervention trial that will follow patients over six months. The 30 participating pharmacies will each enrol 10 patients who have been diagnosed with a new episode of major depression, broken down as follows:
Pharmacists in the coaching group will receive training based on best practices in clinical psychiatry. They will call their participating patients every week during the dose-finding period and conduct a 5-minute semi-structured interview that seeks to create rapport, agree on treatment goals and agree on tasks. Pharmacists will also ask about side effects, which will be addressed as required through separate interventions that will be documented in the dashboard.
Throughout the six months of the study, the app will send notifications to patients every two weeks to remind them to complete the PHQ-9 and GAD-7 questionnaires. The app will also prompt patients to complete the PHQ-2 questionnaire every day for the first 15 days, every two days for the next 15 days, and every three days thereafter. “In a pharmacy setting where everything is so busy, you need to have useful, fast and complete information. This model enables systematic monitoring and a communication bridge between patients and pharmacists,” says Vincent.
The estimated project completion date, including data analysis, is mid 2021.
John Papastergiou, practising community pharmacist, and the research team at University of Toronto is using CFP's grant of $15,000 to quantify adherence rates to adult immunizations, where a series of vaccines or booster vaccines are required, when these vaccines are administered by community pharmacists. It's hoped that the study results will help pharmacists obtain prescribing rights for vaccines.
CFP has awarded Paula Newman and her team at Northwest Telepharmacy Solutions $22,500 to determine the feasibility and effectiveness of a pharmacist-led opioid stewardship program for chronic non-cancer pain, using videoconferencing technology. The project includes prescriber and patient education, risk stratification and screening for potential harm, as well as patient monitoriing with follow-up and continuity of care.
The Presciption to Thrive project, funded by multiple stakeholders including Canada's two national pharmacy associations and the Nova Scotia Department of Health and Wellness, seeks to establish a model for practice change in community pharmacy. Expert facilitators will work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.
Saleema Bhaidani, Director, Pharmacy Innovation & Professional Affairs at Whole Health Pharmacy Partners, and researcher Lisa Dolovich at the University of Toronto are conducting a retrospective analysis of the impact of an appointment-based model (ABM) for pharmacy practice based on data obtained from six independent pharmacies, part of the Whole Health Pharmacy banner, which implemented ABM in September 2017. ABM uses medication synchronization to coordinate refills into one pick-up, which enables pharmacists to conduct appointments where they can review, address and follow up on medication issues on a monthly or regular basis. The study will seek to evaluate clinical outcomes and the impact on adherence, as well as ABM's impact on workflow and pharmacy staff.
Dr. Chang and her team will examine the feasibility and effectiveness of a pharmacist intervention targeting high-dose, high-risk prescription opioids. The study will complement previous research in the area funded by the Ontario Ministry of Health and Long-Term Care, as well as Health Canada Anti-Drug Strategy Initiatives.
Dr. MacCallum and her team are researching strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes.As part of that, the team will also determine how routine monitoring and follow-up is linked to other expanded professional services.
The project began with a survey of about 8,000 pharmacists in early 2018. During phase two, launched in fall 2018, researchers are working with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.
With the support of the Innovation grant and additional funding from the New Brunswick Pharmacists' Association, Dr. Tsuyuki and his team tracked and quantified the impact of pharmacist management of patients with uncomplicated urinary tract infection.
As follow-up to the study, the research team is looking at antibiotic usage and conducting an economic analysis. The group is also developing an online registry and practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.
News article - "Pharmacists for UTI management a 'no-brainer'"
Published study - "Outcomes of Urinary Tract Infection Management by Pharmacists (RxOUTMAP)"
Dr. Barbara Farrell of the Bruyère Research Institute in Ottawa has been awarded $50,000 to support her research project on “Mobilizing Community Pharmacists as Catalysts for Deprescribing.” Based at the Institute, Farrell and her team will work with community pharmacy practices and a national advisory group (with provider and private payer representation) over a one-year period to develop acceptable workflow strategies for deprescribing guideline use.
Research associates will work with each pharmacy to quantify opportunities for deprescribing, describe activities and processes associated with guideline use—including how long such activities take—and highlight enablers and barriers that pharmacists encounter. This project is expected to lay the foundation for a larger demonstration project examining reach, adoption and implementation of deprescribing strategies, and ultimately a randomized controlled trial of deprescribing interventions that explores patient and health system outcomes, including related cost savings.
News article - "Deprescribing, within a pharmacist's domain"
Dr. Line Guénette of the Faculty of Pharmacy at Laval University and her team have received $26,800 to develop evidence-based electronic tools for community pharmacists to detect and improve medication non-adherence. Drawing on their previous research in medication adherence measures, the team aims to develop five electronic tools to target four common chronic disease areas (type 2 diabetes, hypertension, asthma and depression).
“We are committed to building tools that have acceptability, usability, utility, implementation and ways to improve e-tools for supporting pharmacy practice,” says Guénette, noting that the initial focus will be on diabetes and depression. “By developing and providing new tools to better identify patients having adherence problems, we will engage and support pharmacists with their crucial role regarding …medication efficacy/safety."
University of Toronto’s Sara Guilcher and her team were also honoured with a 2016 Innovation Fund grant worth $38,000 to establish and evaluate the feasibility of an Acute care to Community Pharmacy Communication Link (ACC-Link) to improve medication management across transitions of care.
Building on existing best evidence around successful medication management interventions, the ACC-Link provides communication between hospital and community pharmacists to actively equip the latter with information needed to guide patients and their families at the point of hospital discharge. By evaluating the feasibility of the intervention and understanding the factors that may influence implementation, the researchers are expecting the program can be scaled to fit other clinical settings.
“Ultimately, ACC-Link has the potential to improve patients’ medication experiences, safety, overall health, and quality of life for themselves and their caregivers while reducing health-system costs and demand,” noted the research team in their submission.
Researchers Christine Hughes, Terri Schindel and Rene Breault set out to determine how Alberta pharmacists are providing care under the Alberta Pharmacy Services Framework, and how patients are experiencing care planning services in the “real world.”
With funding from the Canadian Foundation for Pharmacy and the Alberta Pharmacists’ Association (RxA), the investigators recruited four different cases, or community pharmacies, in the province and collected data over 12 months per site. Over the course of 83 interviews and 94 hours of observation, they explored the value of pharmacy services to patients, pharmacists, other healthcare providers and policy makers.
Sherilyn Houle and her research team at University of Waterloo studied the clinical effectiveness and patients' satisfaction with travel medicine services provided by pharmacists with independent prescribing authority. Results were very positive. “We hope pharmacists are encouraged by these results, which show that they can safely and effectively prescribe and inject travel vaccines independently, and it’s a service that patients really appreciate,” says Houle.
2018 news article - Pharmacists’ fit in travel medicine
2018 news article - Happy, healthy travels
Working with a physician in a primary care setting, Tejal Patel examines how pharmacist interventions can reduce polypharmacy and high-risk medication use among the frail elderly.
2016 news article - The frail elderly: pharmacists' essential role
"Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)"
With $50,000 in funding from the Canadian Foundation for Pharmacy’s Innovation Fund, a University of Alberta team of researchers and front-line pharmacists are implementing a pharmacist-initiated mental health monitoring and intervention program based in the community setting. “We are grateful to have the opportunity to partner with CFP as an unbiased organization that supports pharmacy initiatives,” says lead researcher/pharmacist Dan Burton.
For the study, up to 10 pharmacies in Calgary and surrounding areas will be involved with some 120 participating patients over a six-month period. The intervention group will be recruiting and monitoring patients with major depressive disorder and general anxiety disorder, providing interventions as needed and collaborating with patients’ physicians. The control group will receive usual pharmacy care.
Participating pharmacists will receive mental health training materials and have support throughout the pilot and are expected to begin recruiting patients by March 2020.
“Given community pharmacists’ training and access, they are in a great position to help the healthcare field better manage depression and anxiety,” says Burton. “They could take the burden off physicians and other providers by stabilizing patients on medication—plus sometimes these patients need more frequent touch points of support and we have that opportunity in the community.”
Burton says he and his team were inspired to develop the study by the recent Bloom Program pilot in Nova Scotia, which showed the positive benefits community pharmacists can have in helping patients with mental health issues. “With additional prescribing authority in Alberta there’s potential for us to do even more,” he says. For example, Alberta pharmacists can titrate and augment therapies by prescribing higher doses, or add on medications to help patients reach maximum treatment benefits. They can also switch therapies if patients aren’t responding or have uncomfortable side effects. “That’s a huge opportunity for pharmacists,” he says.
Burton hopes that positive study results will also encourage other pharmacists to get more involved in helping patients with mental health disorders. “There is still a significant amount of stigma out there around mental health. Pharmacists are also very type A personalities and sometimes we need concrete data before we believe we can do it,” he says. “If the study goes well, it will be a good starting point to build from.”
|
| Laura Murphy |
|
| Olavo Fernandes |
"CannabisCareRx"
A $25,000 grant from the Canadian Foundation for Pharmacy’s Innovation Fund will see the development and study of a program to help community pharmacists identify and support patients using medical cannabis, as part of routine care.
The pilot-based research study out of Ontario is looking to bridge the gap between legal medical cannabis distribution, which currently bypasses community pharmacies, and the expectation that community pharmacists competently provide information and advice to patients who use medical cannabis. Pharmacists in Ontario who provide direct patient care must complete mandatory cannabis training by 2020, yet there is a noticeable lack of a training program that involves pharmacists in screening for cannabis use.
Lead investigators Laura Murphy and Olavo Fernandes, researchers at the University Health Network, will conduct a prospective observational study of a pilot implementation of a structured program, entitled CannabisCareRx. The program will be comprised of screening questions, a structured process for assessment and a template for documentation and referral to other healthcare providers. The program also includes pharmacist education that emphasizes the development of communication skills to engage patients and decrease stigma. The materials and tools developed will be scalable for implementation across Canada.
Overall, the project is set to occur over three years, starting in September of 2020. It is broken up into three steps: set-up, pilot implementation and dissemination. The set-up stage includes development of the pharmacy education and consultation guide, building the research database, and recruiting five pharmacists from the Greater Toronto Area for the pilot occurring throughout year two.
CannabisCareRx will be piloted as part of usual care provided by the participating pharmacists. After completing the Cannabis Education program, the pharmacists will implement the use of the screening questions with all of their adult patients during routine interactions throughout the 12 months of the pilot.
From there, a member of the research team will conduct a follow-up survey with the pharmacists involved and patients who provide their contact information and permission. The feasibility outcomes will include the number of patients who use cannabis for therapeutic reasons, the number of patients who complete the questionnaire, and the amount of pharmacist time required to conduct CannabisCareRx.
The aim is not only to be successful at the end of the three years but also to create a blueprint for pharmacists across Canada. “The outcomes of the pilot implementation of the CannabisCareRx program will provide patient-centred, pharmacist-driven education materials that will not only support the promotion of safe and effective use of cannabis and harm reduction but will also provide a tangible, patient-facing guide that can facilitate brief and effective consultation,” said Murphy.
"SAD-APP: Self-rating App for Depression Aided by Proactive Pharmacists"
Researcher Philippe Vincent and pharmacists at 30 community pharmacies hope to smooth the path to recovery for patients with depression through a ground-breaking research study funded in part with a $50,000 grant from the Canadian Foundation for Pharmacy’s (CFP’s) Innovation Fund.
The research is unique in that it combines pharmacist coaching with a smartphone app. The app will also differentiate itself within the virtual sea of mental health apps in that it will be built around the PHQ-9 and GAD-7 self-assessment questionnaires, two standardised, validated tools to assess depression and anxiety, respectively. Participating pharmacists will be able to access a patient’s results using a secure, online dashboard.
The study’s primary objective is to shorten the time to recovery by helping patients achieve treatment response as quickly as possible and by supporting adherence.
“Our project seeks to bring patients who suffer in silence and pharmacists together into a meaningful relationship. The self-rating scales and smartphone app are mediators of a safe space for private, sometimes emotional conversations and goal-setting,” says Vincent, Associate Professor of Clinical Pharmacy at University of Montreal and a researcher with the university-affiliated Institute universitaire en sante mentale de Montreal (a psychiatric hospital).
A secondary goal is to prove the value of pharmacists’ interventions. “If we can show that the time pharmacists put into monitoring and coaching is directly proportional to the remission of patients, so people can go back to meaningful occupations and live fuller lives, then insurance, government and other stakeholders will understand that the pharmacists’ time is worth something,” says Vincent.
As well, the stage is already set for possible adoption of the research model into regular pharmacy practice, and possibly on a national scale. All 30 participating pharmacies are part of the Pharmaprix banner, a division of Shoppers Drug Mart and Loblaw companies. Pharmaprix is co-funding the project with CFP.
The study is a randomized, unblinded, multicenter intervention trial that will follow patients over six months. The 30 participating pharmacies will each enrol 10 patients who have been diagnosed with a new episode of major depression, broken down as follows:
Pharmacists in the coaching group will receive training based on best practices in clinical psychiatry. They will call their participating patients every week during the dose-finding period and conduct a 5-minute semi-structured interview that seeks to create rapport, agree on treatment goals and agree on tasks. Pharmacists will also ask about side effects, which will be addressed as required through separate interventions that will be documented in the dashboard.
Throughout the six months of the study, the app will send notifications to patients every two weeks to remind them to complete the PHQ-9 and GAD-7 questionnaires. The app will also prompt patients to complete the PHQ-2 questionnaire every day for the first 15 days, every two days for the next 15 days, and every three days thereafter. “In a pharmacy setting where everything is so busy, you need to have useful, fast and complete information. This model enables systematic monitoring and a communication bridge between patients and pharmacists,” says Vincent.
The estimated project completion date, including data analysis, is mid 2021.
John Papastergiou, practising community pharmacist, and the research team at University of Toronto is using CFP's grant of $15,000 to quantify adherence rates to adult immunizations, where a series of vaccines or booster vaccines are required, when these vaccines are administered by community pharmacists. It's hoped that the study results will help pharmacists obtain prescribing rights for vaccines.
CFP has awarded Paula Newman and her team at Northwest Telepharmacy Solutions $22,500 to determine the feasibility and effectiveness of a pharmacist-led opioid stewardship program for chronic non-cancer pain, using videoconferencing technology. The project includes prescriber and patient education, risk stratification and screening for potential harm, as well as patient monitoriing with follow-up and continuity of care.
The Presciption to Thrive project, funded by multiple stakeholders including Canada's two national pharmacy associations and the Nova Scotia Department of Health and Wellness, seeks to establish a model for practice change in community pharmacy. Expert facilitators will work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.
Saleema Bhaidani, Director, Pharmacy Innovation & Professional Affairs at Whole Health Pharmacy Partners, and researcher Lisa Dolovich at the University of Toronto are conducting a retrospective analysis of the impact of an appointment-based model (ABM) for pharmacy practice based on data obtained from six independent pharmacies, part of the Whole Health Pharmacy banner, which implemented ABM in September 2017. ABM uses medication synchronization to coordinate refills into one pick-up, which enables pharmacists to conduct appointments where they can review, address and follow up on medication issues on a monthly or regular basis. The study will seek to evaluate clinical outcomes and the impact on adherence, as well as ABM's impact on workflow and pharmacy staff.
Dr. Chang and her team will examine the feasibility and effectiveness of a pharmacist intervention targeting high-dose, high-risk prescription opioids. The study will complement previous research in the area funded by the Ontario Ministry of Health and Long-Term Care, as well as Health Canada Anti-Drug Strategy Initiatives.
Dr. MacCallum and her team are researching strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes.As part of that, the team will also determine how routine monitoring and follow-up is linked to other expanded professional services.
The project began with a survey of about 8,000 pharmacists in early 2018. During phase two, launched in fall 2018, researchers are working with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.
With the support of the Innovation grant and additional funding from the New Brunswick Pharmacists' Association, Dr. Tsuyuki and his team tracked and quantified the impact of pharmacist management of patients with uncomplicated urinary tract infection.
As follow-up to the study, the research team is looking at antibiotic usage and conducting an economic analysis. The group is also developing an online registry and practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.
News article - "Pharmacists for UTI management a 'no-brainer'"
Published study - "Outcomes of Urinary Tract Infection Management by Pharmacists (RxOUTMAP)"
Dr. Barbara Farrell of the Bruyère Research Institute in Ottawa has been awarded $50,000 to support her research project on “Mobilizing Community Pharmacists as Catalysts for Deprescribing.” Based at the Institute, Farrell and her team will work with community pharmacy practices and a national advisory group (with provider and private payer representation) over a one-year period to develop acceptable workflow strategies for deprescribing guideline use.
Research associates will work with each pharmacy to quantify opportunities for deprescribing, describe activities and processes associated with guideline use—including how long such activities take—and highlight enablers and barriers that pharmacists encounter. This project is expected to lay the foundation for a larger demonstration project examining reach, adoption and implementation of deprescribing strategies, and ultimately a randomized controlled trial of deprescribing interventions that explores patient and health system outcomes, including related cost savings.
News article - "Deprescribing, within a pharmacist's domain"
Dr. Line Guénette of the Faculty of Pharmacy at Laval University and her team have received $26,800 to develop evidence-based electronic tools for community pharmacists to detect and improve medication non-adherence. Drawing on their previous research in medication adherence measures, the team aims to develop five electronic tools to target four common chronic disease areas (type 2 diabetes, hypertension, asthma and depression).
“We are committed to building tools that have acceptability, usability, utility, implementation and ways to improve e-tools for supporting pharmacy practice,” says Guénette, noting that the initial focus will be on diabetes and depression. “By developing and providing new tools to better identify patients having adherence problems, we will engage and support pharmacists with their crucial role regarding …medication efficacy/safety."
University of Toronto’s Sara Guilcher and her team were also honoured with a 2016 Innovation Fund grant worth $38,000 to establish and evaluate the feasibility of an Acute care to Community Pharmacy Communication Link (ACC-Link) to improve medication management across transitions of care.
Building on existing best evidence around successful medication management interventions, the ACC-Link provides communication between hospital and community pharmacists to actively equip the latter with information needed to guide patients and their families at the point of hospital discharge. By evaluating the feasibility of the intervention and understanding the factors that may influence implementation, the researchers are expecting the program can be scaled to fit other clinical settings.
“Ultimately, ACC-Link has the potential to improve patients’ medication experiences, safety, overall health, and quality of life for themselves and their caregivers while reducing health-system costs and demand,” noted the research team in their submission.
Researchers Christine Hughes, Terri Schindel and Rene Breault set out to determine how Alberta pharmacists are providing care under the Alberta Pharmacy Services Framework, and how patients are experiencing care planning services in the “real world.”
With funding from the Canadian Foundation for Pharmacy and the Alberta Pharmacists’ Association (RxA), the investigators recruited four different cases, or community pharmacies, in the province and collected data over 12 months per site. Over the course of 83 interviews and 94 hours of observation, they explored the value of pharmacy services to patients, pharmacists, other healthcare providers and policy makers.
Sherilyn Houle and her research team at University of Waterloo studied the clinical effectiveness and patients' satisfaction with travel medicine services provided by pharmacists with independent prescribing authority. Results were very positive. “We hope pharmacists are encouraged by these results, which show that they can safely and effectively prescribe and inject travel vaccines independently, and it’s a service that patients really appreciate,” says Houle.
2018 news article - Pharmacists’ fit in travel medicine
2018 news article - Happy, healthy travels
Working with a physician in a primary care setting, Tejal Patel examines how pharmacist interventions can reduce polypharmacy and high-risk medication use among the frail elderly.
2016 news article - The frail elderly: pharmacists' essential role
The Evaluation of Pharmacist Prescribing for Minor Ailments - The Clinical and Economic Value
Now that pharmacists in some provinces can prescribe for minor ailments, what’s the impact on patients’ health? It’s a question that researchers in at the University Saskatchewan are keen to answer with a multiple-phase study, funded in part by the CFP.
Phase one in 2012-2013, funded by the provincial government, surveyed 125 pharmacy customers who’d been prescribed at least one medication for a minor ailment at one of 90 participating pharmacies. The study tracked the most common minor ailments treated and captured customers' perceptions of pharmacists. During phase two in 2015, researchers collected feedback about the process from pharmacists and physicians. Preliminary findings are mixed, with some resistance from some physicians. Researchers also returned to patients to capture their additional feedback. The final phase of the research, released in 2017, assessed and projected the economic impact of pharmacists prescribing for minor ailments.
Related articles:
Patient Perspectives on Symptom Severity (SelfCare 2016)
Minor Ailment Prescribing: Part 2 - Physician Feedback (SelfCare 2016)
Minor Ailment Prescribing: Part 1 - Pharmacist Feedback (SelfCare 2016)
Pharmacist-led minor ailment programs: a Canadian perspective (Int J Gen Med. 2016)
Evaluating pharmacist prescribing for minor ailments (Int J Pharm Pract. 2015)
2015 Changing Face of Pharmacy report (page 18)
2014 news article - Vote of confidence for minor ailments
"Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)"
With $50,000 in funding from the Canadian Foundation for Pharmacy’s Innovation Fund, a University of Alberta team of researchers and front-line pharmacists are implementing a pharmacist-initiated mental health monitoring and intervention program based in the community setting. “We are grateful to have the opportunity to partner with CFP as an unbiased organization that supports pharmacy initiatives,” says lead researcher/pharmacist Dan Burton.
For the study, up to 10 pharmacies in Calgary and surrounding areas will be involved with some 120 participating patients over a six-month period. The intervention group will be recruiting and monitoring patients with major depressive disorder and general anxiety disorder, providing interventions as needed and collaborating with patients’ physicians. The control group will receive usual pharmacy care.
Participating pharmacists will receive mental health training materials and have support throughout the pilot and are expected to begin recruiting patients by March 2020.
“Given community pharmacists’ training and access, they are in a great position to help the healthcare field better manage depression and anxiety,” says Burton. “They could take the burden off physicians and other providers by stabilizing patients on medication—plus sometimes these patients need more frequent touch points of support and we have that opportunity in the community.”
Burton says he and his team were inspired to develop the study by the recent Bloom Program pilot in Nova Scotia, which showed the positive benefits community pharmacists can have in helping patients with mental health issues. “With additional prescribing authority in Alberta there’s potential for us to do even more,” he says. For example, Alberta pharmacists can titrate and augment therapies by prescribing higher doses, or add on medications to help patients reach maximum treatment benefits. They can also switch therapies if patients aren’t responding or have uncomfortable side effects. “That’s a huge opportunity for pharmacists,” he says.
Burton hopes that positive study results will also encourage other pharmacists to get more involved in helping patients with mental health disorders. “There is still a significant amount of stigma out there around mental health. Pharmacists are also very type A personalities and sometimes we need concrete data before we believe we can do it,” he says. “If the study goes well, it will be a good starting point to build from.”
|
| Laura Murphy |
|
| Olavo Fernandes |
"CannabisCareRx"
A $25,000 grant from the Canadian Foundation for Pharmacy’s Innovation Fund will see the development and study of a program to help community pharmacists identify and support patients using medical cannabis, as part of routine care.
The pilot-based research study out of Ontario is looking to bridge the gap between legal medical cannabis distribution, which currently bypasses community pharmacies, and the expectation that community pharmacists competently provide information and advice to patients who use medical cannabis. Pharmacists in Ontario who provide direct patient care must complete mandatory cannabis training by 2020, yet there is a noticeable lack of a training program that involves pharmacists in screening for cannabis use.
Lead investigators Laura Murphy and Olavo Fernandes, researchers at the University Health Network, will conduct a prospective observational study of a pilot implementation of a structured program, entitled CannabisCareRx. The program will be comprised of screening questions, a structured process for assessment and a template for documentation and referral to other healthcare providers. The program also includes pharmacist education that emphasizes the development of communication skills to engage patients and decrease stigma. The materials and tools developed will be scalable for implementation across Canada.
Overall, the project is set to occur over three years, starting in September of 2020. It is broken up into three steps: set-up, pilot implementation and dissemination. The set-up stage includes development of the pharmacy education and consultation guide, building the research database, and recruiting five pharmacists from the Greater Toronto Area for the pilot occurring throughout year two.
CannabisCareRx will be piloted as part of usual care provided by the participating pharmacists. After completing the Cannabis Education program, the pharmacists will implement the use of the screening questions with all of their adult patients during routine interactions throughout the 12 months of the pilot.
From there, a member of the research team will conduct a follow-up survey with the pharmacists involved and patients who provide their contact information and permission. The feasibility outcomes will include the number of patients who use cannabis for therapeutic reasons, the number of patients who complete the questionnaire, and the amount of pharmacist time required to conduct CannabisCareRx.
The aim is not only to be successful at the end of the three years but also to create a blueprint for pharmacists across Canada. “The outcomes of the pilot implementation of the CannabisCareRx program will provide patient-centred, pharmacist-driven education materials that will not only support the promotion of safe and effective use of cannabis and harm reduction but will also provide a tangible, patient-facing guide that can facilitate brief and effective consultation,” said Murphy.
"SAD-APP: Self-rating App for Depression Aided by Proactive Pharmacists"
Researcher Philippe Vincent and pharmacists at 30 community pharmacies hope to smooth the path to recovery for patients with depression through a ground-breaking research study funded in part with a $50,000 grant from the Canadian Foundation for Pharmacy’s (CFP’s) Innovation Fund.
The research is unique in that it combines pharmacist coaching with a smartphone app. The app will also differentiate itself within the virtual sea of mental health apps in that it will be built around the PHQ-9 and GAD-7 self-assessment questionnaires, two standardised, validated tools to assess depression and anxiety, respectively. Participating pharmacists will be able to access a patient’s results using a secure, online dashboard.
The study’s primary objective is to shorten the time to recovery by helping patients achieve treatment response as quickly as possible and by supporting adherence.
“Our project seeks to bring patients who suffer in silence and pharmacists together into a meaningful relationship. The self-rating scales and smartphone app are mediators of a safe space for private, sometimes emotional conversations and goal-setting,” says Vincent, Associate Professor of Clinical Pharmacy at University of Montreal and a researcher with the university-affiliated Institute universitaire en sante mentale de Montreal (a psychiatric hospital).
A secondary goal is to prove the value of pharmacists’ interventions. “If we can show that the time pharmacists put into monitoring and coaching is directly proportional to the remission of patients, so people can go back to meaningful occupations and live fuller lives, then insurance, government and other stakeholders will understand that the pharmacists’ time is worth something,” says Vincent.
As well, the stage is already set for possible adoption of the research model into regular pharmacy practice, and possibly on a national scale. All 30 participating pharmacies are part of the Pharmaprix banner, a division of Shoppers Drug Mart and Loblaw companies. Pharmaprix is co-funding the project with CFP.
The study is a randomized, unblinded, multicenter intervention trial that will follow patients over six months. The 30 participating pharmacies will each enrol 10 patients who have been diagnosed with a new episode of major depression, broken down as follows:
Pharmacists in the coaching group will receive training based on best practices in clinical psychiatry. They will call their participating patients every week during the dose-finding period and conduct a 5-minute semi-structured interview that seeks to create rapport, agree on treatment goals and agree on tasks. Pharmacists will also ask about side effects, which will be addressed as required through separate interventions that will be documented in the dashboard.
Throughout the six months of the study, the app will send notifications to patients every two weeks to remind them to complete the PHQ-9 and GAD-7 questionnaires. The app will also prompt patients to complete the PHQ-2 questionnaire every day for the first 15 days, every two days for the next 15 days, and every three days thereafter. “In a pharmacy setting where everything is so busy, you need to have useful, fast and complete information. This model enables systematic monitoring and a communication bridge between patients and pharmacists,” says Vincent.
The estimated project completion date, including data analysis, is mid 2021.
John Papastergiou, practising community pharmacist, and the research team at University of Toronto is using CFP's grant of $15,000 to quantify adherence rates to adult immunizations, where a series of vaccines or booster vaccines are required, when these vaccines are administered by community pharmacists. It's hoped that the study results will help pharmacists obtain prescribing rights for vaccines.
CFP has awarded Paula Newman and her team at Northwest Telepharmacy Solutions $22,500 to determine the feasibility and effectiveness of a pharmacist-led opioid stewardship program for chronic non-cancer pain, using videoconferencing technology. The project includes prescriber and patient education, risk stratification and screening for potential harm, as well as patient monitoriing with follow-up and continuity of care.
The Presciption to Thrive project, funded by multiple stakeholders including Canada's two national pharmacy associations and the Nova Scotia Department of Health and Wellness, seeks to establish a model for practice change in community pharmacy. Expert facilitators will work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.
Saleema Bhaidani, Director, Pharmacy Innovation & Professional Affairs at Whole Health Pharmacy Partners, and researcher Lisa Dolovich at the University of Toronto are conducting a retrospective analysis of the impact of an appointment-based model (ABM) for pharmacy practice based on data obtained from six independent pharmacies, part of the Whole Health Pharmacy banner, which implemented ABM in September 2017. ABM uses medication synchronization to coordinate refills into one pick-up, which enables pharmacists to conduct appointments where they can review, address and follow up on medication issues on a monthly or regular basis. The study will seek to evaluate clinical outcomes and the impact on adherence, as well as ABM's impact on workflow and pharmacy staff.
Dr. Chang and her team will examine the feasibility and effectiveness of a pharmacist intervention targeting high-dose, high-risk prescription opioids. The study will complement previous research in the area funded by the Ontario Ministry of Health and Long-Term Care, as well as Health Canada Anti-Drug Strategy Initiatives.
Dr. MacCallum and her team are researching strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes.As part of that, the team will also determine how routine monitoring and follow-up is linked to other expanded professional services.
The project began with a survey of about 8,000 pharmacists in early 2018. During phase two, launched in fall 2018, researchers are working with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.
With the support of the Innovation grant and additional funding from the New Brunswick Pharmacists' Association, Dr. Tsuyuki and his team tracked and quantified the impact of pharmacist management of patients with uncomplicated urinary tract infection.
As follow-up to the study, the research team is looking at antibiotic usage and conducting an economic analysis. The group is also developing an online registry and practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.
News article - "Pharmacists for UTI management a 'no-brainer'"
Published study - "Outcomes of Urinary Tract Infection Management by Pharmacists (RxOUTMAP)"
Dr. Barbara Farrell of the Bruyère Research Institute in Ottawa has been awarded $50,000 to support her research project on “Mobilizing Community Pharmacists as Catalysts for Deprescribing.” Based at the Institute, Farrell and her team will work with community pharmacy practices and a national advisory group (with provider and private payer representation) over a one-year period to develop acceptable workflow strategies for deprescribing guideline use.
Research associates will work with each pharmacy to quantify opportunities for deprescribing, describe activities and processes associated with guideline use—including how long such activities take—and highlight enablers and barriers that pharmacists encounter. This project is expected to lay the foundation for a larger demonstration project examining reach, adoption and implementation of deprescribing strategies, and ultimately a randomized controlled trial of deprescribing interventions that explores patient and health system outcomes, including related cost savings.
News article - "Deprescribing, within a pharmacist's domain"
Dr. Line Guénette of the Faculty of Pharmacy at Laval University and her team have received $26,800 to develop evidence-based electronic tools for community pharmacists to detect and improve medication non-adherence. Drawing on their previous research in medication adherence measures, the team aims to develop five electronic tools to target four common chronic disease areas (type 2 diabetes, hypertension, asthma and depression).
“We are committed to building tools that have acceptability, usability, utility, implementation and ways to improve e-tools for supporting pharmacy practice,” says Guénette, noting that the initial focus will be on diabetes and depression. “By developing and providing new tools to better identify patients having adherence problems, we will engage and support pharmacists with their crucial role regarding …medication efficacy/safety."
University of Toronto’s Sara Guilcher and her team were also honoured with a 2016 Innovation Fund grant worth $38,000 to establish and evaluate the feasibility of an Acute care to Community Pharmacy Communication Link (ACC-Link) to improve medication management across transitions of care.
Building on existing best evidence around successful medication management interventions, the ACC-Link provides communication between hospital and community pharmacists to actively equip the latter with information needed to guide patients and their families at the point of hospital discharge. By evaluating the feasibility of the intervention and understanding the factors that may influence implementation, the researchers are expecting the program can be scaled to fit other clinical settings.
“Ultimately, ACC-Link has the potential to improve patients’ medication experiences, safety, overall health, and quality of life for themselves and their caregivers while reducing health-system costs and demand,” noted the research team in their submission.
Researchers Christine Hughes, Terri Schindel and Rene Breault set out to determine how Alberta pharmacists are providing care under the Alberta Pharmacy Services Framework, and how patients are experiencing care planning services in the “real world.”
With funding from the Canadian Foundation for Pharmacy and the Alberta Pharmacists’ Association (RxA), the investigators recruited four different cases, or community pharmacies, in the province and collected data over 12 months per site. Over the course of 83 interviews and 94 hours of observation, they explored the value of pharmacy services to patients, pharmacists, other healthcare providers and policy makers.
Sherilyn Houle and her research team at University of Waterloo studied the clinical effectiveness and patients' satisfaction with travel medicine services provided by pharmacists with independent prescribing authority. Results were very positive. “We hope pharmacists are encouraged by these results, which show that they can safely and effectively prescribe and inject travel vaccines independently, and it’s a service that patients really appreciate,” says Houle.
2018 news article - Pharmacists’ fit in travel medicine
2018 news article - Happy, healthy travels
Working with a physician in a primary care setting, Tejal Patel examines how pharmacist interventions can reduce polypharmacy and high-risk medication use among the frail elderly.
2016 news article - The frail elderly: pharmacists' essential role
The Evaluation of Pharmacist Prescribing for Minor Ailments - The Clinical and Economic Value
Now that pharmacists in some provinces can prescribe for minor ailments, what’s the impact on patients’ health? It’s a question that researchers in at the University Saskatchewan are keen to answer with a multiple-phase study, funded in part by the CFP.
Phase one in 2012-2013, funded by the provincial government, surveyed 125 pharmacy customers who’d been prescribed at least one medication for a minor ailment at one of 90 participating pharmacies. The study tracked the most common minor ailments treated and captured customers' perceptions of pharmacists. During phase two in 2015, researchers collected feedback about the process from pharmacists and physicians. Preliminary findings are mixed, with some resistance from some physicians. Researchers also returned to patients to capture their additional feedback. The final phase of the research, released in 2017, assessed and projected the economic impact of pharmacists prescribing for minor ailments.
Related articles:
Patient Perspectives on Symptom Severity (SelfCare 2016)
Minor Ailment Prescribing: Part 2 - Physician Feedback (SelfCare 2016)
Minor Ailment Prescribing: Part 1 - Pharmacist Feedback (SelfCare 2016)
Pharmacist-led minor ailment programs: a Canadian perspective (Int J Gen Med. 2016)
Evaluating pharmacist prescribing for minor ailments (Int J Pharm Pract. 2015)
2015 Changing Face of Pharmacy report (page 18)
2014 news article - Vote of confidence for minor ailments
Assessing need and benefits of home-based medication review services for non-homebound patients
Toronto-based community pharmacist John Papastergiou and his research team are assessing the benefits of providing home-based medication reviews to non-homebound patients. Currently, Ontario's MedsCheck for Home program reimburses pharmacists only for reviews conducted for homebound patients. Findings from previous research, however, as well as experiences with patients in the pharmacy, indicate that that there are medication-management issues that are best addressed in the home environment, whether or not the patient is homebound (for example, expired or discontinued medications). Senior patients taking five or more chronic medications are being recruited for the 12-month study, which reimburses participating pharmacists for their services to patients and for time spent documenting interventions.
Related article:
2017 news article - Home visits warranted for non-housebound
"Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)"
With $50,000 in funding from the Canadian Foundation for Pharmacy’s Innovation Fund, a University of Alberta team of researchers and front-line pharmacists are implementing a pharmacist-initiated mental health monitoring and intervention program based in the community setting. “We are grateful to have the opportunity to partner with CFP as an unbiased organization that supports pharmacy initiatives,” says lead researcher/pharmacist Dan Burton.
For the study, up to 10 pharmacies in Calgary and surrounding areas will be involved with some 120 participating patients over a six-month period. The intervention group will be recruiting and monitoring patients with major depressive disorder and general anxiety disorder, providing interventions as needed and collaborating with patients’ physicians. The control group will receive usual pharmacy care.
Participating pharmacists will receive mental health training materials and have support throughout the pilot and are expected to begin recruiting patients by March 2020.
“Given community pharmacists’ training and access, they are in a great position to help the healthcare field better manage depression and anxiety,” says Burton. “They could take the burden off physicians and other providers by stabilizing patients on medication—plus sometimes these patients need more frequent touch points of support and we have that opportunity in the community.”
Burton says he and his team were inspired to develop the study by the recent Bloom Program pilot in Nova Scotia, which showed the positive benefits community pharmacists can have in helping patients with mental health issues. “With additional prescribing authority in Alberta there’s potential for us to do even more,” he says. For example, Alberta pharmacists can titrate and augment therapies by prescribing higher doses, or add on medications to help patients reach maximum treatment benefits. They can also switch therapies if patients aren’t responding or have uncomfortable side effects. “That’s a huge opportunity for pharmacists,” he says.
Burton hopes that positive study results will also encourage other pharmacists to get more involved in helping patients with mental health disorders. “There is still a significant amount of stigma out there around mental health. Pharmacists are also very type A personalities and sometimes we need concrete data before we believe we can do it,” he says. “If the study goes well, it will be a good starting point to build from.”
|
| Laura Murphy |
|
| Olavo Fernandes |
"CannabisCareRx"
A $25,000 grant from the Canadian Foundation for Pharmacy’s Innovation Fund will see the development and study of a program to help community pharmacists identify and support patients using medical cannabis, as part of routine care.
The pilot-based research study out of Ontario is looking to bridge the gap between legal medical cannabis distribution, which currently bypasses community pharmacies, and the expectation that community pharmacists competently provide information and advice to patients who use medical cannabis. Pharmacists in Ontario who provide direct patient care must complete mandatory cannabis training by 2020, yet there is a noticeable lack of a training program that involves pharmacists in screening for cannabis use.
Lead investigators Laura Murphy and Olavo Fernandes, researchers at the University Health Network, will conduct a prospective observational study of a pilot implementation of a structured program, entitled CannabisCareRx. The program will be comprised of screening questions, a structured process for assessment and a template for documentation and referral to other healthcare providers. The program also includes pharmacist education that emphasizes the development of communication skills to engage patients and decrease stigma. The materials and tools developed will be scalable for implementation across Canada.
Overall, the project is set to occur over three years, starting in September of 2020. It is broken up into three steps: set-up, pilot implementation and dissemination. The set-up stage includes development of the pharmacy education and consultation guide, building the research database, and recruiting five pharmacists from the Greater Toronto Area for the pilot occurring throughout year two.
CannabisCareRx will be piloted as part of usual care provided by the participating pharmacists. After completing the Cannabis Education program, the pharmacists will implement the use of the screening questions with all of their adult patients during routine interactions throughout the 12 months of the pilot.
From there, a member of the research team will conduct a follow-up survey with the pharmacists involved and patients who provide their contact information and permission. The feasibility outcomes will include the number of patients who use cannabis for therapeutic reasons, the number of patients who complete the questionnaire, and the amount of pharmacist time required to conduct CannabisCareRx.
The aim is not only to be successful at the end of the three years but also to create a blueprint for pharmacists across Canada. “The outcomes of the pilot implementation of the CannabisCareRx program will provide patient-centred, pharmacist-driven education materials that will not only support the promotion of safe and effective use of cannabis and harm reduction but will also provide a tangible, patient-facing guide that can facilitate brief and effective consultation,” said Murphy.
"SAD-APP: Self-rating App for Depression Aided by Proactive Pharmacists"
Researcher Philippe Vincent and pharmacists at 30 community pharmacies hope to smooth the path to recovery for patients with depression through a ground-breaking research study funded in part with a $50,000 grant from the Canadian Foundation for Pharmacy’s (CFP’s) Innovation Fund.
The research is unique in that it combines pharmacist coaching with a smartphone app. The app will also differentiate itself within the virtual sea of mental health apps in that it will be built around the PHQ-9 and GAD-7 self-assessment questionnaires, two standardised, validated tools to assess depression and anxiety, respectively. Participating pharmacists will be able to access a patient’s results using a secure, online dashboard.
The study’s primary objective is to shorten the time to recovery by helping patients achieve treatment response as quickly as possible and by supporting adherence.
“Our project seeks to bring patients who suffer in silence and pharmacists together into a meaningful relationship. The self-rating scales and smartphone app are mediators of a safe space for private, sometimes emotional conversations and goal-setting,” says Vincent, Associate Professor of Clinical Pharmacy at University of Montreal and a researcher with the university-affiliated Institute universitaire en sante mentale de Montreal (a psychiatric hospital).
A secondary goal is to prove the value of pharmacists’ interventions. “If we can show that the time pharmacists put into monitoring and coaching is directly proportional to the remission of patients, so people can go back to meaningful occupations and live fuller lives, then insurance, government and other stakeholders will understand that the pharmacists’ time is worth something,” says Vincent.
As well, the stage is already set for possible adoption of the research model into regular pharmacy practice, and possibly on a national scale. All 30 participating pharmacies are part of the Pharmaprix banner, a division of Shoppers Drug Mart and Loblaw companies. Pharmaprix is co-funding the project with CFP.
The study is a randomized, unblinded, multicenter intervention trial that will follow patients over six months. The 30 participating pharmacies will each enrol 10 patients who have been diagnosed with a new episode of major depression, broken down as follows:
Pharmacists in the coaching group will receive training based on best practices in clinical psychiatry. They will call their participating patients every week during the dose-finding period and conduct a 5-minute semi-structured interview that seeks to create rapport, agree on treatment goals and agree on tasks. Pharmacists will also ask about side effects, which will be addressed as required through separate interventions that will be documented in the dashboard.
Throughout the six months of the study, the app will send notifications to patients every two weeks to remind them to complete the PHQ-9 and GAD-7 questionnaires. The app will also prompt patients to complete the PHQ-2 questionnaire every day for the first 15 days, every two days for the next 15 days, and every three days thereafter. “In a pharmacy setting where everything is so busy, you need to have useful, fast and complete information. This model enables systematic monitoring and a communication bridge between patients and pharmacists,” says Vincent.
The estimated project completion date, including data analysis, is mid 2021.
John Papastergiou, practising community pharmacist, and the research team at University of Toronto is using CFP's grant of $15,000 to quantify adherence rates to adult immunizations, where a series of vaccines or booster vaccines are required, when these vaccines are administered by community pharmacists. It's hoped that the study results will help pharmacists obtain prescribing rights for vaccines.
CFP has awarded Paula Newman and her team at Northwest Telepharmacy Solutions $22,500 to determine the feasibility and effectiveness of a pharmacist-led opioid stewardship program for chronic non-cancer pain, using videoconferencing technology. The project includes prescriber and patient education, risk stratification and screening for potential harm, as well as patient monitoriing with follow-up and continuity of care.
The Presciption to Thrive project, funded by multiple stakeholders including Canada's two national pharmacy associations and the Nova Scotia Department of Health and Wellness, seeks to establish a model for practice change in community pharmacy. Expert facilitators will work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.
Saleema Bhaidani, Director, Pharmacy Innovation & Professional Affairs at Whole Health Pharmacy Partners, and researcher Lisa Dolovich at the University of Toronto are conducting a retrospective analysis of the impact of an appointment-based model (ABM) for pharmacy practice based on data obtained from six independent pharmacies, part of the Whole Health Pharmacy banner, which implemented ABM in September 2017. ABM uses medication synchronization to coordinate refills into one pick-up, which enables pharmacists to conduct appointments where they can review, address and follow up on medication issues on a monthly or regular basis. The study will seek to evaluate clinical outcomes and the impact on adherence, as well as ABM's impact on workflow and pharmacy staff.
Dr. Chang and her team will examine the feasibility and effectiveness of a pharmacist intervention targeting high-dose, high-risk prescription opioids. The study will complement previous research in the area funded by the Ontario Ministry of Health and Long-Term Care, as well as Health Canada Anti-Drug Strategy Initiatives.
Dr. MacCallum and her team are researching strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes.As part of that, the team will also determine how routine monitoring and follow-up is linked to other expanded professional services.
The project began with a survey of about 8,000 pharmacists in early 2018. During phase two, launched in fall 2018, researchers are working with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.
With the support of the Innovation grant and additional funding from the New Brunswick Pharmacists' Association, Dr. Tsuyuki and his team tracked and quantified the impact of pharmacist management of patients with uncomplicated urinary tract infection.
As follow-up to the study, the research team is looking at antibiotic usage and conducting an economic analysis. The group is also developing an online registry and practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.
News article - "Pharmacists for UTI management a 'no-brainer'"
Published study - "Outcomes of Urinary Tract Infection Management by Pharmacists (RxOUTMAP)"
Dr. Barbara Farrell of the Bruyère Research Institute in Ottawa has been awarded $50,000 to support her research project on “Mobilizing Community Pharmacists as Catalysts for Deprescribing.” Based at the Institute, Farrell and her team will work with community pharmacy practices and a national advisory group (with provider and private payer representation) over a one-year period to develop acceptable workflow strategies for deprescribing guideline use.
Research associates will work with each pharmacy to quantify opportunities for deprescribing, describe activities and processes associated with guideline use—including how long such activities take—and highlight enablers and barriers that pharmacists encounter. This project is expected to lay the foundation for a larger demonstration project examining reach, adoption and implementation of deprescribing strategies, and ultimately a randomized controlled trial of deprescribing interventions that explores patient and health system outcomes, including related cost savings.
News article - "Deprescribing, within a pharmacist's domain"
Dr. Line Guénette of the Faculty of Pharmacy at Laval University and her team have received $26,800 to develop evidence-based electronic tools for community pharmacists to detect and improve medication non-adherence. Drawing on their previous research in medication adherence measures, the team aims to develop five electronic tools to target four common chronic disease areas (type 2 diabetes, hypertension, asthma and depression).
“We are committed to building tools that have acceptability, usability, utility, implementation and ways to improve e-tools for supporting pharmacy practice,” says Guénette, noting that the initial focus will be on diabetes and depression. “By developing and providing new tools to better identify patients having adherence problems, we will engage and support pharmacists with their crucial role regarding …medication efficacy/safety."
University of Toronto’s Sara Guilcher and her team were also honoured with a 2016 Innovation Fund grant worth $38,000 to establish and evaluate the feasibility of an Acute care to Community Pharmacy Communication Link (ACC-Link) to improve medication management across transitions of care.
Building on existing best evidence around successful medication management interventions, the ACC-Link provides communication between hospital and community pharmacists to actively equip the latter with information needed to guide patients and their families at the point of hospital discharge. By evaluating the feasibility of the intervention and understanding the factors that may influence implementation, the researchers are expecting the program can be scaled to fit other clinical settings.
“Ultimately, ACC-Link has the potential to improve patients’ medication experiences, safety, overall health, and quality of life for themselves and their caregivers while reducing health-system costs and demand,” noted the research team in their submission.
Researchers Christine Hughes, Terri Schindel and Rene Breault set out to determine how Alberta pharmacists are providing care under the Alberta Pharmacy Services Framework, and how patients are experiencing care planning services in the “real world.”
With funding from the Canadian Foundation for Pharmacy and the Alberta Pharmacists’ Association (RxA), the investigators recruited four different cases, or community pharmacies, in the province and collected data over 12 months per site. Over the course of 83 interviews and 94 hours of observation, they explored the value of pharmacy services to patients, pharmacists, other healthcare providers and policy makers.
Sherilyn Houle and her research team at University of Waterloo studied the clinical effectiveness and patients' satisfaction with travel medicine services provided by pharmacists with independent prescribing authority. Results were very positive. “We hope pharmacists are encouraged by these results, which show that they can safely and effectively prescribe and inject travel vaccines independently, and it’s a service that patients really appreciate,” says Houle.
2018 news article - Pharmacists’ fit in travel medicine
2018 news article - Happy, healthy travels
Working with a physician in a primary care setting, Tejal Patel examines how pharmacist interventions can reduce polypharmacy and high-risk medication use among the frail elderly.
2016 news article - The frail elderly: pharmacists' essential role
The Evaluation of Pharmacist Prescribing for Minor Ailments - The Clinical and Economic Value
Now that pharmacists in some provinces can prescribe for minor ailments, what’s the impact on patients’ health? It’s a question that researchers in at the University Saskatchewan are keen to answer with a multiple-phase study, funded in part by the CFP.
Phase one in 2012-2013, funded by the provincial government, surveyed 125 pharmacy customers who’d been prescribed at least one medication for a minor ailment at one of 90 participating pharmacies. The study tracked the most common minor ailments treated and captured customers' perceptions of pharmacists. During phase two in 2015, researchers collected feedback about the process from pharmacists and physicians. Preliminary findings are mixed, with some resistance from some physicians. Researchers also returned to patients to capture their additional feedback. The final phase of the research, released in 2017, assessed and projected the economic impact of pharmacists prescribing for minor ailments.
Related articles:
Patient Perspectives on Symptom Severity (SelfCare 2016)
Minor Ailment Prescribing: Part 2 - Physician Feedback (SelfCare 2016)
Minor Ailment Prescribing: Part 1 - Pharmacist Feedback (SelfCare 2016)
Pharmacist-led minor ailment programs: a Canadian perspective (Int J Gen Med. 2016)
Evaluating pharmacist prescribing for minor ailments (Int J Pharm Pract. 2015)
2015 Changing Face of Pharmacy report (page 18)
2014 news article - Vote of confidence for minor ailments
Assessing need and benefits of home-based medication review services for non-homebound patients
Toronto-based community pharmacist John Papastergiou and his research team are assessing the benefits of providing home-based medication reviews to non-homebound patients. Currently, Ontario's MedsCheck for Home program reimburses pharmacists only for reviews conducted for homebound patients. Findings from previous research, however, as well as experiences with patients in the pharmacy, indicate that that there are medication-management issues that are best addressed in the home environment, whether or not the patient is homebound (for example, expired or discontinued medications). Senior patients taking five or more chronic medications are being recruited for the 12-month study, which reimburses participating pharmacists for their services to patients and for time spent documenting interventions.
Related article:
2017 news article - Home visits warranted for non-housebound
Pharmacists' Innovative Drug Therapy Management Outcomes, Resource use and Economics (PHInDMORE)
The Canadian Foundation for Pharmacy awarded a grant of $35,000 in support of PhInDMORE, a collaboration between Drs. Carlo Marra and Larry Lynd from the Faculty of Pharmaceutical Sciences at the University of British Columbia, and pharmacist John Shaske of Howe Sound Pharmacy. Howe Sound is piloting the province's new PharmaNet system, and PHInDMORE is reviewing pharmacists' interventions and their impacts on patient outcomes, both clinical and economic. PharmaNet is a central database that allows for capture of real-world, real-time documentation of pharmacist-patient encounters to a level of comprehensiveness that has never before been possible. The research aims to demonstrate that there is potential for cost savings to the healthcare system when investing in pharmacists to practice to their full potential.
Related link:
"Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)"
With $50,000 in funding from the Canadian Foundation for Pharmacy’s Innovation Fund, a University of Alberta team of researchers and front-line pharmacists are implementing a pharmacist-initiated mental health monitoring and intervention program based in the community setting. “We are grateful to have the opportunity to partner with CFP as an unbiased organization that supports pharmacy initiatives,” says lead researcher/pharmacist Dan Burton.
For the study, up to 10 pharmacies in Calgary and surrounding areas will be involved with some 120 participating patients over a six-month period. The intervention group will be recruiting and monitoring patients with major depressive disorder and general anxiety disorder, providing interventions as needed and collaborating with patients’ physicians. The control group will receive usual pharmacy care.
Participating pharmacists will receive mental health training materials and have support throughout the pilot and are expected to begin recruiting patients by March 2020.
“Given community pharmacists’ training and access, they are in a great position to help the healthcare field better manage depression and anxiety,” says Burton. “They could take the burden off physicians and other providers by stabilizing patients on medication—plus sometimes these patients need more frequent touch points of support and we have that opportunity in the community.”
Burton says he and his team were inspired to develop the study by the recent Bloom Program pilot in Nova Scotia, which showed the positive benefits community pharmacists can have in helping patients with mental health issues. “With additional prescribing authority in Alberta there’s potential for us to do even more,” he says. For example, Alberta pharmacists can titrate and augment therapies by prescribing higher doses, or add on medications to help patients reach maximum treatment benefits. They can also switch therapies if patients aren’t responding or have uncomfortable side effects. “That’s a huge opportunity for pharmacists,” he says.
Burton hopes that positive study results will also encourage other pharmacists to get more involved in helping patients with mental health disorders. “There is still a significant amount of stigma out there around mental health. Pharmacists are also very type A personalities and sometimes we need concrete data before we believe we can do it,” he says. “If the study goes well, it will be a good starting point to build from.”
|
| Laura Murphy |
|
| Olavo Fernandes |
"CannabisCareRx"
A $25,000 grant from the Canadian Foundation for Pharmacy’s Innovation Fund will see the development and study of a program to help community pharmacists identify and support patients using medical cannabis, as part of routine care.
The pilot-based research study out of Ontario is looking to bridge the gap between legal medical cannabis distribution, which currently bypasses community pharmacies, and the expectation that community pharmacists competently provide information and advice to patients who use medical cannabis. Pharmacists in Ontario who provide direct patient care must complete mandatory cannabis training by 2020, yet there is a noticeable lack of a training program that involves pharmacists in screening for cannabis use.
Lead investigators Laura Murphy and Olavo Fernandes, researchers at the University Health Network, will conduct a prospective observational study of a pilot implementation of a structured program, entitled CannabisCareRx. The program will be comprised of screening questions, a structured process for assessment and a template for documentation and referral to other healthcare providers. The program also includes pharmacist education that emphasizes the development of communication skills to engage patients and decrease stigma. The materials and tools developed will be scalable for implementation across Canada.
Overall, the project is set to occur over three years, starting in September of 2020. It is broken up into three steps: set-up, pilot implementation and dissemination. The set-up stage includes development of the pharmacy education and consultation guide, building the research database, and recruiting five pharmacists from the Greater Toronto Area for the pilot occurring throughout year two.
CannabisCareRx will be piloted as part of usual care provided by the participating pharmacists. After completing the Cannabis Education program, the pharmacists will implement the use of the screening questions with all of their adult patients during routine interactions throughout the 12 months of the pilot.
From there, a member of the research team will conduct a follow-up survey with the pharmacists involved and patients who provide their contact information and permission. The feasibility outcomes will include the number of patients who use cannabis for therapeutic reasons, the number of patients who complete the questionnaire, and the amount of pharmacist time required to conduct CannabisCareRx.
The aim is not only to be successful at the end of the three years but also to create a blueprint for pharmacists across Canada. “The outcomes of the pilot implementation of the CannabisCareRx program will provide patient-centred, pharmacist-driven education materials that will not only support the promotion of safe and effective use of cannabis and harm reduction but will also provide a tangible, patient-facing guide that can facilitate brief and effective consultation,” said Murphy.
"SAD-APP: Self-rating App for Depression Aided by Proactive Pharmacists"
Researcher Philippe Vincent and pharmacists at 30 community pharmacies hope to smooth the path to recovery for patients with depression through a ground-breaking research study funded in part with a $50,000 grant from the Canadian Foundation for Pharmacy’s (CFP’s) Innovation Fund.
The research is unique in that it combines pharmacist coaching with a smartphone app. The app will also differentiate itself within the virtual sea of mental health apps in that it will be built around the PHQ-9 and GAD-7 self-assessment questionnaires, two standardised, validated tools to assess depression and anxiety, respectively. Participating pharmacists will be able to access a patient’s results using a secure, online dashboard.
The study’s primary objective is to shorten the time to recovery by helping patients achieve treatment response as quickly as possible and by supporting adherence.
“Our project seeks to bring patients who suffer in silence and pharmacists together into a meaningful relationship. The self-rating scales and smartphone app are mediators of a safe space for private, sometimes emotional conversations and goal-setting,” says Vincent, Associate Professor of Clinical Pharmacy at University of Montreal and a researcher with the university-affiliated Institute universitaire en sante mentale de Montreal (a psychiatric hospital).
A secondary goal is to prove the value of pharmacists’ interventions. “If we can show that the time pharmacists put into monitoring and coaching is directly proportional to the remission of patients, so people can go back to meaningful occupations and live fuller lives, then insurance, government and other stakeholders will understand that the pharmacists’ time is worth something,” says Vincent.
As well, the stage is already set for possible adoption of the research model into regular pharmacy practice, and possibly on a national scale. All 30 participating pharmacies are part of the Pharmaprix banner, a division of Shoppers Drug Mart and Loblaw companies. Pharmaprix is co-funding the project with CFP.
The study is a randomized, unblinded, multicenter intervention trial that will follow patients over six months. The 30 participating pharmacies will each enrol 10 patients who have been diagnosed with a new episode of major depression, broken down as follows:
Pharmacists in the coaching group will receive training based on best practices in clinical psychiatry. They will call their participating patients every week during the dose-finding period and conduct a 5-minute semi-structured interview that seeks to create rapport, agree on treatment goals and agree on tasks. Pharmacists will also ask about side effects, which will be addressed as required through separate interventions that will be documented in the dashboard.
Throughout the six months of the study, the app will send notifications to patients every two weeks to remind them to complete the PHQ-9 and GAD-7 questionnaires. The app will also prompt patients to complete the PHQ-2 questionnaire every day for the first 15 days, every two days for the next 15 days, and every three days thereafter. “In a pharmacy setting where everything is so busy, you need to have useful, fast and complete information. This model enables systematic monitoring and a communication bridge between patients and pharmacists,” says Vincent.
The estimated project completion date, including data analysis, is mid 2021.
John Papastergiou, practising community pharmacist, and the research team at University of Toronto is using CFP's grant of $15,000 to quantify adherence rates to adult immunizations, where a series of vaccines or booster vaccines are required, when these vaccines are administered by community pharmacists. It's hoped that the study results will help pharmacists obtain prescribing rights for vaccines.
CFP has awarded Paula Newman and her team at Northwest Telepharmacy Solutions $22,500 to determine the feasibility and effectiveness of a pharmacist-led opioid stewardship program for chronic non-cancer pain, using videoconferencing technology. The project includes prescriber and patient education, risk stratification and screening for potential harm, as well as patient monitoriing with follow-up and continuity of care.
The Presciption to Thrive project, funded by multiple stakeholders including Canada's two national pharmacy associations and the Nova Scotia Department of Health and Wellness, seeks to establish a model for practice change in community pharmacy. Expert facilitators will work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.
Saleema Bhaidani, Director, Pharmacy Innovation & Professional Affairs at Whole Health Pharmacy Partners, and researcher Lisa Dolovich at the University of Toronto are conducting a retrospective analysis of the impact of an appointment-based model (ABM) for pharmacy practice based on data obtained from six independent pharmacies, part of the Whole Health Pharmacy banner, which implemented ABM in September 2017. ABM uses medication synchronization to coordinate refills into one pick-up, which enables pharmacists to conduct appointments where they can review, address and follow up on medication issues on a monthly or regular basis. The study will seek to evaluate clinical outcomes and the impact on adherence, as well as ABM's impact on workflow and pharmacy staff.
Dr. Chang and her team will examine the feasibility and effectiveness of a pharmacist intervention targeting high-dose, high-risk prescription opioids. The study will complement previous research in the area funded by the Ontario Ministry of Health and Long-Term Care, as well as Health Canada Anti-Drug Strategy Initiatives.
Dr. MacCallum and her team are researching strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes.As part of that, the team will also determine how routine monitoring and follow-up is linked to other expanded professional services.
The project began with a survey of about 8,000 pharmacists in early 2018. During phase two, launched in fall 2018, researchers are working with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.
With the support of the Innovation grant and additional funding from the New Brunswick Pharmacists' Association, Dr. Tsuyuki and his team tracked and quantified the impact of pharmacist management of patients with uncomplicated urinary tract infection.
As follow-up to the study, the research team is looking at antibiotic usage and conducting an economic analysis. The group is also developing an online registry and practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.
News article - "Pharmacists for UTI management a 'no-brainer'"
Published study - "Outcomes of Urinary Tract Infection Management by Pharmacists (RxOUTMAP)"
Dr. Barbara Farrell of the Bruyère Research Institute in Ottawa has been awarded $50,000 to support her research project on “Mobilizing Community Pharmacists as Catalysts for Deprescribing.” Based at the Institute, Farrell and her team will work with community pharmacy practices and a national advisory group (with provider and private payer representation) over a one-year period to develop acceptable workflow strategies for deprescribing guideline use.
Research associates will work with each pharmacy to quantify opportunities for deprescribing, describe activities and processes associated with guideline use—including how long such activities take—and highlight enablers and barriers that pharmacists encounter. This project is expected to lay the foundation for a larger demonstration project examining reach, adoption and implementation of deprescribing strategies, and ultimately a randomized controlled trial of deprescribing interventions that explores patient and health system outcomes, including related cost savings.
News article - "Deprescribing, within a pharmacist's domain"
Dr. Line Guénette of the Faculty of Pharmacy at Laval University and her team have received $26,800 to develop evidence-based electronic tools for community pharmacists to detect and improve medication non-adherence. Drawing on their previous research in medication adherence measures, the team aims to develop five electronic tools to target four common chronic disease areas (type 2 diabetes, hypertension, asthma and depression).
“We are committed to building tools that have acceptability, usability, utility, implementation and ways to improve e-tools for supporting pharmacy practice,” says Guénette, noting that the initial focus will be on diabetes and depression. “By developing and providing new tools to better identify patients having adherence problems, we will engage and support pharmacists with their crucial role regarding …medication efficacy/safety."
University of Toronto’s Sara Guilcher and her team were also honoured with a 2016 Innovation Fund grant worth $38,000 to establish and evaluate the feasibility of an Acute care to Community Pharmacy Communication Link (ACC-Link) to improve medication management across transitions of care.
Building on existing best evidence around successful medication management interventions, the ACC-Link provides communication between hospital and community pharmacists to actively equip the latter with information needed to guide patients and their families at the point of hospital discharge. By evaluating the feasibility of the intervention and understanding the factors that may influence implementation, the researchers are expecting the program can be scaled to fit other clinical settings.
“Ultimately, ACC-Link has the potential to improve patients’ medication experiences, safety, overall health, and quality of life for themselves and their caregivers while reducing health-system costs and demand,” noted the research team in their submission.
Researchers Christine Hughes, Terri Schindel and Rene Breault set out to determine how Alberta pharmacists are providing care under the Alberta Pharmacy Services Framework, and how patients are experiencing care planning services in the “real world.”
With funding from the Canadian Foundation for Pharmacy and the Alberta Pharmacists’ Association (RxA), the investigators recruited four different cases, or community pharmacies, in the province and collected data over 12 months per site. Over the course of 83 interviews and 94 hours of observation, they explored the value of pharmacy services to patients, pharmacists, other healthcare providers and policy makers.
Sherilyn Houle and her research team at University of Waterloo studied the clinical effectiveness and patients' satisfaction with travel medicine services provided by pharmacists with independent prescribing authority. Results were very positive. “We hope pharmacists are encouraged by these results, which show that they can safely and effectively prescribe and inject travel vaccines independently, and it’s a service that patients really appreciate,” says Houle.
2018 news article - Pharmacists’ fit in travel medicine
2018 news article - Happy, healthy travels
Working with a physician in a primary care setting, Tejal Patel examines how pharmacist interventions can reduce polypharmacy and high-risk medication use among the frail elderly.
2016 news article - The frail elderly: pharmacists' essential role
The Evaluation of Pharmacist Prescribing for Minor Ailments - The Clinical and Economic Value
Now that pharmacists in some provinces can prescribe for minor ailments, what’s the impact on patients’ health? It’s a question that researchers in at the University Saskatchewan are keen to answer with a multiple-phase study, funded in part by the CFP.
Phase one in 2012-2013, funded by the provincial government, surveyed 125 pharmacy customers who’d been prescribed at least one medication for a minor ailment at one of 90 participating pharmacies. The study tracked the most common minor ailments treated and captured customers' perceptions of pharmacists. During phase two in 2015, researchers collected feedback about the process from pharmacists and physicians. Preliminary findings are mixed, with some resistance from some physicians. Researchers also returned to patients to capture their additional feedback. The final phase of the research, released in 2017, assessed and projected the economic impact of pharmacists prescribing for minor ailments.
Related articles:
Patient Perspectives on Symptom Severity (SelfCare 2016)
Minor Ailment Prescribing: Part 2 - Physician Feedback (SelfCare 2016)
Minor Ailment Prescribing: Part 1 - Pharmacist Feedback (SelfCare 2016)
Pharmacist-led minor ailment programs: a Canadian perspective (Int J Gen Med. 2016)
Evaluating pharmacist prescribing for minor ailments (Int J Pharm Pract. 2015)
2015 Changing Face of Pharmacy report (page 18)
2014 news article - Vote of confidence for minor ailments
Assessing need and benefits of home-based medication review services for non-homebound patients
Toronto-based community pharmacist John Papastergiou and his research team are assessing the benefits of providing home-based medication reviews to non-homebound patients. Currently, Ontario's MedsCheck for Home program reimburses pharmacists only for reviews conducted for homebound patients. Findings from previous research, however, as well as experiences with patients in the pharmacy, indicate that that there are medication-management issues that are best addressed in the home environment, whether or not the patient is homebound (for example, expired or discontinued medications). Senior patients taking five or more chronic medications are being recruited for the 12-month study, which reimburses participating pharmacists for their services to patients and for time spent documenting interventions.
Related article:
2017 news article - Home visits warranted for non-housebound
Pharmacists' Innovative Drug Therapy Management Outcomes, Resource use and Economics (PHInDMORE)
The Canadian Foundation for Pharmacy awarded a grant of $35,000 in support of PhInDMORE, a collaboration between Drs. Carlo Marra and Larry Lynd from the Faculty of Pharmaceutical Sciences at the University of British Columbia, and pharmacist John Shaske of Howe Sound Pharmacy. Howe Sound is piloting the province's new PharmaNet system, and PHInDMORE is reviewing pharmacists' interventions and their impacts on patient outcomes, both clinical and economic. PharmaNet is a central database that allows for capture of real-world, real-time documentation of pharmacist-patient encounters to a level of comprehensiveness that has never before been possible. The research aims to demonstrate that there is potential for cost savings to the healthcare system when investing in pharmacists to practice to their full potential.
Related link:
Multi-partner smoking cessation project for vulnerable patient group
Pharmacists Manitoba partnered with Manitoba Health, Healthy Living and Seniors, the College of Pharmacists of Manitoba, Neighbourhood Pharmacy Association of Canada and researchers at the College of Pharmacy, University of Manitoba, to conduct a pilot project focused on helping low-income patient quit smoking. "We successfully reached out and worked with a very hard-to-reach population. Pharmacists proved that they are a key access point to a majority of the population, much more so than other healthcare providers," says Dr. Brenna Shearer, Chief Executive Officer of Pharmacists Manitoba.
In addition to $25,000 in funding from the Canadian Foundation for Pharmacy's Innovation Fund, this project was made possible through a matching grant from Pfizer Canada.
Related links:
2015 news article - MB smoking cessation helps vulnerable group
"Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)"
With $50,000 in funding from the Canadian Foundation for Pharmacy’s Innovation Fund, a University of Alberta team of researchers and front-line pharmacists are implementing a pharmacist-initiated mental health monitoring and intervention program based in the community setting. “We are grateful to have the opportunity to partner with CFP as an unbiased organization that supports pharmacy initiatives,” says lead researcher/pharmacist Dan Burton.
For the study, up to 10 pharmacies in Calgary and surrounding areas will be involved with some 120 participating patients over a six-month period. The intervention group will be recruiting and monitoring patients with major depressive disorder and general anxiety disorder, providing interventions as needed and collaborating with patients’ physicians. The control group will receive usual pharmacy care.
Participating pharmacists will receive mental health training materials and have support throughout the pilot and are expected to begin recruiting patients by March 2020.
“Given community pharmacists’ training and access, they are in a great position to help the healthcare field better manage depression and anxiety,” says Burton. “They could take the burden off physicians and other providers by stabilizing patients on medication—plus sometimes these patients need more frequent touch points of support and we have that opportunity in the community.”
Burton says he and his team were inspired to develop the study by the recent Bloom Program pilot in Nova Scotia, which showed the positive benefits community pharmacists can have in helping patients with mental health issues. “With additional prescribing authority in Alberta there’s potential for us to do even more,” he says. For example, Alberta pharmacists can titrate and augment therapies by prescribing higher doses, or add on medications to help patients reach maximum treatment benefits. They can also switch therapies if patients aren’t responding or have uncomfortable side effects. “That’s a huge opportunity for pharmacists,” he says.
Burton hopes that positive study results will also encourage other pharmacists to get more involved in helping patients with mental health disorders. “There is still a significant amount of stigma out there around mental health. Pharmacists are also very type A personalities and sometimes we need concrete data before we believe we can do it,” he says. “If the study goes well, it will be a good starting point to build from.”
|
| Laura Murphy |
|
| Olavo Fernandes |
"CannabisCareRx"
A $25,000 grant from the Canadian Foundation for Pharmacy’s Innovation Fund will see the development and study of a program to help community pharmacists identify and support patients using medical cannabis, as part of routine care.
The pilot-based research study out of Ontario is looking to bridge the gap between legal medical cannabis distribution, which currently bypasses community pharmacies, and the expectation that community pharmacists competently provide information and advice to patients who use medical cannabis. Pharmacists in Ontario who provide direct patient care must complete mandatory cannabis training by 2020, yet there is a noticeable lack of a training program that involves pharmacists in screening for cannabis use.
Lead investigators Laura Murphy and Olavo Fernandes, researchers at the University Health Network, will conduct a prospective observational study of a pilot implementation of a structured program, entitled CannabisCareRx. The program will be comprised of screening questions, a structured process for assessment and a template for documentation and referral to other healthcare providers. The program also includes pharmacist education that emphasizes the development of communication skills to engage patients and decrease stigma. The materials and tools developed will be scalable for implementation across Canada.
Overall, the project is set to occur over three years, starting in September of 2020. It is broken up into three steps: set-up, pilot implementation and dissemination. The set-up stage includes development of the pharmacy education and consultation guide, building the research database, and recruiting five pharmacists from the Greater Toronto Area for the pilot occurring throughout year two.
CannabisCareRx will be piloted as part of usual care provided by the participating pharmacists. After completing the Cannabis Education program, the pharmacists will implement the use of the screening questions with all of their adult patients during routine interactions throughout the 12 months of the pilot.
From there, a member of the research team will conduct a follow-up survey with the pharmacists involved and patients who provide their contact information and permission. The feasibility outcomes will include the number of patients who use cannabis for therapeutic reasons, the number of patients who complete the questionnaire, and the amount of pharmacist time required to conduct CannabisCareRx.
The aim is not only to be successful at the end of the three years but also to create a blueprint for pharmacists across Canada. “The outcomes of the pilot implementation of the CannabisCareRx program will provide patient-centred, pharmacist-driven education materials that will not only support the promotion of safe and effective use of cannabis and harm reduction but will also provide a tangible, patient-facing guide that can facilitate brief and effective consultation,” said Murphy.
"SAD-APP: Self-rating App for Depression Aided by Proactive Pharmacists"
Researcher Philippe Vincent and pharmacists at 30 community pharmacies hope to smooth the path to recovery for patients with depression through a ground-breaking research study funded in part with a $50,000 grant from the Canadian Foundation for Pharmacy’s (CFP’s) Innovation Fund.
The research is unique in that it combines pharmacist coaching with a smartphone app. The app will also differentiate itself within the virtual sea of mental health apps in that it will be built around the PHQ-9 and GAD-7 self-assessment questionnaires, two standardised, validated tools to assess depression and anxiety, respectively. Participating pharmacists will be able to access a patient’s results using a secure, online dashboard.
The study’s primary objective is to shorten the time to recovery by helping patients achieve treatment response as quickly as possible and by supporting adherence.
“Our project seeks to bring patients who suffer in silence and pharmacists together into a meaningful relationship. The self-rating scales and smartphone app are mediators of a safe space for private, sometimes emotional conversations and goal-setting,” says Vincent, Associate Professor of Clinical Pharmacy at University of Montreal and a researcher with the university-affiliated Institute universitaire en sante mentale de Montreal (a psychiatric hospital).
A secondary goal is to prove the value of pharmacists’ interventions. “If we can show that the time pharmacists put into monitoring and coaching is directly proportional to the remission of patients, so people can go back to meaningful occupations and live fuller lives, then insurance, government and other stakeholders will understand that the pharmacists’ time is worth something,” says Vincent.
As well, the stage is already set for possible adoption of the research model into regular pharmacy practice, and possibly on a national scale. All 30 participating pharmacies are part of the Pharmaprix banner, a division of Shoppers Drug Mart and Loblaw companies. Pharmaprix is co-funding the project with CFP.
The study is a randomized, unblinded, multicenter intervention trial that will follow patients over six months. The 30 participating pharmacies will each enrol 10 patients who have been diagnosed with a new episode of major depression, broken down as follows:
Pharmacists in the coaching group will receive training based on best practices in clinical psychiatry. They will call their participating patients every week during the dose-finding period and conduct a 5-minute semi-structured interview that seeks to create rapport, agree on treatment goals and agree on tasks. Pharmacists will also ask about side effects, which will be addressed as required through separate interventions that will be documented in the dashboard.
Throughout the six months of the study, the app will send notifications to patients every two weeks to remind them to complete the PHQ-9 and GAD-7 questionnaires. The app will also prompt patients to complete the PHQ-2 questionnaire every day for the first 15 days, every two days for the next 15 days, and every three days thereafter. “In a pharmacy setting where everything is so busy, you need to have useful, fast and complete information. This model enables systematic monitoring and a communication bridge between patients and pharmacists,” says Vincent.
The estimated project completion date, including data analysis, is mid 2021.
John Papastergiou, practising community pharmacist, and the research team at University of Toronto is using CFP's grant of $15,000 to quantify adherence rates to adult immunizations, where a series of vaccines or booster vaccines are required, when these vaccines are administered by community pharmacists. It's hoped that the study results will help pharmacists obtain prescribing rights for vaccines.
CFP has awarded Paula Newman and her team at Northwest Telepharmacy Solutions $22,500 to determine the feasibility and effectiveness of a pharmacist-led opioid stewardship program for chronic non-cancer pain, using videoconferencing technology. The project includes prescriber and patient education, risk stratification and screening for potential harm, as well as patient monitoriing with follow-up and continuity of care.
The Presciption to Thrive project, funded by multiple stakeholders including Canada's two national pharmacy associations and the Nova Scotia Department of Health and Wellness, seeks to establish a model for practice change in community pharmacy. Expert facilitators will work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.
Saleema Bhaidani, Director, Pharmacy Innovation & Professional Affairs at Whole Health Pharmacy Partners, and researcher Lisa Dolovich at the University of Toronto are conducting a retrospective analysis of the impact of an appointment-based model (ABM) for pharmacy practice based on data obtained from six independent pharmacies, part of the Whole Health Pharmacy banner, which implemented ABM in September 2017. ABM uses medication synchronization to coordinate refills into one pick-up, which enables pharmacists to conduct appointments where they can review, address and follow up on medication issues on a monthly or regular basis. The study will seek to evaluate clinical outcomes and the impact on adherence, as well as ABM's impact on workflow and pharmacy staff.
Dr. Chang and her team will examine the feasibility and effectiveness of a pharmacist intervention targeting high-dose, high-risk prescription opioids. The study will complement previous research in the area funded by the Ontario Ministry of Health and Long-Term Care, as well as Health Canada Anti-Drug Strategy Initiatives.
Dr. MacCallum and her team are researching strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes.As part of that, the team will also determine how routine monitoring and follow-up is linked to other expanded professional services.
The project began with a survey of about 8,000 pharmacists in early 2018. During phase two, launched in fall 2018, researchers are working with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.
With the support of the Innovation grant and additional funding from the New Brunswick Pharmacists' Association, Dr. Tsuyuki and his team tracked and quantified the impact of pharmacist management of patients with uncomplicated urinary tract infection.
As follow-up to the study, the research team is looking at antibiotic usage and conducting an economic analysis. The group is also developing an online registry and practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.
News article - "Pharmacists for UTI management a 'no-brainer'"
Published study - "Outcomes of Urinary Tract Infection Management by Pharmacists (RxOUTMAP)"
Dr. Barbara Farrell of the Bruyère Research Institute in Ottawa has been awarded $50,000 to support her research project on “Mobilizing Community Pharmacists as Catalysts for Deprescribing.” Based at the Institute, Farrell and her team will work with community pharmacy practices and a national advisory group (with provider and private payer representation) over a one-year period to develop acceptable workflow strategies for deprescribing guideline use.
Research associates will work with each pharmacy to quantify opportunities for deprescribing, describe activities and processes associated with guideline use—including how long such activities take—and highlight enablers and barriers that pharmacists encounter. This project is expected to lay the foundation for a larger demonstration project examining reach, adoption and implementation of deprescribing strategies, and ultimately a randomized controlled trial of deprescribing interventions that explores patient and health system outcomes, including related cost savings.
News article - "Deprescribing, within a pharmacist's domain"
Dr. Line Guénette of the Faculty of Pharmacy at Laval University and her team have received $26,800 to develop evidence-based electronic tools for community pharmacists to detect and improve medication non-adherence. Drawing on their previous research in medication adherence measures, the team aims to develop five electronic tools to target four common chronic disease areas (type 2 diabetes, hypertension, asthma and depression).
“We are committed to building tools that have acceptability, usability, utility, implementation and ways to improve e-tools for supporting pharmacy practice,” says Guénette, noting that the initial focus will be on diabetes and depression. “By developing and providing new tools to better identify patients having adherence problems, we will engage and support pharmacists with their crucial role regarding …medication efficacy/safety."
University of Toronto’s Sara Guilcher and her team were also honoured with a 2016 Innovation Fund grant worth $38,000 to establish and evaluate the feasibility of an Acute care to Community Pharmacy Communication Link (ACC-Link) to improve medication management across transitions of care.
Building on existing best evidence around successful medication management interventions, the ACC-Link provides communication between hospital and community pharmacists to actively equip the latter with information needed to guide patients and their families at the point of hospital discharge. By evaluating the feasibility of the intervention and understanding the factors that may influence implementation, the researchers are expecting the program can be scaled to fit other clinical settings.
“Ultimately, ACC-Link has the potential to improve patients’ medication experiences, safety, overall health, and quality of life for themselves and their caregivers while reducing health-system costs and demand,” noted the research team in their submission.
Researchers Christine Hughes, Terri Schindel and Rene Breault set out to determine how Alberta pharmacists are providing care under the Alberta Pharmacy Services Framework, and how patients are experiencing care planning services in the “real world.”
With funding from the Canadian Foundation for Pharmacy and the Alberta Pharmacists’ Association (RxA), the investigators recruited four different cases, or community pharmacies, in the province and collected data over 12 months per site. Over the course of 83 interviews and 94 hours of observation, they explored the value of pharmacy services to patients, pharmacists, other healthcare providers and policy makers.
Sherilyn Houle and her research team at University of Waterloo studied the clinical effectiveness and patients' satisfaction with travel medicine services provided by pharmacists with independent prescribing authority. Results were very positive. “We hope pharmacists are encouraged by these results, which show that they can safely and effectively prescribe and inject travel vaccines independently, and it’s a service that patients really appreciate,” says Houle.
2018 news article - Pharmacists’ fit in travel medicine
2018 news article - Happy, healthy travels
Working with a physician in a primary care setting, Tejal Patel examines how pharmacist interventions can reduce polypharmacy and high-risk medication use among the frail elderly.
2016 news article - The frail elderly: pharmacists' essential role
The Evaluation of Pharmacist Prescribing for Minor Ailments - The Clinical and Economic Value
Now that pharmacists in some provinces can prescribe for minor ailments, what’s the impact on patients’ health? It’s a question that researchers in at the University Saskatchewan are keen to answer with a multiple-phase study, funded in part by the CFP.
Phase one in 2012-2013, funded by the provincial government, surveyed 125 pharmacy customers who’d been prescribed at least one medication for a minor ailment at one of 90 participating pharmacies. The study tracked the most common minor ailments treated and captured customers' perceptions of pharmacists. During phase two in 2015, researchers collected feedback about the process from pharmacists and physicians. Preliminary findings are mixed, with some resistance from some physicians. Researchers also returned to patients to capture their additional feedback. The final phase of the research, released in 2017, assessed and projected the economic impact of pharmacists prescribing for minor ailments.
Related articles:
Patient Perspectives on Symptom Severity (SelfCare 2016)
Minor Ailment Prescribing: Part 2 - Physician Feedback (SelfCare 2016)
Minor Ailment Prescribing: Part 1 - Pharmacist Feedback (SelfCare 2016)
Pharmacist-led minor ailment programs: a Canadian perspective (Int J Gen Med. 2016)
Evaluating pharmacist prescribing for minor ailments (Int J Pharm Pract. 2015)
2015 Changing Face of Pharmacy report (page 18)
2014 news article - Vote of confidence for minor ailments
Assessing need and benefits of home-based medication review services for non-homebound patients
Toronto-based community pharmacist John Papastergiou and his research team are assessing the benefits of providing home-based medication reviews to non-homebound patients. Currently, Ontario's MedsCheck for Home program reimburses pharmacists only for reviews conducted for homebound patients. Findings from previous research, however, as well as experiences with patients in the pharmacy, indicate that that there are medication-management issues that are best addressed in the home environment, whether or not the patient is homebound (for example, expired or discontinued medications). Senior patients taking five or more chronic medications are being recruited for the 12-month study, which reimburses participating pharmacists for their services to patients and for time spent documenting interventions.
Related article:
2017 news article - Home visits warranted for non-housebound
Pharmacists' Innovative Drug Therapy Management Outcomes, Resource use and Economics (PHInDMORE)
The Canadian Foundation for Pharmacy awarded a grant of $35,000 in support of PhInDMORE, a collaboration between Drs. Carlo Marra and Larry Lynd from the Faculty of Pharmaceutical Sciences at the University of British Columbia, and pharmacist John Shaske of Howe Sound Pharmacy. Howe Sound is piloting the province's new PharmaNet system, and PHInDMORE is reviewing pharmacists' interventions and their impacts on patient outcomes, both clinical and economic. PharmaNet is a central database that allows for capture of real-world, real-time documentation of pharmacist-patient encounters to a level of comprehensiveness that has never before been possible. The research aims to demonstrate that there is potential for cost savings to the healthcare system when investing in pharmacists to practice to their full potential.
Related link:
Multi-partner smoking cessation project for vulnerable patient group
Pharmacists Manitoba partnered with Manitoba Health, Healthy Living and Seniors, the College of Pharmacists of Manitoba, Neighbourhood Pharmacy Association of Canada and researchers at the College of Pharmacy, University of Manitoba, to conduct a pilot project focused on helping low-income patient quit smoking. "We successfully reached out and worked with a very hard-to-reach population. Pharmacists proved that they are a key access point to a majority of the population, much more so than other healthcare providers," says Dr. Brenna Shearer, Chief Executive Officer of Pharmacists Manitoba.
In addition to $25,000 in funding from the Canadian Foundation for Pharmacy's Innovation Fund, this project was made possible through a matching grant from Pfizer Canada.
Related links:
2015 news article - MB smoking cessation helps vulnerable group
Safety Alerts as Drivers for Pharmaceutical Opinion Program: A Pilot Study to Reduce Potential Hospitalizations due to Preventable Drug-Drug Interactions
The Canadian Foundation for Pharmacy's Innovation Fund Grant of $50,000 supports a research project under the guidance of Principal Investigator Certina Ho, ISMP Canada and School of Pharmacy, University of Waterloo, to analyze and support the role of pharmacist to prevent medication errors, while generating new revenue streams via Ontario's funded Pharmaceutical Opinions program.
Related link:
2015 article in Pharmacy Practice+ - Safety alerts a win for patients, pharmacists, government
"Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)"
With $50,000 in funding from the Canadian Foundation for Pharmacy’s Innovation Fund, a University of Alberta team of researchers and front-line pharmacists are implementing a pharmacist-initiated mental health monitoring and intervention program based in the community setting. “We are grateful to have the opportunity to partner with CFP as an unbiased organization that supports pharmacy initiatives,” says lead researcher/pharmacist Dan Burton.
For the study, up to 10 pharmacies in Calgary and surrounding areas will be involved with some 120 participating patients over a six-month period. The intervention group will be recruiting and monitoring patients with major depressive disorder and general anxiety disorder, providing interventions as needed and collaborating with patients’ physicians. The control group will receive usual pharmacy care.
Participating pharmacists will receive mental health training materials and have support throughout the pilot and are expected to begin recruiting patients by March 2020.
“Given community pharmacists’ training and access, they are in a great position to help the healthcare field better manage depression and anxiety,” says Burton. “They could take the burden off physicians and other providers by stabilizing patients on medication—plus sometimes these patients need more frequent touch points of support and we have that opportunity in the community.”
Burton says he and his team were inspired to develop the study by the recent Bloom Program pilot in Nova Scotia, which showed the positive benefits community pharmacists can have in helping patients with mental health issues. “With additional prescribing authority in Alberta there’s potential for us to do even more,” he says. For example, Alberta pharmacists can titrate and augment therapies by prescribing higher doses, or add on medications to help patients reach maximum treatment benefits. They can also switch therapies if patients aren’t responding or have uncomfortable side effects. “That’s a huge opportunity for pharmacists,” he says.
Burton hopes that positive study results will also encourage other pharmacists to get more involved in helping patients with mental health disorders. “There is still a significant amount of stigma out there around mental health. Pharmacists are also very type A personalities and sometimes we need concrete data before we believe we can do it,” he says. “If the study goes well, it will be a good starting point to build from.”
|
| Laura Murphy |
|
| Olavo Fernandes |
"CannabisCareRx"
A $25,000 grant from the Canadian Foundation for Pharmacy’s Innovation Fund will see the development and study of a program to help community pharmacists identify and support patients using medical cannabis, as part of routine care.
The pilot-based research study out of Ontario is looking to bridge the gap between legal medical cannabis distribution, which currently bypasses community pharmacies, and the expectation that community pharmacists competently provide information and advice to patients who use medical cannabis. Pharmacists in Ontario who provide direct patient care must complete mandatory cannabis training by 2020, yet there is a noticeable lack of a training program that involves pharmacists in screening for cannabis use.
Lead investigators Laura Murphy and Olavo Fernandes, researchers at the University Health Network, will conduct a prospective observational study of a pilot implementation of a structured program, entitled CannabisCareRx. The program will be comprised of screening questions, a structured process for assessment and a template for documentation and referral to other healthcare providers. The program also includes pharmacist education that emphasizes the development of communication skills to engage patients and decrease stigma. The materials and tools developed will be scalable for implementation across Canada.
Overall, the project is set to occur over three years, starting in September of 2020. It is broken up into three steps: set-up, pilot implementation and dissemination. The set-up stage includes development of the pharmacy education and consultation guide, building the research database, and recruiting five pharmacists from the Greater Toronto Area for the pilot occurring throughout year two.
CannabisCareRx will be piloted as part of usual care provided by the participating pharmacists. After completing the Cannabis Education program, the pharmacists will implement the use of the screening questions with all of their adult patients during routine interactions throughout the 12 months of the pilot.
From there, a member of the research team will conduct a follow-up survey with the pharmacists involved and patients who provide their contact information and permission. The feasibility outcomes will include the number of patients who use cannabis for therapeutic reasons, the number of patients who complete the questionnaire, and the amount of pharmacist time required to conduct CannabisCareRx.
The aim is not only to be successful at the end of the three years but also to create a blueprint for pharmacists across Canada. “The outcomes of the pilot implementation of the CannabisCareRx program will provide patient-centred, pharmacist-driven education materials that will not only support the promotion of safe and effective use of cannabis and harm reduction but will also provide a tangible, patient-facing guide that can facilitate brief and effective consultation,” said Murphy.
"SAD-APP: Self-rating App for Depression Aided by Proactive Pharmacists"
Researcher Philippe Vincent and pharmacists at 30 community pharmacies hope to smooth the path to recovery for patients with depression through a ground-breaking research study funded in part with a $50,000 grant from the Canadian Foundation for Pharmacy’s (CFP’s) Innovation Fund.
The research is unique in that it combines pharmacist coaching with a smartphone app. The app will also differentiate itself within the virtual sea of mental health apps in that it will be built around the PHQ-9 and GAD-7 self-assessment questionnaires, two standardised, validated tools to assess depression and anxiety, respectively. Participating pharmacists will be able to access a patient’s results using a secure, online dashboard.
The study’s primary objective is to shorten the time to recovery by helping patients achieve treatment response as quickly as possible and by supporting adherence.
“Our project seeks to bring patients who suffer in silence and pharmacists together into a meaningful relationship. The self-rating scales and smartphone app are mediators of a safe space for private, sometimes emotional conversations and goal-setting,” says Vincent, Associate Professor of Clinical Pharmacy at University of Montreal and a researcher with the university-affiliated Institute universitaire en sante mentale de Montreal (a psychiatric hospital).
A secondary goal is to prove the value of pharmacists’ interventions. “If we can show that the time pharmacists put into monitoring and coaching is directly proportional to the remission of patients, so people can go back to meaningful occupations and live fuller lives, then insurance, government and other stakeholders will understand that the pharmacists’ time is worth something,” says Vincent.
As well, the stage is already set for possible adoption of the research model into regular pharmacy practice, and possibly on a national scale. All 30 participating pharmacies are part of the Pharmaprix banner, a division of Shoppers Drug Mart and Loblaw companies. Pharmaprix is co-funding the project with CFP.
The study is a randomized, unblinded, multicenter intervention trial that will follow patients over six months. The 30 participating pharmacies will each enrol 10 patients who have been diagnosed with a new episode of major depression, broken down as follows:
Pharmacists in the coaching group will receive training based on best practices in clinical psychiatry. They will call their participating patients every week during the dose-finding period and conduct a 5-minute semi-structured interview that seeks to create rapport, agree on treatment goals and agree on tasks. Pharmacists will also ask about side effects, which will be addressed as required through separate interventions that will be documented in the dashboard.
Throughout the six months of the study, the app will send notifications to patients every two weeks to remind them to complete the PHQ-9 and GAD-7 questionnaires. The app will also prompt patients to complete the PHQ-2 questionnaire every day for the first 15 days, every two days for the next 15 days, and every three days thereafter. “In a pharmacy setting where everything is so busy, you need to have useful, fast and complete information. This model enables systematic monitoring and a communication bridge between patients and pharmacists,” says Vincent.
The estimated project completion date, including data analysis, is mid 2021.
John Papastergiou, practising community pharmacist, and the research team at University of Toronto is using CFP's grant of $15,000 to quantify adherence rates to adult immunizations, where a series of vaccines or booster vaccines are required, when these vaccines are administered by community pharmacists. It's hoped that the study results will help pharmacists obtain prescribing rights for vaccines.
CFP has awarded Paula Newman and her team at Northwest Telepharmacy Solutions $22,500 to determine the feasibility and effectiveness of a pharmacist-led opioid stewardship program for chronic non-cancer pain, using videoconferencing technology. The project includes prescriber and patient education, risk stratification and screening for potential harm, as well as patient monitoriing with follow-up and continuity of care.
The Presciption to Thrive project, funded by multiple stakeholders including Canada's two national pharmacy associations and the Nova Scotia Department of Health and Wellness, seeks to establish a model for practice change in community pharmacy. Expert facilitators will work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.
Saleema Bhaidani, Director, Pharmacy Innovation & Professional Affairs at Whole Health Pharmacy Partners, and researcher Lisa Dolovich at the University of Toronto are conducting a retrospective analysis of the impact of an appointment-based model (ABM) for pharmacy practice based on data obtained from six independent pharmacies, part of the Whole Health Pharmacy banner, which implemented ABM in September 2017. ABM uses medication synchronization to coordinate refills into one pick-up, which enables pharmacists to conduct appointments where they can review, address and follow up on medication issues on a monthly or regular basis. The study will seek to evaluate clinical outcomes and the impact on adherence, as well as ABM's impact on workflow and pharmacy staff.
Dr. Chang and her team will examine the feasibility and effectiveness of a pharmacist intervention targeting high-dose, high-risk prescription opioids. The study will complement previous research in the area funded by the Ontario Ministry of Health and Long-Term Care, as well as Health Canada Anti-Drug Strategy Initiatives.
Dr. MacCallum and her team are researching strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes.As part of that, the team will also determine how routine monitoring and follow-up is linked to other expanded professional services.
The project began with a survey of about 8,000 pharmacists in early 2018. During phase two, launched in fall 2018, researchers are working with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.
With the support of the Innovation grant and additional funding from the New Brunswick Pharmacists' Association, Dr. Tsuyuki and his team tracked and quantified the impact of pharmacist management of patients with uncomplicated urinary tract infection.
As follow-up to the study, the research team is looking at antibiotic usage and conducting an economic analysis. The group is also developing an online registry and practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.
News article - "Pharmacists for UTI management a 'no-brainer'"
Published study - "Outcomes of Urinary Tract Infection Management by Pharmacists (RxOUTMAP)"
Dr. Barbara Farrell of the Bruyère Research Institute in Ottawa has been awarded $50,000 to support her research project on “Mobilizing Community Pharmacists as Catalysts for Deprescribing.” Based at the Institute, Farrell and her team will work with community pharmacy practices and a national advisory group (with provider and private payer representation) over a one-year period to develop acceptable workflow strategies for deprescribing guideline use.
Research associates will work with each pharmacy to quantify opportunities for deprescribing, describe activities and processes associated with guideline use—including how long such activities take—and highlight enablers and barriers that pharmacists encounter. This project is expected to lay the foundation for a larger demonstration project examining reach, adoption and implementation of deprescribing strategies, and ultimately a randomized controlled trial of deprescribing interventions that explores patient and health system outcomes, including related cost savings.
News article - "Deprescribing, within a pharmacist's domain"
Dr. Line Guénette of the Faculty of Pharmacy at Laval University and her team have received $26,800 to develop evidence-based electronic tools for community pharmacists to detect and improve medication non-adherence. Drawing on their previous research in medication adherence measures, the team aims to develop five electronic tools to target four common chronic disease areas (type 2 diabetes, hypertension, asthma and depression).
“We are committed to building tools that have acceptability, usability, utility, implementation and ways to improve e-tools for supporting pharmacy practice,” says Guénette, noting that the initial focus will be on diabetes and depression. “By developing and providing new tools to better identify patients having adherence problems, we will engage and support pharmacists with their crucial role regarding …medication efficacy/safety."
University of Toronto’s Sara Guilcher and her team were also honoured with a 2016 Innovation Fund grant worth $38,000 to establish and evaluate the feasibility of an Acute care to Community Pharmacy Communication Link (ACC-Link) to improve medication management across transitions of care.
Building on existing best evidence around successful medication management interventions, the ACC-Link provides communication between hospital and community pharmacists to actively equip the latter with information needed to guide patients and their families at the point of hospital discharge. By evaluating the feasibility of the intervention and understanding the factors that may influence implementation, the researchers are expecting the program can be scaled to fit other clinical settings.
“Ultimately, ACC-Link has the potential to improve patients’ medication experiences, safety, overall health, and quality of life for themselves and their caregivers while reducing health-system costs and demand,” noted the research team in their submission.
Researchers Christine Hughes, Terri Schindel and Rene Breault set out to determine how Alberta pharmacists are providing care under the Alberta Pharmacy Services Framework, and how patients are experiencing care planning services in the “real world.”
With funding from the Canadian Foundation for Pharmacy and the Alberta Pharmacists’ Association (RxA), the investigators recruited four different cases, or community pharmacies, in the province and collected data over 12 months per site. Over the course of 83 interviews and 94 hours of observation, they explored the value of pharmacy services to patients, pharmacists, other healthcare providers and policy makers.
Sherilyn Houle and her research team at University of Waterloo studied the clinical effectiveness and patients' satisfaction with travel medicine services provided by pharmacists with independent prescribing authority. Results were very positive. “We hope pharmacists are encouraged by these results, which show that they can safely and effectively prescribe and inject travel vaccines independently, and it’s a service that patients really appreciate,” says Houle.
2018 news article - Pharmacists’ fit in travel medicine
2018 news article - Happy, healthy travels
Working with a physician in a primary care setting, Tejal Patel examines how pharmacist interventions can reduce polypharmacy and high-risk medication use among the frail elderly.
2016 news article - The frail elderly: pharmacists' essential role
The Evaluation of Pharmacist Prescribing for Minor Ailments - The Clinical and Economic Value
Now that pharmacists in some provinces can prescribe for minor ailments, what’s the impact on patients’ health? It’s a question that researchers in at the University Saskatchewan are keen to answer with a multiple-phase study, funded in part by the CFP.
Phase one in 2012-2013, funded by the provincial government, surveyed 125 pharmacy customers who’d been prescribed at least one medication for a minor ailment at one of 90 participating pharmacies. The study tracked the most common minor ailments treated and captured customers' perceptions of pharmacists. During phase two in 2015, researchers collected feedback about the process from pharmacists and physicians. Preliminary findings are mixed, with some resistance from some physicians. Researchers also returned to patients to capture their additional feedback. The final phase of the research, released in 2017, assessed and projected the economic impact of pharmacists prescribing for minor ailments.
Related articles:
Patient Perspectives on Symptom Severity (SelfCare 2016)
Minor Ailment Prescribing: Part 2 - Physician Feedback (SelfCare 2016)
Minor Ailment Prescribing: Part 1 - Pharmacist Feedback (SelfCare 2016)
Pharmacist-led minor ailment programs: a Canadian perspective (Int J Gen Med. 2016)
Evaluating pharmacist prescribing for minor ailments (Int J Pharm Pract. 2015)
2015 Changing Face of Pharmacy report (page 18)
2014 news article - Vote of confidence for minor ailments
Assessing need and benefits of home-based medication review services for non-homebound patients
Toronto-based community pharmacist John Papastergiou and his research team are assessing the benefits of providing home-based medication reviews to non-homebound patients. Currently, Ontario's MedsCheck for Home program reimburses pharmacists only for reviews conducted for homebound patients. Findings from previous research, however, as well as experiences with patients in the pharmacy, indicate that that there are medication-management issues that are best addressed in the home environment, whether or not the patient is homebound (for example, expired or discontinued medications). Senior patients taking five or more chronic medications are being recruited for the 12-month study, which reimburses participating pharmacists for their services to patients and for time spent documenting interventions.
Related article:
2017 news article - Home visits warranted for non-housebound
Pharmacists' Innovative Drug Therapy Management Outcomes, Resource use and Economics (PHInDMORE)
The Canadian Foundation for Pharmacy awarded a grant of $35,000 in support of PhInDMORE, a collaboration between Drs. Carlo Marra and Larry Lynd from the Faculty of Pharmaceutical Sciences at the University of British Columbia, and pharmacist John Shaske of Howe Sound Pharmacy. Howe Sound is piloting the province's new PharmaNet system, and PHInDMORE is reviewing pharmacists' interventions and their impacts on patient outcomes, both clinical and economic. PharmaNet is a central database that allows for capture of real-world, real-time documentation of pharmacist-patient encounters to a level of comprehensiveness that has never before been possible. The research aims to demonstrate that there is potential for cost savings to the healthcare system when investing in pharmacists to practice to their full potential.
Related link:
Multi-partner smoking cessation project for vulnerable patient group
Pharmacists Manitoba partnered with Manitoba Health, Healthy Living and Seniors, the College of Pharmacists of Manitoba, Neighbourhood Pharmacy Association of Canada and researchers at the College of Pharmacy, University of Manitoba, to conduct a pilot project focused on helping low-income patient quit smoking. "We successfully reached out and worked with a very hard-to-reach population. Pharmacists proved that they are a key access point to a majority of the population, much more so than other healthcare providers," says Dr. Brenna Shearer, Chief Executive Officer of Pharmacists Manitoba.
In addition to $25,000 in funding from the Canadian Foundation for Pharmacy's Innovation Fund, this project was made possible through a matching grant from Pfizer Canada.
Related links:
2015 news article - MB smoking cessation helps vulnerable group
Safety Alerts as Drivers for Pharmaceutical Opinion Program: A Pilot Study to Reduce Potential Hospitalizations due to Preventable Drug-Drug Interactions
The Canadian Foundation for Pharmacy's Innovation Fund Grant of $50,000 supports a research project under the guidance of Principal Investigator Certina Ho, ISMP Canada and School of Pharmacy, University of Waterloo, to analyze and support the role of pharmacist to prevent medication errors, while generating new revenue streams via Ontario's funded Pharmaceutical Opinions program.
Related link:
2015 article in Pharmacy Practice+ - Safety alerts a win for patients, pharmacists, government
Pharmacists: Personalized Medicine Experts in Primary Care
Led by Lisa McCarthy (PharmD MSc), (Women’s College Hospital (WCH) and Leslie Dan Faculty of Pharmacy, University of Toronto), this multi-phase project will equip primary care pharmacists with the knowledge and skills required to take a lead role as personalized medicine experts in our health system and evaluate the impact on patients’ health outcomes.
Related links:
2016 article and video, www.CanadianHealthcareNetwork.ca
2016 news article: Personalized medicine in community practice
"Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)"
With $50,000 in funding from the Canadian Foundation for Pharmacy’s Innovation Fund, a University of Alberta team of researchers and front-line pharmacists are implementing a pharmacist-initiated mental health monitoring and intervention program based in the community setting. “We are grateful to have the opportunity to partner with CFP as an unbiased organization that supports pharmacy initiatives,” says lead researcher/pharmacist Dan Burton.
For the study, up to 10 pharmacies in Calgary and surrounding areas will be involved with some 120 participating patients over a six-month period. The intervention group will be recruiting and monitoring patients with major depressive disorder and general anxiety disorder, providing interventions as needed and collaborating with patients’ physicians. The control group will receive usual pharmacy care.
Participating pharmacists will receive mental health training materials and have support throughout the pilot and are expected to begin recruiting patients by March 2020.
“Given community pharmacists’ training and access, they are in a great position to help the healthcare field better manage depression and anxiety,” says Burton. “They could take the burden off physicians and other providers by stabilizing patients on medication—plus sometimes these patients need more frequent touch points of support and we have that opportunity in the community.”
Burton says he and his team were inspired to develop the study by the recent Bloom Program pilot in Nova Scotia, which showed the positive benefits community pharmacists can have in helping patients with mental health issues. “With additional prescribing authority in Alberta there’s potential for us to do even more,” he says. For example, Alberta pharmacists can titrate and augment therapies by prescribing higher doses, or add on medications to help patients reach maximum treatment benefits. They can also switch therapies if patients aren’t responding or have uncomfortable side effects. “That’s a huge opportunity for pharmacists,” he says.
Burton hopes that positive study results will also encourage other pharmacists to get more involved in helping patients with mental health disorders. “There is still a significant amount of stigma out there around mental health. Pharmacists are also very type A personalities and sometimes we need concrete data before we believe we can do it,” he says. “If the study goes well, it will be a good starting point to build from.”
|
| Laura Murphy |
|
| Olavo Fernandes |
"CannabisCareRx"
A $25,000 grant from the Canadian Foundation for Pharmacy’s Innovation Fund will see the development and study of a program to help community pharmacists identify and support patients using medical cannabis, as part of routine care.
The pilot-based research study out of Ontario is looking to bridge the gap between legal medical cannabis distribution, which currently bypasses community pharmacies, and the expectation that community pharmacists competently provide information and advice to patients who use medical cannabis. Pharmacists in Ontario who provide direct patient care must complete mandatory cannabis training by 2020, yet there is a noticeable lack of a training program that involves pharmacists in screening for cannabis use.
Lead investigators Laura Murphy and Olavo Fernandes, researchers at the University Health Network, will conduct a prospective observational study of a pilot implementation of a structured program, entitled CannabisCareRx. The program will be comprised of screening questions, a structured process for assessment and a template for documentation and referral to other healthcare providers. The program also includes pharmacist education that emphasizes the development of communication skills to engage patients and decrease stigma. The materials and tools developed will be scalable for implementation across Canada.
Overall, the project is set to occur over three years, starting in September of 2020. It is broken up into three steps: set-up, pilot implementation and dissemination. The set-up stage includes development of the pharmacy education and consultation guide, building the research database, and recruiting five pharmacists from the Greater Toronto Area for the pilot occurring throughout year two.
CannabisCareRx will be piloted as part of usual care provided by the participating pharmacists. After completing the Cannabis Education program, the pharmacists will implement the use of the screening questions with all of their adult patients during routine interactions throughout the 12 months of the pilot.
From there, a member of the research team will conduct a follow-up survey with the pharmacists involved and patients who provide their contact information and permission. The feasibility outcomes will include the number of patients who use cannabis for therapeutic reasons, the number of patients who complete the questionnaire, and the amount of pharmacist time required to conduct CannabisCareRx.
The aim is not only to be successful at the end of the three years but also to create a blueprint for pharmacists across Canada. “The outcomes of the pilot implementation of the CannabisCareRx program will provide patient-centred, pharmacist-driven education materials that will not only support the promotion of safe and effective use of cannabis and harm reduction but will also provide a tangible, patient-facing guide that can facilitate brief and effective consultation,” said Murphy.
"SAD-APP: Self-rating App for Depression Aided by Proactive Pharmacists"
Researcher Philippe Vincent and pharmacists at 30 community pharmacies hope to smooth the path to recovery for patients with depression through a ground-breaking research study funded in part with a $50,000 grant from the Canadian Foundation for Pharmacy’s (CFP’s) Innovation Fund.
The research is unique in that it combines pharmacist coaching with a smartphone app. The app will also differentiate itself within the virtual sea of mental health apps in that it will be built around the PHQ-9 and GAD-7 self-assessment questionnaires, two standardised, validated tools to assess depression and anxiety, respectively. Participating pharmacists will be able to access a patient’s results using a secure, online dashboard.
The study’s primary objective is to shorten the time to recovery by helping patients achieve treatment response as quickly as possible and by supporting adherence.
“Our project seeks to bring patients who suffer in silence and pharmacists together into a meaningful relationship. The self-rating scales and smartphone app are mediators of a safe space for private, sometimes emotional conversations and goal-setting,” says Vincent, Associate Professor of Clinical Pharmacy at University of Montreal and a researcher with the university-affiliated Institute universitaire en sante mentale de Montreal (a psychiatric hospital).
A secondary goal is to prove the value of pharmacists’ interventions. “If we can show that the time pharmacists put into monitoring and coaching is directly proportional to the remission of patients, so people can go back to meaningful occupations and live fuller lives, then insurance, government and other stakeholders will understand that the pharmacists’ time is worth something,” says Vincent.
As well, the stage is already set for possible adoption of the research model into regular pharmacy practice, and possibly on a national scale. All 30 participating pharmacies are part of the Pharmaprix banner, a division of Shoppers Drug Mart and Loblaw companies. Pharmaprix is co-funding the project with CFP.
The study is a randomized, unblinded, multicenter intervention trial that will follow patients over six months. The 30 participating pharmacies will each enrol 10 patients who have been diagnosed with a new episode of major depression, broken down as follows:
Pharmacists in the coaching group will receive training based on best practices in clinical psychiatry. They will call their participating patients every week during the dose-finding period and conduct a 5-minute semi-structured interview that seeks to create rapport, agree on treatment goals and agree on tasks. Pharmacists will also ask about side effects, which will be addressed as required through separate interventions that will be documented in the dashboard.
Throughout the six months of the study, the app will send notifications to patients every two weeks to remind them to complete the PHQ-9 and GAD-7 questionnaires. The app will also prompt patients to complete the PHQ-2 questionnaire every day for the first 15 days, every two days for the next 15 days, and every three days thereafter. “In a pharmacy setting where everything is so busy, you need to have useful, fast and complete information. This model enables systematic monitoring and a communication bridge between patients and pharmacists,” says Vincent.
The estimated project completion date, including data analysis, is mid 2021.
John Papastergiou, practising community pharmacist, and the research team at University of Toronto is using CFP's grant of $15,000 to quantify adherence rates to adult immunizations, where a series of vaccines or booster vaccines are required, when these vaccines are administered by community pharmacists. It's hoped that the study results will help pharmacists obtain prescribing rights for vaccines.
CFP has awarded Paula Newman and her team at Northwest Telepharmacy Solutions $22,500 to determine the feasibility and effectiveness of a pharmacist-led opioid stewardship program for chronic non-cancer pain, using videoconferencing technology. The project includes prescriber and patient education, risk stratification and screening for potential harm, as well as patient monitoriing with follow-up and continuity of care.
The Presciption to Thrive project, funded by multiple stakeholders including Canada's two national pharmacy associations and the Nova Scotia Department of Health and Wellness, seeks to establish a model for practice change in community pharmacy. Expert facilitators will work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.
Saleema Bhaidani, Director, Pharmacy Innovation & Professional Affairs at Whole Health Pharmacy Partners, and researcher Lisa Dolovich at the University of Toronto are conducting a retrospective analysis of the impact of an appointment-based model (ABM) for pharmacy practice based on data obtained from six independent pharmacies, part of the Whole Health Pharmacy banner, which implemented ABM in September 2017. ABM uses medication synchronization to coordinate refills into one pick-up, which enables pharmacists to conduct appointments where they can review, address and follow up on medication issues on a monthly or regular basis. The study will seek to evaluate clinical outcomes and the impact on adherence, as well as ABM's impact on workflow and pharmacy staff.
Dr. Chang and her team will examine the feasibility and effectiveness of a pharmacist intervention targeting high-dose, high-risk prescription opioids. The study will complement previous research in the area funded by the Ontario Ministry of Health and Long-Term Care, as well as Health Canada Anti-Drug Strategy Initiatives.
Dr. MacCallum and her team are researching strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes.As part of that, the team will also determine how routine monitoring and follow-up is linked to other expanded professional services.
The project began with a survey of about 8,000 pharmacists in early 2018. During phase two, launched in fall 2018, researchers are working with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.
With the support of the Innovation grant and additional funding from the New Brunswick Pharmacists' Association, Dr. Tsuyuki and his team tracked and quantified the impact of pharmacist management of patients with uncomplicated urinary tract infection.
As follow-up to the study, the research team is looking at antibiotic usage and conducting an economic analysis. The group is also developing an online registry and practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.
News article - "Pharmacists for UTI management a 'no-brainer'"
Published study - "Outcomes of Urinary Tract Infection Management by Pharmacists (RxOUTMAP)"
Dr. Barbara Farrell of the Bruyère Research Institute in Ottawa has been awarded $50,000 to support her research project on “Mobilizing Community Pharmacists as Catalysts for Deprescribing.” Based at the Institute, Farrell and her team will work with community pharmacy practices and a national advisory group (with provider and private payer representation) over a one-year period to develop acceptable workflow strategies for deprescribing guideline use.
Research associates will work with each pharmacy to quantify opportunities for deprescribing, describe activities and processes associated with guideline use—including how long such activities take—and highlight enablers and barriers that pharmacists encounter. This project is expected to lay the foundation for a larger demonstration project examining reach, adoption and implementation of deprescribing strategies, and ultimately a randomized controlled trial of deprescribing interventions that explores patient and health system outcomes, including related cost savings.
News article - "Deprescribing, within a pharmacist's domain"
Dr. Line Guénette of the Faculty of Pharmacy at Laval University and her team have received $26,800 to develop evidence-based electronic tools for community pharmacists to detect and improve medication non-adherence. Drawing on their previous research in medication adherence measures, the team aims to develop five electronic tools to target four common chronic disease areas (type 2 diabetes, hypertension, asthma and depression).
“We are committed to building tools that have acceptability, usability, utility, implementation and ways to improve e-tools for supporting pharmacy practice,” says Guénette, noting that the initial focus will be on diabetes and depression. “By developing and providing new tools to better identify patients having adherence problems, we will engage and support pharmacists with their crucial role regarding …medication efficacy/safety."
University of Toronto’s Sara Guilcher and her team were also honoured with a 2016 Innovation Fund grant worth $38,000 to establish and evaluate the feasibility of an Acute care to Community Pharmacy Communication Link (ACC-Link) to improve medication management across transitions of care.
Building on existing best evidence around successful medication management interventions, the ACC-Link provides communication between hospital and community pharmacists to actively equip the latter with information needed to guide patients and their families at the point of hospital discharge. By evaluating the feasibility of the intervention and understanding the factors that may influence implementation, the researchers are expecting the program can be scaled to fit other clinical settings.
“Ultimately, ACC-Link has the potential to improve patients’ medication experiences, safety, overall health, and quality of life for themselves and their caregivers while reducing health-system costs and demand,” noted the research team in their submission.
Researchers Christine Hughes, Terri Schindel and Rene Breault set out to determine how Alberta pharmacists are providing care under the Alberta Pharmacy Services Framework, and how patients are experiencing care planning services in the “real world.”
With funding from the Canadian Foundation for Pharmacy and the Alberta Pharmacists’ Association (RxA), the investigators recruited four different cases, or community pharmacies, in the province and collected data over 12 months per site. Over the course of 83 interviews and 94 hours of observation, they explored the value of pharmacy services to patients, pharmacists, other healthcare providers and policy makers.
Sherilyn Houle and her research team at University of Waterloo studied the clinical effectiveness and patients' satisfaction with travel medicine services provided by pharmacists with independent prescribing authority. Results were very positive. “We hope pharmacists are encouraged by these results, which show that they can safely and effectively prescribe and inject travel vaccines independently, and it’s a service that patients really appreciate,” says Houle.
2018 news article - Pharmacists’ fit in travel medicine
2018 news article - Happy, healthy travels
Working with a physician in a primary care setting, Tejal Patel examines how pharmacist interventions can reduce polypharmacy and high-risk medication use among the frail elderly.
2016 news article - The frail elderly: pharmacists' essential role
The Evaluation of Pharmacist Prescribing for Minor Ailments - The Clinical and Economic Value
Now that pharmacists in some provinces can prescribe for minor ailments, what’s the impact on patients’ health? It’s a question that researchers in at the University Saskatchewan are keen to answer with a multiple-phase study, funded in part by the CFP.
Phase one in 2012-2013, funded by the provincial government, surveyed 125 pharmacy customers who’d been prescribed at least one medication for a minor ailment at one of 90 participating pharmacies. The study tracked the most common minor ailments treated and captured customers' perceptions of pharmacists. During phase two in 2015, researchers collected feedback about the process from pharmacists and physicians. Preliminary findings are mixed, with some resistance from some physicians. Researchers also returned to patients to capture their additional feedback. The final phase of the research, released in 2017, assessed and projected the economic impact of pharmacists prescribing for minor ailments.
Related articles:
Patient Perspectives on Symptom Severity (SelfCare 2016)
Minor Ailment Prescribing: Part 2 - Physician Feedback (SelfCare 2016)
Minor Ailment Prescribing: Part 1 - Pharmacist Feedback (SelfCare 2016)
Pharmacist-led minor ailment programs: a Canadian perspective (Int J Gen Med. 2016)
Evaluating pharmacist prescribing for minor ailments (Int J Pharm Pract. 2015)
2015 Changing Face of Pharmacy report (page 18)
2014 news article - Vote of confidence for minor ailments
Assessing need and benefits of home-based medication review services for non-homebound patients
Toronto-based community pharmacist John Papastergiou and his research team are assessing the benefits of providing home-based medication reviews to non-homebound patients. Currently, Ontario's MedsCheck for Home program reimburses pharmacists only for reviews conducted for homebound patients. Findings from previous research, however, as well as experiences with patients in the pharmacy, indicate that that there are medication-management issues that are best addressed in the home environment, whether or not the patient is homebound (for example, expired or discontinued medications). Senior patients taking five or more chronic medications are being recruited for the 12-month study, which reimburses participating pharmacists for their services to patients and for time spent documenting interventions.
Related article:
2017 news article - Home visits warranted for non-housebound
Pharmacists' Innovative Drug Therapy Management Outcomes, Resource use and Economics (PHInDMORE)
The Canadian Foundation for Pharmacy awarded a grant of $35,000 in support of PhInDMORE, a collaboration between Drs. Carlo Marra and Larry Lynd from the Faculty of Pharmaceutical Sciences at the University of British Columbia, and pharmacist John Shaske of Howe Sound Pharmacy. Howe Sound is piloting the province's new PharmaNet system, and PHInDMORE is reviewing pharmacists' interventions and their impacts on patient outcomes, both clinical and economic. PharmaNet is a central database that allows for capture of real-world, real-time documentation of pharmacist-patient encounters to a level of comprehensiveness that has never before been possible. The research aims to demonstrate that there is potential for cost savings to the healthcare system when investing in pharmacists to practice to their full potential.
Related link:
Multi-partner smoking cessation project for vulnerable patient group
Pharmacists Manitoba partnered with Manitoba Health, Healthy Living and Seniors, the College of Pharmacists of Manitoba, Neighbourhood Pharmacy Association of Canada and researchers at the College of Pharmacy, University of Manitoba, to conduct a pilot project focused on helping low-income patient quit smoking. "We successfully reached out and worked with a very hard-to-reach population. Pharmacists proved that they are a key access point to a majority of the population, much more so than other healthcare providers," says Dr. Brenna Shearer, Chief Executive Officer of Pharmacists Manitoba.
In addition to $25,000 in funding from the Canadian Foundation for Pharmacy's Innovation Fund, this project was made possible through a matching grant from Pfizer Canada.
Related links:
2015 news article - MB smoking cessation helps vulnerable group
Safety Alerts as Drivers for Pharmaceutical Opinion Program: A Pilot Study to Reduce Potential Hospitalizations due to Preventable Drug-Drug Interactions
The Canadian Foundation for Pharmacy's Innovation Fund Grant of $50,000 supports a research project under the guidance of Principal Investigator Certina Ho, ISMP Canada and School of Pharmacy, University of Waterloo, to analyze and support the role of pharmacist to prevent medication errors, while generating new revenue streams via Ontario's funded Pharmaceutical Opinions program.
Related link:
2015 article in Pharmacy Practice+ - Safety alerts a win for patients, pharmacists, government
Pharmacists: Personalized Medicine Experts in Primary Care
Led by Lisa McCarthy (PharmD MSc), (Women’s College Hospital (WCH) and Leslie Dan Faculty of Pharmacy, University of Toronto), this multi-phase project will equip primary care pharmacists with the knowledge and skills required to take a lead role as personalized medicine experts in our health system and evaluate the impact on patients’ health outcomes.
Related links:
2016 article and video, www.CanadianHealthcareNetwork.ca
2016 news article: Personalized medicine in community practice
Impact of Community Pharmacist Interventions in Hypertension Management in Patient Outcomes: A Randomized Control Trial
Canadian Foundation for Pharmacy's $50,000 grant from its Innovation Fund supported ground-breaking research on the impact of regularly scheduled pharmacists' interventions with patients with uncontrolled hypertension in the working population. Pharmacists not only significantly helped improve blood pressure control, but were recognized as effective sources of support for changes in lifestyle behaviours. Green Shield Canada has since launched a pharmacists coaching program for cardiovascular health, available as a core benefit for its clients with drug plans.
Related links:
2015 news article - Insurer invests in CV coaching
2014 news article - Green Shield/OPA results promising for pharmacists
2014 final project report - Ontario Pharmacists Association & Green Shield Canada
"Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)"
With $50,000 in funding from the Canadian Foundation for Pharmacy’s Innovation Fund, a University of Alberta team of researchers and front-line pharmacists are implementing a pharmacist-initiated mental health monitoring and intervention program based in the community setting. “We are grateful to have the opportunity to partner with CFP as an unbiased organization that supports pharmacy initiatives,” says lead researcher/pharmacist Dan Burton.
For the study, up to 10 pharmacies in Calgary and surrounding areas will be involved with some 120 participating patients over a six-month period. The intervention group will be recruiting and monitoring patients with major depressive disorder and general anxiety disorder, providing interventions as needed and collaborating with patients’ physicians. The control group will receive usual pharmacy care.
Participating pharmacists will receive mental health training materials and have support throughout the pilot and are expected to begin recruiting patients by March 2020.
“Given community pharmacists’ training and access, they are in a great position to help the healthcare field better manage depression and anxiety,” says Burton. “They could take the burden off physicians and other providers by stabilizing patients on medication—plus sometimes these patients need more frequent touch points of support and we have that opportunity in the community.”
Burton says he and his team were inspired to develop the study by the recent Bloom Program pilot in Nova Scotia, which showed the positive benefits community pharmacists can have in helping patients with mental health issues. “With additional prescribing authority in Alberta there’s potential for us to do even more,” he says. For example, Alberta pharmacists can titrate and augment therapies by prescribing higher doses, or add on medications to help patients reach maximum treatment benefits. They can also switch therapies if patients aren’t responding or have uncomfortable side effects. “That’s a huge opportunity for pharmacists,” he says.
Burton hopes that positive study results will also encourage other pharmacists to get more involved in helping patients with mental health disorders. “There is still a significant amount of stigma out there around mental health. Pharmacists are also very type A personalities and sometimes we need concrete data before we believe we can do it,” he says. “If the study goes well, it will be a good starting point to build from.”
|
| Laura Murphy |
|
| Olavo Fernandes |
"CannabisCareRx"
A $25,000 grant from the Canadian Foundation for Pharmacy’s Innovation Fund will see the development and study of a program to help community pharmacists identify and support patients using medical cannabis, as part of routine care.
The pilot-based research study out of Ontario is looking to bridge the gap between legal medical cannabis distribution, which currently bypasses community pharmacies, and the expectation that community pharmacists competently provide information and advice to patients who use medical cannabis. Pharmacists in Ontario who provide direct patient care must complete mandatory cannabis training by 2020, yet there is a noticeable lack of a training program that involves pharmacists in screening for cannabis use.
Lead investigators Laura Murphy and Olavo Fernandes, researchers at the University Health Network, will conduct a prospective observational study of a pilot implementation of a structured program, entitled CannabisCareRx. The program will be comprised of screening questions, a structured process for assessment and a template for documentation and referral to other healthcare providers. The program also includes pharmacist education that emphasizes the development of communication skills to engage patients and decrease stigma. The materials and tools developed will be scalable for implementation across Canada.
Overall, the project is set to occur over three years, starting in September of 2020. It is broken up into three steps: set-up, pilot implementation and dissemination. The set-up stage includes development of the pharmacy education and consultation guide, building the research database, and recruiting five pharmacists from the Greater Toronto Area for the pilot occurring throughout year two.
CannabisCareRx will be piloted as part of usual care provided by the participating pharmacists. After completing the Cannabis Education program, the pharmacists will implement the use of the screening questions with all of their adult patients during routine interactions throughout the 12 months of the pilot.
From there, a member of the research team will conduct a follow-up survey with the pharmacists involved and patients who provide their contact information and permission. The feasibility outcomes will include the number of patients who use cannabis for therapeutic reasons, the number of patients who complete the questionnaire, and the amount of pharmacist time required to conduct CannabisCareRx.
The aim is not only to be successful at the end of the three years but also to create a blueprint for pharmacists across Canada. “The outcomes of the pilot implementation of the CannabisCareRx program will provide patient-centred, pharmacist-driven education materials that will not only support the promotion of safe and effective use of cannabis and harm reduction but will also provide a tangible, patient-facing guide that can facilitate brief and effective consultation,” said Murphy.
"SAD-APP: Self-rating App for Depression Aided by Proactive Pharmacists"
Researcher Philippe Vincent and pharmacists at 30 community pharmacies hope to smooth the path to recovery for patients with depression through a ground-breaking research study funded in part with a $50,000 grant from the Canadian Foundation for Pharmacy’s (CFP’s) Innovation Fund.
The research is unique in that it combines pharmacist coaching with a smartphone app. The app will also differentiate itself within the virtual sea of mental health apps in that it will be built around the PHQ-9 and GAD-7 self-assessment questionnaires, two standardised, validated tools to assess depression and anxiety, respectively. Participating pharmacists will be able to access a patient’s results using a secure, online dashboard.
The study’s primary objective is to shorten the time to recovery by helping patients achieve treatment response as quickly as possible and by supporting adherence.
“Our project seeks to bring patients who suffer in silence and pharmacists together into a meaningful relationship. The self-rating scales and smartphone app are mediators of a safe space for private, sometimes emotional conversations and goal-setting,” says Vincent, Associate Professor of Clinical Pharmacy at University of Montreal and a researcher with the university-affiliated Institute universitaire en sante mentale de Montreal (a psychiatric hospital).
A secondary goal is to prove the value of pharmacists’ interventions. “If we can show that the time pharmacists put into monitoring and coaching is directly proportional to the remission of patients, so people can go back to meaningful occupations and live fuller lives, then insurance, government and other stakeholders will understand that the pharmacists’ time is worth something,” says Vincent.
As well, the stage is already set for possible adoption of the research model into regular pharmacy practice, and possibly on a national scale. All 30 participating pharmacies are part of the Pharmaprix banner, a division of Shoppers Drug Mart and Loblaw companies. Pharmaprix is co-funding the project with CFP.
The study is a randomized, unblinded, multicenter intervention trial that will follow patients over six months. The 30 participating pharmacies will each enrol 10 patients who have been diagnosed with a new episode of major depression, broken down as follows:
Pharmacists in the coaching group will receive training based on best practices in clinical psychiatry. They will call their participating patients every week during the dose-finding period and conduct a 5-minute semi-structured interview that seeks to create rapport, agree on treatment goals and agree on tasks. Pharmacists will also ask about side effects, which will be addressed as required through separate interventions that will be documented in the dashboard.
Throughout the six months of the study, the app will send notifications to patients every two weeks to remind them to complete the PHQ-9 and GAD-7 questionnaires. The app will also prompt patients to complete the PHQ-2 questionnaire every day for the first 15 days, every two days for the next 15 days, and every three days thereafter. “In a pharmacy setting where everything is so busy, you need to have useful, fast and complete information. This model enables systematic monitoring and a communication bridge between patients and pharmacists,” says Vincent.
The estimated project completion date, including data analysis, is mid 2021.
John Papastergiou, practising community pharmacist, and the research team at University of Toronto is using CFP's grant of $15,000 to quantify adherence rates to adult immunizations, where a series of vaccines or booster vaccines are required, when these vaccines are administered by community pharmacists. It's hoped that the study results will help pharmacists obtain prescribing rights for vaccines.
CFP has awarded Paula Newman and her team at Northwest Telepharmacy Solutions $22,500 to determine the feasibility and effectiveness of a pharmacist-led opioid stewardship program for chronic non-cancer pain, using videoconferencing technology. The project includes prescriber and patient education, risk stratification and screening for potential harm, as well as patient monitoriing with follow-up and continuity of care.
The Presciption to Thrive project, funded by multiple stakeholders including Canada's two national pharmacy associations and the Nova Scotia Department of Health and Wellness, seeks to establish a model for practice change in community pharmacy. Expert facilitators will work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.
Saleema Bhaidani, Director, Pharmacy Innovation & Professional Affairs at Whole Health Pharmacy Partners, and researcher Lisa Dolovich at the University of Toronto are conducting a retrospective analysis of the impact of an appointment-based model (ABM) for pharmacy practice based on data obtained from six independent pharmacies, part of the Whole Health Pharmacy banner, which implemented ABM in September 2017. ABM uses medication synchronization to coordinate refills into one pick-up, which enables pharmacists to conduct appointments where they can review, address and follow up on medication issues on a monthly or regular basis. The study will seek to evaluate clinical outcomes and the impact on adherence, as well as ABM's impact on workflow and pharmacy staff.
Dr. Chang and her team will examine the feasibility and effectiveness of a pharmacist intervention targeting high-dose, high-risk prescription opioids. The study will complement previous research in the area funded by the Ontario Ministry of Health and Long-Term Care, as well as Health Canada Anti-Drug Strategy Initiatives.
Dr. MacCallum and her team are researching strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes.As part of that, the team will also determine how routine monitoring and follow-up is linked to other expanded professional services.
The project began with a survey of about 8,000 pharmacists in early 2018. During phase two, launched in fall 2018, researchers are working with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.
With the support of the Innovation grant and additional funding from the New Brunswick Pharmacists' Association, Dr. Tsuyuki and his team tracked and quantified the impact of pharmacist management of patients with uncomplicated urinary tract infection.
As follow-up to the study, the research team is looking at antibiotic usage and conducting an economic analysis. The group is also developing an online registry and practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.
News article - "Pharmacists for UTI management a 'no-brainer'"
Published study - "Outcomes of Urinary Tract Infection Management by Pharmacists (RxOUTMAP)"
Dr. Barbara Farrell of the Bruyère Research Institute in Ottawa has been awarded $50,000 to support her research project on “Mobilizing Community Pharmacists as Catalysts for Deprescribing.” Based at the Institute, Farrell and her team will work with community pharmacy practices and a national advisory group (with provider and private payer representation) over a one-year period to develop acceptable workflow strategies for deprescribing guideline use.
Research associates will work with each pharmacy to quantify opportunities for deprescribing, describe activities and processes associated with guideline use—including how long such activities take—and highlight enablers and barriers that pharmacists encounter. This project is expected to lay the foundation for a larger demonstration project examining reach, adoption and implementation of deprescribing strategies, and ultimately a randomized controlled trial of deprescribing interventions that explores patient and health system outcomes, including related cost savings.
News article - "Deprescribing, within a pharmacist's domain"
Dr. Line Guénette of the Faculty of Pharmacy at Laval University and her team have received $26,800 to develop evidence-based electronic tools for community pharmacists to detect and improve medication non-adherence. Drawing on their previous research in medication adherence measures, the team aims to develop five electronic tools to target four common chronic disease areas (type 2 diabetes, hypertension, asthma and depression).
“We are committed to building tools that have acceptability, usability, utility, implementation and ways to improve e-tools for supporting pharmacy practice,” says Guénette, noting that the initial focus will be on diabetes and depression. “By developing and providing new tools to better identify patients having adherence problems, we will engage and support pharmacists with their crucial role regarding …medication efficacy/safety."
University of Toronto’s Sara Guilcher and her team were also honoured with a 2016 Innovation Fund grant worth $38,000 to establish and evaluate the feasibility of an Acute care to Community Pharmacy Communication Link (ACC-Link) to improve medication management across transitions of care.
Building on existing best evidence around successful medication management interventions, the ACC-Link provides communication between hospital and community pharmacists to actively equip the latter with information needed to guide patients and their families at the point of hospital discharge. By evaluating the feasibility of the intervention and understanding the factors that may influence implementation, the researchers are expecting the program can be scaled to fit other clinical settings.
“Ultimately, ACC-Link has the potential to improve patients’ medication experiences, safety, overall health, and quality of life for themselves and their caregivers while reducing health-system costs and demand,” noted the research team in their submission.
Researchers Christine Hughes, Terri Schindel and Rene Breault set out to determine how Alberta pharmacists are providing care under the Alberta Pharmacy Services Framework, and how patients are experiencing care planning services in the “real world.”
With funding from the Canadian Foundation for Pharmacy and the Alberta Pharmacists’ Association (RxA), the investigators recruited four different cases, or community pharmacies, in the province and collected data over 12 months per site. Over the course of 83 interviews and 94 hours of observation, they explored the value of pharmacy services to patients, pharmacists, other healthcare providers and policy makers.
Sherilyn Houle and her research team at University of Waterloo studied the clinical effectiveness and patients' satisfaction with travel medicine services provided by pharmacists with independent prescribing authority. Results were very positive. “We hope pharmacists are encouraged by these results, which show that they can safely and effectively prescribe and inject travel vaccines independently, and it’s a service that patients really appreciate,” says Houle.
2018 news article - Pharmacists’ fit in travel medicine
2018 news article - Happy, healthy travels
Working with a physician in a primary care setting, Tejal Patel examines how pharmacist interventions can reduce polypharmacy and high-risk medication use among the frail elderly.
2016 news article - The frail elderly: pharmacists' essential role
The Evaluation of Pharmacist Prescribing for Minor Ailments - The Clinical and Economic Value
Now that pharmacists in some provinces can prescribe for minor ailments, what’s the impact on patients’ health? It’s a question that researchers in at the University Saskatchewan are keen to answer with a multiple-phase study, funded in part by the CFP.
Phase one in 2012-2013, funded by the provincial government, surveyed 125 pharmacy customers who’d been prescribed at least one medication for a minor ailment at one of 90 participating pharmacies. The study tracked the most common minor ailments treated and captured customers' perceptions of pharmacists. During phase two in 2015, researchers collected feedback about the process from pharmacists and physicians. Preliminary findings are mixed, with some resistance from some physicians. Researchers also returned to patients to capture their additional feedback. The final phase of the research, released in 2017, assessed and projected the economic impact of pharmacists prescribing for minor ailments.
Related articles:
Patient Perspectives on Symptom Severity (SelfCare 2016)
Minor Ailment Prescribing: Part 2 - Physician Feedback (SelfCare 2016)
Minor Ailment Prescribing: Part 1 - Pharmacist Feedback (SelfCare 2016)
Pharmacist-led minor ailment programs: a Canadian perspective (Int J Gen Med. 2016)
Evaluating pharmacist prescribing for minor ailments (Int J Pharm Pract. 2015)
2015 Changing Face of Pharmacy report (page 18)
2014 news article - Vote of confidence for minor ailments
Assessing need and benefits of home-based medication review services for non-homebound patients
Toronto-based community pharmacist John Papastergiou and his research team are assessing the benefits of providing home-based medication reviews to non-homebound patients. Currently, Ontario's MedsCheck for Home program reimburses pharmacists only for reviews conducted for homebound patients. Findings from previous research, however, as well as experiences with patients in the pharmacy, indicate that that there are medication-management issues that are best addressed in the home environment, whether or not the patient is homebound (for example, expired or discontinued medications). Senior patients taking five or more chronic medications are being recruited for the 12-month study, which reimburses participating pharmacists for their services to patients and for time spent documenting interventions.
Related article:
2017 news article - Home visits warranted for non-housebound
Pharmacists' Innovative Drug Therapy Management Outcomes, Resource use and Economics (PHInDMORE)
The Canadian Foundation for Pharmacy awarded a grant of $35,000 in support of PhInDMORE, a collaboration between Drs. Carlo Marra and Larry Lynd from the Faculty of Pharmaceutical Sciences at the University of British Columbia, and pharmacist John Shaske of Howe Sound Pharmacy. Howe Sound is piloting the province's new PharmaNet system, and PHInDMORE is reviewing pharmacists' interventions and their impacts on patient outcomes, both clinical and economic. PharmaNet is a central database that allows for capture of real-world, real-time documentation of pharmacist-patient encounters to a level of comprehensiveness that has never before been possible. The research aims to demonstrate that there is potential for cost savings to the healthcare system when investing in pharmacists to practice to their full potential.
Related link:
Multi-partner smoking cessation project for vulnerable patient group
Pharmacists Manitoba partnered with Manitoba Health, Healthy Living and Seniors, the College of Pharmacists of Manitoba, Neighbourhood Pharmacy Association of Canada and researchers at the College of Pharmacy, University of Manitoba, to conduct a pilot project focused on helping low-income patient quit smoking. "We successfully reached out and worked with a very hard-to-reach population. Pharmacists proved that they are a key access point to a majority of the population, much more so than other healthcare providers," says Dr. Brenna Shearer, Chief Executive Officer of Pharmacists Manitoba.
In addition to $25,000 in funding from the Canadian Foundation for Pharmacy's Innovation Fund, this project was made possible through a matching grant from Pfizer Canada.
Related links:
2015 news article - MB smoking cessation helps vulnerable group
Safety Alerts as Drivers for Pharmaceutical Opinion Program: A Pilot Study to Reduce Potential Hospitalizations due to Preventable Drug-Drug Interactions
The Canadian Foundation for Pharmacy's Innovation Fund Grant of $50,000 supports a research project under the guidance of Principal Investigator Certina Ho, ISMP Canada and School of Pharmacy, University of Waterloo, to analyze and support the role of pharmacist to prevent medication errors, while generating new revenue streams via Ontario's funded Pharmaceutical Opinions program.
Related link:
2015 article in Pharmacy Practice+ - Safety alerts a win for patients, pharmacists, government
Pharmacists: Personalized Medicine Experts in Primary Care
Led by Lisa McCarthy (PharmD MSc), (Women’s College Hospital (WCH) and Leslie Dan Faculty of Pharmacy, University of Toronto), this multi-phase project will equip primary care pharmacists with the knowledge and skills required to take a lead role as personalized medicine experts in our health system and evaluate the impact on patients’ health outcomes.
Related links:
2016 article and video, www.CanadianHealthcareNetwork.ca
2016 news article: Personalized medicine in community practice
Impact of Community Pharmacist Interventions in Hypertension Management in Patient Outcomes: A Randomized Control Trial
Canadian Foundation for Pharmacy's $50,000 grant from its Innovation Fund supported ground-breaking research on the impact of regularly scheduled pharmacists' interventions with patients with uncontrolled hypertension in the working population. Pharmacists not only significantly helped improve blood pressure control, but were recognized as effective sources of support for changes in lifestyle behaviours. Green Shield Canada has since launched a pharmacists coaching program for cardiovascular health, available as a core benefit for its clients with drug plans.
Related links:
2015 news article - Insurer invests in CV coaching
2014 news article - Green Shield/OPA results promising for pharmacists
2014 final project report - Ontario Pharmacists Association & Green Shield Canada
SafetyNET-Rx: Development and Testing of Evaluation Guides
Neil McKinnon and his research team at Dalhousie University received $48,000 from the Canadian Foundation for Pharmacy's Innovation Fund to support SafetyNET-Rx, a standardized community pharmacy quality improvement program. Pharmacists and pharmacy assistants and technicians learn to identify and categorize specific medication errors and "near misses" (errors intercepted before a patient receives a prescription), then anonymously submit each error to a national database for subsequent analysis so pharmacy may implement practice changes to help prevent such errors from occurring again.
Related links:
2016 news article - SafetyNET-Rx has been a game changer
2014 news article - SK adopts SafetyNET-Rx for quality assurance
2010 news article - CFP announces 2010 Innovation Fund Grant winner
"Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)"
With $50,000 in funding from the Canadian Foundation for Pharmacy’s Innovation Fund, a University of Alberta team of researchers and front-line pharmacists are implementing a pharmacist-initiated mental health monitoring and intervention program based in the community setting. “We are grateful to have the opportunity to partner with CFP as an unbiased organization that supports pharmacy initiatives,” says lead researcher/pharmacist Dan Burton.
For the study, up to 10 pharmacies in Calgary and surrounding areas will be involved with some 120 participating patients over a six-month period. The intervention group will be recruiting and monitoring patients with major depressive disorder and general anxiety disorder, providing interventions as needed and collaborating with patients’ physicians. The control group will receive usual pharmacy care.
Participating pharmacists will receive mental health training materials and have support throughout the pilot and are expected to begin recruiting patients by March 2020.
“Given community pharmacists’ training and access, they are in a great position to help the healthcare field better manage depression and anxiety,” says Burton. “They could take the burden off physicians and other providers by stabilizing patients on medication—plus sometimes these patients need more frequent touch points of support and we have that opportunity in the community.”
Burton says he and his team were inspired to develop the study by the recent Bloom Program pilot in Nova Scotia, which showed the positive benefits community pharmacists can have in helping patients with mental health issues. “With additional prescribing authority in Alberta there’s potential for us to do even more,” he says. For example, Alberta pharmacists can titrate and augment therapies by prescribing higher doses, or add on medications to help patients reach maximum treatment benefits. They can also switch therapies if patients aren’t responding or have uncomfortable side effects. “That’s a huge opportunity for pharmacists,” he says.
Burton hopes that positive study results will also encourage other pharmacists to get more involved in helping patients with mental health disorders. “There is still a significant amount of stigma out there around mental health. Pharmacists are also very type A personalities and sometimes we need concrete data before we believe we can do it,” he says. “If the study goes well, it will be a good starting point to build from.”
|
| Laura Murphy |
|
| Olavo Fernandes |
"CannabisCareRx"
A $25,000 grant from the Canadian Foundation for Pharmacy’s Innovation Fund will see the development and study of a program to help community pharmacists identify and support patients using medical cannabis, as part of routine care.
The pilot-based research study out of Ontario is looking to bridge the gap between legal medical cannabis distribution, which currently bypasses community pharmacies, and the expectation that community pharmacists competently provide information and advice to patients who use medical cannabis. Pharmacists in Ontario who provide direct patient care must complete mandatory cannabis training by 2020, yet there is a noticeable lack of a training program that involves pharmacists in screening for cannabis use.
Lead investigators Laura Murphy and Olavo Fernandes, researchers at the University Health Network, will conduct a prospective observational study of a pilot implementation of a structured program, entitled CannabisCareRx. The program will be comprised of screening questions, a structured process for assessment and a template for documentation and referral to other healthcare providers. The program also includes pharmacist education that emphasizes the development of communication skills to engage patients and decrease stigma. The materials and tools developed will be scalable for implementation across Canada.
Overall, the project is set to occur over three years, starting in September of 2020. It is broken up into three steps: set-up, pilot implementation and dissemination. The set-up stage includes development of the pharmacy education and consultation guide, building the research database, and recruiting five pharmacists from the Greater Toronto Area for the pilot occurring throughout year two.
CannabisCareRx will be piloted as part of usual care provided by the participating pharmacists. After completing the Cannabis Education program, the pharmacists will implement the use of the screening questions with all of their adult patients during routine interactions throughout the 12 months of the pilot.
From there, a member of the research team will conduct a follow-up survey with the pharmacists involved and patients who provide their contact information and permission. The feasibility outcomes will include the number of patients who use cannabis for therapeutic reasons, the number of patients who complete the questionnaire, and the amount of pharmacist time required to conduct CannabisCareRx.
The aim is not only to be successful at the end of the three years but also to create a blueprint for pharmacists across Canada. “The outcomes of the pilot implementation of the CannabisCareRx program will provide patient-centred, pharmacist-driven education materials that will not only support the promotion of safe and effective use of cannabis and harm reduction but will also provide a tangible, patient-facing guide that can facilitate brief and effective consultation,” said Murphy.
"SAD-APP: Self-rating App for Depression Aided by Proactive Pharmacists"
Researcher Philippe Vincent and pharmacists at 30 community pharmacies hope to smooth the path to recovery for patients with depression through a ground-breaking research study funded in part with a $50,000 grant from the Canadian Foundation for Pharmacy’s (CFP’s) Innovation Fund.
The research is unique in that it combines pharmacist coaching with a smartphone app. The app will also differentiate itself within the virtual sea of mental health apps in that it will be built around the PHQ-9 and GAD-7 self-assessment questionnaires, two standardised, validated tools to assess depression and anxiety, respectively. Participating pharmacists will be able to access a patient’s results using a secure, online dashboard.
The study’s primary objective is to shorten the time to recovery by helping patients achieve treatment response as quickly as possible and by supporting adherence.
“Our project seeks to bring patients who suffer in silence and pharmacists together into a meaningful relationship. The self-rating scales and smartphone app are mediators of a safe space for private, sometimes emotional conversations and goal-setting,” says Vincent, Associate Professor of Clinical Pharmacy at University of Montreal and a researcher with the university-affiliated Institute universitaire en sante mentale de Montreal (a psychiatric hospital).
A secondary goal is to prove the value of pharmacists’ interventions. “If we can show that the time pharmacists put into monitoring and coaching is directly proportional to the remission of patients, so people can go back to meaningful occupations and live fuller lives, then insurance, government and other stakeholders will understand that the pharmacists’ time is worth something,” says Vincent.
As well, the stage is already set for possible adoption of the research model into regular pharmacy practice, and possibly on a national scale. All 30 participating pharmacies are part of the Pharmaprix banner, a division of Shoppers Drug Mart and Loblaw companies. Pharmaprix is co-funding the project with CFP.
The study is a randomized, unblinded, multicenter intervention trial that will follow patients over six months. The 30 participating pharmacies will each enrol 10 patients who have been diagnosed with a new episode of major depression, broken down as follows:
Pharmacists in the coaching group will receive training based on best practices in clinical psychiatry. They will call their participating patients every week during the dose-finding period and conduct a 5-minute semi-structured interview that seeks to create rapport, agree on treatment goals and agree on tasks. Pharmacists will also ask about side effects, which will be addressed as required through separate interventions that will be documented in the dashboard.
Throughout the six months of the study, the app will send notifications to patients every two weeks to remind them to complete the PHQ-9 and GAD-7 questionnaires. The app will also prompt patients to complete the PHQ-2 questionnaire every day for the first 15 days, every two days for the next 15 days, and every three days thereafter. “In a pharmacy setting where everything is so busy, you need to have useful, fast and complete information. This model enables systematic monitoring and a communication bridge between patients and pharmacists,” says Vincent.
The estimated project completion date, including data analysis, is mid 2021.
John Papastergiou, practising community pharmacist, and the research team at University of Toronto is using CFP's grant of $15,000 to quantify adherence rates to adult immunizations, where a series of vaccines or booster vaccines are required, when these vaccines are administered by community pharmacists. It's hoped that the study results will help pharmacists obtain prescribing rights for vaccines.
CFP has awarded Paula Newman and her team at Northwest Telepharmacy Solutions $22,500 to determine the feasibility and effectiveness of a pharmacist-led opioid stewardship program for chronic non-cancer pain, using videoconferencing technology. The project includes prescriber and patient education, risk stratification and screening for potential harm, as well as patient monitoriing with follow-up and continuity of care.
The Presciption to Thrive project, funded by multiple stakeholders including Canada's two national pharmacy associations and the Nova Scotia Department of Health and Wellness, seeks to establish a model for practice change in community pharmacy. Expert facilitators will work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.
Saleema Bhaidani, Director, Pharmacy Innovation & Professional Affairs at Whole Health Pharmacy Partners, and researcher Lisa Dolovich at the University of Toronto are conducting a retrospective analysis of the impact of an appointment-based model (ABM) for pharmacy practice based on data obtained from six independent pharmacies, part of the Whole Health Pharmacy banner, which implemented ABM in September 2017. ABM uses medication synchronization to coordinate refills into one pick-up, which enables pharmacists to conduct appointments where they can review, address and follow up on medication issues on a monthly or regular basis. The study will seek to evaluate clinical outcomes and the impact on adherence, as well as ABM's impact on workflow and pharmacy staff.
Dr. Chang and her team will examine the feasibility and effectiveness of a pharmacist intervention targeting high-dose, high-risk prescription opioids. The study will complement previous research in the area funded by the Ontario Ministry of Health and Long-Term Care, as well as Health Canada Anti-Drug Strategy Initiatives.
Dr. MacCallum and her team are researching strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes.As part of that, the team will also determine how routine monitoring and follow-up is linked to other expanded professional services.
The project began with a survey of about 8,000 pharmacists in early 2018. During phase two, launched in fall 2018, researchers are working with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.
With the support of the Innovation grant and additional funding from the New Brunswick Pharmacists' Association, Dr. Tsuyuki and his team tracked and quantified the impact of pharmacist management of patients with uncomplicated urinary tract infection.
As follow-up to the study, the research team is looking at antibiotic usage and conducting an economic analysis. The group is also developing an online registry and practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.
News article - "Pharmacists for UTI management a 'no-brainer'"
Published study - "Outcomes of Urinary Tract Infection Management by Pharmacists (RxOUTMAP)"
Dr. Barbara Farrell of the Bruyère Research Institute in Ottawa has been awarded $50,000 to support her research project on “Mobilizing Community Pharmacists as Catalysts for Deprescribing.” Based at the Institute, Farrell and her team will work with community pharmacy practices and a national advisory group (with provider and private payer representation) over a one-year period to develop acceptable workflow strategies for deprescribing guideline use.
Research associates will work with each pharmacy to quantify opportunities for deprescribing, describe activities and processes associated with guideline use—including how long such activities take—and highlight enablers and barriers that pharmacists encounter. This project is expected to lay the foundation for a larger demonstration project examining reach, adoption and implementation of deprescribing strategies, and ultimately a randomized controlled trial of deprescribing interventions that explores patient and health system outcomes, including related cost savings.
News article - "Deprescribing, within a pharmacist's domain"
Dr. Line Guénette of the Faculty of Pharmacy at Laval University and her team have received $26,800 to develop evidence-based electronic tools for community pharmacists to detect and improve medication non-adherence. Drawing on their previous research in medication adherence measures, the team aims to develop five electronic tools to target four common chronic disease areas (type 2 diabetes, hypertension, asthma and depression).
“We are committed to building tools that have acceptability, usability, utility, implementation and ways to improve e-tools for supporting pharmacy practice,” says Guénette, noting that the initial focus will be on diabetes and depression. “By developing and providing new tools to better identify patients having adherence problems, we will engage and support pharmacists with their crucial role regarding …medication efficacy/safety."
University of Toronto’s Sara Guilcher and her team were also honoured with a 2016 Innovation Fund grant worth $38,000 to establish and evaluate the feasibility of an Acute care to Community Pharmacy Communication Link (ACC-Link) to improve medication management across transitions of care.
Building on existing best evidence around successful medication management interventions, the ACC-Link provides communication between hospital and community pharmacists to actively equip the latter with information needed to guide patients and their families at the point of hospital discharge. By evaluating the feasibility of the intervention and understanding the factors that may influence implementation, the researchers are expecting the program can be scaled to fit other clinical settings.
“Ultimately, ACC-Link has the potential to improve patients’ medication experiences, safety, overall health, and quality of life for themselves and their caregivers while reducing health-system costs and demand,” noted the research team in their submission.
Researchers Christine Hughes, Terri Schindel and Rene Breault set out to determine how Alberta pharmacists are providing care under the Alberta Pharmacy Services Framework, and how patients are experiencing care planning services in the “real world.”
With funding from the Canadian Foundation for Pharmacy and the Alberta Pharmacists’ Association (RxA), the investigators recruited four different cases, or community pharmacies, in the province and collected data over 12 months per site. Over the course of 83 interviews and 94 hours of observation, they explored the value of pharmacy services to patients, pharmacists, other healthcare providers and policy makers.
Sherilyn Houle and her research team at University of Waterloo studied the clinical effectiveness and patients' satisfaction with travel medicine services provided by pharmacists with independent prescribing authority. Results were very positive. “We hope pharmacists are encouraged by these results, which show that they can safely and effectively prescribe and inject travel vaccines independently, and it’s a service that patients really appreciate,” says Houle.
2018 news article - Pharmacists’ fit in travel medicine
2018 news article - Happy, healthy travels
Working with a physician in a primary care setting, Tejal Patel examines how pharmacist interventions can reduce polypharmacy and high-risk medication use among the frail elderly.
2016 news article - The frail elderly: pharmacists' essential role
The Evaluation of Pharmacist Prescribing for Minor Ailments - The Clinical and Economic Value
Now that pharmacists in some provinces can prescribe for minor ailments, what’s the impact on patients’ health? It’s a question that researchers in at the University Saskatchewan are keen to answer with a multiple-phase study, funded in part by the CFP.
Phase one in 2012-2013, funded by the provincial government, surveyed 125 pharmacy customers who’d been prescribed at least one medication for a minor ailment at one of 90 participating pharmacies. The study tracked the most common minor ailments treated and captured customers' perceptions of pharmacists. During phase two in 2015, researchers collected feedback about the process from pharmacists and physicians. Preliminary findings are mixed, with some resistance from some physicians. Researchers also returned to patients to capture their additional feedback. The final phase of the research, released in 2017, assessed and projected the economic impact of pharmacists prescribing for minor ailments.
Related articles:
Patient Perspectives on Symptom Severity (SelfCare 2016)
Minor Ailment Prescribing: Part 2 - Physician Feedback (SelfCare 2016)
Minor Ailment Prescribing: Part 1 - Pharmacist Feedback (SelfCare 2016)
Pharmacist-led minor ailment programs: a Canadian perspective (Int J Gen Med. 2016)
Evaluating pharmacist prescribing for minor ailments (Int J Pharm Pract. 2015)
2015 Changing Face of Pharmacy report (page 18)
2014 news article - Vote of confidence for minor ailments
Assessing need and benefits of home-based medication review services for non-homebound patients
Toronto-based community pharmacist John Papastergiou and his research team are assessing the benefits of providing home-based medication reviews to non-homebound patients. Currently, Ontario's MedsCheck for Home program reimburses pharmacists only for reviews conducted for homebound patients. Findings from previous research, however, as well as experiences with patients in the pharmacy, indicate that that there are medication-management issues that are best addressed in the home environment, whether or not the patient is homebound (for example, expired or discontinued medications). Senior patients taking five or more chronic medications are being recruited for the 12-month study, which reimburses participating pharmacists for their services to patients and for time spent documenting interventions.
Related article:
2017 news article - Home visits warranted for non-housebound
Pharmacists' Innovative Drug Therapy Management Outcomes, Resource use and Economics (PHInDMORE)
The Canadian Foundation for Pharmacy awarded a grant of $35,000 in support of PhInDMORE, a collaboration between Drs. Carlo Marra and Larry Lynd from the Faculty of Pharmaceutical Sciences at the University of British Columbia, and pharmacist John Shaske of Howe Sound Pharmacy. Howe Sound is piloting the province's new PharmaNet system, and PHInDMORE is reviewing pharmacists' interventions and their impacts on patient outcomes, both clinical and economic. PharmaNet is a central database that allows for capture of real-world, real-time documentation of pharmacist-patient encounters to a level of comprehensiveness that has never before been possible. The research aims to demonstrate that there is potential for cost savings to the healthcare system when investing in pharmacists to practice to their full potential.
Related link:
Multi-partner smoking cessation project for vulnerable patient group
Pharmacists Manitoba partnered with Manitoba Health, Healthy Living and Seniors, the College of Pharmacists of Manitoba, Neighbourhood Pharmacy Association of Canada and researchers at the College of Pharmacy, University of Manitoba, to conduct a pilot project focused on helping low-income patient quit smoking. "We successfully reached out and worked with a very hard-to-reach population. Pharmacists proved that they are a key access point to a majority of the population, much more so than other healthcare providers," says Dr. Brenna Shearer, Chief Executive Officer of Pharmacists Manitoba.
In addition to $25,000 in funding from the Canadian Foundation for Pharmacy's Innovation Fund, this project was made possible through a matching grant from Pfizer Canada.
Related links:
2015 news article - MB smoking cessation helps vulnerable group
Safety Alerts as Drivers for Pharmaceutical Opinion Program: A Pilot Study to Reduce Potential Hospitalizations due to Preventable Drug-Drug Interactions
The Canadian Foundation for Pharmacy's Innovation Fund Grant of $50,000 supports a research project under the guidance of Principal Investigator Certina Ho, ISMP Canada and School of Pharmacy, University of Waterloo, to analyze and support the role of pharmacist to prevent medication errors, while generating new revenue streams via Ontario's funded Pharmaceutical Opinions program.
Related link:
2015 article in Pharmacy Practice+ - Safety alerts a win for patients, pharmacists, government
Pharmacists: Personalized Medicine Experts in Primary Care
Led by Lisa McCarthy (PharmD MSc), (Women’s College Hospital (WCH) and Leslie Dan Faculty of Pharmacy, University of Toronto), this multi-phase project will equip primary care pharmacists with the knowledge and skills required to take a lead role as personalized medicine experts in our health system and evaluate the impact on patients’ health outcomes.
Related links:
2016 article and video, www.CanadianHealthcareNetwork.ca
2016 news article: Personalized medicine in community practice
Impact of Community Pharmacist Interventions in Hypertension Management in Patient Outcomes: A Randomized Control Trial
Canadian Foundation for Pharmacy's $50,000 grant from its Innovation Fund supported ground-breaking research on the impact of regularly scheduled pharmacists' interventions with patients with uncontrolled hypertension in the working population. Pharmacists not only significantly helped improve blood pressure control, but were recognized as effective sources of support for changes in lifestyle behaviours. Green Shield Canada has since launched a pharmacists coaching program for cardiovascular health, available as a core benefit for its clients with drug plans.
Related links:
2015 news article - Insurer invests in CV coaching
2014 news article - Green Shield/OPA results promising for pharmacists
2014 final project report - Ontario Pharmacists Association & Green Shield Canada
SafetyNET-Rx: Development and Testing of Evaluation Guides
Neil McKinnon and his research team at Dalhousie University received $48,000 from the Canadian Foundation for Pharmacy's Innovation Fund to support SafetyNET-Rx, a standardized community pharmacy quality improvement program. Pharmacists and pharmacy assistants and technicians learn to identify and categorize specific medication errors and "near misses" (errors intercepted before a patient receives a prescription), then anonymously submit each error to a national database for subsequent analysis so pharmacy may implement practice changes to help prevent such errors from occurring again.
Related links:
2016 news article - SafetyNET-Rx has been a game changer
2014 news article - SK adopts SafetyNET-Rx for quality assurance
2010 news article - CFP announces 2010 Innovation Fund Grant winner
How have Pharmacists in Different Practice Settings integrated Prescribing into Practice in Alberta?
The Canadian Foundation for Pharmacy and Alberta College of Pharmacists are funding a three-stage research project on pharmacists' prescribing behaviours. Stage one, conducted in 2013, was a qualitative exploration based on interviews with small cohorts of pharmacists in Alberta and Ontario who prescribe at least weekly. It found that pharmacists in all practice settings were prescribing in product-, disease- and patient-focused ways. Many also focused their prescribing in a clinical area, such as anticoagulation, hypertension and diabetes. Stage two, currently under development, will draw from the findings of stage one to survey a great number of pharmacists. Stage three, a mixed-methods survey, will continue to build upon the findings from the previous stages, focusing on pharmacists in Alberta.
Related links:
2011 article in Canadian Pharmacists Journal - Study Design and Rationale
"Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)"
With $50,000 in funding from the Canadian Foundation for Pharmacy’s Innovation Fund, a University of Alberta team of researchers and front-line pharmacists are implementing a pharmacist-initiated mental health monitoring and intervention program based in the community setting. “We are grateful to have the opportunity to partner with CFP as an unbiased organization that supports pharmacy initiatives,” says lead researcher/pharmacist Dan Burton.
For the study, up to 10 pharmacies in Calgary and surrounding areas will be involved with some 120 participating patients over a six-month period. The intervention group will be recruiting and monitoring patients with major depressive disorder and general anxiety disorder, providing interventions as needed and collaborating with patients’ physicians. The control group will receive usual pharmacy care.
Participating pharmacists will receive mental health training materials and have support throughout the pilot and are expected to begin recruiting patients by March 2020.
“Given community pharmacists’ training and access, they are in a great position to help the healthcare field better manage depression and anxiety,” says Burton. “They could take the burden off physicians and other providers by stabilizing patients on medication—plus sometimes these patients need more frequent touch points of support and we have that opportunity in the community.”
Burton says he and his team were inspired to develop the study by the recent Bloom Program pilot in Nova Scotia, which showed the positive benefits community pharmacists can have in helping patients with mental health issues. “With additional prescribing authority in Alberta there’s potential for us to do even more,” he says. For example, Alberta pharmacists can titrate and augment therapies by prescribing higher doses, or add on medications to help patients reach maximum treatment benefits. They can also switch therapies if patients aren’t responding or have uncomfortable side effects. “That’s a huge opportunity for pharmacists,” he says.
Burton hopes that positive study results will also encourage other pharmacists to get more involved in helping patients with mental health disorders. “There is still a significant amount of stigma out there around mental health. Pharmacists are also very type A personalities and sometimes we need concrete data before we believe we can do it,” he says. “If the study goes well, it will be a good starting point to build from.”
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| Laura Murphy |
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| Olavo Fernandes |
"CannabisCareRx"
A $25,000 grant from the Canadian Foundation for Pharmacy’s Innovation Fund will see the development and study of a program to help community pharmacists identify and support patients using medical cannabis, as part of routine care.
The pilot-based research study out of Ontario is looking to bridge the gap between legal medical cannabis distribution, which currently bypasses community pharmacies, and the expectation that community pharmacists competently provide information and advice to patients who use medical cannabis. Pharmacists in Ontario who provide direct patient care must complete mandatory cannabis training by 2020, yet there is a noticeable lack of a training program that involves pharmacists in screening for cannabis use.
Lead investigators Laura Murphy and Olavo Fernandes, researchers at the University Health Network, will conduct a prospective observational study of a pilot implementation of a structured program, entitled CannabisCareRx. The program will be comprised of screening questions, a structured process for assessment and a template for documentation and referral to other healthcare providers. The program also includes pharmacist education that emphasizes the development of communication skills to engage patients and decrease stigma. The materials and tools developed will be scalable for implementation across Canada.
Overall, the project is set to occur over three years, starting in September of 2020. It is broken up into three steps: set-up, pilot implementation and dissemination. The set-up stage includes development of the pharmacy education and consultation guide, building the research database, and recruiting five pharmacists from the Greater Toronto Area for the pilot occurring throughout year two.
CannabisCareRx will be piloted as part of usual care provided by the participating pharmacists. After completing the Cannabis Education program, the pharmacists will implement the use of the screening questions with all of their adult patients during routine interactions throughout the 12 months of the pilot.
From there, a member of the research team will conduct a follow-up survey with the pharmacists involved and patients who provide their contact information and permission. The feasibility outcomes will include the number of patients who use cannabis for therapeutic reasons, the number of patients who complete the questionnaire, and the amount of pharmacist time required to conduct CannabisCareRx.
The aim is not only to be successful at the end of the three years but also to create a blueprint for pharmacists across Canada. “The outcomes of the pilot implementation of the CannabisCareRx program will provide patient-centred, pharmacist-driven education materials that will not only support the promotion of safe and effective use of cannabis and harm reduction but will also provide a tangible, patient-facing guide that can facilitate brief and effective consultation,” said Murphy.
"SAD-APP: Self-rating App for Depression Aided by Proactive Pharmacists"
Researcher Philippe Vincent and pharmacists at 30 community pharmacies hope to smooth the path to recovery for patients with depression through a ground-breaking research study funded in part with a $50,000 grant from the Canadian Foundation for Pharmacy’s (CFP’s) Innovation Fund.
The research is unique in that it combines pharmacist coaching with a smartphone app. The app will also differentiate itself within the virtual sea of mental health apps in that it will be built around the PHQ-9 and GAD-7 self-assessment questionnaires, two standardised, validated tools to assess depression and anxiety, respectively. Participating pharmacists will be able to access a patient’s results using a secure, online dashboard.
The study’s primary objective is to shorten the time to recovery by helping patients achieve treatment response as quickly as possible and by supporting adherence.
“Our project seeks to bring patients who suffer in silence and pharmacists together into a meaningful relationship. The self-rating scales and smartphone app are mediators of a safe space for private, sometimes emotional conversations and goal-setting,” says Vincent, Associate Professor of Clinical Pharmacy at University of Montreal and a researcher with the university-affiliated Institute universitaire en sante mentale de Montreal (a psychiatric hospital).
A secondary goal is to prove the value of pharmacists’ interventions. “If we can show that the time pharmacists put into monitoring and coaching is directly proportional to the remission of patients, so people can go back to meaningful occupations and live fuller lives, then insurance, government and other stakeholders will understand that the pharmacists’ time is worth something,” says Vincent.
As well, the stage is already set for possible adoption of the research model into regular pharmacy practice, and possibly on a national scale. All 30 participating pharmacies are part of the Pharmaprix banner, a division of Shoppers Drug Mart and Loblaw companies. Pharmaprix is co-funding the project with CFP.
The study is a randomized, unblinded, multicenter intervention trial that will follow patients over six months. The 30 participating pharmacies will each enrol 10 patients who have been diagnosed with a new episode of major depression, broken down as follows:
Pharmacists in the coaching group will receive training based on best practices in clinical psychiatry. They will call their participating patients every week during the dose-finding period and conduct a 5-minute semi-structured interview that seeks to create rapport, agree on treatment goals and agree on tasks. Pharmacists will also ask about side effects, which will be addressed as required through separate interventions that will be documented in the dashboard.
Throughout the six months of the study, the app will send notifications to patients every two weeks to remind them to complete the PHQ-9 and GAD-7 questionnaires. The app will also prompt patients to complete the PHQ-2 questionnaire every day for the first 15 days, every two days for the next 15 days, and every three days thereafter. “In a pharmacy setting where everything is so busy, you need to have useful, fast and complete information. This model enables systematic monitoring and a communication bridge between patients and pharmacists,” says Vincent.
The estimated project completion date, including data analysis, is mid 2021.
John Papastergiou, practising community pharmacist, and the research team at University of Toronto is using CFP's grant of $15,000 to quantify adherence rates to adult immunizations, where a series of vaccines or booster vaccines are required, when these vaccines are administered by community pharmacists. It's hoped that the study results will help pharmacists obtain prescribing rights for vaccines.
CFP has awarded Paula Newman and her team at Northwest Telepharmacy Solutions $22,500 to determine the feasibility and effectiveness of a pharmacist-led opioid stewardship program for chronic non-cancer pain, using videoconferencing technology. The project includes prescriber and patient education, risk stratification and screening for potential harm, as well as patient monitoriing with follow-up and continuity of care.
The Presciption to Thrive project, funded by multiple stakeholders including Canada's two national pharmacy associations and the Nova Scotia Department of Health and Wellness, seeks to establish a model for practice change in community pharmacy. Expert facilitators will work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.
Saleema Bhaidani, Director, Pharmacy Innovation & Professional Affairs at Whole Health Pharmacy Partners, and researcher Lisa Dolovich at the University of Toronto are conducting a retrospective analysis of the impact of an appointment-based model (ABM) for pharmacy practice based on data obtained from six independent pharmacies, part of the Whole Health Pharmacy banner, which implemented ABM in September 2017. ABM uses medication synchronization to coordinate refills into one pick-up, which enables pharmacists to conduct appointments where they can review, address and follow up on medication issues on a monthly or regular basis. The study will seek to evaluate clinical outcomes and the impact on adherence, as well as ABM's impact on workflow and pharmacy staff.
Dr. Chang and her team will examine the feasibility and effectiveness of a pharmacist intervention targeting high-dose, high-risk prescription opioids. The study will complement previous research in the area funded by the Ontario Ministry of Health and Long-Term Care, as well as Health Canada Anti-Drug Strategy Initiatives.
Dr. MacCallum and her team are researching strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes.As part of that, the team will also determine how routine monitoring and follow-up is linked to other expanded professional services.
The project began with a survey of about 8,000 pharmacists in early 2018. During phase two, launched in fall 2018, researchers are working with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.
With the support of the Innovation grant and additional funding from the New Brunswick Pharmacists' Association, Dr. Tsuyuki and his team tracked and quantified the impact of pharmacist management of patients with uncomplicated urinary tract infection.
As follow-up to the study, the research team is looking at antibiotic usage and conducting an economic analysis. The group is also developing an online registry and practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.
News article - "Pharmacists for UTI management a 'no-brainer'"
Published study - "Outcomes of Urinary Tract Infection Management by Pharmacists (RxOUTMAP)"
Dr. Barbara Farrell of the Bruyère Research Institute in Ottawa has been awarded $50,000 to support her research project on “Mobilizing Community Pharmacists as Catalysts for Deprescribing.” Based at the Institute, Farrell and her team will work with community pharmacy practices and a national advisory group (with provider and private payer representation) over a one-year period to develop acceptable workflow strategies for deprescribing guideline use.
Research associates will work with each pharmacy to quantify opportunities for deprescribing, describe activities and processes associated with guideline use—including how long such activities take—and highlight enablers and barriers that pharmacists encounter. This project is expected to lay the foundation for a larger demonstration project examining reach, adoption and implementation of deprescribing strategies, and ultimately a randomized controlled trial of deprescribing interventions that explores patient and health system outcomes, including related cost savings.
News article - "Deprescribing, within a pharmacist's domain"
Dr. Line Guénette of the Faculty of Pharmacy at Laval University and her team have received $26,800 to develop evidence-based electronic tools for community pharmacists to detect and improve medication non-adherence. Drawing on their previous research in medication adherence measures, the team aims to develop five electronic tools to target four common chronic disease areas (type 2 diabetes, hypertension, asthma and depression).
“We are committed to building tools that have acceptability, usability, utility, implementation and ways to improve e-tools for supporting pharmacy practice,” says Guénette, noting that the initial focus will be on diabetes and depression. “By developing and providing new tools to better identify patients having adherence problems, we will engage and support pharmacists with their crucial role regarding …medication efficacy/safety."
University of Toronto’s Sara Guilcher and her team were also honoured with a 2016 Innovation Fund grant worth $38,000 to establish and evaluate the feasibility of an Acute care to Community Pharmacy Communication Link (ACC-Link) to improve medication management across transitions of care.
Building on existing best evidence around successful medication management interventions, the ACC-Link provides communication between hospital and community pharmacists to actively equip the latter with information needed to guide patients and their families at the point of hospital discharge. By evaluating the feasibility of the intervention and understanding the factors that may influence implementation, the researchers are expecting the program can be scaled to fit other clinical settings.
“Ultimately, ACC-Link has the potential to improve patients’ medication experiences, safety, overall health, and quality of life for themselves and their caregivers while reducing health-system costs and demand,” noted the research team in their submission.
Researchers Christine Hughes, Terri Schindel and Rene Breault set out to determine how Alberta pharmacists are providing care under the Alberta Pharmacy Services Framework, and how patients are experiencing care planning services in the “real world.”
With funding from the Canadian Foundation for Pharmacy and the Alberta Pharmacists’ Association (RxA), the investigators recruited four different cases, or community pharmacies, in the province and collected data over 12 months per site. Over the course of 83 interviews and 94 hours of observation, they explored the value of pharmacy services to patients, pharmacists, other healthcare providers and policy makers.
Sherilyn Houle and her research team at University of Waterloo studied the clinical effectiveness and patients' satisfaction with travel medicine services provided by pharmacists with independent prescribing authority. Results were very positive. “We hope pharmacists are encouraged by these results, which show that they can safely and effectively prescribe and inject travel vaccines independently, and it’s a service that patients really appreciate,” says Houle.
2018 news article - Pharmacists’ fit in travel medicine
2018 news article - Happy, healthy travels
Working with a physician in a primary care setting, Tejal Patel examines how pharmacist interventions can reduce polypharmacy and high-risk medication use among the frail elderly.
2016 news article - The frail elderly: pharmacists' essential role
The Evaluation of Pharmacist Prescribing for Minor Ailments - The Clinical and Economic Value
Now that pharmacists in some provinces can prescribe for minor ailments, what’s the impact on patients’ health? It’s a question that researchers in at the University Saskatchewan are keen to answer with a multiple-phase study, funded in part by the CFP.
Phase one in 2012-2013, funded by the provincial government, surveyed 125 pharmacy customers who’d been prescribed at least one medication for a minor ailment at one of 90 participating pharmacies. The study tracked the most common minor ailments treated and captured customers' perceptions of pharmacists. During phase two in 2015, researchers collected feedback about the process from pharmacists and physicians. Preliminary findings are mixed, with some resistance from some physicians. Researchers also returned to patients to capture their additional feedback. The final phase of the research, released in 2017, assessed and projected the economic impact of pharmacists prescribing for minor ailments.
Related articles:
Patient Perspectives on Symptom Severity (SelfCare 2016)
Minor Ailment Prescribing: Part 2 - Physician Feedback (SelfCare 2016)
Minor Ailment Prescribing: Part 1 - Pharmacist Feedback (SelfCare 2016)
Pharmacist-led minor ailment programs: a Canadian perspective (Int J Gen Med. 2016)
Evaluating pharmacist prescribing for minor ailments (Int J Pharm Pract. 2015)
2015 Changing Face of Pharmacy report (page 18)
2014 news article - Vote of confidence for minor ailments
Assessing need and benefits of home-based medication review services for non-homebound patients
Toronto-based community pharmacist John Papastergiou and his research team are assessing the benefits of providing home-based medication reviews to non-homebound patients. Currently, Ontario's MedsCheck for Home program reimburses pharmacists only for reviews conducted for homebound patients. Findings from previous research, however, as well as experiences with patients in the pharmacy, indicate that that there are medication-management issues that are best addressed in the home environment, whether or not the patient is homebound (for example, expired or discontinued medications). Senior patients taking five or more chronic medications are being recruited for the 12-month study, which reimburses participating pharmacists for their services to patients and for time spent documenting interventions.
Related article:
2017 news article - Home visits warranted for non-housebound
Pharmacists' Innovative Drug Therapy Management Outcomes, Resource use and Economics (PHInDMORE)
The Canadian Foundation for Pharmacy awarded a grant of $35,000 in support of PhInDMORE, a collaboration between Drs. Carlo Marra and Larry Lynd from the Faculty of Pharmaceutical Sciences at the University of British Columbia, and pharmacist John Shaske of Howe Sound Pharmacy. Howe Sound is piloting the province's new PharmaNet system, and PHInDMORE is reviewing pharmacists' interventions and their impacts on patient outcomes, both clinical and economic. PharmaNet is a central database that allows for capture of real-world, real-time documentation of pharmacist-patient encounters to a level of comprehensiveness that has never before been possible. The research aims to demonstrate that there is potential for cost savings to the healthcare system when investing in pharmacists to practice to their full potential.
Related link:
Multi-partner smoking cessation project for vulnerable patient group
Pharmacists Manitoba partnered with Manitoba Health, Healthy Living and Seniors, the College of Pharmacists of Manitoba, Neighbourhood Pharmacy Association of Canada and researchers at the College of Pharmacy, University of Manitoba, to conduct a pilot project focused on helping low-income patient quit smoking. "We successfully reached out and worked with a very hard-to-reach population. Pharmacists proved that they are a key access point to a majority of the population, much more so than other healthcare providers," says Dr. Brenna Shearer, Chief Executive Officer of Pharmacists Manitoba.
In addition to $25,000 in funding from the Canadian Foundation for Pharmacy's Innovation Fund, this project was made possible through a matching grant from Pfizer Canada.
Related links:
2015 news article - MB smoking cessation helps vulnerable group
Safety Alerts as Drivers for Pharmaceutical Opinion Program: A Pilot Study to Reduce Potential Hospitalizations due to Preventable Drug-Drug Interactions
The Canadian Foundation for Pharmacy's Innovation Fund Grant of $50,000 supports a research project under the guidance of Principal Investigator Certina Ho, ISMP Canada and School of Pharmacy, University of Waterloo, to analyze and support the role of pharmacist to prevent medication errors, while generating new revenue streams via Ontario's funded Pharmaceutical Opinions program.
Related link:
2015 article in Pharmacy Practice+ - Safety alerts a win for patients, pharmacists, government
Pharmacists: Personalized Medicine Experts in Primary Care
Led by Lisa McCarthy (PharmD MSc), (Women’s College Hospital (WCH) and Leslie Dan Faculty of Pharmacy, University of Toronto), this multi-phase project will equip primary care pharmacists with the knowledge and skills required to take a lead role as personalized medicine experts in our health system and evaluate the impact on patients’ health outcomes.
Related links:
2016 article and video, www.CanadianHealthcareNetwork.ca
2016 news article: Personalized medicine in community practice
Impact of Community Pharmacist Interventions in Hypertension Management in Patient Outcomes: A Randomized Control Trial
Canadian Foundation for Pharmacy's $50,000 grant from its Innovation Fund supported ground-breaking research on the impact of regularly scheduled pharmacists' interventions with patients with uncontrolled hypertension in the working population. Pharmacists not only significantly helped improve blood pressure control, but were recognized as effective sources of support for changes in lifestyle behaviours. Green Shield Canada has since launched a pharmacists coaching program for cardiovascular health, available as a core benefit for its clients with drug plans.
Related links:
2015 news article - Insurer invests in CV coaching
2014 news article - Green Shield/OPA results promising for pharmacists
2014 final project report - Ontario Pharmacists Association & Green Shield Canada
SafetyNET-Rx: Development and Testing of Evaluation Guides
Neil McKinnon and his research team at Dalhousie University received $48,000 from the Canadian Foundation for Pharmacy's Innovation Fund to support SafetyNET-Rx, a standardized community pharmacy quality improvement program. Pharmacists and pharmacy assistants and technicians learn to identify and categorize specific medication errors and "near misses" (errors intercepted before a patient receives a prescription), then anonymously submit each error to a national database for subsequent analysis so pharmacy may implement practice changes to help prevent such errors from occurring again.
Related links:
2016 news article - SafetyNET-Rx has been a game changer
2014 news article - SK adopts SafetyNET-Rx for quality assurance
2010 news article - CFP announces 2010 Innovation Fund Grant winner
How have Pharmacists in Different Practice Settings integrated Prescribing into Practice in Alberta?
The Canadian Foundation for Pharmacy and Alberta College of Pharmacists are funding a three-stage research project on pharmacists' prescribing behaviours. Stage one, conducted in 2013, was a qualitative exploration based on interviews with small cohorts of pharmacists in Alberta and Ontario who prescribe at least weekly. It found that pharmacists in all practice settings were prescribing in product-, disease- and patient-focused ways. Many also focused their prescribing in a clinical area, such as anticoagulation, hypertension and diabetes. Stage two, currently under development, will draw from the findings of stage one to survey a great number of pharmacists. Stage three, a mixed-methods survey, will continue to build upon the findings from the previous stages, focusing on pharmacists in Alberta.
Related links:
2011 article in Canadian Pharmacists Journal - Study Design and Rationale
In 2007 Dr. Ross Tsuyuki, Director of the EPICORE Centre, University of Alberta, received financial support from the Innovation Fund for the following series of studies on the implementation of chronic disease management services in community pharmacies:
In 2008 Dr. Tsuyuki received additional funding for research focussing on hypertension management, detailed in the following published articles:
Related articles:
2016 news article - "Stunning" results from hypertension study
