Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

This project will determine the effective of a pharmacist-led medication management program, in colloabrating with patients, prescribers and community pharmacists, in supporting diabetes patients in a remote indigenous community. Researchers will look at patient, prescriber and pharmacist satisfaction around the program, including the use of appropriate medication in improving health outcomes, disease prevention, as well as reduced healthcare utilization and subsequent costs. 

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

This project will determine the effective of a pharmacist-led medication management program, in colloabrating with patients, prescribers and community pharmacists, in supporting diabetes patients in a remote indigenous community. Researchers will look at patient, prescriber and pharmacist satisfaction around the program, including the use of appropriate medication in improving health outcomes, disease prevention, as well as reduced healthcare utilization and subsequent costs. 

This project will develop a pharmacist-led virtual hypertension management program centered around the use of a health tracking mobile app for patients. The aim is to help patients achieve blood pressure (BP) targets and improve medication adherence along with their knowledge of BP management. The goal is also to provide pharmacists with a simple, systematic method for contributing to virtually enabled hypertension management in the community, while leveraging patient-driven technology.

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

This project will determine the effective of a pharmacist-led medication management program, in colloabrating with patients, prescribers and community pharmacists, in supporting diabetes patients in a remote indigenous community. Researchers will look at patient, prescriber and pharmacist satisfaction around the program, including the use of appropriate medication in improving health outcomes, disease prevention, as well as reduced healthcare utilization and subsequent costs. 

This project will develop a pharmacist-led virtual hypertension management program centered around the use of a health tracking mobile app for patients. The aim is to help patients achieve blood pressure (BP) targets and improve medication adherence along with their knowledge of BP management. The goal is also to provide pharmacists with a simple, systematic method for contributing to virtually enabled hypertension management in the community, while leveraging patient-driven technology.

Pharmacist intervention has been shown to improve outcomes for patients with hypertension, dyslipidemia and other conditions. However, comprehensive medication assessments (CMA) that consider patients holistically may identify even more opportunities to improve outcomes in other ways, such as reducing potentially inappropriate medication use and improving quality of life.This study aims to show that CMA provided through a pharmacist clinic for patients with complex medication needs will improve medication-related burden, reduce medication complexity, and increase patient satisfaction.

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

This project will determine the effective of a pharmacist-led medication management program, in colloabrating with patients, prescribers and community pharmacists, in supporting diabetes patients in a remote indigenous community. Researchers will look at patient, prescriber and pharmacist satisfaction around the program, including the use of appropriate medication in improving health outcomes, disease prevention, as well as reduced healthcare utilization and subsequent costs. 

This project will develop a pharmacist-led virtual hypertension management program centered around the use of a health tracking mobile app for patients. The aim is to help patients achieve blood pressure (BP) targets and improve medication adherence along with their knowledge of BP management. The goal is also to provide pharmacists with a simple, systematic method for contributing to virtually enabled hypertension management in the community, while leveraging patient-driven technology.

Pharmacist intervention has been shown to improve outcomes for patients with hypertension, dyslipidemia and other conditions. However, comprehensive medication assessments (CMA) that consider patients holistically may identify even more opportunities to improve outcomes in other ways, such as reducing potentially inappropriate medication use and improving quality of life.This study aims to show that CMA provided through a pharmacist clinic for patients with complex medication needs will improve medication-related burden, reduce medication complexity, and increase patient satisfaction.

To continue to support cancer patients through treatment during the COVID-19 pandemic, Carlo and his team developed a strategy to maximize virtual delivery of clincial pharmacy services (vCPS). Their study will look at how successful these services are and which patients most benefit from them. While initiated in an outpatient pharmacy cancer clinic setting, the lessons learned from the vCPS can also be applied to the community pharmacy setting and used to implement long-term pharmacy practice change.

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

This project will determine the effective of a pharmacist-led medication management program, in colloabrating with patients, prescribers and community pharmacists, in supporting diabetes patients in a remote indigenous community. Researchers will look at patient, prescriber and pharmacist satisfaction around the program, including the use of appropriate medication in improving health outcomes, disease prevention, as well as reduced healthcare utilization and subsequent costs. 

This project will develop a pharmacist-led virtual hypertension management program centered around the use of a health tracking mobile app for patients. The aim is to help patients achieve blood pressure (BP) targets and improve medication adherence along with their knowledge of BP management. The goal is also to provide pharmacists with a simple, systematic method for contributing to virtually enabled hypertension management in the community, while leveraging patient-driven technology.

Pharmacist intervention has been shown to improve outcomes for patients with hypertension, dyslipidemia and other conditions. However, comprehensive medication assessments (CMA) that consider patients holistically may identify even more opportunities to improve outcomes in other ways, such as reducing potentially inappropriate medication use and improving quality of life.This study aims to show that CMA provided through a pharmacist clinic for patients with complex medication needs will improve medication-related burden, reduce medication complexity, and increase patient satisfaction.

To continue to support cancer patients through treatment during the COVID-19 pandemic, Carlo and his team developed a strategy to maximize virtual delivery of clincial pharmacy services (vCPS). Their study will look at how successful these services are and which patients most benefit from them. While initiated in an outpatient pharmacy cancer clinic setting, the lessons learned from the vCPS can also be applied to the community pharmacy setting and used to implement long-term pharmacy practice change.

"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.

Pharmacists in the coaching group of the study 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 five-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. “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.

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

This project will determine the effective of a pharmacist-led medication management program, in colloabrating with patients, prescribers and community pharmacists, in supporting diabetes patients in a remote indigenous community. Researchers will look at patient, prescriber and pharmacist satisfaction around the program, including the use of appropriate medication in improving health outcomes, disease prevention, as well as reduced healthcare utilization and subsequent costs. 

This project will develop a pharmacist-led virtual hypertension management program centered around the use of a health tracking mobile app for patients. The aim is to help patients achieve blood pressure (BP) targets and improve medication adherence along with their knowledge of BP management. The goal is also to provide pharmacists with a simple, systematic method for contributing to virtually enabled hypertension management in the community, while leveraging patient-driven technology.

Pharmacist intervention has been shown to improve outcomes for patients with hypertension, dyslipidemia and other conditions. However, comprehensive medication assessments (CMA) that consider patients holistically may identify even more opportunities to improve outcomes in other ways, such as reducing potentially inappropriate medication use and improving quality of life.This study aims to show that CMA provided through a pharmacist clinic for patients with complex medication needs will improve medication-related burden, reduce medication complexity, and increase patient satisfaction.

To continue to support cancer patients through treatment during the COVID-19 pandemic, Carlo and his team developed a strategy to maximize virtual delivery of clincial pharmacy services (vCPS). Their study will look at how successful these services are and which patients most benefit from them. While initiated in an outpatient pharmacy cancer clinic setting, the lessons learned from the vCPS can also be applied to the community pharmacy setting and used to implement long-term pharmacy practice change.

"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.

Pharmacists in the coaching group of the study 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 five-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. “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.”

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

This project will determine the effective of a pharmacist-led medication management program, in colloabrating with patients, prescribers and community pharmacists, in supporting diabetes patients in a remote indigenous community. Researchers will look at patient, prescriber and pharmacist satisfaction around the program, including the use of appropriate medication in improving health outcomes, disease prevention, as well as reduced healthcare utilization and subsequent costs. 

This project will develop a pharmacist-led virtual hypertension management program centered around the use of a health tracking mobile app for patients. The aim is to help patients achieve blood pressure (BP) targets and improve medication adherence along with their knowledge of BP management. The goal is also to provide pharmacists with a simple, systematic method for contributing to virtually enabled hypertension management in the community, while leveraging patient-driven technology.

Pharmacist intervention has been shown to improve outcomes for patients with hypertension, dyslipidemia and other conditions. However, comprehensive medication assessments (CMA) that consider patients holistically may identify even more opportunities to improve outcomes in other ways, such as reducing potentially inappropriate medication use and improving quality of life.This study aims to show that CMA provided through a pharmacist clinic for patients with complex medication needs will improve medication-related burden, reduce medication complexity, and increase patient satisfaction.

To continue to support cancer patients through treatment during the COVID-19 pandemic, Carlo and his team developed a strategy to maximize virtual delivery of clincial pharmacy services (vCPS). Their study will look at how successful these services are and which patients most benefit from them. While initiated in an outpatient pharmacy cancer clinic setting, the lessons learned from the vCPS can also be applied to the community pharmacy setting and used to implement long-term pharmacy practice change.

"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.

Pharmacists in the coaching group of the study 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 five-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. “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.

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

This project will determine the effective of a pharmacist-led medication management program, in colloabrating with patients, prescribers and community pharmacists, in supporting diabetes patients in a remote indigenous community. Researchers will look at patient, prescriber and pharmacist satisfaction around the program, including the use of appropriate medication in improving health outcomes, disease prevention, as well as reduced healthcare utilization and subsequent costs. 

This project will develop a pharmacist-led virtual hypertension management program centered around the use of a health tracking mobile app for patients. The aim is to help patients achieve blood pressure (BP) targets and improve medication adherence along with their knowledge of BP management. The goal is also to provide pharmacists with a simple, systematic method for contributing to virtually enabled hypertension management in the community, while leveraging patient-driven technology.

Pharmacist intervention has been shown to improve outcomes for patients with hypertension, dyslipidemia and other conditions. However, comprehensive medication assessments (CMA) that consider patients holistically may identify even more opportunities to improve outcomes in other ways, such as reducing potentially inappropriate medication use and improving quality of life.This study aims to show that CMA provided through a pharmacist clinic for patients with complex medication needs will improve medication-related burden, reduce medication complexity, and increase patient satisfaction.

To continue to support cancer patients through treatment during the COVID-19 pandemic, Carlo and his team developed a strategy to maximize virtual delivery of clincial pharmacy services (vCPS). Their study will look at how successful these services are and which patients most benefit from them. While initiated in an outpatient pharmacy cancer clinic setting, the lessons learned from the vCPS can also be applied to the community pharmacy setting and used to implement long-term pharmacy practice change.

"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.

Pharmacists in the coaching group of the study 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 five-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. “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.

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 work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.

Updates:

June 2021 - New practice model a win for all

January 2020 - New models of pharmacy practice working, research shows

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

This project will determine the effective of a pharmacist-led medication management program, in colloabrating with patients, prescribers and community pharmacists, in supporting diabetes patients in a remote indigenous community. Researchers will look at patient, prescriber and pharmacist satisfaction around the program, including the use of appropriate medication in improving health outcomes, disease prevention, as well as reduced healthcare utilization and subsequent costs. 

This project will develop a pharmacist-led virtual hypertension management program centered around the use of a health tracking mobile app for patients. The aim is to help patients achieve blood pressure (BP) targets and improve medication adherence along with their knowledge of BP management. The goal is also to provide pharmacists with a simple, systematic method for contributing to virtually enabled hypertension management in the community, while leveraging patient-driven technology.

Pharmacist intervention has been shown to improve outcomes for patients with hypertension, dyslipidemia and other conditions. However, comprehensive medication assessments (CMA) that consider patients holistically may identify even more opportunities to improve outcomes in other ways, such as reducing potentially inappropriate medication use and improving quality of life.This study aims to show that CMA provided through a pharmacist clinic for patients with complex medication needs will improve medication-related burden, reduce medication complexity, and increase patient satisfaction.

To continue to support cancer patients through treatment during the COVID-19 pandemic, Carlo and his team developed a strategy to maximize virtual delivery of clincial pharmacy services (vCPS). Their study will look at how successful these services are and which patients most benefit from them. While initiated in an outpatient pharmacy cancer clinic setting, the lessons learned from the vCPS can also be applied to the community pharmacy setting and used to implement long-term pharmacy practice change.

"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.

Pharmacists in the coaching group of the study 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 five-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. “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.

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 work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.

Updates:

June 2021 - New practice model a win for all

January 2020 - New models of pharmacy practice working, research shows

John Papastergiou, practising community pharmacist and assistant professor at the University of Toronto and the University of Waterloo, used 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.

The results, published by the International Journal for Pharmacy in October 2021, clearly demonstrated the impact pharmacist-immunizers can make when enabled by provincial legislation and funding. You can also access the article by clicking "Download File" below.

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

This project will determine the effective of a pharmacist-led medication management program, in colloabrating with patients, prescribers and community pharmacists, in supporting diabetes patients in a remote indigenous community. Researchers will look at patient, prescriber and pharmacist satisfaction around the program, including the use of appropriate medication in improving health outcomes, disease prevention, as well as reduced healthcare utilization and subsequent costs. 

This project will develop a pharmacist-led virtual hypertension management program centered around the use of a health tracking mobile app for patients. The aim is to help patients achieve blood pressure (BP) targets and improve medication adherence along with their knowledge of BP management. The goal is also to provide pharmacists with a simple, systematic method for contributing to virtually enabled hypertension management in the community, while leveraging patient-driven technology.

Pharmacist intervention has been shown to improve outcomes for patients with hypertension, dyslipidemia and other conditions. However, comprehensive medication assessments (CMA) that consider patients holistically may identify even more opportunities to improve outcomes in other ways, such as reducing potentially inappropriate medication use and improving quality of life.This study aims to show that CMA provided through a pharmacist clinic for patients with complex medication needs will improve medication-related burden, reduce medication complexity, and increase patient satisfaction.

To continue to support cancer patients through treatment during the COVID-19 pandemic, Carlo and his team developed a strategy to maximize virtual delivery of clincial pharmacy services (vCPS). Their study will look at how successful these services are and which patients most benefit from them. While initiated in an outpatient pharmacy cancer clinic setting, the lessons learned from the vCPS can also be applied to the community pharmacy setting and used to implement long-term pharmacy practice change.

"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.

Pharmacists in the coaching group of the study 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 five-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. “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.

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 work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.

Updates:

June 2021 - New practice model a win for all

January 2020 - New models of pharmacy practice working, research shows

John Papastergiou, practising community pharmacist and assistant professor at the University of Toronto and the University of Waterloo, used 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.

The results, published by the International Journal for Pharmacy in October 2021, clearly demonstrated the impact pharmacist-immunizers can make when enabled by provincial legislation and funding. You can also access the article by clicking "Download File" below.

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.

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

This project will determine the effective of a pharmacist-led medication management program, in colloabrating with patients, prescribers and community pharmacists, in supporting diabetes patients in a remote indigenous community. Researchers will look at patient, prescriber and pharmacist satisfaction around the program, including the use of appropriate medication in improving health outcomes, disease prevention, as well as reduced healthcare utilization and subsequent costs. 

This project will develop a pharmacist-led virtual hypertension management program centered around the use of a health tracking mobile app for patients. The aim is to help patients achieve blood pressure (BP) targets and improve medication adherence along with their knowledge of BP management. The goal is also to provide pharmacists with a simple, systematic method for contributing to virtually enabled hypertension management in the community, while leveraging patient-driven technology.

Pharmacist intervention has been shown to improve outcomes for patients with hypertension, dyslipidemia and other conditions. However, comprehensive medication assessments (CMA) that consider patients holistically may identify even more opportunities to improve outcomes in other ways, such as reducing potentially inappropriate medication use and improving quality of life.This study aims to show that CMA provided through a pharmacist clinic for patients with complex medication needs will improve medication-related burden, reduce medication complexity, and increase patient satisfaction.

To continue to support cancer patients through treatment during the COVID-19 pandemic, Carlo and his team developed a strategy to maximize virtual delivery of clincial pharmacy services (vCPS). Their study will look at how successful these services are and which patients most benefit from them. While initiated in an outpatient pharmacy cancer clinic setting, the lessons learned from the vCPS can also be applied to the community pharmacy setting and used to implement long-term pharmacy practice change.

"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.

Pharmacists in the coaching group of the study 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 five-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. “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.

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 work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.

Updates:

June 2021 - New practice model a win for all

January 2020 - New models of pharmacy practice working, research shows

John Papastergiou, practising community pharmacist and assistant professor at the University of Toronto and the University of Waterloo, used 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.

The results, published by the International Journal for Pharmacy in October 2021, clearly demonstrated the impact pharmacist-immunizers can make when enabled by provincial legislation and funding. You can also access the article by clicking "Download File" below.

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.

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.

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

This project will determine the effective of a pharmacist-led medication management program, in colloabrating with patients, prescribers and community pharmacists, in supporting diabetes patients in a remote indigenous community. Researchers will look at patient, prescriber and pharmacist satisfaction around the program, including the use of appropriate medication in improving health outcomes, disease prevention, as well as reduced healthcare utilization and subsequent costs. 

This project will develop a pharmacist-led virtual hypertension management program centered around the use of a health tracking mobile app for patients. The aim is to help patients achieve blood pressure (BP) targets and improve medication adherence along with their knowledge of BP management. The goal is also to provide pharmacists with a simple, systematic method for contributing to virtually enabled hypertension management in the community, while leveraging patient-driven technology.

Pharmacist intervention has been shown to improve outcomes for patients with hypertension, dyslipidemia and other conditions. However, comprehensive medication assessments (CMA) that consider patients holistically may identify even more opportunities to improve outcomes in other ways, such as reducing potentially inappropriate medication use and improving quality of life.This study aims to show that CMA provided through a pharmacist clinic for patients with complex medication needs will improve medication-related burden, reduce medication complexity, and increase patient satisfaction.

To continue to support cancer patients through treatment during the COVID-19 pandemic, Carlo and his team developed a strategy to maximize virtual delivery of clincial pharmacy services (vCPS). Their study will look at how successful these services are and which patients most benefit from them. While initiated in an outpatient pharmacy cancer clinic setting, the lessons learned from the vCPS can also be applied to the community pharmacy setting and used to implement long-term pharmacy practice change.

"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.

Pharmacists in the coaching group of the study 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 five-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. “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.

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 work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.

Updates:

June 2021 - New practice model a win for all

January 2020 - New models of pharmacy practice working, research shows

John Papastergiou, practising community pharmacist and assistant professor at the University of Toronto and the University of Waterloo, used 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.

The results, published by the International Journal for Pharmacy in October 2021, clearly demonstrated the impact pharmacist-immunizers can make when enabled by provincial legislation and funding. You can also access the article by clicking "Download File" below.

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.

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.

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

This project will determine the effective of a pharmacist-led medication management program, in colloabrating with patients, prescribers and community pharmacists, in supporting diabetes patients in a remote indigenous community. Researchers will look at patient, prescriber and pharmacist satisfaction around the program, including the use of appropriate medication in improving health outcomes, disease prevention, as well as reduced healthcare utilization and subsequent costs. 

This project will develop a pharmacist-led virtual hypertension management program centered around the use of a health tracking mobile app for patients. The aim is to help patients achieve blood pressure (BP) targets and improve medication adherence along with their knowledge of BP management. The goal is also to provide pharmacists with a simple, systematic method for contributing to virtually enabled hypertension management in the community, while leveraging patient-driven technology.

Pharmacist intervention has been shown to improve outcomes for patients with hypertension, dyslipidemia and other conditions. However, comprehensive medication assessments (CMA) that consider patients holistically may identify even more opportunities to improve outcomes in other ways, such as reducing potentially inappropriate medication use and improving quality of life.This study aims to show that CMA provided through a pharmacist clinic for patients with complex medication needs will improve medication-related burden, reduce medication complexity, and increase patient satisfaction.

To continue to support cancer patients through treatment during the COVID-19 pandemic, Carlo and his team developed a strategy to maximize virtual delivery of clincial pharmacy services (vCPS). Their study will look at how successful these services are and which patients most benefit from them. While initiated in an outpatient pharmacy cancer clinic setting, the lessons learned from the vCPS can also be applied to the community pharmacy setting and used to implement long-term pharmacy practice change.

"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.

Pharmacists in the coaching group of the study 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 five-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. “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.

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 work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.

Updates:

June 2021 - New practice model a win for all

January 2020 - New models of pharmacy practice working, research shows

John Papastergiou, practising community pharmacist and assistant professor at the University of Toronto and the University of Waterloo, used 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.

The results, published by the International Journal for Pharmacy in October 2021, clearly demonstrated the impact pharmacist-immunizers can make when enabled by provincial legislation and funding. You can also access the article by clicking "Download File" below.

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.

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 researched strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes. As part of that, the team also determined 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 worked with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.

Research results were published in April 2020 in the international journal, Research in Social and Administrative Pharmacy.

Highlights are captured in this news article on CFP's website, posted in June 2020.

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

This project will determine the effective of a pharmacist-led medication management program, in colloabrating with patients, prescribers and community pharmacists, in supporting diabetes patients in a remote indigenous community. Researchers will look at patient, prescriber and pharmacist satisfaction around the program, including the use of appropriate medication in improving health outcomes, disease prevention, as well as reduced healthcare utilization and subsequent costs. 

This project will develop a pharmacist-led virtual hypertension management program centered around the use of a health tracking mobile app for patients. The aim is to help patients achieve blood pressure (BP) targets and improve medication adherence along with their knowledge of BP management. The goal is also to provide pharmacists with a simple, systematic method for contributing to virtually enabled hypertension management in the community, while leveraging patient-driven technology.

Pharmacist intervention has been shown to improve outcomes for patients with hypertension, dyslipidemia and other conditions. However, comprehensive medication assessments (CMA) that consider patients holistically may identify even more opportunities to improve outcomes in other ways, such as reducing potentially inappropriate medication use and improving quality of life.This study aims to show that CMA provided through a pharmacist clinic for patients with complex medication needs will improve medication-related burden, reduce medication complexity, and increase patient satisfaction.

To continue to support cancer patients through treatment during the COVID-19 pandemic, Carlo and his team developed a strategy to maximize virtual delivery of clincial pharmacy services (vCPS). Their study will look at how successful these services are and which patients most benefit from them. While initiated in an outpatient pharmacy cancer clinic setting, the lessons learned from the vCPS can also be applied to the community pharmacy setting and used to implement long-term pharmacy practice change.

"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.

Pharmacists in the coaching group of the study 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 five-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. “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.

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 work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.

Updates:

June 2021 - New practice model a win for all

January 2020 - New models of pharmacy practice working, research shows

John Papastergiou, practising community pharmacist and assistant professor at the University of Toronto and the University of Waterloo, used 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.

The results, published by the International Journal for Pharmacy in October 2021, clearly demonstrated the impact pharmacist-immunizers can make when enabled by provincial legislation and funding. You can also access the article by clicking "Download File" below.

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.

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 researched strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes. As part of that, the team also determined 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 worked with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.

Research results were published in April 2020 in the international journal, Research in Social and Administrative Pharmacy.

Highlights are captured in this news article on CFP's website, posted in June 2020.

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 conductied an economic analysis and developed a practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.

RxOUTMAP practice tool for pharmacists

Published study July 2019 - Economic analysis

News article Sept 2018 - "Pharmacists for UTI management a 'no-brainer'"

Published study June 2018 - "Outcomes of Urinary Tract Infection Management by Pharmacists (RxOUTMAP)"

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

This project will determine the effective of a pharmacist-led medication management program, in colloabrating with patients, prescribers and community pharmacists, in supporting diabetes patients in a remote indigenous community. Researchers will look at patient, prescriber and pharmacist satisfaction around the program, including the use of appropriate medication in improving health outcomes, disease prevention, as well as reduced healthcare utilization and subsequent costs. 

This project will develop a pharmacist-led virtual hypertension management program centered around the use of a health tracking mobile app for patients. The aim is to help patients achieve blood pressure (BP) targets and improve medication adherence along with their knowledge of BP management. The goal is also to provide pharmacists with a simple, systematic method for contributing to virtually enabled hypertension management in the community, while leveraging patient-driven technology.

Pharmacist intervention has been shown to improve outcomes for patients with hypertension, dyslipidemia and other conditions. However, comprehensive medication assessments (CMA) that consider patients holistically may identify even more opportunities to improve outcomes in other ways, such as reducing potentially inappropriate medication use and improving quality of life.This study aims to show that CMA provided through a pharmacist clinic for patients with complex medication needs will improve medication-related burden, reduce medication complexity, and increase patient satisfaction.

To continue to support cancer patients through treatment during the COVID-19 pandemic, Carlo and his team developed a strategy to maximize virtual delivery of clincial pharmacy services (vCPS). Their study will look at how successful these services are and which patients most benefit from them. While initiated in an outpatient pharmacy cancer clinic setting, the lessons learned from the vCPS can also be applied to the community pharmacy setting and used to implement long-term pharmacy practice change.

"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.

Pharmacists in the coaching group of the study 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 five-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. “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.

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 work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.

Updates:

June 2021 - New practice model a win for all

January 2020 - New models of pharmacy practice working, research shows

John Papastergiou, practising community pharmacist and assistant professor at the University of Toronto and the University of Waterloo, used 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.

The results, published by the International Journal for Pharmacy in October 2021, clearly demonstrated the impact pharmacist-immunizers can make when enabled by provincial legislation and funding. You can also access the article by clicking "Download File" below.

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.

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 researched strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes. As part of that, the team also determined 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 worked with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.

Research results were published in April 2020 in the international journal, Research in Social and Administrative Pharmacy.

Highlights are captured in this news article on CFP's website, posted in June 2020.

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 conductied an economic analysis and developed a practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.

RxOUTMAP practice tool for pharmacists

Published study July 2019 - Economic analysis

News article Sept 2018 - "Pharmacists for UTI management a 'no-brainer'"

Published study June 2018 - "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) 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.

In January 2020, the Canadian Pharmacists Journal published "Community pharmacists as catalysts for deprescribing: An exploratory study using quality improvement processes," which pertains to this research project. Click here to access the article.

News article - "Deprescribing, within a pharmacist's domain"

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

This project will determine the effective of a pharmacist-led medication management program, in colloabrating with patients, prescribers and community pharmacists, in supporting diabetes patients in a remote indigenous community. Researchers will look at patient, prescriber and pharmacist satisfaction around the program, including the use of appropriate medication in improving health outcomes, disease prevention, as well as reduced healthcare utilization and subsequent costs. 

This project will develop a pharmacist-led virtual hypertension management program centered around the use of a health tracking mobile app for patients. The aim is to help patients achieve blood pressure (BP) targets and improve medication adherence along with their knowledge of BP management. The goal is also to provide pharmacists with a simple, systematic method for contributing to virtually enabled hypertension management in the community, while leveraging patient-driven technology.

Pharmacist intervention has been shown to improve outcomes for patients with hypertension, dyslipidemia and other conditions. However, comprehensive medication assessments (CMA) that consider patients holistically may identify even more opportunities to improve outcomes in other ways, such as reducing potentially inappropriate medication use and improving quality of life.This study aims to show that CMA provided through a pharmacist clinic for patients with complex medication needs will improve medication-related burden, reduce medication complexity, and increase patient satisfaction.

To continue to support cancer patients through treatment during the COVID-19 pandemic, Carlo and his team developed a strategy to maximize virtual delivery of clincial pharmacy services (vCPS). Their study will look at how successful these services are and which patients most benefit from them. While initiated in an outpatient pharmacy cancer clinic setting, the lessons learned from the vCPS can also be applied to the community pharmacy setting and used to implement long-term pharmacy practice change.

"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.

Pharmacists in the coaching group of the study 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 five-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. “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.

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 work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.

Updates:

June 2021 - New practice model a win for all

January 2020 - New models of pharmacy practice working, research shows

John Papastergiou, practising community pharmacist and assistant professor at the University of Toronto and the University of Waterloo, used 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.

The results, published by the International Journal for Pharmacy in October 2021, clearly demonstrated the impact pharmacist-immunizers can make when enabled by provincial legislation and funding. You can also access the article by clicking "Download File" below.

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.

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 researched strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes. As part of that, the team also determined 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 worked with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.

Research results were published in April 2020 in the international journal, Research in Social and Administrative Pharmacy.

Highlights are captured in this news article on CFP's website, posted in June 2020.

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 conductied an economic analysis and developed a practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.

RxOUTMAP practice tool for pharmacists

Published study July 2019 - Economic analysis

News article Sept 2018 - "Pharmacists for UTI management a 'no-brainer'"

Published study June 2018 - "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) 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.

In January 2020, the Canadian Pharmacists Journal published "Community pharmacists as catalysts for deprescribing: An exploratory study using quality improvement processes," which pertains to this research project. Click here to access the article.

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 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."

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

This project will determine the effective of a pharmacist-led medication management program, in colloabrating with patients, prescribers and community pharmacists, in supporting diabetes patients in a remote indigenous community. Researchers will look at patient, prescriber and pharmacist satisfaction around the program, including the use of appropriate medication in improving health outcomes, disease prevention, as well as reduced healthcare utilization and subsequent costs. 

This project will develop a pharmacist-led virtual hypertension management program centered around the use of a health tracking mobile app for patients. The aim is to help patients achieve blood pressure (BP) targets and improve medication adherence along with their knowledge of BP management. The goal is also to provide pharmacists with a simple, systematic method for contributing to virtually enabled hypertension management in the community, while leveraging patient-driven technology.

Pharmacist intervention has been shown to improve outcomes for patients with hypertension, dyslipidemia and other conditions. However, comprehensive medication assessments (CMA) that consider patients holistically may identify even more opportunities to improve outcomes in other ways, such as reducing potentially inappropriate medication use and improving quality of life.This study aims to show that CMA provided through a pharmacist clinic for patients with complex medication needs will improve medication-related burden, reduce medication complexity, and increase patient satisfaction.

To continue to support cancer patients through treatment during the COVID-19 pandemic, Carlo and his team developed a strategy to maximize virtual delivery of clincial pharmacy services (vCPS). Their study will look at how successful these services are and which patients most benefit from them. While initiated in an outpatient pharmacy cancer clinic setting, the lessons learned from the vCPS can also be applied to the community pharmacy setting and used to implement long-term pharmacy practice change.

"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.

Pharmacists in the coaching group of the study 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 five-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. “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.

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 work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.

Updates:

June 2021 - New practice model a win for all

January 2020 - New models of pharmacy practice working, research shows

John Papastergiou, practising community pharmacist and assistant professor at the University of Toronto and the University of Waterloo, used 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.

The results, published by the International Journal for Pharmacy in October 2021, clearly demonstrated the impact pharmacist-immunizers can make when enabled by provincial legislation and funding. You can also access the article by clicking "Download File" below.

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.

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 researched strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes. As part of that, the team also determined 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 worked with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.

Research results were published in April 2020 in the international journal, Research in Social and Administrative Pharmacy.

Highlights are captured in this news article on CFP's website, posted in June 2020.

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 conductied an economic analysis and developed a practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.

RxOUTMAP practice tool for pharmacists

Published study July 2019 - Economic analysis

News article Sept 2018 - "Pharmacists for UTI management a 'no-brainer'"

Published study June 2018 - "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) 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.

In January 2020, the Canadian Pharmacists Journal published "Community pharmacists as catalysts for deprescribing: An exploratory study using quality improvement processes," which pertains to this research project. Click here to access the article.

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 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 will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

This project will determine the effective of a pharmacist-led medication management program, in colloabrating with patients, prescribers and community pharmacists, in supporting diabetes patients in a remote indigenous community. Researchers will look at patient, prescriber and pharmacist satisfaction around the program, including the use of appropriate medication in improving health outcomes, disease prevention, as well as reduced healthcare utilization and subsequent costs. 

This project will develop a pharmacist-led virtual hypertension management program centered around the use of a health tracking mobile app for patients. The aim is to help patients achieve blood pressure (BP) targets and improve medication adherence along with their knowledge of BP management. The goal is also to provide pharmacists with a simple, systematic method for contributing to virtually enabled hypertension management in the community, while leveraging patient-driven technology.

Pharmacist intervention has been shown to improve outcomes for patients with hypertension, dyslipidemia and other conditions. However, comprehensive medication assessments (CMA) that consider patients holistically may identify even more opportunities to improve outcomes in other ways, such as reducing potentially inappropriate medication use and improving quality of life.This study aims to show that CMA provided through a pharmacist clinic for patients with complex medication needs will improve medication-related burden, reduce medication complexity, and increase patient satisfaction.

To continue to support cancer patients through treatment during the COVID-19 pandemic, Carlo and his team developed a strategy to maximize virtual delivery of clincial pharmacy services (vCPS). Their study will look at how successful these services are and which patients most benefit from them. While initiated in an outpatient pharmacy cancer clinic setting, the lessons learned from the vCPS can also be applied to the community pharmacy setting and used to implement long-term pharmacy practice change.

"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.

Pharmacists in the coaching group of the study 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 five-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. “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.

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 work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.

Updates:

June 2021 - New practice model a win for all

January 2020 - New models of pharmacy practice working, research shows

John Papastergiou, practising community pharmacist and assistant professor at the University of Toronto and the University of Waterloo, used 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.

The results, published by the International Journal for Pharmacy in October 2021, clearly demonstrated the impact pharmacist-immunizers can make when enabled by provincial legislation and funding. You can also access the article by clicking "Download File" below.

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.

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 researched strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes. As part of that, the team also determined 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 worked with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.

Research results were published in April 2020 in the international journal, Research in Social and Administrative Pharmacy.

Highlights are captured in this news article on CFP's website, posted in June 2020.

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 conductied an economic analysis and developed a practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.

RxOUTMAP practice tool for pharmacists

Published study July 2019 - Economic analysis

News article Sept 2018 - "Pharmacists for UTI management a 'no-brainer'"

Published study June 2018 - "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) 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.

In January 2020, the Canadian Pharmacists Journal published "Community pharmacists as catalysts for deprescribing: An exploratory study using quality improvement processes," which pertains to this research project. Click here to access the article.

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 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 remunerated comprehensive annual care plans, 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.

In July 2019, pharmacy (an MDPI open-access journal) published the following article, focussed on participants' perceived value of the service: " 'It Made a Difference to Me': A Comparative Case Study of Community Pharmacists' Care Planning Services in Primary Health Care." Click here to access the article.

In December 2019, the Journal of the American Pharmacists Association posted the following article, which focuses on the implementation of care planning services: "A qualitative case study exploring the implementation of pharmacist care planning services in community pharmacies." Click here to access the article.

Related links:

2018 news article - How are pharmacy services measuring up?

2015 news article - CFP's Innovation Fund Winners

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

This project will determine the effective of a pharmacist-led medication management program, in colloabrating with patients, prescribers and community pharmacists, in supporting diabetes patients in a remote indigenous community. Researchers will look at patient, prescriber and pharmacist satisfaction around the program, including the use of appropriate medication in improving health outcomes, disease prevention, as well as reduced healthcare utilization and subsequent costs. 

This project will develop a pharmacist-led virtual hypertension management program centered around the use of a health tracking mobile app for patients. The aim is to help patients achieve blood pressure (BP) targets and improve medication adherence along with their knowledge of BP management. The goal is also to provide pharmacists with a simple, systematic method for contributing to virtually enabled hypertension management in the community, while leveraging patient-driven technology.

Pharmacist intervention has been shown to improve outcomes for patients with hypertension, dyslipidemia and other conditions. However, comprehensive medication assessments (CMA) that consider patients holistically may identify even more opportunities to improve outcomes in other ways, such as reducing potentially inappropriate medication use and improving quality of life.This study aims to show that CMA provided through a pharmacist clinic for patients with complex medication needs will improve medication-related burden, reduce medication complexity, and increase patient satisfaction.

To continue to support cancer patients through treatment during the COVID-19 pandemic, Carlo and his team developed a strategy to maximize virtual delivery of clincial pharmacy services (vCPS). Their study will look at how successful these services are and which patients most benefit from them. While initiated in an outpatient pharmacy cancer clinic setting, the lessons learned from the vCPS can also be applied to the community pharmacy setting and used to implement long-term pharmacy practice change.

"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.

Pharmacists in the coaching group of the study 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 five-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. “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.

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 work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.

Updates:

June 2021 - New practice model a win for all

January 2020 - New models of pharmacy practice working, research shows

John Papastergiou, practising community pharmacist and assistant professor at the University of Toronto and the University of Waterloo, used 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.

The results, published by the International Journal for Pharmacy in October 2021, clearly demonstrated the impact pharmacist-immunizers can make when enabled by provincial legislation and funding. You can also access the article by clicking "Download File" below.

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.

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 researched strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes. As part of that, the team also determined 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 worked with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.

Research results were published in April 2020 in the international journal, Research in Social and Administrative Pharmacy.

Highlights are captured in this news article on CFP's website, posted in June 2020.

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 conductied an economic analysis and developed a practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.

RxOUTMAP practice tool for pharmacists

Published study July 2019 - Economic analysis

News article Sept 2018 - "Pharmacists for UTI management a 'no-brainer'"

Published study June 2018 - "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) 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.

In January 2020, the Canadian Pharmacists Journal published "Community pharmacists as catalysts for deprescribing: An exploratory study using quality improvement processes," which pertains to this research project. Click here to access the article.

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 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 remunerated comprehensive annual care plans, 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.

In July 2019, pharmacy (an MDPI open-access journal) published the following article, focussed on participants' perceived value of the service: " 'It Made a Difference to Me': A Comparative Case Study of Community Pharmacists' Care Planning Services in Primary Health Care." Click here to access the article.

In December 2019, the Journal of the American Pharmacists Association posted the following article, which focuses on the implementation of care planning services: "A qualitative case study exploring the implementation of pharmacist care planning services in community pharmacies." Click here to access the article.

Related links:

2018 news article - How are pharmacy services measuring up?

2015 news article - CFP's Innovation Fund Winners

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

2015 news article - CFP's Innovation Fund winners

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

This project will determine the effective of a pharmacist-led medication management program, in colloabrating with patients, prescribers and community pharmacists, in supporting diabetes patients in a remote indigenous community. Researchers will look at patient, prescriber and pharmacist satisfaction around the program, including the use of appropriate medication in improving health outcomes, disease prevention, as well as reduced healthcare utilization and subsequent costs. 

This project will develop a pharmacist-led virtual hypertension management program centered around the use of a health tracking mobile app for patients. The aim is to help patients achieve blood pressure (BP) targets and improve medication adherence along with their knowledge of BP management. The goal is also to provide pharmacists with a simple, systematic method for contributing to virtually enabled hypertension management in the community, while leveraging patient-driven technology.

Pharmacist intervention has been shown to improve outcomes for patients with hypertension, dyslipidemia and other conditions. However, comprehensive medication assessments (CMA) that consider patients holistically may identify even more opportunities to improve outcomes in other ways, such as reducing potentially inappropriate medication use and improving quality of life.This study aims to show that CMA provided through a pharmacist clinic for patients with complex medication needs will improve medication-related burden, reduce medication complexity, and increase patient satisfaction.

To continue to support cancer patients through treatment during the COVID-19 pandemic, Carlo and his team developed a strategy to maximize virtual delivery of clincial pharmacy services (vCPS). Their study will look at how successful these services are and which patients most benefit from them. While initiated in an outpatient pharmacy cancer clinic setting, the lessons learned from the vCPS can also be applied to the community pharmacy setting and used to implement long-term pharmacy practice change.

"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.

Pharmacists in the coaching group of the study 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 five-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. “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.

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 work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.

Updates:

June 2021 - New practice model a win for all

January 2020 - New models of pharmacy practice working, research shows

John Papastergiou, practising community pharmacist and assistant professor at the University of Toronto and the University of Waterloo, used 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.

The results, published by the International Journal for Pharmacy in October 2021, clearly demonstrated the impact pharmacist-immunizers can make when enabled by provincial legislation and funding. You can also access the article by clicking "Download File" below.

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.

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 researched strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes. As part of that, the team also determined 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 worked with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.

Research results were published in April 2020 in the international journal, Research in Social and Administrative Pharmacy.

Highlights are captured in this news article on CFP's website, posted in June 2020.

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 conductied an economic analysis and developed a practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.

RxOUTMAP practice tool for pharmacists

Published study July 2019 - Economic analysis

News article Sept 2018 - "Pharmacists for UTI management a 'no-brainer'"

Published study June 2018 - "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) 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.

In January 2020, the Canadian Pharmacists Journal published "Community pharmacists as catalysts for deprescribing: An exploratory study using quality improvement processes," which pertains to this research project. Click here to access the article.

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 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 remunerated comprehensive annual care plans, 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.

In July 2019, pharmacy (an MDPI open-access journal) published the following article, focussed on participants' perceived value of the service: " 'It Made a Difference to Me': A Comparative Case Study of Community Pharmacists' Care Planning Services in Primary Health Care." Click here to access the article.

In December 2019, the Journal of the American Pharmacists Association posted the following article, which focuses on the implementation of care planning services: "A qualitative case study exploring the implementation of pharmacist care planning services in community pharmacies." Click here to access the article.

Related links:

2018 news article - How are pharmacy services measuring up?

2015 news article - CFP's Innovation Fund Winners

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

2015 news article - CFP's Innovation Fund winners

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.

Published study - "Clinical outcomes and satisfaction with a pharmacist-managed travel clinic in Alberta, Canada"

2018 news article - Pharmacists’ fit in travel medicine

2018 news article - Happy, healthy travels

2017 news article - Untapped potential of travel meds

2015 news article - CFP's Innovation Fund winners

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

This project will determine the effective of a pharmacist-led medication management program, in colloabrating with patients, prescribers and community pharmacists, in supporting diabetes patients in a remote indigenous community. Researchers will look at patient, prescriber and pharmacist satisfaction around the program, including the use of appropriate medication in improving health outcomes, disease prevention, as well as reduced healthcare utilization and subsequent costs. 

This project will develop a pharmacist-led virtual hypertension management program centered around the use of a health tracking mobile app for patients. The aim is to help patients achieve blood pressure (BP) targets and improve medication adherence along with their knowledge of BP management. The goal is also to provide pharmacists with a simple, systematic method for contributing to virtually enabled hypertension management in the community, while leveraging patient-driven technology.

Pharmacist intervention has been shown to improve outcomes for patients with hypertension, dyslipidemia and other conditions. However, comprehensive medication assessments (CMA) that consider patients holistically may identify even more opportunities to improve outcomes in other ways, such as reducing potentially inappropriate medication use and improving quality of life.This study aims to show that CMA provided through a pharmacist clinic for patients with complex medication needs will improve medication-related burden, reduce medication complexity, and increase patient satisfaction.

To continue to support cancer patients through treatment during the COVID-19 pandemic, Carlo and his team developed a strategy to maximize virtual delivery of clincial pharmacy services (vCPS). Their study will look at how successful these services are and which patients most benefit from them. While initiated in an outpatient pharmacy cancer clinic setting, the lessons learned from the vCPS can also be applied to the community pharmacy setting and used to implement long-term pharmacy practice change.

"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.

Pharmacists in the coaching group of the study 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 five-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. “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.

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 work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.

Updates:

June 2021 - New practice model a win for all

January 2020 - New models of pharmacy practice working, research shows

John Papastergiou, practising community pharmacist and assistant professor at the University of Toronto and the University of Waterloo, used 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.

The results, published by the International Journal for Pharmacy in October 2021, clearly demonstrated the impact pharmacist-immunizers can make when enabled by provincial legislation and funding. You can also access the article by clicking "Download File" below.

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.

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 researched strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes. As part of that, the team also determined 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 worked with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.

Research results were published in April 2020 in the international journal, Research in Social and Administrative Pharmacy.

Highlights are captured in this news article on CFP's website, posted in June 2020.

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 conductied an economic analysis and developed a practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.

RxOUTMAP practice tool for pharmacists

Published study July 2019 - Economic analysis

News article Sept 2018 - "Pharmacists for UTI management a 'no-brainer'"

Published study June 2018 - "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) 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.

In January 2020, the Canadian Pharmacists Journal published "Community pharmacists as catalysts for deprescribing: An exploratory study using quality improvement processes," which pertains to this research project. Click here to access the article.

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 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 remunerated comprehensive annual care plans, 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.

In July 2019, pharmacy (an MDPI open-access journal) published the following article, focussed on participants' perceived value of the service: " 'It Made a Difference to Me': A Comparative Case Study of Community Pharmacists' Care Planning Services in Primary Health Care." Click here to access the article.

In December 2019, the Journal of the American Pharmacists Association posted the following article, which focuses on the implementation of care planning services: "A qualitative case study exploring the implementation of pharmacist care planning services in community pharmacies." Click here to access the article.

Related links:

2018 news article - How are pharmacy services measuring up?

2015 news article - CFP's Innovation Fund Winners

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

2015 news article - CFP's Innovation Fund winners

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.

Published study - "Clinical outcomes and satisfaction with a pharmacist-managed travel clinic in Alberta, Canada"

2018 news article - Pharmacists’ fit in travel medicine

2018 news article - Happy, healthy travels

2017 news article - Untapped potential of travel meds

2015 news article - CFP's Innovation Fund winners

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

2015 news article - CFP funds study of home-based reviews

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

This project will determine the effective of a pharmacist-led medication management program, in colloabrating with patients, prescribers and community pharmacists, in supporting diabetes patients in a remote indigenous community. Researchers will look at patient, prescriber and pharmacist satisfaction around the program, including the use of appropriate medication in improving health outcomes, disease prevention, as well as reduced healthcare utilization and subsequent costs. 

This project will develop a pharmacist-led virtual hypertension management program centered around the use of a health tracking mobile app for patients. The aim is to help patients achieve blood pressure (BP) targets and improve medication adherence along with their knowledge of BP management. The goal is also to provide pharmacists with a simple, systematic method for contributing to virtually enabled hypertension management in the community, while leveraging patient-driven technology.

Pharmacist intervention has been shown to improve outcomes for patients with hypertension, dyslipidemia and other conditions. However, comprehensive medication assessments (CMA) that consider patients holistically may identify even more opportunities to improve outcomes in other ways, such as reducing potentially inappropriate medication use and improving quality of life.This study aims to show that CMA provided through a pharmacist clinic for patients with complex medication needs will improve medication-related burden, reduce medication complexity, and increase patient satisfaction.

To continue to support cancer patients through treatment during the COVID-19 pandemic, Carlo and his team developed a strategy to maximize virtual delivery of clincial pharmacy services (vCPS). Their study will look at how successful these services are and which patients most benefit from them. While initiated in an outpatient pharmacy cancer clinic setting, the lessons learned from the vCPS can also be applied to the community pharmacy setting and used to implement long-term pharmacy practice change.

"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.

Pharmacists in the coaching group of the study 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 five-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. “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.

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 work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.

Updates:

June 2021 - New practice model a win for all

January 2020 - New models of pharmacy practice working, research shows

John Papastergiou, practising community pharmacist and assistant professor at the University of Toronto and the University of Waterloo, used 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.

The results, published by the International Journal for Pharmacy in October 2021, clearly demonstrated the impact pharmacist-immunizers can make when enabled by provincial legislation and funding. You can also access the article by clicking "Download File" below.

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.

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 researched strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes. As part of that, the team also determined 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 worked with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.

Research results were published in April 2020 in the international journal, Research in Social and Administrative Pharmacy.

Highlights are captured in this news article on CFP's website, posted in June 2020.

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 conductied an economic analysis and developed a practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.

RxOUTMAP practice tool for pharmacists

Published study July 2019 - Economic analysis

News article Sept 2018 - "Pharmacists for UTI management a 'no-brainer'"

Published study June 2018 - "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) 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.

In January 2020, the Canadian Pharmacists Journal published "Community pharmacists as catalysts for deprescribing: An exploratory study using quality improvement processes," which pertains to this research project. Click here to access the article.

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 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 remunerated comprehensive annual care plans, 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.

In July 2019, pharmacy (an MDPI open-access journal) published the following article, focussed on participants' perceived value of the service: " 'It Made a Difference to Me': A Comparative Case Study of Community Pharmacists' Care Planning Services in Primary Health Care." Click here to access the article.

In December 2019, the Journal of the American Pharmacists Association posted the following article, which focuses on the implementation of care planning services: "A qualitative case study exploring the implementation of pharmacist care planning services in community pharmacies." Click here to access the article.

Related links:

2018 news article - How are pharmacy services measuring up?

2015 news article - CFP's Innovation Fund Winners

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

2015 news article - CFP's Innovation Fund winners

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.

Published study - "Clinical outcomes and satisfaction with a pharmacist-managed travel clinic in Alberta, Canada"

2018 news article - Pharmacists’ fit in travel medicine

2018 news article - Happy, healthy travels

2017 news article - Untapped potential of travel meds

2015 news article - CFP's Innovation Fund winners

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

2015 news article - CFP funds study of home-based reviews

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:

Costs and savings associated with pharmacists prescribing for minor ailments program in Saskatchewan (Cost Eff Resource Alloc. 2017)

Patient Feedback on Pharmacist Prescribing for Minor Ailments in a Canadian Province (Innov Pharm. 2017)

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

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

This project will determine the effective of a pharmacist-led medication management program, in colloabrating with patients, prescribers and community pharmacists, in supporting diabetes patients in a remote indigenous community. Researchers will look at patient, prescriber and pharmacist satisfaction around the program, including the use of appropriate medication in improving health outcomes, disease prevention, as well as reduced healthcare utilization and subsequent costs. 

This project will develop a pharmacist-led virtual hypertension management program centered around the use of a health tracking mobile app for patients. The aim is to help patients achieve blood pressure (BP) targets and improve medication adherence along with their knowledge of BP management. The goal is also to provide pharmacists with a simple, systematic method for contributing to virtually enabled hypertension management in the community, while leveraging patient-driven technology.

Pharmacist intervention has been shown to improve outcomes for patients with hypertension, dyslipidemia and other conditions. However, comprehensive medication assessments (CMA) that consider patients holistically may identify even more opportunities to improve outcomes in other ways, such as reducing potentially inappropriate medication use and improving quality of life.This study aims to show that CMA provided through a pharmacist clinic for patients with complex medication needs will improve medication-related burden, reduce medication complexity, and increase patient satisfaction.

To continue to support cancer patients through treatment during the COVID-19 pandemic, Carlo and his team developed a strategy to maximize virtual delivery of clincial pharmacy services (vCPS). Their study will look at how successful these services are and which patients most benefit from them. While initiated in an outpatient pharmacy cancer clinic setting, the lessons learned from the vCPS can also be applied to the community pharmacy setting and used to implement long-term pharmacy practice change.

"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.

Pharmacists in the coaching group of the study 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 five-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. “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.

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 work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.

Updates:

June 2021 - New practice model a win for all

January 2020 - New models of pharmacy practice working, research shows

John Papastergiou, practising community pharmacist and assistant professor at the University of Toronto and the University of Waterloo, used 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.

The results, published by the International Journal for Pharmacy in October 2021, clearly demonstrated the impact pharmacist-immunizers can make when enabled by provincial legislation and funding. You can also access the article by clicking "Download File" below.

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.

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 researched strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes. As part of that, the team also determined 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 worked with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.

Research results were published in April 2020 in the international journal, Research in Social and Administrative Pharmacy.

Highlights are captured in this news article on CFP's website, posted in June 2020.

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 conductied an economic analysis and developed a practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.

RxOUTMAP practice tool for pharmacists

Published study July 2019 - Economic analysis

News article Sept 2018 - "Pharmacists for UTI management a 'no-brainer'"

Published study June 2018 - "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) 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.

In January 2020, the Canadian Pharmacists Journal published "Community pharmacists as catalysts for deprescribing: An exploratory study using quality improvement processes," which pertains to this research project. Click here to access the article.

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 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 remunerated comprehensive annual care plans, 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.

In July 2019, pharmacy (an MDPI open-access journal) published the following article, focussed on participants' perceived value of the service: " 'It Made a Difference to Me': A Comparative Case Study of Community Pharmacists' Care Planning Services in Primary Health Care." Click here to access the article.

In December 2019, the Journal of the American Pharmacists Association posted the following article, which focuses on the implementation of care planning services: "A qualitative case study exploring the implementation of pharmacist care planning services in community pharmacies." Click here to access the article.

Related links:

2018 news article - How are pharmacy services measuring up?

2015 news article - CFP's Innovation Fund Winners

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

2015 news article - CFP's Innovation Fund winners

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.

Published study - "Clinical outcomes and satisfaction with a pharmacist-managed travel clinic in Alberta, Canada"

2018 news article - Pharmacists’ fit in travel medicine

2018 news article - Happy, healthy travels

2017 news article - Untapped potential of travel meds

2015 news article - CFP's Innovation Fund winners

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

2015 news article - CFP funds study of home-based reviews

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:

Costs and savings associated with pharmacists prescribing for minor ailments program in Saskatchewan (Cost Eff Resource Alloc. 2017)

Patient Feedback on Pharmacist Prescribing for Minor Ailments in a Canadian Province (Innov Pharm. 2017)

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

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:

2014 article in Changing Face of Pharmacy (page 21): Data analysis and progressive practice show worth of medication management

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

This project will determine the effective of a pharmacist-led medication management program, in colloabrating with patients, prescribers and community pharmacists, in supporting diabetes patients in a remote indigenous community. Researchers will look at patient, prescriber and pharmacist satisfaction around the program, including the use of appropriate medication in improving health outcomes, disease prevention, as well as reduced healthcare utilization and subsequent costs. 

This project will develop a pharmacist-led virtual hypertension management program centered around the use of a health tracking mobile app for patients. The aim is to help patients achieve blood pressure (BP) targets and improve medication adherence along with their knowledge of BP management. The goal is also to provide pharmacists with a simple, systematic method for contributing to virtually enabled hypertension management in the community, while leveraging patient-driven technology.

Pharmacist intervention has been shown to improve outcomes for patients with hypertension, dyslipidemia and other conditions. However, comprehensive medication assessments (CMA) that consider patients holistically may identify even more opportunities to improve outcomes in other ways, such as reducing potentially inappropriate medication use and improving quality of life.This study aims to show that CMA provided through a pharmacist clinic for patients with complex medication needs will improve medication-related burden, reduce medication complexity, and increase patient satisfaction.

To continue to support cancer patients through treatment during the COVID-19 pandemic, Carlo and his team developed a strategy to maximize virtual delivery of clincial pharmacy services (vCPS). Their study will look at how successful these services are and which patients most benefit from them. While initiated in an outpatient pharmacy cancer clinic setting, the lessons learned from the vCPS can also be applied to the community pharmacy setting and used to implement long-term pharmacy practice change.

"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.

Pharmacists in the coaching group of the study 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 five-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. “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.

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 work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.

Updates:

June 2021 - New practice model a win for all

January 2020 - New models of pharmacy practice working, research shows

John Papastergiou, practising community pharmacist and assistant professor at the University of Toronto and the University of Waterloo, used 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.

The results, published by the International Journal for Pharmacy in October 2021, clearly demonstrated the impact pharmacist-immunizers can make when enabled by provincial legislation and funding. You can also access the article by clicking "Download File" below.

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.

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 researched strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes. As part of that, the team also determined 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 worked with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.

Research results were published in April 2020 in the international journal, Research in Social and Administrative Pharmacy.

Highlights are captured in this news article on CFP's website, posted in June 2020.

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 conductied an economic analysis and developed a practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.

RxOUTMAP practice tool for pharmacists

Published study July 2019 - Economic analysis

News article Sept 2018 - "Pharmacists for UTI management a 'no-brainer'"

Published study June 2018 - "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) 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.

In January 2020, the Canadian Pharmacists Journal published "Community pharmacists as catalysts for deprescribing: An exploratory study using quality improvement processes," which pertains to this research project. Click here to access the article.

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 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 remunerated comprehensive annual care plans, 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.

In July 2019, pharmacy (an MDPI open-access journal) published the following article, focussed on participants' perceived value of the service: " 'It Made a Difference to Me': A Comparative Case Study of Community Pharmacists' Care Planning Services in Primary Health Care." Click here to access the article.

In December 2019, the Journal of the American Pharmacists Association posted the following article, which focuses on the implementation of care planning services: "A qualitative case study exploring the implementation of pharmacist care planning services in community pharmacies." Click here to access the article.

Related links:

2018 news article - How are pharmacy services measuring up?

2015 news article - CFP's Innovation Fund Winners

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

2015 news article - CFP's Innovation Fund winners

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.

Published study - "Clinical outcomes and satisfaction with a pharmacist-managed travel clinic in Alberta, Canada"

2018 news article - Pharmacists’ fit in travel medicine

2018 news article - Happy, healthy travels

2017 news article - Untapped potential of travel meds

2015 news article - CFP's Innovation Fund winners

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

2015 news article - CFP funds study of home-based reviews

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:

Costs and savings associated with pharmacists prescribing for minor ailments program in Saskatchewan (Cost Eff Resource Alloc. 2017)

Patient Feedback on Pharmacist Prescribing for Minor Ailments in a Canadian Province (Innov Pharm. 2017)

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

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:

2014 article in Changing Face of Pharmacy (page 21): Data analysis and progressive practice show worth of medication management

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

2015 Manitoba Smoking Cessation Full Report

2015 Manitoga Smoking Cessation Report in Brief

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

This project will determine the effective of a pharmacist-led medication management program, in colloabrating with patients, prescribers and community pharmacists, in supporting diabetes patients in a remote indigenous community. Researchers will look at patient, prescriber and pharmacist satisfaction around the program, including the use of appropriate medication in improving health outcomes, disease prevention, as well as reduced healthcare utilization and subsequent costs. 

This project will develop a pharmacist-led virtual hypertension management program centered around the use of a health tracking mobile app for patients. The aim is to help patients achieve blood pressure (BP) targets and improve medication adherence along with their knowledge of BP management. The goal is also to provide pharmacists with a simple, systematic method for contributing to virtually enabled hypertension management in the community, while leveraging patient-driven technology.

Pharmacist intervention has been shown to improve outcomes for patients with hypertension, dyslipidemia and other conditions. However, comprehensive medication assessments (CMA) that consider patients holistically may identify even more opportunities to improve outcomes in other ways, such as reducing potentially inappropriate medication use and improving quality of life.This study aims to show that CMA provided through a pharmacist clinic for patients with complex medication needs will improve medication-related burden, reduce medication complexity, and increase patient satisfaction.

To continue to support cancer patients through treatment during the COVID-19 pandemic, Carlo and his team developed a strategy to maximize virtual delivery of clincial pharmacy services (vCPS). Their study will look at how successful these services are and which patients most benefit from them. While initiated in an outpatient pharmacy cancer clinic setting, the lessons learned from the vCPS can also be applied to the community pharmacy setting and used to implement long-term pharmacy practice change.

"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.

Pharmacists in the coaching group of the study 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 five-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. “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.

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 work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.

Updates:

June 2021 - New practice model a win for all

January 2020 - New models of pharmacy practice working, research shows

John Papastergiou, practising community pharmacist and assistant professor at the University of Toronto and the University of Waterloo, used 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.

The results, published by the International Journal for Pharmacy in October 2021, clearly demonstrated the impact pharmacist-immunizers can make when enabled by provincial legislation and funding. You can also access the article by clicking "Download File" below.

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.

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 researched strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes. As part of that, the team also determined 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 worked with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.

Research results were published in April 2020 in the international journal, Research in Social and Administrative Pharmacy.

Highlights are captured in this news article on CFP's website, posted in June 2020.

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 conductied an economic analysis and developed a practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.

RxOUTMAP practice tool for pharmacists

Published study July 2019 - Economic analysis

News article Sept 2018 - "Pharmacists for UTI management a 'no-brainer'"

Published study June 2018 - "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) 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.

In January 2020, the Canadian Pharmacists Journal published "Community pharmacists as catalysts for deprescribing: An exploratory study using quality improvement processes," which pertains to this research project. Click here to access the article.

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 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 remunerated comprehensive annual care plans, 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.

In July 2019, pharmacy (an MDPI open-access journal) published the following article, focussed on participants' perceived value of the service: " 'It Made a Difference to Me': A Comparative Case Study of Community Pharmacists' Care Planning Services in Primary Health Care." Click here to access the article.

In December 2019, the Journal of the American Pharmacists Association posted the following article, which focuses on the implementation of care planning services: "A qualitative case study exploring the implementation of pharmacist care planning services in community pharmacies." Click here to access the article.

Related links:

2018 news article - How are pharmacy services measuring up?

2015 news article - CFP's Innovation Fund Winners

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

2015 news article - CFP's Innovation Fund winners

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.

Published study - "Clinical outcomes and satisfaction with a pharmacist-managed travel clinic in Alberta, Canada"

2018 news article - Pharmacists’ fit in travel medicine

2018 news article - Happy, healthy travels

2017 news article - Untapped potential of travel meds

2015 news article - CFP's Innovation Fund winners

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

2015 news article - CFP funds study of home-based reviews

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:

Costs and savings associated with pharmacists prescribing for minor ailments program in Saskatchewan (Cost Eff Resource Alloc. 2017)

Patient Feedback on Pharmacist Prescribing for Minor Ailments in a Canadian Province (Innov Pharm. 2017)

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

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:

2014 article in Changing Face of Pharmacy (page 21): Data analysis and progressive practice show worth of medication management

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

2015 Manitoba Smoking Cessation Full Report

2015 Manitoga Smoking Cessation Report in Brief

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

Researchers will evaluate the impact of COVID-19 on front-line pharmacists’ roles and identity using face-to-face interviews. They will aim to answer the following research questions: How do pharmacists describe their professional roles and identity pre-COVID-19? How has the COVID-19 pandemic influenced pharmacists' roles and their professional identity (what they do and what it means to them)? Which aspects of pharmacists' roles and professional identity changes, if any, they project to be sustained post-COVID-19?

This study will look at the value and impact of mental health first-aid training for pharmacists. Researchers will train 25 community pharmacists in mental health first aid, then assess changes in their confidence, stigma and attitudes towards providing care for patients experiencing mental health issues. The study will also capture the frequency and description of patient encounters, intervention and follow-up. 

Oral cancer drugs, while growing in use, are challenging with regards to risk of inappropriate handling, drug interactions and delayed detection and management of side effects. The Chemo Pharmacy Team at North York General Hospital is creating the Community Pharmacy Engagement Initiative to enhance information transfer and knowledge dissemination to community pharmacists caring for the hospital’s cancer patients. The goal is to connect community pharmacists with oncology trained pharmacists who can address questions, provide tailored education and direct community pharmacists to online oncology resources for self-directed learning.

This project will determine the effective of a pharmacist-led medication management program, in colloabrating with patients, prescribers and community pharmacists, in supporting diabetes patients in a remote indigenous community. Researchers will look at patient, prescriber and pharmacist satisfaction around the program, including the use of appropriate medication in improving health outcomes, disease prevention, as well as reduced healthcare utilization and subsequent costs. 

This project will develop a pharmacist-led virtual hypertension management program centered around the use of a health tracking mobile app for patients. The aim is to help patients achieve blood pressure (BP) targets and improve medication adherence along with their knowledge of BP management. The goal is also to provide pharmacists with a simple, systematic method for contributing to virtually enabled hypertension management in the community, while leveraging patient-driven technology.

Pharmacist intervention has been shown to improve outcomes for patients with hypertension, dyslipidemia and other conditions. However, comprehensive medication assessments (CMA) that consider patients holistically may identify even more opportunities to improve outcomes in other ways, such as reducing potentially inappropriate medication use and improving quality of life.This study aims to show that CMA provided through a pharmacist clinic for patients with complex medication needs will improve medication-related burden, reduce medication complexity, and increase patient satisfaction.

To continue to support cancer patients through treatment during the COVID-19 pandemic, Carlo and his team developed a strategy to maximize virtual delivery of clincial pharmacy services (vCPS). Their study will look at how successful these services are and which patients most benefit from them. While initiated in an outpatient pharmacy cancer clinic setting, the lessons learned from the vCPS can also be applied to the community pharmacy setting and used to implement long-term pharmacy practice change.

"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.

Pharmacists in the coaching group of the study 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 five-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. “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.

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 work directly with pharmacy staff to address multiple factors affecting the provision of expanded patient care services.

Updates:

June 2021 - New practice model a win for all

January 2020 - New models of pharmacy practice working, research shows

John Papastergiou, practising community pharmacist and assistant professor at the University of Toronto and the University of Waterloo, used 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.

The results, published by the International Journal for Pharmacy in October 2021, clearly demonstrated the impact pharmacist-immunizers can make when enabled by provincial legislation and funding. You can also access the article by clicking "Download File" below.

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.

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 researched strategies needed to encourage pharmacist routine follow up after an initial medication review in people with diabetes. As part of that, the team also determined 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 worked with pharmacists to test solutions to improve follow-ups in their own pharmacies, over a period of several months.

Research results were published in April 2020 in the international journal, Research in Social and Administrative Pharmacy.

Highlights are captured in this news article on CFP's website, posted in June 2020.

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 conductied an economic analysis and developed a practice tool to help pharmacists document their work around UTI treatment and keep track of patients treated.

RxOUTMAP practice tool for pharmacists

Published study July 2019 - Economic analysis

News article Sept 2018 - "Pharmacists for UTI management a 'no-brainer'"

Published study June 2018 - "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) 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.

In January 2020, the Canadian Pharmacists Journal published "Community pharmacists as catalysts for deprescribing: An exploratory study using quality improvement processes," which pertains to this research project. Click here to access the article.

News article - "Deprescribing, within a pharmacist's domain"