Louise Gastonguay

Pharmacist‐initiated intervention trial in osteoarthritis: A multidisciplinary intervention for knee osteoarthritis

Knee osteoarthritis (OA) is a commonly undiagnosed condition and care is often not provided. Pharmacists are uniquely placed for launching a multidisciplinary intervention for knee OA.

After patients are diagnosed with knee osteoarthritis, what do they do?

To learn more about the health services and products that patients use after receiving a diagnosis of knee osteoarthritis (OA), as well as the trajectory of their health‐related quality of life (HRQOL).

Patients with genital warts have a decreased quality of life.

Human papilloma virus (hpv) is one of the most common sexually transmitted infections. It is estimated that 75% of sexually active individuals will have HPV-related infection in their lifetime.1 Of the numerous HPV subtypes, 15 are considered high-risk and lead to the development of cervical cancer.

Pharmacy-based Immunization in Rural Communities Strategy (PhICS): A community cluster-randomized trial.

Background: Influenza is a major cause of morbidity and mortality in Canada, with up to 7000 influenza-related deaths occurring every year. The elderly and individuals with chronic diseases are at increased risk for influenza-related morbidity and mortality. Methods: We conducted a 2-year, community cluster-randomized trial targeting elderly people and at-risk groups to assess the effectiveness of pharmacy-based influenza vaccination clinics on influenza vaccination rates. Small rural communities in interior and northern British Columbia were randomly allocated to the intervention or control. In the intervention communities, pharmacy-based influenza vaccination clinics were held and were promoted to eligible patients using personalized invitations from the pharmacists, invitations distributed opportunistically by a pharmacist to eligible patients presenting to pharmacies during the flu season and community-wide promotion using posters and the local media. The main outcome measure was a difference in the mean influenza vaccination rates. The immunization rates were calculated using the number of immunizations given in each community divided by the population size estimated from the census data. Results: Baseline influenza immunization rates in the population ≥65 years of age were the same in the control (n = 10, mean 85.6% [SD 16.6]) and intervention (n = 14, mean 83.8% [SD 16.3]) communities in 2009 (p = 0.79). In 2010, the mean influenza immunization rate was 56.9% (SD 28.0) in the control communities (n = 15) and 80.1% (SD 18.4) in the intervention communities (n = 14) (p = 0.01) for those ≥65 years of age. However, in 2010, for those 2 to 64 years with chronic medical conditions, the immunization rates were lower in the intervention communities (mean 16.3% [SD 7.1]) compared with the control communities (mean 21.2% [SD 5.8]) (p = 0.04). Conclusion Clinics were feasible and well attended and they resulted in increased vaccination rates for elderly residents. In contrast, vaccination rates in the younger population with comorbidities remained low and unchanged.

De-escalation of therapy for pediatric medulloblastoma: trade-offs between quality of life and survival.

Treatment intensity for pediatric medulloblastoma may vary depending on the type of medulloblastoma. In some cases, the dose of radiation may be reduced or eliminated. Correspondingly, there may be trade‐offs between quality of life and survival. In this study, focus groups were conducted with parents and clinicians to explore their opinions about these trade‐offs as well as the alignment/misalignment between parents and clinicians regarding the trade‐offs.

Factors associated with pharmacists' perceptions of their working conditions and safety and effectiveness of patient care.

Background: In recent years, the role of pharmacists has changed, as have various provincial legislations, which now allow pharmacists to provide additional health services to patients. With these changes comes growing concern about how well the current pharmacy working environment is adapting and whether it may also be creating work-related stress that may contribute to potentially unsafe practices of patient care. Methods: To characterize the current working conditions of pharmacists in British Columbia, an online survey was developed and distributed to all College of Pharmacists of BC (CPBC) registrants by email. The survey consisted of questions on pharmacists’ demographics, practice setting and perceptions of workplace conditions. Responses were collected from October 1 to November 10, 2013. All data were summarized using descriptive statistics, and regression models were constructed to assess the association between various factors and pharmacists’ self-reported working conditions. Results: Twenty-three percent (1241/5300) of pharmacists registered with the CPBC responded, with 78% working in the community pharmacy setting (58% chain, 19% independent). Pharmacists mostly disagreed with the statements that they had enough time for breaks or lunches or to do their jobs, as well as enough staffing support. Pharmacists’ perceptions of their workplace environment were negatively associated with workplace-imposed advanced service quotas (for medication reviews, immunizations and prescription adaptations); being employed at chain store pharmacies, compared to independent pharmacies or hospitals/long-term care settings; and higher prescription volume. Discussion: Pharmacists working in chain community pharmacies who are required to meet monthly quotas for expanded services reported a substantial negative impact on their working conditions and perceived safety of patient care. Can Pharm J (Ott) 2016;149:xx-xx.

Cost‐Utility Analysis of a Multidisciplinary Strategy to Manage Osteoarthritis of the Knee: Economic Evaluation of a Cluster Randomized Controlled Trial Study

To determine if a pharmacist‐initiated multidisciplinary strategy provides value for money compared to usual care in participants with previously undiagnosed knee osteoarthritis.

Perceptions of British Columbia residents and their willingness to pay for medication management services provided by pharmacists

Background: Across Canada, pharmacists have expanded their scope of practice by performing medication management (MM) services. However, little is currently known about the opinions and attitudes of patients and the general population toward MM services. Methods: A cross-sectional online survey, including a best-worst scaling task, was designed to understand the general public’s opinions, preferences and willingness-to-pay with respect to MM services in British Columbia. Results: Of 977 individuals contacted, 819 responded to the questionnaire (84% response rate). The mean age was 45 years (standard deviation [SD] 16 years), and 37% were male. Overall, 93% of respondents felt that the medication advice from their pharmacist resulted in improvement in patient outcomes and/or medication use. This was also selected as the “best” attribute of MM, while other preferred attributes of MM included being able to obtain an appointment with the pharmacist on the same day or via walk-in, improved patient-physician relationships and MM sessions able to be completed in 15 minutes with the pharmacist. The average willingness to pay for MM was

Design of a randomized trial of a multidisciplinary intervention for knee osteoarthritis: Pharmacist Initiated Intervention Trial in Osteoarthritis (PhIT-OA)

24.55 (SD

BC Medication Management Project: Perspectives of pharmacists, patients and physicians.

21.44). Younger males with higher household income and those who had had MM in the past were willing to pay more for MM services out of pocket. Discussion and Conclusion: The accessibility of pharmacists was valued highly by respondents who, overall, were supportive of MM services and recognized the potential of pharmacists’ involvement in drug therapy management to improve patient outcomes and medication use. Alternative models of funding are worth considering for the sustainability of MM service provision.