RxCELLENCE December 2024

DECEMBER 2024

THE

IN THIS ISSUE Holiday Greetings!

Diabetes Awareness Month

W I S H I N G Y O U

HAPPY HOLIDAYS &

A

B R I G H T

N E W

Y E A R

F R O M T H E E P I C O R E T E A M

A

M E S S A G E

F R O M

O U R

T E A M :

“Happy Holidays to all. We look forward to working with you and supporting you in the new year” - Dr. Ross Tsuyuki

“Wishing you and your loved ones a joyful and blessed holiday season.

Thanks for all your hard work to deliver the highest level of care to everyone who needs it. I can’t wait to see what we will do together in the new year” - Dr. Yazid Al Hamarneh

DECEMBER 2024

Diabetes Awareness Month Did you know [1]: A person is diagnosed with diabetes in Canada every three minutes.

Diabetes is a continuous cycle that demands

your

patient’s

time,

attention, and energy.

Your patients living with diabetes are two to three times more likely to live with depression.

People with diabetes have a 2 to 4

Pharmacists play an integral role in the

fold greater risk of cardiovascular

detection and management of diabetes.

events.

In Alberta, pharmacists have been actively

November

was

Diabetes

Awareness

Month. Diabetes remains one of the leading

public

health

problems

in

Canada, with one in three Canadians living with diabetes or pre-diabetes (11 million

people).

diabetes

Complications

include

of

retinopathy,

managing patients’ diabetes over the years.

From screening for diabetes using the CANRISK Questionnaire, to taking charge of diabetes management through prescribing medications, ordering lab tests, adjusting lifestye, and many more interventions - YOU have been a steadfast source of care for

neuropathy, kidney disease, and major

people with diabetes.

cardiovascular

Pharmacist

events.

These

care

for

diabetes

is

well-

complications can significantly affect

supported by the literature; some of which

your patients’ quality of life and lead to

is coming from Alberta. For example, your

morbidity and even death.

contribution to the Rx ING Trial highlighted pharmacist interventions led to a significant reduction

in

A1C

from

9.1%

to

7.3%

(p<0.001) [2]. We encourage you to keep up the vital care you are providing to people with diabetes.

To get actively involved in our newest initiatives to improve diabetes management, sign up to the PRx OACT Trial (details below) or a diabetes Care Pathway Trial being released in early 2025! Stay tuned for more details!

1. Diabetes Canada. Make time to end diabetes. https://www.diabetes.ca/let-s-make-time-to-end-diabetes 2. Al Hamarneh et al., Pharmacist intervention for glycaemic control in the community (the RxING study). BMJ Open. doi: 10.1136/bmjopen-2013-003154

DECEMBER 2024

Pharmacist Feedback and Input Requested Hypertension Canada is planning to launch an advocacy campaign to lobby governments to support the implementation of a Canadian Community Pharmacy Hypertension Case Finding Service, modeled after a similar Hypertension Case Finding Service in the UK by the National Health Service (NHS). See description below.

We are interested in hearing from community pharmacists and pharmacy owners from across Canada about this advocacy initiative as well as their interest (or not) in this type of program. We kindly ask that you complete the short survey linked here: https://t.co/j2lLmVESug Implementation of a Community Pharmacy Hypertension Case Finding Service in Canada The Canadian Community Pharmacy Hypertension Case Finding Service would enable pharmacists to play a significant role in Hypertension Canada’s hypertension surveillance program. Further, it will provide pharmacists with an opportunity to assist with identifying, managing, and preventing hypertension by offering community-based, accessible blood pressure screenings at local pharmacies.

The Canadian Community Pharmacy Hypertension Case Finding Service would leverage the wide network of community pharmacies to reach at-risk populations, many of whom might not regularly visit a primary care physician or nurse practitioner. With proper training and technology, such as Automated Office and Ambulatory Blood Pressure Monitoring Devices, pharmacists could help reduce the burden of undiagnosed or poorly managed hypertension.

To ensure sustainability and widespread adoption, Hypertension Canada is collaborating with the Pharmacy Practice and Research Network, Canada (PPRNCanada)—a network established by pharmacy practice researchers, patients, and organizational partners—at three Universities in Canada to complete this work (i.e., Memorial University, the University of Alberta, and the University of Toronto). The work of PPRNCanada is supported by funding from the Canadian Institutes of Health Research.

Hypertension Canada will embark on advocating for a remuneration model that is consistent with the NHS service agreement, as follows: Fee-for-Service: Pharmacies would receive a standard fee for each Automatic Office Blood Pressure (AOBP) screening. The service would be directed at adults aged 18+.

Performance-Based Incentives: Pharmacies would be rewarded for meeting certain health outcome targets, such as reducing blood pressure in patients or increasing referrals to other primary care providers. The service would be directed at adults aged 18 years+.

DECEMBER 2024

Implementation of Pharmacist Case Finding and Intervention for Vascular Prevention: PRxOACT Study We are seeking pharmacists to participate in this new study. In this study, we are developing electronic tools to assist pharmacists in their assessment and care of patients at high cardiovascular risk. We are looking for pharmacists working in primary care clinics or who are already delivering advanced clinical services.

Cardiovascular disease is still one of the leading causes of death in Canada, even though most of its cases and deaths are caused by well-known modifiable risk factors. Guidelines recommend using cardiovascular (CV) risk assessment to guide the treatment and prevention of cardiovascular disease and its risk factors. However, such assessment has not been integrated into clinicians’ daily routine.

Pharmacists are frontline primary healthcare providers who see patients with chronic conditions frequently. Their interventions in patients with such conditions have been demonstrated to improve outcomes and are associated with very high levels of patient satisfaction and significant cost savings.

While there is strong evidence for the impact of pharmacist care in cardiovascular disease, implementation of this evidence is lacking. Such lack of implementation, combined with the family physician crisis in Canada, highlights the need for creative implementation initiatives for this excellent evidence.

Primary objective: To determine the impact of a pharmacist care pathway on patients’ estimated risk for major cardiovascular events.

Methods Design: Randomized controlled trial with the patient as the unit of randomization Setting: Pharmacist primary care clinics Intervention: Patient assessment, lab assessment, individualized CV risk calculation and education about this risk Using EPI·RxISK™ (https://www.epicore.ualberta.ca/epirxisk/), adherence assessment, shared decision making, treatment initiation/adjustment and lifestyle adjustment based on co-designed treatment plan, regular follow-up.

What this study adds: This initiative builds on well-studied interventions and will not only improve Albertans access to CV care, but it will also enhance their knowledge and understanding of their CV risk and risk factors. Moreover, the proposed project meets the recommendations of the latest proposals and calls for modernizing Alberta’s primary health Care system (MAPS) as it will be the first project to evaluate CVD services at the pharmacist primary care clinics which will ensure “sufficient research and evaluation capacity built into all early actions to facilitate both accountability and improvement" and will use the online interactive EPI·RxISK™ CV calculator which will embrace “technology-enabled care as a foundation” that was identified as a major driver for transformation.

If you are interested in joining please contact: yazid.alhamarneh@ualberta.ca & shania.liu@ualberta.ca

Participate in a PharmacistPhysiotherapist Collaborative RCT Starting early 2025

PACE-OA: Pharmacist-physiotherapist (PT) collaborative management for early knee osteoarthritis (OA)

Interprofessional Care:

This is an opportunity to collaborate across disciplines with a local physiotherapist in your area to manage early knee OA for your patients.

About:

We are interested in evaluating how well a pharmacist-physiotherapist collaboration works to reduce pain and improve function in patients with early OA of the knee. Ultimately, we hope this reduces medication burden.

Join Us If You: Are a pharmacist working in any community practice setting with additional prescribing authority Are keen to collaborate with nearby PTs Are interested in better supporting patients with OA pain Bonus: Have pharmacy students on site!

Who Will Be Enrolled:

People 50 years of age or older who have been regularly experiencing pain, aching, or stiffness in and/or around the knee(s) for at least 1 month.

Participants will be recruited using 2 strategies: (1) Posters and infographics placed near the OTC and NHP section(s), which will recommend that those with knee pain talk to you.

(2) You will ask patients receiving care for other conditions that have similar risk factors as OA about symptomatic knee OA.

To learn more or join now, contact the study team Allyson Jones & Jill Hall

PACEOA@ualberta.ca

DECEMBER 2024

RxOC-IT: A Pharmacist-Led Obesity Care Intervention ***Seeking CDE and/or CBE Pharmacists in Alberta*** Objectives: To develop the first pharmacist-led obesity management clinics in Canada.

Determine the benefit of a pharmacist-led weight management program in patients struggling with overweight and obesity.

Background: Overweight and obesity is associated with stigma and can also affect the social, economic, and mental wellbeing of those who experience it. We need to find better ways for people who have overweight and obesity to access health care services that help them improve their health. In Alberta, pharmacists have the broadest scope of practice in Canada. They have the ability to prescribe medications and order laboratory tests thus are well positioned to increase access to comprehensive, collaborative care and follow-up for patients living with overweight and obesity in Alberta.

Design: Prospective before and after study design. With one core community pharmacy-led clinic (Apothecare Pharmacy) and three satellite pharmacy-led clinics across Alberta.

The initial step involved creating a core pharmacist-led obesity clinic to establish a benchmark – complete.

Satellite pharmacies and pharmacist trainees will be determined and provided standardized training based on Obesity Canada’s clinical practice guidelines and via experiential learning.

We are seeking pharmacists/pharmacies with the following criteria below that would be interested in participating: Independent community pharmacy/pharmacists outside of Calgary, AB. Have sufficient staffing/overlap.

Pharmacists must have APA, and a PRAC-ID to order lab work.

Practice as a Certified Diabetes Educator® and/or Certified Bariatric Educator®.

If you are interested in participating please send an email to dan@apothecarerx.ca.

DECEMBER 2024

Studies: Call for Ideas Have you noticed something interesting, or had a question come up in practice and thought that would make a great research question? Are you currently recruiting participants for an ongoing study?

We are always looking for ways that we can help YOU turn your questions into research studies or provide you with assistance with your ongoing endeavors. Please email us at rxexcell@ualberta.ca with any ideas or requests, and we’ll work with you to make it a reality!

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