Medication management is at the core of pharmacists’ clinical practice and contribution to patient care. The Centre for Practice Excellence (CPE) at the Leslie Dan Faculty of Pharmacy supports innovation and leadership in this field through the Collaborative Research Seed Funding (CRSF) Program.
“The CRSF provides support to investigators who are initiating or pilot-testing innovative models, methods, or research questions related to medication management,” says Dr. Zubin Austin, Academic Director of the CPE and Murray B. Koffler Chair in Pharmacy Management. “This year’s successful proposals demonstrated real-world potential impact as well as cross-disciplinary collaboration.”
Recipients of 2017 Collaborative Research Seed Funding:
Dr. Lisa McCarthy, Assistant Professor, Leslie Dan Faculty of Pharmacy, and Clinician Scientist Women’s College Hospital
Evaluating the feasibility of PROMPT (Pharmacy Communication Partnership): A program to improve medication experiences at health care system transitions
Dr. Sara Guilcher, Assistant Professor, Leslie Dan Faculty of Pharmacy and Dr. Jennifer Lake, Lecturer, Leslie Dan Faculty of Pharmacy
Should Community Pharmacy be “linked”? A pilot study exploring perceptions of the integration of community pharmacy with Health Links in Ontario
In Canada, 40 to 50 per cent of patients experience unintentional medication discrepancies on hospital admission, and at least 40 per cent on discharge. These discrepancies happen when a patient receives a different medication while in hospital than what they were taking at home, or vice versa, – a change not intended by the original prescriber.
“Transitions between community care and hospital settings are high-risk periods for vulnerable older adults because they can experience medication errors,” says Dr. Lisa McCarthy, Assistant Professor at the Leslie Dan Faculty of Pharmacy and Pharmacy Scientist at Women’s College Hospital. “By improving communication and coordination between pharmacists in each setting, our project has the potential to improve patient safety and overall health while also reducing health-system costs.”
PROMPT suggests that medication errors at this time of transition can be reduced if hospital pharmacists faxed a comprehensive discharge package to the local community pharmacist involved in the patient’s care. The hospital pharmacist would then be available for follow up if needed. The solution is simple but meaningful and capitalizes on technology already in use.
The funding Dr. McCarthy received through CRSF is pivotal for taking this work from its development phase into a broader evaluation that looks at the impact of the PROMPT on clinical and health system outcomes, she says.
The interdisciplinary requirement is also a welcome focus.
“We have many talented people connected with the Faculty of Pharmacy. Yet, it can be difficult to develop new partnerships that are competitive for funding when you are compared to teams with demonstrated solid records of productivity,” she says. “The faculty's support through the Centre for Practice Excellence is critical for allowing our team to build this record.”
Should community pharmacy be “linked”?
In Ontario, patients with complex needs account for more than 60 per cent of healthcare spending. To address this issue, the Ministry of Health and Long-term Care created Health Links – a network of 79 teams embedded in the province’s Local Integrated Health Networks (LHINs). To date, Health Links teams do not include pharmacists.
Dr. Jennifer Lake, Lecturer at the Leslie Dan Faculty of Pharmacy argues that the lack of pharmacists in this sphere represents a potential gap in the delivery of care. “Majority of patients with complex needs are on an average of 13 different medications,” she says. “We also know that pharmacists can improve chronic disease management and patient safety by decreasing medication errors, so we think there is an opportunity here for pharmacists to play an important role in the care of these complex patients.”
The research team, co-lead by Dr. Sara Guilcher, Assistant Professor at the Leslie Dan Faculty of Pharmacy, hopes to identify ways to facilitate the integration of pharmacists into Health Links.
“By integrating pharmacists, patients with complex medical conditions may have improved care with respect to their medication management,” says Dr. Guilcher who also points to the opportunity for the Faculty of Pharmacy to play a lead role is this work. “We are training the practitioners of tomorrow so research into how to improve our practice helps bridge the gap between education, practice and policy.”
PROMPT Co-Investigators include:
Sara Guilcher BSc(Hons), MScPT, MSc, PhD1,4
Olavo Fernandes BScPhm, ACPR, PharmD, FCSHP1,5,6,7
Gary Wong BScPhm1,5
Karen Cameron BScPhm, ACPR, CGP1,5
Philip Lui BScPhm, PharmD1,5
John Papastergiou BSc, BScPhm1,8
Pauline Pariser MASc, MD, CCFP, FCFP3,5
1Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario
2Women’s College Research Institute at Women's College Hospital, Toronto, Ontario
3Department of Family and Community Medicine, University of Toronto, Toronto, Ontario
4Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario
5University Health Network, Toronto, Ontario
6Centre for Patient Safety, University of Toronto, Toronto, Ontario
7Centre for Interprofessional Education, University of Toronto, Toronto, Ontario
8Shoppers Drug Mart, Toronto, Ontario
Should community pharmacy be “linked”? Co-Investigators include:
Dr. Katie Dainty, PhD
Research Chair, Patient-Centred Outcomes. North York General Hospital
Assistant Professor, Outcomes & Evaluation PAS Co-lead
Institute of Health Policy, Management & Evaluation (IHPME)
Dr. Zahava Rosenberg-Yunger, PhD
Director Health Policy & Research, Ontario Pharmacists Association