OBJECTIVE: Diabetes is a major public health problem in Canada and requires multifactorial, consistent clinical management. The COVID-19 pandemic has increased challenges in the management of many chronic ailments, including diabetes. Diabetes was associated with a higher risk of severe illness in the context of COVID-19. Pandemic restrictions also impacted diabetes care continuity, which may have contributed to an increased risk of diabetes-related complications and mortality.
METHODS: This was a retrospective cross-sectional study of prescription patterns of antihyperglycemic medications claimed by individuals with type 2 diabetes (T2D) before and during the COVID-19 pandemic using the IQVIA Canada Longitudinal Prescription Claims database. The study period was from March 1, 2018, to February 28, 2021. The study outcomes are described on a monthly, quarterly, and yearly basis and overall, and by medication, medication class, and insurance coverage type. \"New-to-molecule\" patients were defined as those claiming a medication during the analysis period that they had no history of claiming in the database. Adults with at least 1 year of prescription history available and claiming their first prescription for an antihyperglycemic drug during the analysis period were classified as newly diagnosed with T2D.
RESULTS: A similar number of people had at least 1 non-insulin antihyperglycemic prescription during the baseline, prepandemic, and pandemic periods in Canada (1,778,155, 1,822,403, and 1,797,272, respectively). However, the number of people initiating newer antihyperglycemic medications decreased at the beginning of the pandemic, in contrast to older medications, which remained consistent across the pandemic period. The number of people diagnosed with T2D decreased in the early months of the pandemic but recovered by October 2020.
CONCLUSIONS: The COVID-19 epidemic in Canada impacted clinical care for at-risk Canadians, with fewer being prescribed newer antihyperglycemic drugs and a reduction in the number of diagnoses of T2D.

UNASSIGNED: Past research on disciplinary action by pharmacist regulatory bodies has shown that most cases concern community pharmacists, with few occurring in a hospital setting.
UNASSIGNED: To investigate how discipline-related issues involving pharmacists are dealt with by hospital pharmacy departments in Canada.
UNASSIGNED: Hospital pharmacy directors and managers from small, medium, and large hospitals across Canada were invited to participate in semi-structured telephone interviews. The interview questions focused on the discipline process in participants\' organizations, the situations when reporting to the regulatory body is deemed to be warranted, possible penalties, and recommendations for improving the regulatory body or organizational discipline process.
UNASSIGNED: Ten participants, from British Columbia, Saskatchewan, Ontario, New Brunswick, Prince Edward Island, and Newfoundland and Labrador, agreed to be interviewed. Five key themes emerged as contributing to lower rates of hospital pharmacist discipline cases being escalated to the regulatory college level: robust organizational discipline processes independent from the regulatory college, a practice environment promoting competence, union representation, preference for a remedial approach to discipline, and lack of clarity about when to report to the regulatory authority.
UNASSIGNED: This study identified a number of reasons why discipline of hospital pharmacists by a regulatory body may be less prevalent than discipline relating to community pharmacists. The main reasons may be lack of clarity about when to report a case to the regulator and a lack of transparency, given that many cases are handled internally within hospitals. Environmental supports for competence and employee protections (e.g., through a union) may also reduce discipline cases.
UNASSIGNED: Des recherches antérieures sur les mesures disciplinaires prises par les organismes de réglementation des pharmaciens ont montré que la plupart des cas concernaient des pharmaciens communautaires, et que peu se produisaient en milieu hospitalier.
UNASSIGNED: Examiner comment les questions disciplinaires impliquant des pharmaciens sont traitées par les départements de pharmacie hospitalière au Canada.
UNASSIGNED: Les directeurs et gestionnaires de pharmacies de petits, moyens et grands hôpitaux au Canada ont été invités à participer à des entrevues téléphoniques semi-structurées. Les questions portaient sur le processus disciplinaire en place dans les organismes des participants; les situations où le signalement à l’organisme de réglementation était jugé justifié; les sanctions possibles; et les recommandations pour améliorer le processus disciplinaire de l’organisme de réglementation ou de l’organisme.
UNASSIGNED: Dix participants de la Colombie-Britannique, de la Saskatchewan, de l’Ontario, du Nouveau-Brunswick, de l’Île-du-Prince-Édouard et de Terre-Neuve-et-Labrador ont accepté d’être interrogés. Cinq thèmes clés ont été identifiés comme contribuant au taux plus faible de cas de discipline des pharmaciens hospitaliers remontés au niveau de l’organisme de réglementation: des processus disciplinaires organisationnels solides indépendants de l’organisme de réglementation; un environnement de pratique favorisant la compétence; la représentation syndicale; la préférence pour une approche corrective de la discipline; et le manque de clarté quant au moment où il faut signaler à l’autorité de réglementation.
UNASSIGNED: Cette étude a identifié un certain nombre de raisons pour lesquelles les mesures disciplinaires relatives des pharmaciens hospitaliers par un organisme de réglementation peuvent être moins répandues que celles liées aux pharmaciens communautaires. Les principales raisons pourraient être le manque de clarté quant au moment de signaler un cas à l’autorité réglementaire et un manque de transparence, étant donné que de nombreux cas sont traités en interne dans les hôpitaux. Les soutiens environnementaux pour la compétence et la protection des employés (par exemple, par l’entremise d’un syndicat) peuvent également réduire les cas de discipline.

UNASSIGNED: The relationship between a preceptor and a learner is complex and can be prone to conflict. The issue of conflict in experiential education has been studied in medicine, nursing, social work, and education; however, conflict between pharmacy preceptors and learners has not been described.
UNASSIGNED: To describe types of conflict between pharmacy preceptors and learners, the outcomes of such conflict, the impacts on the preceptor-learner relationship, and conflict-resolution strategies.
UNASSIGNED: An anonymous electronic survey of pharmacist preceptors and pharmacy residents in British Columbia was conducted. The survey included various types of questions to enrich the quality of responses (e.g., Likert scale, ranking, and requests for comments). Descriptive statistics were used.
UNASSIGNED: Forty-nine participants completed the survey from the preceptor\'s perspective, 12 from the learner\'s perspective, and 4 from both perspectives. Sixty percent of preceptors (32/53) and 75% of learners (12/16) admitted experiencing conflict. Preceptors (n = 27) cited the learner\'s professionalism (74%), knowledge/skills (59%), communication issues (59%), personal issues (56%), and punctuality/attendance (52%) as causes of conflict. Learners, however (n = 12), cited differing expectations (67%), teaching versus learning style preferences (50%), and communication issues (67%) as causes of conflict. The majority of preceptors and learners indicated that conflict had negatively affected the relationship; however, most preceptors (69% [18/26]) and learners (50% [6/12]) agreed or strongly agreed with the statement, \"I have generally felt comfortable working with preceptors/learners after a conflict.\" More learners than preceptors felt that the learner\'s ability to perform was negatively affected by the conflict (92% [11/12] versus 52% [13/25]). Preceptors were more likely to take initiative to resolve conflict. Verbal communication was the method of conflict resolution preferred by both preceptors and learners. Most preceptors and learners indicated that they felt that conflicts were generally resolved.
UNASSIGNED: Conflict was common in the pharmacy preceptor-learner relationship. Pharmacy preceptors and learners had different perspectives about the causes and outcomes of conflict.
UNASSIGNED: La relation entre le précepteur et l’apprenant est complexe et peut entraîner des conflits. Le problème du conflit dans le domaine de l’éducation expérientielle a été étudié en médecine, en infirmerie, en travail social et en éducation; cependant, il n’existe aucune description des conflits entre les précepteurs et les apprenants en pharmacie.
UNASSIGNED: Décrire les types de conflits entre les précepteurs en pharmacie et les apprenants, les conséquences de tels conflits ainsi que les impacts sur la relation précepteur-apprenant et les stratégies de résolution de conflit.
UNASSIGNED: Une enquête électronique anonyme a été menée auprès de précepteurs et de résidents en pharmacie en Colombie-Britannique. L’enquête comprenait diverses questions visant à enrichir la qualité des réponses (p. ex., échelle de Likert, classement et demandes de commentaires). L’étude s’appuie sur des statistiques descriptives.
UNASSIGNED: Quarante-neuf participants ont répondu à l’enquête en adoptant le point de vue du précepteur, 12 en adoptant celui de l’apprenant et 4 ont adopté le point de vue de l’apprenant et du précepteur. Soixante pour cent des précepteurs (32/53) et 75 % des apprenants (12/16) ont admis traverser des conflits. Les sources de conflits citées par les précepteurs (n = 27) sont le professionnalisme de l’apprenant (74 %), les connaissances et compétences (59 %), les problèmes de communication (59 %), les problèmes personnels (56 %) ainsi que la ponctualité et la présence (52 %). Quant aux apprenants (n = 12), ils ont cité des attentes divergentes (67 %), des préférences de style d’enseignement ou d’apprentissage (50 %) et des problèmes de communication (67 %) comme causes de conflit. La majorité des précepteurs et des apprenants ont indiqué que ces conflits avaient affecté la relation; cependant, la plupart des précepteurs (69 % [18/26]) et des apprenants (50 % [6/12]) étaient d’accord ou fortement d’accord avec l’énoncé suivant : « En général, je me suis senti à l’aise de travailler avec des précepteurs ou des apprenants après un conflit. » Un plus grand nombre d’apprenants que de précepteurs ont perçu que le conflit avait perturbé la capacité de l’apprenant (92 % [11/12] par rapport à 52 % [13/25]). Les précepteurs étaient plus enclins à faire preuve d’initiative pour résoudre le conflit. La communication verbale était la méthode de résolution de conflit préférée des précepteurs et des apprenants. La plupart des précepteurs et des apprenants ont indiqué ressentir que les conflits étaient généralement résolus.
UNASSIGNED: Le conflit était répandu dans la relation précepteur et apprenant en pharmacie. Les précepteurs en pharmacie et les apprenants avaient différents points de vue sur les causes et les conséquences de ces conflits.

The evolution of patient management has led the pharmacist to change gear and get closer to the patient. To better ensure these missions, several educational and support programs have emerged: \"Advice\", \"consultations\" and \"pharmaceutical interviews\", \"shared medication report\" or \"therapeutic patient education\", all these programs are intended \"guarantee the best conditions for initiation, monitoring and compliance as well as evaluation of treatment\", taking into account the wishes and needs of patients. Although these programs have similarities, there are significant differences (i.e. regulatory, functional, organisational, educational). The aim here is to clarify the various support programs in order to better know their fields of application and put them into practice.

OBJECTIVE: The evolution of community pharmacist education is guided by successive reforms. They aim to reduce the gap between academic education and community pharmacy practice but the perception regarding these reforms is poorly documented. The present study describes the cross-perceptions between community pharmacists, pharmacy students and academics teachers regarding the gap between academic education and community pharmacy practice, and, therefore, the essential knowledges and skills for the community pharmacy practice.
METHODS: This study was conducted between April 2017 and April 2018 using an electronic survey for community pharmacists, academic teachers and pharmacy students. The results were discussed regarding previous studies with the aim to detect improvement points and vigilance related points.
RESULTS: This study shows that the pharmacy education program remains to be improved: 77% of respondents believe that there is a significant gap between the initial education program and the community pharmacy practice.
CONCLUSIONS: This cross-perception helps to better identify the several ways to improve the points of vigilance and the associated-barriers. All the propositions by the three groups of respondents prior ask for a better definition of the needed skills for community pharmacy practice before determine the most important knowledges and pedagogic methods to reach these. All these propositions seem consistent with reducing the gap between pharmacy education and community pharmacy practice but they also raise several questions about unicity of the pharmacy graduation in France.

OBJECTIVE: Many signs point to the growing importance of drug shortages in Canada and around the world. Although drug shortages affect clinicians and patients every day, there is a paucity of literature describing the specific problems experienced and their clinical consequences. To describe the drug shortage situation in Canada in 2016-2017 and to discuss this issue in the Canadian context.
METHODS: This retrospective study was based on data from one Canadian wholesaler (McKesson Canada) and the official Drug Shortages Canada website.
RESULTS: From August 31, 2016, to September 4, 2017, the McKesson database showed 583 drug shortages, averaging 160 (standard deviation [SD] 180) days, and the drug shortage website showed 2,129 shortages, averaging 118 (SD 113) days. Of these shortages, 26% in the McKesson database and 14% at the official drug shortage website were for parenteral products. In both the McKesson database and the Canadian drug shortage database, the leading drug classes with shortages were central nervous system drugs (26.4% and 31.8%, respectively), cardiovascular drugs (12.0% and 21.9%), anti-infective agents (11.2% and 8.5%), gastrointestinal drugs (7.9% and 6.2%) and antineoplastic agents (7.4% and 5.1%).
CONCLUSIONS: This descriptive study highlights the high number of shortages in Canada in 2016-2017. The new federal regulation requiring declaration of drug shortages should lead to better monitoring of this problem at the national level. Although the causes of shortages are often identified, manufacturers and regulators are frequently unable to address or effectively prevent drug shortages.

OBJECTIVE: Evaluate the level of knowledge and perceptions of French and Quebec hospital\'s pharmacists/residents about bibliometrics indicators applied in pharmacy. Identify the determinants associated with this knowledge.
METHODS: This is a descriptive cross-sectional study. An anonymous questionnaire of 17 questions answers was developed. The questionnaire was published on the SurveyMonkey site (www.SurveyMonkey.com, SurveyMonkey, Portland, OR, USA) and released from March 19 to April 9, 2018. We calculated and compared the proportion of respondents in Quebec and France by using a Chi2 test. A value less than 0.05 is considered statistically significant.
RESULTS: A total of 899 pharmacists (646 in Quebec and 253 in France) and 147 residents (70 in Quebec and 77 in France) were contacted by email. The survey was completed by 401 respondents, e.g., 301 in Quebec (participation rate: 42%) and 100 in France (30%). Overall 26% (106/401) of respondents (67/301 in Quebec vs. 39/100 in France) reported having knowledge or good knowledge of those indicators. These data are corroborated by many other results.
CONCLUSIONS: Small proportions are aware of those indicators. A good knowledge is associated with being a French pharmacist, working in a teaching hospital or university, having a professional experience of 10 years or more, be involved in a research project, having a scientific watch or having an online profile on database. It appears necessary to inform pharmacists and residents on notoriety indicators.

There are several indicators to evaluate the impact of the scientific publication in pharmacy. Given their number, complexity, heterogeneity, strengths and weaknesses, we believe that pharmacists are not sufficiently familiar with these indicators. The main objective is to present an inventory of available indicator to measure the research impact. PubMed, GoogleScholar and Google were interviewed in October 2017 from the following terms: bibliométrique/bibliometrics, facteur d\'impact/impact factor, impact de citations/citation impact, revue/journal, chercheur/researcher, article, indicateur/indicator, score. For each identified indicator, the following variables were extracted: name, calculation method, calculation time window, data sources considered, access conditions, inclusion of self-citation, strengths and weaknesses. A total of 15 indicators were included: seven for journals, four for researchers and four for articles. Among them two are non-bibliometric indicators: the Altmetric attention score, the RGscore and one other indicator deriving from the impact factor: the SIGAPS indicator developed to finance the research activity of French hospitals. Of the 12 bibliometric indicators, nine include self-citation. All involve forces (e.g. exclusion of editorials, letters, free access) and weaknesses (e.g. self-citations included, time window too short, disciplinary indistinction). There is no indicator with no weaknesses and pharmacists should be able to understand their strengths and weaknesses.

BACKGROUND: HIV infection affects about 150,000 people in France. In total, 30,000 of them are unaware of their serostatus. In this context, HIV self-testing has arrived in France in September 2015. The aim of our study was to analyze the level of application of the recommendations during the purchase of an HIV self-test. Our primary hypothesis was that the delivered information is poor.
METHODS: We realized a comprehensive transversal and observational study with surveys without modification of practice in all Caen pharmacies. The primary endpoint was the seller\'s assessment of the presence or possibility of an emergency situation requiring a post-exposure prophylaxis and suitability assessment of self-testing for the patient\'s case.
RESULTS: Seven pharmacies out of the 41 visited (17.07%) validated our primary endpoint. In all pharmacies, 43.9% had HIV self-tests available for sale. The availabality of the self-tests is linked to the main endpoint (P<0.005). In total, 31.71% of the vendors redirected the patient to another method of screening (general practitioner, sexual health clinic…).
CONCLUSIONS: The delivered information about HIV self-tests is poor. Improving it would put the pharmacist at the heart of the HIV screening strategy. The introduction of training for the professionnals in our region could be interesting to improve the dispensing of the self-tests.

CAR T-cells are autologous or allogeneic human lymphocytes that are genetically engineered to express a chimeric antigen receptor targeting an antigen expressed on tumor cells such as CD19. CAR T-cells represent a new class of medicinal products, and belong to the broad category of Advanced Therapy Medicinal Products (ATMPs), as defined by EC Regulation 2007-1394. Specifically, they are categorized as gene therapy medicinal products. Although CAR T-cells are cellular therapies, the organization for manufacturing and delivery is far different from the one used to deliver hematopoietic cell grafts, for different reasons including their classification as medicinal products. Currently available clinical observations were mostly produced in the context of trials conducted either in the USA or in China. They demonstrate remarkable efficacy for patients presenting advanced or poor-prognosis hematological malignancies, however with severe side effects in a significant proportion of patients. Toxicities can and must be anticipated and dealt with in the context of a full coordination between the clinical cell therapy ward in charge of the patient, and the neighboring intensive care unit. The present workshop aimed at identifying prerequisites to be met in order for French hospitals to get efficiently organized and fulfill sponsors\' expectations before initiation of clinical trials designed to investigate CAR T-cells.