Optimizing Prescribing for Individuals With Type 2 Diabetes and Chronic Kidney Disease Through the Development and Validation of Algorithms for Community Pharmacists.

Background: Diabetes is the leading cause of kidney disease and contributes to 38% of kidney failure requiring dialysis. A gap in detection and management of type 2 diabetes (T2D) in chronic kidney disease (CKD) exists in primary care. Community pharmacists are positioned to support those not able to access kidney care through traditional pathways.

Enabling pharmacist prescribing: Lessons learned in Nova Scotia using behaviour change theory.

Background: The COVID-19 pandemic alongside increased patient demand, enablement of scope, and government funding has accelerated the need and demand for pharmacist prescribing in Nova Scotia.

Methods: A sequential explanatory mixed-methods study was undertaken to understand barriers and facilitators to pharmacist prescribing in Nova Scotia, Canada. This consisted of: 1) a cross-sectional survey and 2) semistructured, qualitative interviews with pharmacists practising in the community.

Medications for community pharmacists to dose adjust or avoid to enhance prescribing safety in individuals with advanced chronic kidney disease: a scoping review and modified Delphi.

Background: Community pharmacists commonly see individuals with chronic kidney disease (CKD) and are in an ideal position to mitigate harm from inappropriate prescribing. We sought to develop a relevant medication list for community pharmacists to dose adjust or avoid in individuals with an estimated glomerular filtration rate (eGFR) below 30 mL/min informed through a scoping review and modified Delphi panel of nephrology, geriatric and primary care pharmacists.

Methods: A scoping review was undertaken to identify higher risk medications common to community pharmacy practice, which require a dose adaptation in individuals with advanced CKD.

A longitudinal study of interprofessional education experiences among health professional graduates.

Effective teamwork and collaboration among health professionals is a well-recognized strategy toward enhancing patient outcomes. However, there is a lack of understanding on how to best prepare health professionals for collaborative practice. The aim of this research is to gain a better understanding of how graduates of five health professions (dentistry, medicine, nursing, pharmacy, physiotherapy) perceive and experience interprofessional education for collaborative practice (IPECP) throughout their health professions journey, with a focus on transition to practice.

How Preceptors Support Pharmacy Learner Professional Identity Formation.

Objective: Pharmacy preceptors play a role in helping learners form professional identities during experiential education. However, it is not clear what specific roles and precepting strategies best foster professional identity formation (PIF). The objective of this study was to explore how preceptors support pharmacy learner PIF.

Patient perspectives on the vital primary care role of community pharmacists in Nova Scotia, Canada: qualitative findings from the PUPPY Study.

Objectives: Community pharmacists play an important role in primary care access and delivery for all patients, including patients with a family physician or nurse practitioner ("attached") and patients without a family physician or nurse practitioner ("unattached"). During the COVID-19 pandemic, community pharmacists were accessible care providers for unattached patients and patients who had difficulty accessing their usual primary care providers ("semi-attached"). Before and during the pandemic, pharmacist services expanded in several Canadian provinces.

A Narrative Inquiry of Critical Events Supporting Professional Identity Formation in Introductory Pharmacy Practice Experiences.

Objective: Professional identity formation (PIF) is the process of internalizing a profession's core values and beliefs so that one begins to think, act, and feel like a member of that profession. PIF occurs over an individual's professional socialization in stages, precipitated by critical moments or experiences. The purpose of this study was to answer the following: (1) What are the critical events for pharmacy student PIF in introductory pharmacy practice experiences?; and (2) How do these events support or challenge PIF?

Methods: This study used critical event narrative inquiry methodology.

Making it happen: Development of an interprofessional deprescribing education programme.

Deprescribing is the planned and supervised reduction or discontinuation of medications that may be causing harm or are no longer benefiting a patient. The need for deprescribing to be a routine part of patient care is essential with an aging population and the rising prevalence of polypharmacy, which has been associated with increased adverse outcomes such as falls, hospitalizations and mortality. Deprescribing is a complex intervention that requires collaboration between the patient, caregivers and healthcare providers to adequately support all involved, as well as to ensure medications are not restarted in error.

A longitudinal, narrative case-study of interprofessional socialization among pharmacy students.

Introduction: Despite growing evidence that interprofessional education (IPE) develops students' attitudes and competencies towards collaboration, there is a lack of theoretical, longitudinal research to inform the development of IPE initiatives. The purpose of this study was to examine pharmacy student interprofessional identity development during early professional and interprofessional socialization experiences in the pharmacy curriculum and at early entry into pharmacy practice.

Methods: This longitudinal, narrative case study used one-on-one, semi-structured interviews conducted at four time points; pre-entry, end of first term, end of first year, and two years post-graduation.

Pharmacy student contribution to direct patient care during inpatient hospital experiential rotations: a scoping review.

Objectives: The aim of this scoping review was to identify and characterise pharmacy students' contributions to extend pharmacist's direct patient care during inpatient hospital experiential rotations.

Methods: A search of PubMed, Embase and CINAHL databases from 2000 to July 2021 was conducted. Articles were included if they involved pharmacy students during experiential rotations, described student's contribution to direct patient care in the inpatient hospital setting, and reported outcomes.

Categorization of deprescribing communication tools: A scoping review.

Background: Deprescribing can be beneficial to a wide variety of patients but is often not done due to barriers including lack of time and challenges starting conversations.

Objectives: This study aimed to identify and broadly categorize existing deprescribing communication tools for clinicians and patients.

Methods: Our scoping review protocol was based on the Arksey and O'Malley methods and incorporated the Levac and Joanna Briggs Institute recommendations.

Indicators, influences, and changes in professional identity formation in early experiential learning in community pharmacy.

Background: Experiential education is a key area in the pharmacy curriculum that professional identity formation (PIF) occurs. However, little is known about PIF influences and supports for pharmacy students during early experiential placements. The study aimed to explore pharmacy student PIF in an early experiential rotation in community pharmacy using reflective writing.

Supporting Interprofessional Collaboration in Deprescribing: Needs Assessment for an Education Program.

Introduction: : Deprescribing is a complex process involving patients and healthcare providers. The aim of the project was to examine the learning needs and preferences of healthcare providers and students to inform the development of an interprofessional deprescribing education program.

Methods: : An online survey of pharmacists, nurses, nurse practitioners, family physicians, and associated students practicing or studying in Nova Scotia was conducted.

Increased self-reported pharmacist prescribing during the COVID-19 pandemic: Using the Theoretical Domains Framework to identify barriers and facilitators to prescribing.

Background: Community pharmacists are positioned to improve access to medications through their ever-expanding role as prescribers, with this role becoming more pronounced during the COVID-19 pandemic.

Objectives: Our research aimed to determine the extent of self-reported pharmacist prescribing pre-COVID-19 and during the COVID-19 pandemic, to identify barriers and facilitators to pharmacist prescribing, and to explore the relationship between these factors and self-reported prescribing activity.

Methods: A questionnaire based on the Theoretical Domains Framework (TDFv2) assessing self-reported prescribing was electronically distributed to all direct patient care pharmacists in NS (N = 1338) in July 2020.

Implementation of pharmacist-led deprescribing in collaborative primary care settings.

In many jurisdictions pharmacists share prescribing responsibilities with other members of the primary care team. Responsibility for deprescribing, the healthcare professional supervised withdrawal of medications that are no longer needed, has not been assumed by a specific member of the primary care team. In this commentary we describe implementation of pharmacist-led deprescribing in collaborative primary care settings using the seven components of knowledge translation.

Using the behavior change wheel to link published deprescribing strategies to identified local primary healthcare needs.

Background: Polypharmacy is a major global problem. Evidence in primary care shows deprescribing can be beneficial. Behaviour change theories such as the Theoretical Domains Framework (TDF) and the Behaviour Change Wheel (BCW) can help develop successful implementation of deprescribing initiatives.

A Behavioral analysis of nurses' and pharmacists' role in addressing vaccine hesitancy: scoping review.

The purpose of this review was to identify, characterize, and map the existing knowledge on a) nurses' and pharmacists' perceived barriers and enablers to addressing vaccine hesitancy among patients; and b) strategies or interventions for nurses and pharmacists to address vaccine hesitancy in their practice. Our comprehensive search strategy targeted peer-reviewed and grey literature. Two independent reviewers screened papers and extracted data.

Community pharmacists' evolving role in Canadian primary health care: a vision of harmonization in a patchwork system.

Canada's universal public health care system provides physician, diagnostic, and hospital services at no cost to all Canadians, accounting for approximately 70% of the 264 billion CAD spent in health expenditure yearly. Pharmacy-related services, including prescription drugs, however, are not universally publicly insured. Although this system underpins the Canadian identity, primary health care reform has long been desired by Canadians wanting better access to high quality, effective, patient-centred, and safe primary care services.

Deprescribing interventions in primary health care mapped to the Behaviour Change Wheel: A scoping review.

Background: Polypharmacy and inappropriate medication use are an increasing concern. Deprescribing may improve medication use through planned and supervised dose reduction or stopping of medications. As most medication management occurs in primary health care, which is generally described as the first point of access for day-to-day care, deprescribing in primary health care is the focus on this review.

Influencers on deprescribing practice of primary healthcare providers in Nova Scotia: An examination using behavior change frameworks.

Background: Deprescribing is a complex process requiring consideration of behavior change theory to improve implementation and uptake.

Aim: The aim of this study was to describe the knowledge, attitudes, beliefs, and behaviors that influence deprescribing for primary healthcare providers (family physicians, nurse practitioners (NPs), and pharmacists) within Nova Scotia using the (TDF(v2)) and the .

Methods: Interviews and focus groups were completed with primary care providers (physicians, NPs, and pharmacists) in Nova Scotia, Canada.

Primary care of adults with intellectual and developmental disabilities: 2018 Canadian consensus guidelines.

Objective: To update the 2011 Canadian guidelines for primary care of adults with intellectual and developmental disabilities (IDD).

Methods: Family physicians and other health professionals experienced in the care of people with IDD reviewed and synthesized recent empirical, ecosystem, expert, and experiential knowledge. A system was developed to grade the strength of recommendations.

Pharmacist provision of primary health care: a modified Delphi validation of pharmacists' competencies.

Background: Pharmacists have expanded their roles and responsibilities as a result of primary health care reform. There is currently no consensus on the core competencies for pharmacists working in these evolving practices. The aim of this study was to develop and validate competencies for pharmacists' effective performance in these roles, and in so doing, document the perceived contribution of pharmacists providing collaborative primary health care services.