65 Quality of medication use in chronic kidney disease patients

THE CANADIAN ASSOCIATION FOR POPULATION THERAPEUTICS – ANNUAL CONFERENCE
Evaluation criteria were derived from Canadian, UK
and USA EE guidelines. Data extraction considered the
use of local data sources for model parameters,
methods of sensitivity analysis (scenario, univariate,
multivariate and probabilistic) and uncertainty
representation (cost-effectiveness plane, scatterplot,
confidence ellipses, tornado diagrams, costeffectiveness acceptability curve).
Results: We identified 10 EEs of trastuzumab in early
BC. Local data were most frequently used to estimate
costs (10/10). Utilities (2/10) and trastuzumab efficacy
(0/10) were informed by local data rarely. Univariate
sensitivity analysis was common (8/10), probabilistic
analysis was less frequent (6/10) and only half of
surveyed studies provided visual representation of
results and decision uncertainty.
Conclusions: Local data beyond costs is rarely used in
EEs of trastuzumab in early BC. Parameter and
decision uncertainty quantification did not meet
guideline recommendations and highlights areas that
can be improved for decision-making support.
Keywords: Systematic review, personalized medicine,
trastuzumab
65
Quality of medication use in chronic kidney
disease patients: development and pilot testing
of a web-based training program for
community pharmacists
Legris ME1,2, Charbonneau-Séguin N1,2,Desforges K1,3,
Sauvé P1,3, Lord A3, Bell R2, Berbiche D4, Desrochers
JF1,2, Lemieux JP1,3, Morin-Bélanger C1,3, Ste-Marie
F1,2, Lalonde L1,4,5
1
Faculty of pharmacy, Université de Montréal,
Montreal, Canada, 2Hôpital Maisonneuve-Rosemont,
Montreal, Canada, 3Centre de santé et de services
sociaux de Laval, Laval, Canada, 4équipe de recherche
en soins de première ligne, Centre de santé et de
services sociaux de Laval, Laval, Canada, 5Sanofi
Aventis Endowment Research Chair in Ambulatory
Pharmaceutical Care, Faculty of pharmacy, Université
de Montréal, Montreal, Canada
Corresponding Author: [email protected]
Funding Source: Bourse du Cercle du doyen Faculty of
pharmacy Université de Montréal; Amgen Canada Inc.
Background: To improve the quality of medication
use in chronic kidney disease (CKD) patients, a Webbased training program for community pharmacists
was developed. The program is based on the
Pharmacotherapy Assessment In chronic Renal disease
PAIR criteria; a list of clinically significant drugrelated problems requiring a pharmaceutical
intervention in CKD patients. The impact of the
training program on the knowledge and skills of
pharmacists and their satisfaction were evaluated.
Methods: Pharmacists were randomly assigned to the
training program or the control group. The program
included a 60-minute web-based interactive training
supported by a clinical guide. Each pharmacist
completed a knowledge and skills questionnaire at
baseline and after one month. Trained pharmacists
completed a satisfaction questionnaire. Semi-directed
telephone interviews were conducted with eight
pharmacists.
Results: Seventy pharmacists (Training: 52; Control:
18) were recruited. They were mainly women with less
than 15 years of experience in pharmacy. Compared to
the control group, an adjusted incremental increase in
knowledge score (22%; 95% confidence interval (CI):
16%-27%) and skill scores (24% CI 16%-33%) were
observed in the training group. Most pharmacists
(87%-100%) rated as excellent or very good each
aspect of the program. Many pharmacists would
appreciate receiving additional training in this field.
Adding a discussion forum was proposed to
complement the program.
Conclusion: The program was appreciated by
pharmacists and improved their knowledge and skills.
Its impact on clinical practices and quality of
medication use remain to be evaluated.
Keywords: Progression of renal disease, diabetes
mellitus, drug-induced nephropathies
66
Quality of medication use in chronic kidney
disease patients: development and validation of
the pair criteria
Desrochers JF1,2, Lemieux JP1,3, Morin-Bélanger C1,3,
Ste-Marie Paradis F1,2, Lord A3, Bell R2, Berbiche D4,
Charbonneau-Séguin N1,2, Desforges K1,3, Legris
ME1,2, Sauvé P1,3, Lalonde L1,4,5
1
Faculty of pharmacy, Université de Montréal,
Montreal, Canada, 2Hôpital Maisonneuve-Rosemont,
Montreal, Canada, 3Centre de Santé et de Services
Sociaux de Laval, Laval, Canada, 4équipe de recherche
en soins de premiére ligne, Centre de Santé et de
Services Sociaux de Laval, Laval, Canada, 5Sanofi
Aventis Endowment Research Chair in Ambulatory
Pharmaceutical Care, Faculty of pharmacy, Université
de Montréal, Montreal, Canada
Corresponding Author: [email protected]
Funding Source: Bourse du Cercle du doyen Faculty of
pharmacy Université de Montréal; Amgen Canada Inc.
Background: Explicit criteria for judging the quality
of medication use in chronic kidney disease (CKD)
patients are lacking. We developed and validated a list
of clinically significant drug-related problems (DRPs)
J Popul Ther Clin Pharmacol Vol 18 (2):e176-e218; April 8, 2011
© 2011 Canadian Society of Clinical Pharmacology and Therapeutics. All rights reserved.
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