Assessing cardiometabolic parameter monitoring in inpatients taking a second-generation antipsychotic : the CAMI-SGA study – a crosssectional study

Objectives This study aims to determine the proportion of initial cardiometabolic assessment and its predicting factors in adults with schizophrenia, bipolar disorder or other related diagnoses for whom a second-generation antipsychotic was prescribed in the hospital setting. Design Cross-sectional study. Setting The psychiatry unit of a Canadian tertiary care teaching hospital in Montreal, Canada. Participants 402 patients with aforementioned disorders who initiated, restarted or switched to one of the following antipsychotics: clozapine, olanzapine, risperidone, paliperidone or quetiapine, between 2013 and 2016. Primary outcome measures We assessed the proportion of cardiometabolic parameters monitored. Secondary outcome measures We identified predictors that influence the monitoring of cardiometabolic parameters and we assessed the proportion of adequate interventions following the screening of uncontrolled blood pressure and fasting glucose or glycated haemoglobin (HbA1c) results. Results Only 37.3% of patients received monitoring for at least three cardiometabolic parameters. Blood pressure was assessed in 99.8% of patients; lipid profile in 24.4%; fasting glucose or HbA1c in 33.3% and weight or body mass index in 97.8% of patients while waist circumference was assessed in 4.5% of patients. For patients with abnormal blood pressure and glycaemic values, 42.3% and 41.2% subsequent interventions were done, respectively. The study highlighted the psychiatric diagnosis (substance induced disorder OR 0.06 95% CI 0.00 to 0.44), the presence of a court-ordered treatment (OR 0.79 95% CI 0.35 to 1.79) and the treating psychiatrist (up to OR 34.0 95% CI 16.2 to 140.7) as predictors of cardiometabolic monitoring. Conclusions This study reports suboptimal baseline cardiometabolic monitoring of patients taking an antipsychotic in a Canadian hospital. Optimising collaboration within a multidisciplinary team may increase cardiometabolic monitoring

Enquête sur les programmes de formation à l’embauche et en cours d’emploi en établissement de santé pour les assistants techniques en pharmacie

RésuméObjectif : Établir un portrait des programmes de formation à l’embauche et en cours d’emploi en établissement de santé pour les assistants techniques en pharmacie.Description de la problématique : Les tâches des assistants techniques en pharmacie se sont grandement diversifiées et complexifiées au cours des dernières années. Un assistant technique en pharmacie doit suivre une formation initiale au moment de son embauche, ainsi que diverses formations en cours d’emploi afin de pouvoir accomplir de nouvelles tâches. Il n’existe pas de recommandation spécifique pour ces différents types de formation. Les politiques de formation, laissées à la discrétion des gestionnaires des départements de pharmacie, varient donc fortement d’un établissement à l’autre.Discussion : Une enquête réalisée auprès des gestionnaires des départements de pharmacie des établissements de santé du Québec a permis d’évaluer la formation offerte aux assistants techniques en pharmacie pour cinq tâches, à savoir la saisie des ordonnances, la préparation stérile des médicaments non dangereux, la préparation stérile des médicaments dangereux, la délégation de la vérification contenant-contenu et le bilan comparatif des médicaments.Conclusion : Une formation adéquate du personnel est primordiale pour assurer le respect du cadre législatif et la sécurité des services et des soins pharmaceutiques. La présente enquête établit un premier portrait québécois des programmes de formation en établissement de santé pour le personnel technique en pharmacie. Si une majorité de personnes ayant répondu au sondage ont mis en place des programmes de formation, il reste encore beaucoup à faire pour uniformiser la formation du personnel technique en établissement de santé.AbstractObjective: To draw a portrait of initial and ongoing training programs for technical pharmacy staff in healthcare facilities.Problem description: The tasks assigned to pharmacy technical assistants have become much more diverse and complex in the past few years. Pharmacy technical assistants require initial training upon hiring, as well as various types of ongoing training for new tasks. There are no specific recommendations for these different types of training. Training policies are left to the discretion of pharmacy department managers, which leads to wide variability from one facility to another.Problem resolution: A survey conducted among the pharmacy department managers in Quebec’s healthcare facilities enabled us to evaluate the training provided to pharmacy technical assistants for five tasks: entering prescriptions, sterile preparation of nonhazardous drugs, sterile preparation of hazardous drugs, delegation of container-contents verification, and medication reconciliation.Conclusion: Adequate staff training is essential for ensuring compliance with the legislative framework and the safety of pharmaceutical services and care. This survey provided a first portrait of technical pharmacy staff training programs in Quebec’s healthcare facilities. Although most of the respondents have instituted training programs, much work remains to be done to standardize the training of technical staff in healthcare facilities