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Abstract: Objectives: Shared decision‐making (SDM) is an approach where patients and clinicians share evidence and patients are supported to deliberate options resulting in preference‐based informed decisions. The aim of this study was to describe community pharmacists’ perceptions and awareness of SDM within their provision of general diabetes management [including Ontario's MedsCheck for Diabetes (MCD) programme], and potential challenges of implementing SDM within community pharmacy. Methods: This qualitative study used semistructured interviews with a convenience sample of community pharmacists. Data were analysed using thematic analysis. Key findings: We conducted 16 interviews. Six participants were male, and nine were certified diabetes educators. When providing a MCD, participants used aspects of a patient‐centred approach focusing on providing education. Variation was evident in participants’ description and use of SDM, as well as in their perceived level of training in SDM. Participants also highlighted challenges surrounding implementing a SDM approach in practice. Conclusion: Pharmacists are well positioned to apply SDM within community settings; however, implementation barriers exist. Pharmacists will require additional training as well as perceived patient and physician barriers should be addressed to encourage uptake. [ABSTRACT FROM AUTHOR]

Background: Current treatments for adolescents with eating disorders (ED) show limited effectiveness, emphasizing the need for enhanced therapeutic approaches. Cognitive behavioral therapy (CBT) has emerged as a potential alternative. A derivative of this approach, group cognitive behavioral therapy (G-CBT), has been shown to reduce treatment costs and increase treatment accessibility when compared to CBT. This program evaluation aimed to assess the effectiveness of G-CBT in adolescents and young adults diagnosed with anorexia nervosa (AN) or bulimia nervosa (BN) and experiencing comorbid anxiety and depression within a Canadian mental health facility. The specific objectives were to determine if participants increased their knowledge about eating normalization and coping strategies after participating in the eating disorder (ED) treatment program and examine if participants experienced changes in eating-disordered behavior, anxiety, and mental health., Methods: We conducted a program evaluation using secondary data collected at admission and discharge from 44 adolescents and young adults (16-39 years) with AN or BN participating in the ED program at a Canadian health center. Outcome measures were eating psychopathology, depression, anxiety, and illness cognitions assessed using validated tools: Eating Disorder Examination Questionnaire (EDE-Q), Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), and Illness Cognition Scale (ICS)., Results: The mean age of participants was 24.1 years (standard deviation (SD) = 5.8). All outcome measures showed statistically significant improvement from admission to discharge (p < 0.001). Specifically, subscales of the EDE-Q (eating concern, weight concern, shape concern, and restraint) and the global score indicated a significant reduction in ED behaviors (p < 0.001)., Conclusion: Findings suggest that G-CBT is effective in reducing eating-disordered behavior, depression, anxiety, and maladaptive illness cognitions in adolescents and young adults with EDs. These results underscore the potential of G-CBT to address both behavioral and psychological aspects of ED recovery, although further studies with control groups are warranted to confirm these findings., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. The Toronto Metropolitan University Research Ethics Board issued approval REB 2022-294. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Dewar-Morgan et al.)

Background: This study explored the perceptions of Canadian pharmacists about the barriers and facilitators of providing opioid stewardship activities in pharmacy practice, considering the subsection 56(1) class exemption under Health Canada's Controlled Drugs and Substances Act (CDSA)., Methods: Qualitative key informant telephone interviews were conducted with a convenience sample of pharmacists from across Canada. We included community or primary health care team-based pharmacists who self-identified as having experience with providing care for patients using opioids via the exemptions. All transcripts were de-identified, and thematic analysis was conducted to identify themes. Ethics approval was obtained., Results: Twenty pharmacists from community and primary health care teams, from all provinces and from urban and rural practices were interviewed. The following themes emerged: 1) optimization of opioid-related patient care, 2) jurisdictional impact and 3) awareness and education. Barriers and facilitators for opioid stewardship activities were identified., Discussion: The exemptions facilitated the pharmacists' ability to provide opioid stewardship and positively affect patient care by providing continuity of and timely access to care. Our research demonstrated that pharmacists can responsibly and independently manage opioid prescriptions within this expanded scope, demonstrating the valuable contribution pharmacists can have in opioid stewardship., Conclusion: Pharmacists were willing and able to care for patients receiving opioid medication and thereby played a role in helping address the opioid crisis. The benefits of these exemptions were demonstrated beyond situations related to the COVID-19 pandemic and warrant consideration for consistent implementation across provincial and territorial jurisdictions, thereby ensuring equitable access to care for all Canadians., Competing Interests: Declaration of Conflicting Interests: L. Bishop received honoraria to present the findings of this research at national events and conferences (2020, 2021); she also served as an expert witness to provide expert opinion evidence for fentanyl (2018). Z. Rosenberg-Yunger was a consultant for CPhA during the time the research was conducted. S. Dattani was a staff member at CPhA at the time the research was conducted and serves on the advisory board for EBSI (Emergent Biosolutions)., (© The Author(s) 2021.)

Background: Ontario's Health Links approach to care is an integrated care model designed to optimize care for patients with complex needs. Currently, community pharmacists have no formalized role. This study aimed to explore stakeholders' perceptions about privacy and its impact on community pharmacists' involvement with integrated care models., Methods: A qualitative study using semistructured telephone-based interviews was conducted. Participants worked in Ontario as pharmacists, providers in Health Links or team-based models or decision-makers in Health Links or health regions. Thematic analysis followed the Qualitative Analysis Guide of Leuven., Results: Twenty-two participants were interviewed, and all but one commented on privacy or information sharing in integrating community pharmacists with integrated care models. The 4 themes identified were as follows: 1) what does the circle of care look like? 2) value of sharing information, 3) uncertainty of what information to share and 4) perceptions on how to share information., Interpretation: The concerns surrounding privacy of personal health information and who is included in the circle of care represented an important barrier for integration. Enablers to mitigate privacy concerns included relationship building between community pharmacists, patients and other health care professionals and mutual access to information-sharing platforms such as electronic health records., Conclusion: Providers' and decision-makers' perceptions about community pharmacists and privacy affect information sharing and are incongruent with Ontario's Personal Health Information Protection Act. Education is needed for health care professionals on legislation, especially as health systems move towards integrated care models to improve care. Can Pharm J (Ott) 2020;153:xx-xx., Competing Interests: Conflict of Interest Declaration:Dr. Lake has received payment from Ontario Pharmacists Association (OPA) for delivery of continuing education. OPA provided assistance with recruitment but was not involved in the design, analysis or reporting of the study., (© The Author(s) 2020.)

Competing Interests: Declaration of Conflicting Interests:The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Background: Canada legalized assisted dying with the passing of Bill C-14, Medical Assistance in Dying (MAiD), in June 2016. This legislation has implications for health care professionals participating in MAiD. This research aims to understand the effect that MAiD has on pharmacists and pharmacy technicians in Canada., Methods: We conducted a thematic document analysis of pharmacy guidelines, position statements and standards of practice from pharmacy regulatory authorities across Canada. In addition, the Ontario Pharmacists Association surveyed its members (including pharmacists, pharmacy technicians and pharmacy students) about their perceptions of MAiD., Results: Our thematic analysis of the reviewed documents resulted in 3 major themes: pharmacists' role in quality assurance, practice considerations when implementing MAiD and resources for pharmacy staff involved in MAiD. Survey responses illustrated that most (68%) pharmacy staff would dispense MAiD medications. Nonetheless, many respondents perceived that they lacked knowledge or comfort with different aspects of the MAiD process. Overall, 80% of participants reported a desire for professional development about MAiD., Conclusion: Despite the rapidly changing landscape surrounding medical assistance in dying within the past year, most pharmacy regulatory authorities have provided direction and resources to their pharmacists. Ontario pharmacists and pharmacy technicians are willing to dispense MAiD medications; however, additional support in the form of professional development may be necessary based on participants' desire for education coupled with their perceived lack of knowledge. Future research may focus on the efficacy of provincial guidelines in supporting pharmacists' participation in MAiD., Competing Interests: Declaration of Conflicting Interests:The authors have no conflicts of interest to declare.