Shoppers Drug Mart Inc. (named Pharmaprix in Quebec) is a Canadian retail pharmacy chain based in Toronto, Ontario. It has more than 1,300 stores in nine provinces and two territories.The company was founded by pharmacist Murray Koffler in 1962; the Koffler family still retains ownership of the Super-Pharm pharmacy, which has locations in Israel, Poland, and formerly in China (as Ensure from 2005 to 2011). Super-Pharm's logo is similar to that of Shoppers Drug Mart, which was created by the artist Sylvain Liu. It also uses some of the same private-label brands, such as Life Brand and Quo.In 2014, Brampton-based Loblaw Companies Limited acquired Shoppers Drug Mart for $12.4 billion in cash and stock. By early 2016, Shoppers had over 1,300 locations in Canada.
Abstract Background: Efforts to improve antibiotic prescribing in the community have largely focused on physicians; however, pharmacists may represent an untapped opportunity to expand antibiotic stewardship. We sought to understand barriers and facilitators to implementing antibiotic stewardship in community pharmacy settings to identify scalable strategies to improve antibiotic use. Methods: This qualitative study employed semi-structured interviews with community pharmacists, physicians, nurse practitioners, and members of the public. The study was guided by the Consolidated Framework for Implementation Research and the Theoretical Domains Framework. Interviews were independently coded by two researchers, and implementation mapping was used to identify potential change strategies. Results: Sixty-five individuals expressed interest, and 35 participated, including 13 community pharmacists, 13 members of the public, and 9 other healthcare providers. Key determinants of community pharmacy stewardship included 1. Patient expectations and public perceptions, 2. Access to clinical information, 3. Communication infrastructure and practices, 4. Interprofessional roles and relationships, 5. Beliefs about community pharmacist capability. Several potential strategies were identified including public awareness campaigns, secure messaging to facilitate pharmacist and prescriber collaboration, showcasing successful examples of community pharmacy antimicrobial stewardship (AMS), and encouraging the inclusion of indications for use on all antibiotic prescriptions. Conclusion: Perceived barriers and facilitators to AMS in community pharmacy settings vary across the public, prescribers, and pharmacists. However, consistent challenges identified included the siloed system of disciplines, lack of direct pharmacist–prescriber communication, and limited access to patient records. These determinants uncovered several potential change strategies that may help improve antibiotic use for patients in the community.
Abstract Background Previous research has suggested that alternative (respiratory) care providers (ACP) may provide affordable, accessible care for sleep-disordered breathing (SDB) that decreases wait-times and improves clinical outcomes. The objective of this study was to compare ACP-led and sleep physician-led care for SDB on patient reported outcome and experiences, with a focus on general and health-related quality of life, sleepiness, and patient satisfaction. Methods We conducted a secondary analysis of a randomized trial in which participants with severe SDB were assigned to either ACP-led or physician-led management. We created longitudinal linear mixed models to assess the impacts of treatment arm and timepoint on total and domain-level scores of multiple patient-reported outcome measures and patient-reported experience measures. Results Patients in both treatment arms (ACP-led n = 81; sleep-physician = 75) reported improved outcomes on the Sleep Apnea Quality of Life Index, Health Utilities Index, and Epworth Sleepiness Scale. Patients in each group had similar and clinically meaningful improvements on domains assessing cognition, emotion, and social functioning. The linear mixed models suggested no significant difference between treatment arms on the patient-reported outcomes. However, scores significantly improved over time. Conclusions Management of SDB using ACPs was comparable to physician-led care, as measured bypatient-reported outcome and experience measures. While loss to follow-up limits our findings, these results provide some support for the use of this novel health service delivery model to improve access to high quality SDB care. Clinical trial registration This is analysis of data from the study registered Clinicaltrials.gov (NCT02191085).
Objective: Our objective was to explore the effectiveness and utility of a newly introduced capstone course for developing leadership and management skills in pharmacy students. Methods: A secondary analysis was conducted on precourse and postcourse questionnaire data collected from third-year doctoral-level students and their mentors. The frequency and mean scores of responses to statements regarding confidence in leadership, management, and collaboration skills scored on the Likert scale were presented. Open-ended comments from students and mentors were also grouped and summarized. Results: For all questionnaire items related to the confidence self-assessment, the majority of students responded either agree (40%-69% per question) or strongly agree (6%-56% per question). Students also showed a significant increase in confidence in their management skills after completing the course. Student comments and feedback regarding the course were grouped into 3 major categories: content, timeline/organization, and group dynamics. Conclusion: Based on feedback from students and mentors, the capstone course is a valuable learning experience for pharmacy students and an effective tool for developing leadership, management, and collaboration skills. The value of in-person learning, engaged mentors, and real-world relevance for the capstone project is highlighted.
Among numerous choices in cardiovascular therapies used for the management of hypertension and heart failure, drugs affecting the renin–angiotensin–aldosterone system (RAAS) hold substantial therapeutic roles. Therapies aimed at modifying the RAAS and its overactivation are employed for the management of various insidious disorders. In the pharmacologic perspective, RAAS is one of the frequently manipulated systems for the management of hypertension, heart failure, myocardial infarction, and renal disease. The RAAS pharmacologic interventions principally include the ACE inhibitors, the angiotensin II-AT1 receptor blockers, the mineralocorticoid receptor antagonists, and the direct renin inhibitors. In addition, therapeutic implication of ACE2/angiotensin (1–7)/Mas receptor activation using various ligands is being explored owing to their anti-inflammatory, anti-fibrotic, vasodilatory, and cardiovascular defensive roles. Moreover, being considered as the counter-regulatory arm of AT1 receptor, the potential role of AT2 receptor activation using selective AT2 receptor agonist is currently investigated for its efficacy in pulmonary complications. As an important regulator of fluid volume, blood pressure, and cardiovascular–renal function, the RAAS has been documented as a diversified intricate system with several therapeutic possibilities coupled with their fundamental structural and functional modulatory roles in cardiovascular, renal, and other systems. The RAAS possesses a number of regulatory, deregulatory, and counter-regulatory axes of physiopathologic importance in health and disease. The counter-regulatory arms of the RAAS might play an essential role in mitigating cardiovascular, renal, and pulmonary pathologies. In light of this background, we sought to explore the classical and counter-regulatory axes/arms of the RAAS and their imperative roles in physiologic functions and disease pathogenesis.
