Skip header and navigation

Refine By

20 records – page 1 of 2.

The adequacy of pharmaceutical treatment of schizophrenia in Quebec varies with age, but is not influenced by sex or neighbourhood deprivation.

https://arctichealth.org/en/permalink/ahliterature107816
Source
Can J Psychiatry. 2013 Aug;58(8):456-65
Publication Type
Article
Date
Aug-2013
Author
Frederieke M Brouwers
Josiane Courteau
Jean-Pierre Grégoire
Jocelyne Moisan
Sophie Lauzier
Alain Lesage
Marie-Josée Fleury
Alain Vanasse
Author Affiliation
Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, Quebec.
Source
Can J Psychiatry. 2013 Aug;58(8):456-65
Date
Aug-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Antipsychotic Agents - therapeutic use
Cohort Studies
Drug Prescriptions - statistics & numerical data
Female
Humans
Male
Middle Aged
Quebec - epidemiology
Residence Characteristics - statistics & numerical data
Schizophrenia - drug therapy - epidemiology
Sex Factors
Socioeconomic Factors
Young Adult
Abstract
Though high discontinuation rates for antipsychotics (APs) by patients with schizophrenia are frequently reported, the percentage of patients receiving pharmaceutical treatment for schizophrenia in routine practice in accordance with international clinical guidelines is unknown. Further, it is unknown if these rates are influenced by levels of neighbourhood deprivation or by a patient's age or sex. Our study aims to investigate if inequalities in AP treatment could be observed between patients living in neighbourhoods with the highest levels of material and social deprivation and those with the lowest deprivation levels, between patients from different age groups, or between men and women.
We conducted a secondary analysis of medical-administrative data of a cohort of adult patients in the province of Quebec with a medical contact for schizophrenia in a 2-year period (2004-2005). We assessed the proportion of patients that filled at least 1 prescription for an AP and received adequate pharmaceutical treatment, defined as being in possession of APs at least 80% of the time as outpatients during a 2-year follow-up period.
Among the 30 544 study patients, 88.5% filled at least 1 prescription for an AP, and 67.5% of the treated patients received adequate treatment. Though no clinically significant differences were observed by deprivation or sex, younger age was associated with lower proportions of patients receiving adequate treatment (46% of treated patients aged between 18 and 29 years, compared with 72% aged between 30 and 64 years, and 77% aged 65 years and over).
In Quebec's routine practice, over 70% of treated patients aged 30 and over received adequate pharmacological treatment, regardless of sex or neighbourhood socioeconomic status. In contrast, in patients aged between 18 and 29 years this percentage was 47%. This is a discouraging finding, especially because optimal treatment in the early phase of disease is reported to result in the best long-term outcomes.
PubMed ID
23972107 View in PubMed
Less detail

Community pharmacy loyalty among individuals with schizophrenia.

https://arctichealth.org/en/permalink/ahliterature115283
Source
Res Social Adm Pharm. 2013 Nov-Dec;9(6):806-16
Publication Type
Article
Author
Sophie Lauzier
Jean-Pierre Grégoire
Alain Lesage
Jocelyne Moisan
Author Affiliation
Faculty of Pharmacy, 1050 avenue de la Médecine, Université Laval, Québec, QC, Canada G1V 0A6; Chair on adherence to treatments, Université Laval, Québec, QC, Canada G1V 0A6; Santé des populations: URESP, Centre de recherche du CHU de Québec, 1050 Chemin Ste-Foy, Québec, QC, Canada G1S 4L8. Electronic address: sophie.lauzier@pha.ulaval.ca.
Source
Res Social Adm Pharm. 2013 Nov-Dec;9(6):806-16
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antipsychotic Agents - therapeutic use
Community Pharmacy Services - statistics & numerical data
Female
Humans
Male
Middle Aged
Quebec
Schizophrenia - drug therapy
Young Adult
Abstract
Community pharmacists can use medication records to assist individuals who are loyal to their pharmacy in better managing their pharmacotherapy. However, the extent of community pharmacy loyalty among individuals with severe mental illness such as schizophrenia remains unknown.
To assess the extent of community pharmacy loyalty among individuals with schizophrenia and identify factors associated with loyalty.
Using the Quebec Health Insurance Board databases, a cohort study of individuals with schizophrenia who claimed an antipsychotic drug for the first time between January 1, 2001 and December 31, 2005 was conducted. Such individuals were considered loyal to their community pharmacy if they filled all their prescriptions for any drug at the same community pharmacy during the second year after antipsychotics initiation. Logistic regression models were used to identify factors associated with community pharmacy loyalty (measured in the first year after antipsychotics initiation).
Of the 6159 individuals in the study, 57.8% were loyal to one pharmacy. Men were more likely to be loyal (Adjusted OR = 1.29; 95% CI = 1.16-1.44), as were individuals aged 30-64 years and those aged =65 years, when compared to individuals 20-29 years (1.70; 1.48-1.95 and 2.39; 1.97-2.90, respectively). Individuals who filled their antipsychotics on a weekly basis were also more likely to be loyal (1.39; 1.18-1.63). Factors associated with non-loyalty were welfare beneficiary status (0.79; 0.70-0.89), having substance-use disorder (0.69; 0.60-0.80), a greater number of different types of drugs (5-8 types = 0.76; 0.66-0.87; 9-51 = 0.59; 0.50-0.69), and emergency department visits (0.71; 0.60-0.82).
Results suggest that medication records in community pharmacies are incomplete for 42.2% of individuals with schizophrenia. Individuals more likely to experience more severe illness were also those less likely to be loyal. Given the potentially severe consequences of medication-related problems in this latter population, strategies to further improve the comprehensiveness of medication information should be promoted.
PubMed ID
23522802 View in PubMed
Less detail

Determinants of discontinuation of new courses of antihypertensive medications.

https://arctichealth.org/en/permalink/ahliterature189125
Source
J Clin Epidemiol. 2002 Jul;55(7):728-35
Publication Type
Article
Date
Jul-2002
Author
Jean-Pierre Grégoire
Jocelyne Moisan
Rémi Guibert
Antonio Ciampi
Alain Milot
Michel Gaudet
Isabelle Côté
Author Affiliation
Faculté de pharmacie and Unité de recherche en santé des populations, Université Laval, Québec, Canada. jeanpierre_gregoire@merck.com
Source
J Clin Epidemiol. 2002 Jul;55(7):728-35
Date
Jul-2002
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Antihypertensive Agents - adverse effects - economics - therapeutic use
Canada
Cohort Studies
Female
Health Knowledge, Attitudes, Practice
Humans
Insurance, Pharmaceutical Services
Interviews as Topic
Male
Middle Aged
Pharmacies
Proportional Hazards Models
Prospective Studies
Self Administration - psychology - utilization
Treatment Refusal - psychology - statistics & numerical data
Abstract
Discontinuation of medication use constitutes a major barrier to adequate control of high blood pressure. We examined the effect of an array of potential predisposing, enabling and reinforcing factors on the discontinuation of newly prescribed antihypertensive medications. We conducted a prospective cohort study through a network of 173 pharmacies across Canada where were identified individuals newly prescribed an antihypertensive monotherapy. We interviewed participants by telephone four times to obtain information for a minimum duration of 18 months after entry into the cohort. We analyzed data using a multivariate proportional hazard model. Of 682 eligible participants, 43.3% had discontinued their initial medication at the end of the observation period. Individuals more likely to discontinue their initial medication were those who perceived side effects from this medication [Hazard Ratio (HR) = 1.91; 95% Confidence Interval (CI) 1.47-2.47). Individuals with medication insurance coverage were less likely to discontinue (HR = 0.74; 95% CI 0.55-0.99). Persistence with newly prescribed medications could be improved by selecting antihypertensive medications containing fewer side effects and by lifting economic barriers to drug treatment.
PubMed ID
12160922 View in PubMed
Less detail

Does elapsed time between first diagnosis of schizophrenia and migration between health territories vary by place of residence? A survival analysis approach.

https://arctichealth.org/en/permalink/ahliterature116633
Source
Health Place. 2013 Mar;20:66-74
Publication Type
Article
Date
Mar-2013
Author
André Ngamini Ngui
Alan A Cohen
Josiane Courteau
Alain Lesage
Marie-Josée Fleury
Jean-Pierre Grégoire
Jocelyne Moisan
Alain Vanasse
Author Affiliation
Groupe PRIMUS, Centre de recherche clinique Étienne-Le Bel, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, QC, Canada, J1H 5N4. ngaminingui@gmail.com
Source
Health Place. 2013 Mar;20:66-74
Date
Mar-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Cohort Studies
Emigration and Immigration
Female
Humans
Male
Middle Aged
Quebec - epidemiology
Schizophrenia - diagnosis - epidemiology
Survival Analysis
Time Factors
Transients and Migrants - psychology
Young Adult
Abstract
Migration of patients with schizophrenia might influence health care access and utilization. However, the time between diagnosis and migration of these patients has not yet been explored. We studied the first migration between health territories of 6873 patients newly diagnosed with schizophrenia in Quebec in 2001, aiming to describe the pattern of migration and assess the influence of the place of residence on migration. Between 2001 and 2007, 34.5% of patients migrated between health territories; those living in metropolitan areas were more likely to migrate than others but tended to remain in metropolitan areas. Migrant patients were also more likely to stay in or migrate to the most socially or materially deprived territories.
PubMed ID
23376731 View in PubMed
Less detail

Effect of drug utilization reviews on the quality of in-hospital prescribing: a quasi-experimental study.

https://arctichealth.org/en/permalink/ahliterature170264
Source
BMC Health Serv Res. 2006;6:33
Publication Type
Article
Date
2006
Author
Jean-Pierre Grégoire
Jocelyne Moisan
Louise Potvin
Isabelle Chabot
René Verreault
Alain Milot
Author Affiliation
Population Health Research Unit, Centre hospitalier affilié universitaire de Québec, 1050 Chemin Ste-Foy, Québec, Qc, G1S 4L8, Canada. jean-pierre.gregoire@pha.ulaval.ca
Source
BMC Health Serv Res. 2006;6:33
Date
2006
Language
English
Publication Type
Article
Keywords
Cisapride - therapeutic use
Concurrent Review
Control Groups
Drug Prescriptions - standards
Drug Utilization Review - methods
Gastrointestinal Agents - therapeutic use
Hospitals, Teaching - standards
Humans
Medical Audit
Pharmacy Service, Hospital
Physician's Practice Patterns
Quebec
Retrospective Studies
Abstract
Drug utilization review (DUR) programs are being conducted in Canadian hospitals with the aim of improving the appropriateness of prescriptions. However, there is little evidence of their effectiveness. The objective of this study was to assess the impact of both a retrospective and a concurrent DUR programs on the quality of in-hospital prescribing.
We conducted an interrupted time series quasi-experimental study. Using explicit criteria for quality of prescribing, the natural history of cisapride prescription was established retrospectively in three university-affiliated hospitals. A retrospective DUR was implemented in one of the hospitals, a concurrent DUR in another, whereas the third hospital served as a control. An archivist abstracted records of all patients who were prescribed cisapride during the observation period. The effect of DURs relative to the control hospital was determined by comparing estimated regression coefficients from the time series models and by testing the statistical significance using a 2-tailed Student's t test.
The concurrent DUR program significantly improved the appropriateness of prescriptions for the indication for use whereas the retrospective DUR brought about no significant effect on the quality of prescribing.
Results suggest a retrospective DUR approach may not be sufficient to improve the quality of prescribing. However, a concurrent DUR strategy, with direct feedback to prescribers seems effective and should be tested in other settings with other drugs.
Notes
Cites: Arch Intern Med. 2000 Oct 9;160(18):2741-711025783
Cites: JAMA. 1998 Oct 14;280(14):1249-529786375
Cites: CMAJ. 2003 Jul 8;169(1):30-112847036
Cites: Am J Hosp Pharm. 1978 Jan;35(1):76-8623123
Cites: Milbank Mem Fund Q Health Soc. 1984 Summer;62(3):447-746433223
Cites: JAMA. 1990 Jan 26;263(4):549-562104640
Cites: Milbank Q. 1989;67(2):268-3172698446
Cites: JAMA. 1993 Oct 27;270(16):1937-428411550
Cites: Med Care. 1993 Dec;31(12):1069-828246637
Cites: Clin Ther. 1995 May-Jun;17(3):525-33; discussion 5167585856
Cites: Healthc Manage Forum. 1996 Summer;9(2):44-710159412
Cites: Health Serv Res. 1997 Oct;32(4):471-899327814
Cites: JAMA. 1998 May 6;279(17):1358-639582043
Cites: Med Care. 1998 Jul;36(7):1013-219674619
Cites: JAMA. 2000 Dec 20;284(23):3036-911122591
PubMed ID
16536865 View in PubMed
Less detail

Effects of job strain on blood pressure: a prospective study of male and female white-collar workers.

https://arctichealth.org/en/permalink/ahliterature168540
Source
Am J Public Health. 2006 Aug;96(8):1436-43
Publication Type
Article
Date
Aug-2006
Author
Chantal Guimont
Chantal Brisson
Gilles R Dagenais
Alain Milot
Michel Vézina
Benoît Mâsse
Jocelyne Moisan
Nathalie Laflamme
Caty Blanchette
Author Affiliation
Unité de recherche en santé des populations, Quebec City, Quebec, Canada.
Source
Am J Public Health. 2006 Aug;96(8):1436-43
Date
Aug-2006
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Blood Pressure Determination
Employment - psychology
Exercise
Female
Government Agencies
Health Surveys
Humans
Hypertension - epidemiology - etiology - psychology
Male
Middle Aged
Occupational Health - statistics & numerical data
Occupations - classification
Prospective Studies
Quebec - epidemiology
Risk assessment
Risk factors
Social Support
Stress, Psychological - complications - epidemiology
Abstract
We evaluated whether cumulative exposure to job strain increases blood pressure.
A prospective study of 8395 white-collar workers was initiated during 1991 to 1993. At follow-up, 7.5 years later, 84% of the participants were reassessed to estimate cumulative exposure to job strain.
Compared with men who had never been exposed, men with cumulative exposure and those who became exposed during follow-up showed significant systolic blood pressure increments of 1.8 mm Hg (95% confidence interval [CI]=0.1, 3.5) and 1.5 mm Hg (95% CI=0.2, 2.8), respectively, and relative risks of blood pressure increases in the highest quintile group of 1.33 (95% CI = 1.01, 1.76) and 1.40 (95% CI = 1.14, 1.73). Effect magnitudes were smaller among women. Effects tended to be more pronounced among men and women with low levels of social support at work.
Among these white-collar workers, exposure to cumulative job strain had a modest but significant effect on systolic blood pressure among men. The risk was of comparable magnitude to that observed for age and sedentary behavior. Men and women with low levels of social support at work appeared to be at higher risk for increases in blood pressure.
Notes
Cites: Hypertension. 1992 Aug;20(2):214-81639463
Cites: Int Arch Occup Environ Health. 1998 Sep;71(6):429-329766917
Cites: Scand J Work Environ Health. 1994 Oct;20(5):349-637863299
Cites: J Psychosom Res. 1995 Jan;39(1):19-297760300
Cites: J Psychosom Res. 1995 Feb;39(2):133-447595871
Cites: J Hypertens. 1995 Feb;13(2):201-107615950
Cites: JAMA. 1996 May 22-29;275(20):1590-78622251
Cites: Ethn Dis. 1999 Autumn;9(3):359-6810600058
Cites: Occup Med. 2000 Jan-Mar;15(1):1-6, iii10620785
Cites: J Occup Environ Med. 2000 Jan;42(1):40-610652687
Cites: N Engl J Med. 2001 Jan 4;344(1):3-1011136953
Cites: Ann Intern Med. 2002 Apr 2;136(7):493-50311926784
Cites: JAMA. 2002 Oct 16;288(15):1882-812377087
Cites: Lancet. 2002 Dec 14;360(9349):1903-1312493255
Cites: Int J Obes Relat Metab Disord. 2003 Mar;27(3):369-7612629565
Cites: Am J Epidemiol. 2003 Jun 1;157(11):998-100612777363
Cites: J Am Soc Nephrol. 2003 Jul;14(7 Suppl 2):S99-S10212819311
Cites: Scand J Work Environ Health. 2003 Jun;29(3):206-1512828390
Cites: J Hypertens. 2003 Sep;21(9):1599-60812923384
Cites: JAMA. 2003 Oct 22;290(16):2138-4814570949
Cites: J Occup Health Psychol. 1998 Oct;3(4):322-559805280
Cites: Psychosom Med. 1998 Nov-Dec;60(6):697-7069847028
Cites: Rev Epidemiol Sante Publique. 1998 Nov;46(5):371-819864766
Cites: Scand J Work Environ Health. 1998 Oct;24(5):334-439869304
Cites: CMAJ. 1999 May 4;160(9):1341-310333841
Cites: N Engl J Med. 1999 Aug 5;341(6):427-3410432328
Cites: Psychosom Med. 1999 Jul-Aug;61(4):476-8710443756
Cites: Hypertension. 2003 Dec;42(6):1112-614597647
Cites: Scand J Work Environ Health. 2004 Apr;30(2):85-12815127782
Cites: Ann Behav Med. 2004 Aug;28(1):4-915249254
Cites: Am J Epidemiol. 1978 May;107(5):362-83665654
Cites: Scand J Work Environ Health. 1988 Aug;14(4):257-643175559
Cites: Am J Epidemiol. 1989 Mar;129(3):483-942916541
Cites: Psychosom Med. 1989 Jan-Feb;51(1):46-572928460
Cites: J Cardiovasc Pharmacol. 1989;13 Suppl 1:S4-102468976
Cites: Int J Health Serv. 1989;19(3):457-82753578
Cites: Lancet. 1990 Mar 31;335(8692):765-741969518
Cites: Scand J Work Environ Health. 1990 Aug;16(4):258-692389133
Cites: Scand J Work Environ Health. 1991 Dec;17(6):380-51788530
Cites: Hypertension. 1992 May;19(5):488-941568768
Cites: Psychosom Med. 1992 May-Jun;54(3):337-431620809
Cites: J Psychosom Res. 1996 Apr;40(4):359-688736416
Cites: Scand J Work Environ Health. 1996 Aug;22(4):294-3058881018
Cites: BMJ. 1997 Feb 22;314(7080):558-659055714
Cites: Am J Public Health. 1997 Aug;87(8):1297-3029279264
Cites: J Hum Hypertens. 1997 Aug;11 Suppl 1:S9-189321735
Cites: Int J Epidemiol. 1998 Feb;27(1):91-59563700
Cites: Psychoneuroendocrinology. 1998 Jan;23(1):1-179618748
Cites: Am J Med. 1998 Jun 22;104(6A):50S-53S9684852
Cites: JAMA. 1993 Nov 24;270(20):2439-438230620
PubMed ID
16809603 View in PubMed
Less detail

Exploring the risk of diabetes mellitus and dyslipidemia among ambulatory users of atypical antipsychotics: a population-based comparison of risperidone and olanzapine.

https://arctichealth.org/en/permalink/ahliterature175614
Source
Pharmacoepidemiol Drug Saf. 2005 Jun;14(6):427-36
Publication Type
Article
Date
Jun-2005
Author
Jocelyne Moisan
Jean-Pierre Grégoire
Michel Gaudet
Dan Cooper
Author Affiliation
Faculty of Pharmacy, Université Laval, Québec, Que., Canada.
Source
Pharmacoepidemiol Drug Saf. 2005 Jun;14(6):427-36
Date
Jun-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Ambulatory Care - statistics & numerical data
Antipsychotic Agents - adverse effects - therapeutic use
Benzodiazepines - adverse effects - therapeutic use
Cohort Studies
Databases, Factual - statistics & numerical data
Diabetes Mellitus - chemically induced - epidemiology
Drug Utilization - statistics & numerical data
Female
Humans
Hyperlipidemias - chemically induced - epidemiology
Incidence
Insurance, Pharmaceutical Services - statistics & numerical data
Male
Middle Aged
Quebec - epidemiology
Risk Assessment - methods
Risk factors
Risperidone - adverse effects - therapeutic use
Survival Analysis
Abstract
To compare the incidence rates of diabetes mellitus and dyslipidemia in ambulatory first-time users of risperidone and olanzapine.
The database for the Prescription Drug Insurance Plan in the province of Quebec was used as the data source for a population-based cohort study. Denominalized data were extracted for all ambulatory patients who first received an atypical antipsychotic between 1 January 1997 and 31 August 1999. Eligible patients were categorized as taking: no antidiabetic medication; no lipid reducing medication; neither type of medication. Those who started to use an outcome drug (an antidiabetic or lipid-lowering medication) before the end of the follow-up period (31 August 2000) were considered to have developed the corresponding outcome disease. Incidence rate ratios (IRR) (and 95% confidence intervals) for initiating antihyperglycemic or lipid-lowering drug treatment, or both were calculated. Outcomes on risperidone were compared to those on olanzapine.
A total of 19 582 eligible patients were included in the analysis. Relative to risperidone, olanzapine was associated with a higher risk of initiating a pharmacologic treatment for diabetes [IRR: 1.33 (1.03-1.74)], dyslipidemia [IRR: 1.49 (1.22-1.83)], or either condition [1.47 (1.23-1.76)].
Olanzapine seems to be associated with a higher risk of developing diabetes and/or dyslipidemia than risperidone. Further prospective studies are needed to rigorously assess the safety of olanzapine.
PubMed ID
15786513 View in PubMed
Less detail

[Health inequities in mood disorders based on material and social deprivation in dwelling sectors ].

https://arctichealth.org/en/permalink/ahliterature118243
Source
Can J Psychiatry. 2012 Dec;57(12):772-81
Publication Type
Article
Date
Dec-2012
Author
Alain Vanasse
Josiane Courteau
Alain Lesage
Marie-Josée Fleury
Jean-Pierre Grégoire
Jocelyne Moisan
Sophie Lauzier
Claude Bergeron
Author Affiliation
Département de médecine de famille, Université de Sherbrooke, Sherbrooke, Canada.
Source
Can J Psychiatry. 2012 Dec;57(12):772-81
Date
Dec-2012
Language
French
Publication Type
Article
Keywords
Adult
Cohort Studies
Comorbidity
Female
Health Services - utilization
Humans
Male
Mood Disorders - drug therapy - epidemiology
Poverty - psychology - statistics & numerical data
Prescription Drugs - therapeutic use
Quebec - epidemiology
Social Isolation - psychology
Social Marginalization - psychology
Substance-Related Disorders - epidemiology
Abstract
To compare mood disorder (MD) prevalence in Quebec in 2006, and compare health services and medication use, mortality and morbidity in patients with MD based on sex and the dwelling sector level of material and social deprivation. The objective was also to identify subgroups of individuals using health services in a larger proportion and having a higher risk of morbidity and mortality.
We conducted a secondary analysis of the Régie de l’assurance maladie du Québec medico-administrative data. The cohort is composed of adults diagnosed with MD and living in Quebec in 2006. Variables include: physician consultation, medication demand, consultation for substance or alcohol abuse, emergency visit, hospitalization for a mental disorder, and death. Dwelling sector types are defined by crossing Pampalon material and social deprivation quintiles.
MD prevalence in 2006 was 3.06% (177 850 patients), with prevalence in women 1.7-fold with respect to men. Findings show a higher MD prevalence as well as a higher mortality and morbidity rate in materially and socially deprived dwelling sectors. Young men also represent a specifically vulnerable subgroup for many study variables.
Public policies aimed at improving material conditions (income, education, employment) and breaking out social isolation would have an important impact on the population mental health. Public health program development should pay close attention to young men population.
PubMed ID
23228237 View in PubMed
Less detail

Immunization services offered in Québec (Canada) pharmacies.

https://arctichealth.org/en/permalink/ahliterature112941
Source
Hum Vaccin Immunother. 2013 Sep;9(9):1943-9
Publication Type
Article
Date
Sep-2013
Author
Chantal Sauvageau
Eve Dubé
Richard Bradet
Myrto Mondor
France Lavoie
Jocelyne Moisan
Author Affiliation
Institut National de Santé Publique du Québec; Québec, QC Canada; Centre de Recherche du CHU de Québec; Québec, QC Canada; Département de Médecine Sociale et Préventive; Faculté de Médecine; Université Laval; Québec, QC Canada.
Source
Hum Vaccin Immunother. 2013 Sep;9(9):1943-9
Date
Sep-2013
Language
English
Publication Type
Article
Keywords
Cross-Sectional Studies
Health Services - statistics & numerical data
Humans
Immunization - methods
Pharmacies
Quebec
Questionnaires
Abstract
Canadian Pharmacists are easy to reach. Although Québec pharmacists are not allowed to administer vaccines, they can: (1) promote vaccination, (2) counsel patients on vaccination, (3) sell vaccines and (4) provide vaccine administration by a nurse. Our objectives were to describe immunization services given in Québec pharmacies and assess the potential relation between, on one hand, pharmacy characteristics and difficulties perceived by pharmacists and, on the other hand, vaccine administration. In 2008-09, an anonymous questionnaire was mailed to all Québec pharmacy owners (n = 1663). Among the 1102 (66%) respondents, 90% stated that vaccines were sold, 27% that a nurse administered vaccines in their pharmacy and 44% were planning to offer vaccine administration in the next five years. Three out of four stated they were doing vaccine promotion and 65%, vaccine counselling. Half of respondents said they would be willing to administer vaccines themselves if legislative modifications were made. Recommendations for cold chain maintenance were followed in 23% of pharmacies selling vaccines. Presence of another health professional in the pharmacy, higher number of opening hours, not being located in the same building than a medical clinic and having an agreement to collaborate with a public health unit or a medical clinic for immunization were positively associated with vaccine administration in multivariate analysis. Higher perceived difficulties with lack of demand from patients were negatively associated with vaccine administration. Most pharmacists are willing to increase their involvement in immunization. Collaboration between public health professionals and pharmacists should be reinforced.
Notes
Cites: Am J Prev Med. 2000 Jan;18(1 Suppl):92-610806981
Cites: J Am Pharm Assoc (Wash). 2001 Jan-Feb;41(1):46-5211216111
Cites: J Clin Epidemiol. 2002 Mar;55(3):279-8411864799
Cites: J Am Pharm Assoc (2003). 2003 Jul-Aug;43(4):470-8212952311
Cites: Vaccine. 1998 Nov;16(18):1705-109778745
Cites: J Am Pharm Assoc (2003). 2006 Mar-Apr;46(2):168-79; quiz 179-8216602227
Cites: Vaccine. 2007 Nov 7;25(45):7841-717923173
Cites: Occup Environ Med. 2008 Jul;65(7):481, 501-618562687
Cites: J Am Pharm Assoc (2003). 2008 Nov-Dec;48(6):744-5119019803
Cites: Yakugaku Zasshi. 2009 Sep;129(9):1063-819721382
Cites: Vaccine. 2010 Feb 3;28(5):1177-8019945413
Cites: Int J Pharm Pract. 2010 Apr;18(2):100-720441119
Cites: BMC Med Educ. 2010;10:8621110845
PubMed ID
23782530 View in PubMed
Less detail

The impact of the type of insurance plan on adherence and persistence with antidepressants: a matched cohort study.

https://arctichealth.org/en/permalink/ahliterature115075
Source
Can J Psychiatry. 2013 Apr;58(4):233-9
Publication Type
Article
Date
Apr-2013
Author
Jonathan Assayag
Amélie Forget
Fatima-Zohra Kettani
Marie-France Beauchesne
Jocelyne Moisan
Lucie Blais
Author Affiliation
Université de Montréal, Montreal, Quebec.
Source
Can J Psychiatry. 2013 Apr;58(4):233-9
Date
Apr-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Antidepressive Agents - economics - therapeutic use
Cohort Studies
Databases, Factual
Depressive Disorder - drug therapy - economics
Female
Health Benefit Plans, Employee - economics - statistics & numerical data
Humans
Insurance, Pharmaceutical Services - statistics & numerical data
Kaplan-Meier Estimate
Male
Medication Adherence - statistics & numerical data
Middle Aged
National Health Programs - economics - statistics & numerical data
Prescription Fees - statistics & numerical data
Proportional Hazards Models
Quebec
Research Design
Retrospective Studies
Young Adult
Abstract
To compare adherence to, and persistence with, antidepressants (AD) in Quebec patients who are covered by private and public drug insurance.
A matched cohort study was conducted using prescription claims databases: reMed, a medication data registry for Quebec residents covered by private drug insurance, and Régie de l'assurance maladie du Québec database for Quebec residents with public drug insurance. Patients were aged 18 to 64 years and filled at least 1 prescription for an AD in monotherapy between December 2007 and September 2009 (194 privately and 2055 publicly insured patients). Adherence over 1 year was estimated using the proportion of prescribed days covered (PPDC). The difference in mean PPDC between patients with private and public drug insurance was estimated with linear regression. Persistence was compared between the groups with a Cox regression model.
The PPDC was 86.4% (95% CI 83.3% to 89.5%) in privately insured and 82.2% (95% CI 78.5% to 85.9%) in publicly insured patients and the adjusted mean difference was 5.1% (95% CI 1.6% to 8.6%). Persistence was 51.0% in the private group and 19.7% in the public group at 1 year (P
PubMed ID
23547647 View in PubMed
Less detail

20 records – page 1 of 2.