Drug Stewardship within Alberta Health Services is defined as the effective, safe, and sustainable use of medications by all staff and physicians. The Drug Stewardship Pharmacists have zonal responsibilities, but they focus on provincewide activities through working with stakeholders to develop and execute initiatives.
Resources provided here are available for all staff and physicians to access.
Drug Stewardship Initiatives
Contact
If you have any questions or concerns, please contact us:
Email: AHS.PharmacyDrugStewardship@ahs.ca
Biosimilars have no clinically meaningful differences in potency, quality, physiochemical structure, pharmacokinetics, and immunogenicity compared to the innovator. Globally, biosimilars have been adopted into formularies over the past 15 years and clinical evidence supports that approved biosimilars are safe and effective. For more information on AHS policy on biosimilars please contact the Drug Stewardship Team - AHS.PharmacyDrugStewardship@ahs.ca
Ontario Health (Cancer Care Ontario) and the Leslie Dan Faculty of Pharmacy, University of Toronto have collaborated to develop two online courses to increase awareness and knowledge of biologic (originator and biosimilar) medications among relevant patients, caregivers, and healthcare providers by providing accessible, evidence-based educational content and resources. Hosted by edX.org, the two online courses include:
Enoxaparin Biosimilars
For details on Noromby formulary status please refer to AHS formulary on the AHS intranet
Background
The prescribing of medications for specified clinical indications is considered usual practice. However, when a medication no longer serves its intended purpose, it may cause harm and unnecessary burden. Choosing Wisely Canada recommends not to start or renew drug therapy unless there is an appropriate indication and reasonable expectation of benefit in the individual patient.
Deprescribing in selected older adults
Polypharmacy in older adults increases risks for negative outcomes such as adverse drug events, disability, morbidity and mortality. Evidence for the benefits of deprescribing in selected older adults is accumulating.
Resources:
Background
Iron deficiency anemia (IDA) is an important medical condition that has been shown to impact mortality and quality of life across many patient populations. Perioperative anemia lengthens recovery time and length of stay. While, iron deficiency anemia in pregnancy increases the risk of preterm delivery, caesarean section, and long term newborn cognitive/motor/memory issues.
The goals of the Iron Stewardship initiative is to support clinically appropriate parenteral iron use. Using the tools below, the healthcare team can examine viable clinical alternatives to parental iron. Thus allowing for consistent, appropriate treatment of IDA across care settings.
Tools
Contact
If you have any questions or concerns, please contact us:
Email: AHS.PharmacyDrugStewardship@ahs.ca
Background
Melatonin is an endogenous hormone produced in the brain by the pineal gland. It regulates the body’s circadian rhythm, endocrine secretions, and sleep patterns. In Canada, melatonin is considered a natural health product (NHP) indicated promoted for adults 18 years of age and older to improve sleep in shift workers, jet lag and delayed sleep phase disorder.
Due to inconsistent evidence and manufacturing concerns, the Drugs and Therapeutic Committee has revised the formulary listing of melatonin to non-formulary do not supply (NFDNP) effective September 2024. This means that pharmacy cannot provide melatonin, but patient’s own medication supply is allowed.
Summary of Evidence – Drugs and Therapeutics Backgrounder: Issue 43 January 2024
Background
Proton pump inhibitors (PPIs) are one of the most commonly prescribed medications in Canada and are effective in the management of a variety of conditions such as gastroesophageal reflux disease (GERD), dyspepsia, Barrett’s esophagus, esophagitis and Helicobacter pylori associated gastric and peptic ulcers. Even though many indications require short term therapy there is growing concern about the overuse of PPI’s and the risks and adverse events associated with long term use. Studies assessing PPI use report up to 60% of patients taking a PPI may not have a proper indication for long term use. Choosing Wisely Canada guidelines recommend that an attempt should be made to stop/reduce PPIs in most patients on therapy for gastrointestinal symptoms at least once a year as they are often used inappropriately without an indication and for longer durations than recommended.
The goals of the Proton pump inhibitors deprescribing initiative is to promote the appropriate use of PPI’s including indication, dose and treatment duration. Using the tools created the healthcare team of can support the deprescribing PPIs
Tools
Contact
If you have any questions or concerns, please contact us:
Email: AHS.PharmacyDrugStewardship@ahs.ca
Alberta Health has made changes to mycophenolate mofetil oral suspension drug benefit coverage for people who have a had transplant. Cellcept® oral suspension is being replaced with a generic equivalent, Mar-Mycophenolate Mofetil oral suspension, which Health Canada says is as effective and safe as Cellcept® oral suspension.
Resources
Docusate sodium and docusate calcium for constipation have been removed from the AHS Provincial Drug Formulary and Supplements, effective November 1, 2017. Please see the following document for further information.
