BackgroundCanadians have long been proud of their universal health insurance system, which publicly funds the cost of physician visits and hospitalizations at the point of care. Prescription drugs however, have been subject to a patchwork of public and private coverage which is frequently inefficient and creates access barriers to necessary medicine for many Canadians.MethodsA narrative review was undertaken to understand the important economic, policy and political considerations regarding implementation of universal prescription drug access in Canada (pan-Canadian pharmacare). PubMed, SCOPUS and google scholar were searched for relevant citations. Citation trails were followed for additional information sources. Published books, public reports, press releases, policy papers, government webpages and other forms of gray literature were collected from iterative internet searches to provide a complete view of the current state on this topic.Main findingsRegarding health economics, all five of the reviewed pharmacare simulation models have shown reductions in annual prescription drug expenditure. However, differing policy and cost assumptions have resulted in a wide range of cost-saving estimates between models. In terms of policy, a single-payer, ‘first-dollar’ coverage model, using a minimum national formulary, is the model most frequently advocated by the academic community, healthcare professions and many public and patient groups. In contrast, a multi-payer, catastrophic ‘last-dollar’ coverage model, more similar to the current “patchwork” state of public and private coverage, is preferred by industry drug manufacturers and private health insurance companies. Primary concerns from the detractors of universal, single-payer, ‘first-dollar’ coverage are the financing required for its implementation and the access barriers that may be created for certain patient populations that are not majorly present in the current public-private payer mix.ConclusionCanada patiently awaits to see how the issue of prescription drug coverage will be resolved through the work of the Advisory Council on the Implementation of National Pharmacare. The overarching and ongoing discourse on policy and program implementation may be construed as a political debate informed by divergent public and private interests.Electronic supplementary materialThe online version of this article (10.1186/s40545-018-0154-x) contains supplementary material, which is available to authorized users.
Continuing education is part of a pharmacist's professional development. We sought to expose the differences in continuing education resources for pharmacist prescribing for ambulatory ailments. This serves as the first step in understanding what form of continuing education will be most helpful to practising pharmacists.
Asian/Pacific Islander, 2 were other/unknown; 4 were Hispanic and 14 non-Hispanic. Both GC positive female students were asymptomatic; one was 19, and one was 25 yrs old. Both were nonHispanic with one being Asian and one White. Conclusions This ongoing screening program of male and female students from the Johns Hopkins University Student Health and Wellness Center demonstrated a low prevalence of CT and GC among students, attending the Center. Targeted, innovative screening programs may improve outreach to populations with higher prevalences. Results In the study period, there were 14 000 (1303 per 100 000) chlamydia notifications in Aboriginal people and 111 947 (242 per 100 000) in non-Indigenous people. In both populations the highest rates were in females aged 15À19, with Aboriginal females reporting a rate four times that of the non-Indigenous females. There was a significant increasing trend in the chlamydia notification rate in Aboriginal people over the 5 years (10%, p-trend p<0.001) and also in non-Indigenous people (59% p-trend p<0.001). Over the 5 years there were 17 336 (964 per 100 000) gonorrhoea notifications in Aboriginal people compared to 14 771 (22 per 100 000) in nonIndigenous people. The highest notification rates were in Aboriginal people aged 15À19 years who lived in very remote areas while in non-Indigenous people the highest notification rates were in males aged 30À39 years. Gonorrhoea notification rates in Aboriginal people over the 5 years decreased over the time period (18%, p-trend p<0.001), but there was no significant trend in non-Indigenous people (19% p-trend p¼0.667). Although the rate of gonorrhoea decreased in Aboriginal people the rate was 26 times greater than the rate in non-Indigenous people. The female to male ratio for gonorrhoea of 1.1:1 in Aboriginal people suggests mainly heterosexual transmission, while in non-Indigenous people the female to male ratio was 0.29:1 suggesting predominantly homosexual transmission. The reported rates of gonorrhoea in Aboriginal people resident in very remote areas were 19 times Aboriginal people resident in urban areas. Conclusion Chlamydia is a generalised epidemic among both Aboriginal and non-Indigenous peoples. In contrast gonorrhoea is predominantly a disease of Aboriginal people in remote areas and urban gay men. We are undertaking a range of trials in quality improvement interventions with Aboriginal communities to address the continued higher burden of STIs notified among Indigenous people in Australia. Background Information on human papillomavirus (HPV) prevalence among Aboriginal populations (First Nations, Métis, Inuit) in Canada remains scarce but is needed for informed public health programming. This need is reinforced by the rapidly changing rates of cervical cancer screening in these populations and the introduction of prophylactic vaccines. Method In 2008, 52 clinics across the province of Manitoba, Canada participated in a Pap Week initiative during which left over tissues from conventional Pap tests were used for HP...
Current literature demonstrates the positive impact of pharmacists prescribing medication on patient outcomes and pharmacist perceptions of the practice. The aim of this study was to understand the factors affecting prescribing practices among Manitoba pharmacists and identify whether additional training methods would be beneficial for a practice behavior change. A web-based survey was developed and participation was solicited from pharmacists in Manitoba. Descriptive statistics were calculated to summarize the frequency of demographic characteristics. Chi-square tests were used to explore possible correlations between variables of interest and thematic analysis of qualitative data was completed. A total of 162 participants completed the survey. The response rate was 12.3%. Of those who had met the requirements to prescribe, none were doing so on a daily basis and 23.5% had not assessed or prescribed since being certified. Respondents identified the top barriers for providing this service as a lack of sufficient revenue and a lack of time. Qualitative analysis of responses identified additional barriers including a limiting scope and inadequate tools. Approximately half (54.4%) of respondents expressed that additional training would be of value. The themes identified from the survey data suggest that practice-based education would help pharmacists apply skills. In addition, expansion of prescribing authority and strategies addressing remuneration issues may help overcome barriers to pharmacists prescribing within Manitoba.
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