Proton pump inhibitors (PPIs) are acid-suppressant drugs that are widely prescribed for a number of gastrointestinal (GI) indications. In 2015, PPIs accounted for Can$253.3 million in public drug program spending in Canada, and were one of the top ten drug classes with the highest spending. 1 Furthermore, pantoprazole was found to be the fifth most common drug prescribed in Canada, with more than 11 million prescriptions dispensed in 2012. 2 With pantoprazole's high prevalence of use, there is a growing concern in the appropriateness and duration of its use. A Canadian prospective study found that 30.7% of patients were inappropriately prescribed with PPIs, in relation to the Quebec guidelines. 3 In addition, a retrospective cross-sectional study conducted in British Columbia found that the proportion of PPI orders without a documented common evidence-based indication or broad evidencebased indication were 43.7% and 16.2%, respectively. 4 While PPIs are generally well-tolerated, the long-term safety profiles of PPIs This is an open access article under the terms of the Creat ive Commo ns Attri bution-NonCo mmerc ial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. AbstractObjective: Long-term use of proton pump inhibitors (PPIs) has been associated with an increased risk of harm. There are few studies evaluating pharmacist-led PPI deprescribing interventions within a long-term care facility setting. The aim of this study was to describe the changes and influencing factors seen with a pharmacist-led PPI deprescribing intervention in two Fraser Health Authority long-term care facilities in British Columbia. Methods:This 4-month intervention involved lists of residents who had active PPI orders being handed out to physicians from two facilities. The pharmacist conducted weekly reviews of residents from Facility 1 and offered deprescribing recommendations. The number and methods of PPI deprescribing orders per facility were determined after the intervention.Results: Out of 58 residents from the two facilities, 30 (62.5%) had a deprescribing order. Facility 1 had 83.3% (20/24) of residents with a PPI deprescribing order, in contrast to 41.7% (10/24) from Facility 2. Overall, 80.0% of residents had successfully completed PPI deprescribing orders by the end of the study period. Conclusion: Clinical pharmacist intervention may increase the rate of initiation in PPI deprescribing orders within a long-term care facility setting. Factors that influence success include intervention timing, active collaboration, having residents under direct care, and clear documentation of PPI indications. K E Y W O R D S deprescribing, pharmacist, proton pump inhibitors [Correction added on 16 May 2019, after first online publication: The corresponding author's email address has been corrected.] | 113 TANDUN eT Al.are controversial, as they are often associated with an increased risk of Clostridium diffici...

Background: Venous thromboembolism (VTE), comprised of both deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common complication for hospitalized patients. Clear guidance is available to practitioners in regard to risk factors for the development of VTE as well as strategies to decrease its prevalence. Despite knowing who is at risk and how to prevent VTE, practitioners provide adequate measures to only half of the patients who are eligible for VTE prophylaxis. Pharmacy practitioners within the Regina Qu'Appelle Health Region (RQHR) have been actively involved in improving VTE prophylaxis for inpatients over the past 10 years. Objective: To improve the rate of VTE prophylaxis within the RQHR, thereby improving patient safety. Methods: The strategy involved 3 phases: a preparation phase, an active intervention phase, and a maintenance and improvement phase. The preparation phase included education and participation in a national registry along with a residency project. The intervention phase consisted of a number of strategies in conjunction with 1-day VTE prophylaxis audits, and the maintenance phase consisted of ongoing educational initiatives and audits. , the percentage of patients being appropriately managed for VTE prophylaxis within the RQHR improved from 62% to 94% (P , .005). Looking specifically at our medical and surgical populations, rates increased from 47% to 90% (P , .005) and 79% to 97% (P , .005), respectively. Conclusion: The strategy was successful in improving VTE prophylaxis in the inpatient population.Hosp Pharm-2011;46(8):574-579 V enous thromboembolism (VTE), comprised of deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common complication in hospitalized medical and surgical patients, with an incidence rate of up to 40% and 60%, respectively. 1 The majority of inpatients have at least 1 risk factor for VTE, while approximately 40% have 3 or more. 2 VTE leads to significant mortality; PE is associated with a case-fatality rate of up to 12%. 3 The risk is higher in elderly patients as the 1-year mortality rate of DVT and PE reaches 21% and 40%, respectively. 4 A decade ago, the American Agency for Healthcare Research and Quality highlighted the need for inpatient VTE prophylaxis and identified it as the number one preventative strategy to improve patient safety. 5 Despite the risk and recognition over the past