1: Don’t Leave Your Statin on Read

A health system-embedded randomized trial of 20K adults found that digital outreach via secure portal messaging, SMS texting, and email increased 14-day statin refill rates to 14.4%, compared with 12.0% with usual communication. A second outreach attempt also improved refill rates among those who did not pick up their prescriptions the first time around. These results support digital outreach as a scalable strategy to improve short-term statin adherence among patients with or at risk for atherosclerotic cardiovascular disease and documented nonadherence.

2: Could Methadone Access Move Closer to the Pharmacy?

A recent JAMA Network Open economic evaluation examined 2 pharmacy-based models for expanding access to methadone for opioid use disorder and found both could be financially viable. Over 3 years, the pharmacy-based medication unit model returned an estimated $3.53 for every $1 invested, while a pharmacist-dispensed model returned $2.64 per $1 invested. The analysis is U.S.-based and regulatory changes would be needed for broader implementation there, but the findings add to the conversation around community pharmacies as an access point for opioid use disorder treatment.

3: Pharmacist Call, Safer Diabetes Rx?

A randomized clinical trial of 200 adults with type 2 diabetes at high risk of hypoglycemia found that proactive, protocol-driven outreach from a clinical pharmacist led to safer diabetes prescribing in 28% of patients, compared with 16% receiving usual care. Pharmacists used an evidence-based algorithm to identify opportunities to discontinue or modify medications associated with hypoglycemia, including sulfonylureas and certain insulins. The findings suggest pharmacist-led outreach could play a meaningful role in reducing medication-related hypoglycemia risk in high-risk patients.

Controlled substances are getting new rules

Big changes are coming to controlled-substance prescriptions on October 1. Under Health Canada’s new regulations, pharmacists will be able to therapeutically substitute one controlled substance for another, provided it’s allowed within their provincial or territorial scope of practice. Pharmacy technicians and intern technicians are also gaining new authorities, including receiving controlled-substance prescriptions, transferring them to another pharmacist or technician in Canada and participating in destruction of controlled substances. The changes are designed in part to make continuity of care easier, particularly during drug shortages and other urgent situations.

205 patients. 300 drug-therapy problems.

What happened: Put a pharmacist inside a geriatric oncology clinic, and they may find a lot. A 1-year pilot at Toronto’s Princess Margaret Cancer Centre had pharmacists conduct comprehensive medication reviews for 205 older adults with cancer. The patients were 81 years old on average and taking an average of 11.5 medications each. By the end of the pilot, pharmacists had identified 300 drug-therapy problems, with adverse drug reactions the most common.

Why it matters: Nearly 48% of patients had at least 1 drug-therapy problem, and researchers found potential for medication optimization in almost 73%. The issues pharmacists uncovered included adverse drug reactions, unnecessary medications, patients who needed additional treatment, and doses that were too high or too low. And, 65% of the drug-therapy problems pharmacists identified were accepted or acknowledged by the clinic’s geriatricians. Many patients were also reviewed before starting systemic cancer therapy, giving the care team an opportunity to address medication problems before adding another complicated treatment regimen.

But: Finding those problems took time. A complete pharmacist assessment averaged about 103 minutes per patient, and the pharmacist was only allocated one 7-hour shift per week to the clinic. That worked out to roughly 4 patients reviewed each week. Researchers also ran into very practical problems: patients couldn’t always be reached, medication histories could be difficult to obtain remotely and last-minute clinic changes made prioritizing patients difficult.

The study also wasn’t designed to show that pharmacist involvement reduced hospitalizations, improved survival or prevented adverse events. It was a one-year quality-improvement pilot at a single cancer centre, so larger prospective studies are still needed to determine whether the model ultimately changes patient outcomes.

Bottom line: Pharmacists reviewed 205 medically complex cancer patients and found 300 potential medication problems, suggesting there may be plenty hiding inside the medication lists of older adults undergoing cancer care. The pilot shows that embedding a pharmacist in geriatric oncology is feasible, but doing it at scale would require something every pharmacy team knows is in short supply: time. For pharmacists, though, the message is hard to miss: when a patient is taking 11 medications and cancer therapy is about to become number 12, a medication review can uncover a lot.

1: 💊 The next frontier for semaglutide? Children as young as 6. Novo Nordisk has reported that in its late-stage trial called STEP Young, about 40% of children aged 6 to under 12 treated with semaglutide were no longer considered obese after 68 weeks. Everyone in the trial also followed a reduced-calorie diet and increased physical activity. Novo says kids tolerated the drug much like adults and teens did in earlier trials. With prescriptions among US children under 12 already up 300-fold — despite GLP-1s not being approved for that age group — this could be the next big frontier for the drugs.

2: 😴 Would you prioritize sleep for $4.75? Research says: university students just might. Those who got bedtime reminders, morning feedback and a small cash reward for hitting 7 hours of sleep had 26% more nights meeting that goal. Their average sleep rose by about 19 minutes on weeknights, and their grades improved too. The biggest academic gains showed up among 1st-year students, especially in STEM courses and classes held in the middle of the day. An organization paying healthcare workers for sleep has yet to be established.

3: 🏒 The opposing team wasn’t the biggest threat at this hockey tournament. A new CMAJ report details how 4 Alberta youth hockey teams were exposed to carbon monoxide during a weekend tournament after a blocked heater exhaust released the colourless, odourless gas inside the arena. Players developed symptoms including headache, dizziness and nausea, but the cause wasn’t immediately obvious. The case is a reminder that CO poisoning can show up in unexpected places, and that clusters of similar symptoms should raise suspicion of an environmental exposure.

4: 🇨🇦 If you’ve lost the plot on the Canada-US trade war, here’s where things stand. Canada’s counter-tariffs kicked in Tuesday, with duties ranging from 15% to 50% on billions of dollars of US goods. And now the fight is moving beyond tariffs: the US has announced upcoming bans on certain Canadian dairy products, most alcohol and motorcycles, while Trump has also threatened to block Bombardier aircraft sales unless more production moves south of the border. So, what could cost you more? Here are some of the everyday items Canadians could soon pay more for.

💰 Save: 20% on regular-priced merchandise at participating Rexall locations if you work in healthcare. The discount runs through Healthcare Hero Thursdays. Just sign up for their free Be Well program before you go.

🍳 Make: one of these editor-picked September dinners for when summer is over and figuring out what to cook every night is back.

📚 Read: Exit Party, the new novel from Canadian author Emily St. John Mandel, who wrote Station Eleven. It's set in 2031 Los Angeles after the collapse of the United States, which is a pretty irresistible premise. 

🎧 Listen: to this podcast that investigates the massive data centres powering the AI boom, why communities are pushing back against them and what our growing appetite for AI actually looks like on the ground.

🍕 Watch: this video tour of Europe’s tastiest cheap eats, from pizza in Naples and tapas in Madrid to Venetian cicchetti and Portuguese barnacles. Probably best not watched hungry.

🐧 Fall is coming, and so is respiratory season. Which question are you already hearing most at the pharmacy counter? 🤧

First clue: Legendary rapper Shakur, to friends

Need a rematch? We’ve got you covered. Check out our Crossword Archive to find every puzzle we’ve ever made, all in one place.

Think you crushed it? Challenge your pharmacist friends to beat your time.

Want to reach thousands of Canadian pharmacists every week? Email [email protected] to learn more.