Session Descriptions

Session descriptions will be posted as they become available. Please visit this page regularly for updated information.  
Click on the links below to be directed to specific days: 

Saturday, April 22

Opening Plenary (09:00-09:45)

Winning a Tickle Fight

Mike Lang, CancerControl Alberta and Alberta Health Services, Calgary, AB

The documentary film How to Win a Tickle Fight is a true story that follows one young father, Brock, and his family for two years as they strive to live full, meaningful lives despite the metastatic cancer diagnosis they are navigating. Through their difficult journey, the family comes to realize that many things can still go right even when things have gone terribly wrong. In this presentation, Brock's friend and filmmaker, Mike Lang, will show excerpts from the film and reflect on the "why" questions of cancer care that can sometimes be overlooked in service design and delivery. The session will provide oncology pharmacy professionals with a candid and honest glimpse into the cancer experience and emphasize the role that they play in helping their patients live well despite cancer.
Learning Objectives:
  1. Highlight the personal experience of cancer diagnosis and treatment;
  2. Emphasize the importance of reflecting on the "why" questions in health care service delivery and design; and
  3. Explore how oncology pharmacy professionals can have a large impact on patient quality of life.

Plenary (09:45-10:30)

A Diagnosis of Childhood Cancer Lasts a Lifetime

Presentation Handout

Greg Guilcher, University of Calgary/Alberta Children's Hospital, Calgary, AB

A diagnosis of childhood cancer can affect any tissue in a developing child, and therapies come with numerous short and long-term side effects. Additionally, it takes years to fully understand the late effects of these treatments which are undergoing constant change with medical advances. Knowledge of long-term effects of childhood cancer therapies allow for better patient and provider education and screening; such knowledge also informs new treatment protocols with the goal of improving rates of cure while minimizing toxicities.
At present, most survivors of childhood cancer have a major lasting effect from their oncologic diagnosis and its treatment. Many survivors have multiple or even life-limiting complications. Any organ system can be affected, and the long-term psychosocial and neurocognitive impacts of childhood cancer should not be overlooked.
Learning Objectives:
  1. Review the advances made in childhood cancer therapy over the last 60 years; 
  2. Understand the many disease and therapy-specific complications of childhood cancer treatment;
  3. Recognize that childhood cancer survivorship may be accompanied by chronic medical and psychosocial issues which require specialized knowledge for optimal care; and
  4. Discuss future directions of childhood cancer therapy and late effects research.

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Plenary (11:10-11:55)

Medically Assisted Dying

Patrick Mayo, University of Alberta Hospital, Edmonton, AB
Canadian legislation was passed in June 2016 that allows dying patients, who are suffering intolerably from a serious medical condition, a choice of a medically-assisted death.  Bill C-14 clearly defines the conditions and limitations for MAID in Canada, while allowing for individual provincial implementation.   Physicians and nurse practitioners are allowed to provide this service with the assistance of pharmacists and pharmacy technicians, however, it is essential that pharmacy staff understand their role and limitations under the current legislation.   The need to respect patient autonomy will be reviewed along with patient specific criteria that may influence drug protocol selection.  Finally the right for conscientious objection and the need access to palliative care will be discussed. 
Learning Objectives:
  1. Review the conditions established by Bill C14 for Medical Assistance in Dying in Canada;
  2. Review the patient's right to autonomy and provision of care;
  3. Discuss the role of conscientious objection and the ethical responsibility for effective referral;
  4. Review the literature on drug protocols utilized for the provision of euthanasia; and
  5. Discuss the MAID as one option in end-of-life care.  

CAPhO Annual General Meeting

All Conference participants are welcome to attend. CAPhO members are encouraged to attend the AGM and have a chance to win a free registration to the CAPhO Conference 2018. Tickets will be distributed at the entrance to the AGM. You have to be present to win!

Plenary (13:45-14:45)

Rx Drugs in the 21st Century: Prices, Access and Regulation in an Era of Unsustainable Costs

Marc-André Gagnon, Carleton University’s School of Public Policy and Administration, Ottawa, ON
The presentation will first present the transformation of the dominant business model in the pharmaceutical sector, emphasizing the growing trend of very high-priced specialty drugs, and then explore necessary reforms in order to better achieve access, cost-effectiveness and appropriate use of medicines. This first section will analyze the determinants of prices and the regulatory impacts of the transformation of the dominant business model. The second section will analyze how the current patchwork of drug coverage in Canada is completely inadequate to confront the contemporary challenges in pharmaceutical policy. 
Learning Objectives:
  1. Identify the main business models in the brand-name pharmaceutical sector and their impact on innovation, costs and regulation;
  2. Grasp the main determinants of drug pricing;
  3. Distinguish the main reasons behind the inefficiency of current drug coverage in Canada; and 
  4. Identify potential reforms to achieve better access to prescription drugs, cost-effectiveness and appropriate use of medicines.

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Concurrent Sessions 1 (14:45-15:25)

Administrative Stream: Exploring a Collaborative National Process to Co-create Consensus Clinical Pharmacy Key Performance Indicators for Ambulatory Oncology Pharmacists

Olavo Fernandes, University Health Network, Toronto, ON
Key Performance Indicators (KPIs) are quantifiable measures of quality that reflect the critical success factors of an organization. A set of eight Canadian hospital clinical pharmacy key performance indicators (cpKPI) was recently established using a systematic, pan-Canadian, consensus-building (modified-Delphi) process. A cpKPI is defined by 5 characteristics: it reflects a desired quality practice; it is a metric which links to direct patient care; it is associated with evidence of impact on meaningful patient outcomes; it is pharmacist sensitive; and it is feasible to measure. cpKPIs may allow pharmacists to re-focus and prioritize their patient-care efforts on interventions “that matter” and influence important outcomes such as hospital re-admissions. cpKPI were collaboratively developed, with representatives from all 10 provinces, with the goal to advance pharmacy practice to improve patient outcomes. The original cpKPI were developed with a focus on published evidence on “inpatient” pharmacy practice and associated patient outcomes. A Canadian national consensus on a suite of evidence-informed cpKPI for ambulatory pharmacy practice or specialty practices such as oncology, primary care, pediatrics or geriatrics is yet to be established. 
In this facilitated, interactive session, a 10-step process will be described that could be used by CAPHO members to conduct a Delphi consensus process for establishing key performance indicators (cpKPI) for Canadian ambulatory oncology pharmacists. Discussion topics will include: a process for establishing a cpKPI definition for a specialty practice, ideal attribute selection criteria, a process of polling stakeholders and reviewing the literature for “candidate cpKPI”, establishing  criteria for selecting an appropriate Delphi panel, preparing Delphi evidence summary tables, drafting pre-Delphi candidate cpKPI, and conducting a 3-round Delphi process (with a live interactive meeting). The merits and challenges of “disease-specific” cpKPI vs. “process of care” based cpKPI will be discussed as well as the potential to establish “high value action items” for this ambulatory pharmacy specialty.
Learning Objectives:
  1. Outline key milestone steps that could be used by CAPHO to conduct a Delphi consensus process for establishing key performance indicators (cpKPI) for Canadian ambulatory oncology pharmacists;
  2. Highlight ideal attribute cpKPI selection criteria that could be adapted for establishing key performance indicators (cpKPI) for Canadian ambulatory oncology pharmacists;
  3. Summarize the merits and challenges of establishing and implementing “disease-specific” vs. “process of care” based cpKPI; and
  4. List potential Delphi controversial discussion topics that may arise to guide panelists with their voting preferences for cpKPI.

Clinical Stream: A Science-Based Look at "Integrative Oncology"

Scott Gavura, Cancer Care Ontario, Toronto, ON
“Integrative oncology” is said to combine elements of complementary and/or alternative medicine into usual evidence-based cancer treatment plans in a way that is said to deliver care that is superior to “conventional” cancer care. While proponents of integrative oncology claim that integrative oncology is evidence-based, critics suggest that it is simply a rebranding of alternative medicine and a means to “integrate” non-evidence-based practices into oncology. With the interest and growth in integrative oncology practices, it is essential for pharmacists to understand the evidence base for “integrative” practices, and the implications to oncology pharmacy practice. 
Learning Objectives:
  1. The purported rationale for integrative oncology;
  2. The potential benefits, and possible harms, of integrative oncology practices;
  3. Implications and consequences of integrative oncology; and
  4. How pharmacists can effectively advocate for ethical, science-based patient care.

Research Stream: Deciphering The Alphabet Soup of Survival Analysis: DFS, PFS, OS, KM, HR, and CI

Lauren Bresee, Canadian Agency for Drugs and Technologies in Health (CADTH)/University of Calgary, Calgary, AB
Survival analysis is frequently used in oncology studies to examine the efficacy or effectiveness of drugs.  There are a number of types of survival endpoints, and several ways survival analyses can be performed.  During my presentation, I will review the common types of survival endpoints that oncology pharmacists will encounter on a regular basis, the common methods for completing survival analyses, and the strengths and limitations of survival outcomes and analyses that participants can apply when critically appraising an oncology manuscript. 
Learning Objectives:
  1. Understand the different types of survival endpoints, including disease-free survival (DFS), progression-free survival (PFS), and overall survival (OS);
  2. Understand the common types of survival analyses including Kaplan-Meier (KM) estimates and Cox Proportional Hazards regression, and how to apply the results of these survival analyses;
  3. Understand what censoring is and why it is used in survival analysis; and
  4. Recognize the strengths and limitations associated with the different types of survival endpoints and analyses, and be able to apply this information when critically appraising an oncology manuscript. 

Technician Stream: Psychological Safety: Speaking up for Patient Safety

Terry Ell, Alberta Health Services, Calgary, AB
Gina Lachuk, Alberta Health Services, Calgary, AB
A pharmacy tech notices a hazard in the workplace that could impact the safety of patients. What happens next?  Would you speak up?
This session explores how psychological safety among teams impacts individual behaviours and overall team effectiveness, which can determine whether we provide safe or unsafe care. Discussion will include obstacles and enablers to psychological safety and how to recognize them within a team. The role of the individual and the organization in building psychological safety will also be considered. Finally, we will offer an opportunity to learn and practice strategies that can be applied to practice. 
Learning Objectives:
  1. Distinguish between a psychologically safe and a psychologically unsafe workplace;
  2. List obstacles and risk factors to a psychologically safe environment;
  3. Recognize coping mechanisms associated with a psychologically unsafe workplace;
  4. Explain the impact of a Just Culture on psychological safety; and
  5. Describe the role of the organization, leadership and the individual in ensuring psychological safety.

Concurrent Sessions 2 (16:05-16:45)

Administrative Stream: Defining Canadian Certification for Oncology Pharmacists

Flay Charbonneau, Sunnybrook Health Sciences Centre - Odette Cancer Centre Pharmacy, Toronto, ON
Mark Pasetka, Sunnybrook Health Sciences Centre - Odette Cancer Centre Pharmacy, Toronto, ON
Recognition of specialist expertise through a certification process is common in many health professions, particularly medicine, but also in nursing, physiotherapy, dentistry and others. Pharmacists, while frequently aligning in practice with the medical profession and developing expertise in specialized therapeutic areas, have not had the opportunity in Canada to receive official recognition of such expertise. Many CAPhO members have expressed a desire to have the opportunity to become certified in oncology pharmacy practice. This session will provide an overview of existing oncology certification programs. Through a guided discussion of current models, the presenters will collate input to help inform the newly struck Task Force on Oncology Pharmacy Specialization. 
Learning Objectives:
  1. To review the current state of allied health specialist certifications in Canada;
  2. To discuss the options for certification available to Canadian oncology pharmacists; and
  3. To propose required elements for a Canadian-based certification program in oncology pharmacy practice.

Clinical Stream: Practice Changing Articles in Neuro Oncology in 2016/17

Frances Cusano, Tom Baker Cancer Centre, Calgary, AB
Patients diagnosed with malignant gliomas nearly all die prematurely.  Both low grade and high grade gliomas remain incurable diseases; however, there have been advances in treatment of gliomas which give patients improved survival outcomes.  
The presentation will review two recent studies in treatment of gliomas.  The presentation will also review a guideline for deprescribing in oncological palliative care patients.
Learning Objectives:
  1. To describe the patient selection, methodology and outcomes of study RTOG 9802 involving use of radiation therapy plus procarbazine, lomustine and vincristine in low grade glioma;
  2. To describe the patient selection, methodology and outcomes of study CCTG CE6 involving short-course radiotherapy with or without concomitant and adjuvant temozolomide in elderly patients with glioblastoma; and
  3. To understand the benefit of deprescribing in palliative patients and develop an approach to incorporate deprescribing into your practice.

Clinical Stream: Chemotherapy-Related Cardiac Dysfunction & How a Cardio-Oncology Clinic Can Help!

Maria Anwar, Alberta Health Services, South Health Campus, Calgary, AB
Certain chemotherapeutic agents can contribute to cardiac dysfunction when administered as part of a patient’s cancer treatment regimen. For instance, anthracyclines may increase the risk of early (within the first year of treatment) or late (several years after treatment) cardiac damage resulting in left ventricular (LV) dysfunction and heart failure. This usually occurs in an irreversible and cumulative dose related manner. Conversely, trastuzumab related cardiac dysfunction generally appears during treatment, is thought to be mainly reversible and not dose dependant. Symptomatic heart failure has also been observed in cancer patients receiving vascular endothelial growth factor (VEGF) inhibitor therapy. Additional risk factors for cardiac dysfunction include increased age, pre-existing cardiovascular disease or established cardiovascular risk factors and the concomitant use of multiple known cardiotoxic chemotherapeutic agents. 
This complex interplay of cancer biology and disease, cancer treatment, cardiovascular risk factors and disease can significantly impact the patient journey. Cardio-Oncology is an emerging multidisciplinary subspecialty that aims to support patients at higher risk of cardiotoxicity through detection, prevention and treatment. The recently published Canadian Cardiovascular Society (CCS) guidelines include recommendations to help optimize the care of cancer patients with established cardiovascular disease as well as those at risk of developing cardiotoxicity from their cancer therapy.
This session will focus on a review of evidence and approach to the treatment of chemotherapy-related cardiac dysfunction. The speaker will also highlight how the interdisciplinary team in the Cardio-Oncology clinic at South Health Campus in Calgary, Alberta and is engaging patients and their families in order to help support their cancer care journey and protect their hearts! 
Learning Objectives: 
  1. Review risk factors for chemotherapy-related cardiac dysfunction; and
  2. Discuss treatment strategies for chemotherapy-related cardiac dysfunction.

Technician Stream: Technicians Checking Chemotherapy: How Do We Get There?

Robin Burns, Cancer Network for CancerControl Alberta Pharmacy, Edmonton, AB
In the province of Alberta, pharmacy technicians traditionally have not performed tech check tech duties for oral and parenteral chemotherapy preparations.  As technician regulation came into force on January 1, 2016 CancerControl Alberta (CCA) Pharmacy was faced with a technician workforce that had a new expanded scope of practice and professional responsibilities.  As a result, in the spring of 2015 CCA Pharmacy began to look at workforce optimization and developed a certification program to have technicians fill the role of chemotherapy checkers in order to allow technicians to practice to their full scope while at the same time supporting pharmacists in expanding clinical roles within CCA Pharmacy.  Although technicians are the main focus of the chemotherapy checking certification program, it is also applicable to new and existing pharmacists within CCA Pharmacy.
Learning Objectives: 
  1. Learn about CCA Pharmacy’s policies and procedures for Authorized Chemotherapy Checking certification;
  2. Learn about the various tools developed for becoming an Authorized Chemotherapy Checker such as embedded worksheet audits, e-learning modules, and demonstration of chemotherapy checking;
  3. Review CCA Pharmacy’s embedded worksheets and checking process; and
  4. Gain understanding of how to develop a chemotherapy checking certification program/process for pharmacy technicians (and pharmacists).

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Sunday, April 23

CAPhO Town Hall Breakfast Meeting

Influence and contribute to the growth and development of your association by discussing what matters the most with the CAPhO Executive Committee and fellow members. A light breakfast will be offered during this session.

Oral Sessions: Award Winning Posters

CAPhO Poster Awards will be presented for the best posters in Research, Pharmacy Practice and Administration. Award recipients will make a short presentation summarizing the subject of their poster.

Hot Topic Cluster Discussions (09:45-10:30)

During the Hot Topic Discussions, participants will have the opportunity to discuss two of the eight available topics, each led by a different facilitator. Read below for details on the topics and facilitators for this session. Participation is limited and sign up is required during online registration.

1. Chemotherapy Dosing in Obesity

Frances Cusano, Tom Baker Cancer Centre, Calgary, AB

Studies have shown that as many as 40 percent of obese patients receive limited chemotherapy doses.  This is often due to concern regarding side effects and long-standing practices such as dose capping.  The American Society of Clinical Oncology has published clinical practice guidelines for appropriate chemotherapy dosing for obese adult patients with cancer. 
The discussion in this hot topic will involve chemotherapy dosing in obese patients.

2. Demystifying Opioid Rotation Calculations

Chris Ralph, Tom Baker Cancer Centre, Calgary, AB

Typically, when performing medication math there is ONE correct answer, but this is often not the case when it comes to opioid conversion calculations. In this discussion, we'll explore clinical scenarios appropriate for opioid conversion, the principles and limitations of opioid conversion tables, and a process to switch a person from one opioid to a different opioid.

3. Establishing an Oral Chemotherapy Program, a Technician Perspective.

Susan Singh, Sunnybrook Health Sciences Center, Odette Cancer Center, Toronto, ON

This hot topic will focus on the role of the technician in an oral chemo program which supports safe dispensing, optimizing patient access to OACMs and maintaining patient adherence and allow discussions to share experiences for best practice.

4. Communication Strategies for Precepting – Providing Feedback to Optimize Learning and Professional Socialization

Tara Leslie, Tom Baker Cancer Centre/University of Alberta, Calgary, AB

How do you provide feedback with your learners? Does it enhance student performance, optimize learning, and facilitate integration in your practice? Join this hot topic to share ideas in communication strategies to transition your role as student supervisor to preceptor and ultimately to mentor.

5. Steroid-Resistant Graft Versus Host Disease

Jennifer Jupp, Alberta Health Services, Calgary, AB

What happens when the graft no longer wants to be with the host and steroids can’t fix the relationship?  Bring your complex cases and let’s share our experiences when it comes to steroid resistant GVHD.

6. The Dirt on Environmental Monitoring - At Your Fingertips

Tana Yoon, Alberta Health Services, Calgary, AB

Why do we perform environmental monitoring?  What does it tell us?  Why is it important to our patients?  What is the risk if we do NOT do it?  

7. There's an App for That: Top 5 Apps and e-Resources for Patients

Christina Mychaskiw, Sunnybrook Health Sciences Center, Odette Cancer Center, Toronto, ON

A discussion on the usability, sustainability and feasibility of smartphone health applications for patients and recommendations 

8. There's an App for That: Top 5 Apps, Social Media, and e-Resources for Pharmacists

Soha Ahrari, Princess Margaret Cancer Centre, Toronto, ON

A discussion on how we can use apps, social media, and other e-resources to enhance daily pharmacy practice. Bring your smartphones and be ready to try some new ones out!  

Workshop (09:45-10:30)

Research Mentorship

Carlo DeAngelis, Sunnybrook Health Sciences Center, Odette Cancer Center, Toronto, ON
Michelle Deschamps, Saskatchewan Cancer Agency, Saskatoon, SK
Michelle Lui, Hamilton Health Sciences Centre, Hamilton, ON
Tom McFarlane, University of Waterloo, Kitchener, ON

This workshop will allow members to bring research ideas or drafted proposals to facilitators who have experience in research for discussion and suggestions. The intent will be to help move projects forward to implementation and find potential collaborators if needed. Participation is limited and sign up is required during online registration.

Panel (10:45-11:30)

Integrating Students into Everyday Practice 

Tara Leslie, Tom Baker Cancer Centre/University of Alberta, Calgary, AB
Michael LeBlanc, The Moncton Hospital, Moncton, NB
Mark Pasetka, Sunnybrook Health Sciences Center, Odette Cancer Center, Toronto, ON
Cameron Roessner, Foothills Medical Center, Calgary, AB
Ann Thompson, University of Alberta, Edmonton, AB
Integrating learners into your practice can enhance patient care, contribute to the completion of projects, and also be a meaningful learning experience for the student.  Further, offering a learning opportunity in oncology brings awareness to cancer care as a career choice for the next generation of pharmacists.  In this session, panelists will share their experiences and perspectives on precepting and abolish the myth that precepting always increases workload.  Panelists will describe practical strategies in placement planning and precepting to facilitate rich student learning while maintaining a reasonable overall workload.  
Learning Objectives:
  1. To describe perspectives and approaches for preparing students for experiential education within oncology practice;   
  2. To discuss how different types of supervision can influence student learning and preceptor workload; 
  3. To explore how placement activity planning can impact the provision of patient care and mobilizing projects; and
  4. To explore innovative strategies to integrate learners into oncology pharmacy practice.

Debate (11:30-12:15)

Physical Assessment as Part of Toxicity Management 

Presentation Handout - Pro
Presentation Handout - Con

Carlo DeAngelis, Sunnybrook Odette Cancer Center, Toronto, ON
Scott Edwards, Dr. H. Bliss Murphy Cancer Center, St. John's, NL