Sessions 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 4

Opening Plenary (09:00-10:30)

Karyn Gordon

CAPhO Awards (11:10-11:40)

Plenary (11:40-12:25)

CAPhO Annual General Meeting (12:25-13:00)

Plenary (14:00-14:40)

Management of Cancer Medication-Related Infusion Reactions

Andrea Crespo and Dr. Leta Forbes, Cancer Care Ontario, Toronto, ON

Cancer medication-related infusion reactions (CMIRs) can lead to treatment delays, switching to less optimal therapy, or discontinuation. Variation in the management of CMIRs was identified as a quality and safety gap by Ontario clinicians. A clinical practice guideline and supporting resources were developed to help standardize the prevention and management of IRs across the province. The guideline is informed by best available evidence and expert consensus, and provides recommendations on assessment, prophylaxis, acute management, and re-challenge (including desensitization). This presentation summarizes content from the guideline and supporting resources, and highlights key clinical questions that led to potentially practice-changing recommendations.

Learning Objectives:

  1. Provide an overview on CMIRs (definition, grading, and assessment);
  2. Summarize key clinical content around CMIR management (prophylaxis, acute management, and re-challenge); and
  3. Highlight select clinical questions and potentially practice-changing recommendations.
     

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

Common Infections in the Ambulatory Malignant Hematology Patient Population

Melissa Lo and Samantha Polito, Princess Margaret Cancer Centre, Toronto, ON
 
Patients with a hematological malignancy often present with infectious complications. During their disease trajectory, it is estimated that 80% of these patients will experience an episode of febrile neutropenia; 70-80% of these episodes will not have an identifiable source. Others are found to be caused by a multitude of different infections. Management of these patients on an outpatient basis remains a major challenge for oncology pharmacists and the multidisciplinary health care team. In this presentation, we will review febrile neutropenia as an infectious syndrome, and discuss central line infections, lower respiratory tract infections (focusing on fungal pneumonia), and CMV mucositis as infections commonly seen in this patient population.
 
Learning Objectives:
 
  1. Identify malignant hematology patients most at risk for infectious complications in the ambulatory setting;
  2. Review Febrile Neutropenia as an infectious syndrome commonly seen in malignant hematology patients;
  3. Describe the management of central line infections, lower respiratory tract infections, and CMV mucositis in the ambulatory setting; and
  4. Discuss difficulties and potential risks of infection management in the ambulatory setting.

Biomarkers – Where Did We Come From, and Where Are We Going?

Tom McFarlane, University of Waterloo / Sunnybrook Health Sciences, Toronto, ON
 
Oncology medicine is becoming increasingly personalized, and the mapping of the human genome has led to the uncovering of many potential targets which may allow us to direct therapeutic interventions in cancer patients. This session will define what makes a good biomarker, give historical perspective on biomarker use in cancer treatment, briefly discuss where we are in terms of the biomarkers available to us currently, and outline future directions for biomarker development and discovery.
 
Learning Objectives:
 
  1. Understand how the term biomarker is defined and the different types of biomarkers;
  2. Understand biomarkers within the context of cancer treatment and why personalized medicine is important;
  3. Identify biomarkers that have made a large clinical impact in oncology treatment; and
  4. Comprehend the directions we are taking with biomarkers and design of future clinical trials involving biomarkers.

Implementing a New Oncology Electronic Health Record – Voices of Experience

Catherine Bond-Mills, London Regional Cancer Program / Southwest Regional Cancer Program, London, ON
Lisa Rambout, Ottawa Hospital, Ottawa, ON

In the past few years there has been an increasing drive in the oncology space towards implementing Electronic Health Record (EHR) systems which will allow for Computerized Physician Order Entry (CPOE) and which bring all patient care systems together under one roof. The Ottawa Hospital (TOH) and London Health Sciences Centre (LHSC) have both adopted such systems; EPIC at TOH and Cerner Powerchart Oncology at LHSC. We aim to share our experiences and lessons learned in order to be helpful to other institutions which may be looking at similar implementations. 

Learning Objectives:

  1. Understand how EHR systems can add value to patient care in oncology settings;
  2. Understand how to prepare effectively for the changes associated with implementing a new EHR system;
  3. Understand how to survive going live; expectations versus reality during implementation; and
  4. Share lessons learned at TOH and LHSC in order to support other centres implementing EHR systems.
     

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

Top 5 Articles That Changed My Practice

Scott Edward, Dr. H. Bliss Murphy Cancer Centre, Newfoundland, NL

Chemotherapy Checking for Technicians - Alberta's Journey

J. Robin Burns, Alberta Health Services, Alberta, 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).

Thinking Beyond the Pharmacy Box – A Safety Framework for Operationalizing New Protocols

Tonya Ng and Stephanie Woo, BC Cancer, Vancouver, BC

Recent scientific advances have significantly increased the pace of introducing new oncology drug treatments. The complexity of cancer drug regimens and toxicity monitoring required, place high
demand on organizations. To safely deliver cancer treatments, clear systematic processes, with education and supports in place for patients and staff, are required to ensure clinical and operational readiness. A patient-centred, interdisciplinary team-focused planning approach, under the tenets of a strong patient safety culture is essential.

The BC Cancer Provincial Systemic Therapy Program formed an interdisciplinary subcommittee, to look at resource impact, safety and operational considerations of new protocol launches. Using a recent example, the talk aims to highlight examples of:

  • How utilizing patient-centred lens shifted the planning process
  • Operational/medication safety challenges encountered
  • Medication safety principles used in the review
  • Lessons learnt

Learning Objectives:

  1. Understand the importance of patient-focused care in the cancer drug treatment delivery planning process;
  2. Understand the pivotal role the pharmacy profession plays within an interdisciplinary team in the end-to-end planning and delivery of cancer drug treatments; and
  3. Understand vulnerable points in the cancer medication management process and risk mitigation strategies.

From Opioid Mythbusting to Therapeutic Psychedelics: Ten Tips from Your Palliative Oncology Pharmacist 

Chris Ralph, Tom Baker Cancer Centre Pharmacy, Calgary, AB

As palliative care moves upstream in the course of a patient’s cancer journey, oncology pharmacists are well-positioned to improve patients’ quality of life by helping manage cancer pain and symptoms as experts in the nuances of medication management. This presentation will offer ten useful and practical clinical pharmacy tips that palliative care pharmacists think all oncology pharmacists  should know for safe and effective symptom management. Close collaboration with or addition of a trained pharmacist to the palliative care team can improve clinical care for all patients.

Palliative care clinicians occasionally encounter patients with existential suffering which can prove refractory despite optimal existing treatments. Recent published studies have demonstrated the safety and efficacy of certain pyschedelics when administered in a medically supervised and monitored approach. This topic will be briefly discussed in this presentation as well.

Learning Objectives:

  1. Discuss the upstream movement of palliative care in a patient’s cancer journey;
  2. Provide ten useful and practical clinical pharmacy tips that palliative care pharmacists think all oncology pharmacists should know for safe and effective symptom management; and
  3. Provide an overview of the potential legitimate therapeutic use of psychedelics in the palliative oncology setting, highlighting recent publications.

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Sunday, April 5

CAPhO Town Hall Breakfast Meeting (08:30-09:15)

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.

CAPhO Poster Award Presentations (09:15-09:45)

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

Round Table Discussions (09:45-10:30)

During the Round Table Discussions, participants will have the opportunity to discuss two of the nine 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. Registration for the Round Table Discussions will be available in January.

1. Practical Implementation of the NAPRA Standards for the Compounding of Sterile IV Hazardous Preparations

Alana Alyward, Peterborough Regional Health Cener, Peterborough, ON

Discussion will focus on challenges we all face with implementation of the NAPRA standards, from selecting products, to cleaning the facilities, to developing practical and theoretical training material and policies to certify compounding and environment services personnel. Participants are asked to bring your NAPRA pain points for discussion and sharing of management strategies.

3. Biosimilar Implementation - Sharing Similar Experiences

Ivan Tyono, Sunnybrook Odette Cancer Centre, Toronto, ON

An opportunity to share our experiences on biosimilar implementation from different parts of the country.  Learning how others may have dealt with similar challenges.

5. The Role of the Pharmacy Technician in Managing Clinical Trials

Shirley Ho, Princess Margaret Cancer Centre, Toronto, ON

The role of pharmacy technicians is constantly evolving. This discussion describes the role of the clinical trials technician and how the role has developed. 

6. Creating Strategies for Maintaining a Hazardous Drug List Between Published NIOSH Lists

Nadine Badry, BC Cancer, Vancouver, BC

The NIOSH review process for hazardous drugs is quite lengthy and new NIOSH HD Lists are published infrequently. To ensure ongoing staff safety between published NIOSH Lists, pharmacy professionals who handle hazardous drugs will require a systematic strategy to address the evaluation of newly marketed drugs for their workplace while waiting for the next NIOSH List to be published.

Plenary (10:45-11:30)

Opioid Risk Mitigation Strategies for Patients with Cancer: Putting Pharmacy in the Driver’s Seat

Lauren Hutton and Dr. Jenny Lau

The conference theme of “driving safety forward” is at the heart of this plenary session. In response to the increase in opioid-related deaths in Canada, national strategies and guidelines have been developed to help support both practitioners and patients in improving opioid use. Unfortunately, these strategies focus on opioid use for chronic non-cancer pain. During this session we will explore:

  • some of the safety concerns around opioid use in patients with cancer;
  • how pharmacy can capitalize on its unique position and high accessibility within the health care system to implement meaningful strategies to better support patients requiring opioids to manage cancer related pain; and,
  • outline current Canadian research initiatives that you can engage with to help build a more robust evidence base to better support health care professionals in keeping our uniquely vulnerable patient population safe, without compromising their pain control and quality of life. 

We hope you leave this session feeling informed and empowered to collaborate with both your patients and inter-professional health care teams to ensure patients with cancer are receiving the most effective pain control strategies and are supported and educated regarding using these strategies safely. 

Learning Objectives:

  1. Describe the current opioid crisis in Canada;
  2. Explain the role of opioids in management of cancer related pain;
  3. Compare and contrast different healthcare professions attitudes, confidences, and practices in opioid management and risk mitigation in patients cancer; identifying the unique role of the pharmacy team in the care of this patient population;
  4. Identify patients with cancer at risk of problematic opioid use, opioid use disorder, or opioid overdose based on expert consensus guidelines; and
  5. Summarize recommended opioid prescribing and monitoring practices based on expert consensus guidelines.
     

Plenary (11:30-12:15)

Improving Patient Safety through Adverse Event Reporting: What's Happening in Canada?

Kathy Vu and Thanh Vu

Patient safety is a fundamental cornerstone of health care. Organizations all strive to set up systems and processes that will reduce the risk of adverse drug events (ADEs) for patients in their care.  An adverse drug event is an injury resulting from medical intervention related to a drug. This includes medication incidents, adverse drug reactions (ADRs), allergic reactions, and overdoses.1 ADEs can happen in a variety of places including hospitals, long-term care settings, and community settings.  This session will focus on two major components of ADEs: medication incidents and adverse drug reactions.
 
While it is estimated that ADRs account for up to two-thirds of drug-related hospital admissions and emergency department visits2, international studies estimate, on average, no more than 5% of serious ADRs detected by health care professionals are actually being reported3,4, and there is no evidence to suggest that Canadian reporting rates are higher. This suggests significant under-reporting of important therapeutic product information, which reduces Health Canada’s ability to identify, at an early stage, potential safety problems.
 
On December 16, 2019, new federal regulations came into effect requiring hospitals across the country to report serious adverse drug reactions and medical device incidents (MDIs) to Health Canada within 30 days of being documented within the hospital. The mandatory reporting regulations are designed to improve the reporting of a valuable source of information about the ‘real world’ experiences of patients and health care professionals using the drugs and devices on the Canadian market. Improved reporting will help Health Canada identify emerging safety issues with health products and take action when needed to protect patients. 
 
Under-reporting of medication incidents is also well described in Canada and globally.  This poses a significant problem for patient safety because incident learning and quality improvement initiatives are hindered by the lack of awareness and collaboration.  The Medication Safety Summit in 2014 resulted in a white paper outlining key recommendations to improve the quantity and quality of reporting.5 Since then, provinces across Canada have attempted to move these recommendations forward in different manners.  Mandatory incident reporting exists in some provinces while others have managed to develop a centralized repository for incident reporting to be analyzed provincially and shared nationally.
 
In oncology, most ADRs and medication incidents from systemic therapy are considered inevitable and decades of clinical expertise in oncology have allowed clinicians to effectively manage or prevent them. In this sense, the contribution of reporting has been, and continues to be, of paramount importance in recognizing the risks associated with delivering therapy. 
 
The importance of ADR and medication incident reporting in oncology cannot be overemphasized. Any improvements in drug safety knowledge and the process by which they flow through the medication management system will ultimately lead to improvements in safety and care, and offer patients with cancer every possible help to improve their quality of life during such a critical period of their lives

Learning Objectives:

  1. Distinguish adverse drug reactions (ADRs) from incident reporting (IR); 
  2. Explain the potential impact of ADRs and IR on population health;  
  3. Provide an overview of the mandatory reporting of serious ADRs and MDIs by hospitals requirement; 
  4. Provide an overview of incident reporting across Canada; and
  5. Discuss the challenges and opportunities of mandatory adverse drug reaction and incident reporting within the healthcare system.