Health Canada defines a natural health product (NHP) as “any vitamin, mineral, herbal remedy, homeopathic medicine, traditional medicine (Chinese, Ayurvedic), probiotic, or other product such as amino acid and essential fatty acid used to prevent, diagnose, or treat disease, restore or correct function, or maintain or promote health.” Almost 3 out of 4 Canadians report using NHPs, and some studies of inpatient settings have shown up to 80% prevalence of use of NHPs. Despite widespread use, it is also well recognized that NHPs are not innocuous substances, and can potentially have harmful effects on patient treatment and outcomes.
Hospital pharmacists are responsible for working with inpatients and the healthcare team to optimize medication regimens, including non-prescription drugs and NHPs. Pharmacy departments often develop policies relating to patient care to maximize standardized care and safety. As such, it is important to evaluate whether hospital pharmacy departments have existing policies to manage inpatients who are taking non-formulary NHPs.
Purpose and Objectives
The pharmacy department policy framework regarding managing NHP use in inpatient hospital settings is unknown in the Canadian context. To our knowledge, a Canadian study exploring NHP policies of hospitals or hospital pharmacy departments has never been conducted. We are conducting this survey as a pharmacy residency project to evaluate Canadian pharmacy department policies regarding inpatient non-formulary NHP use. Our primary objective is to determine the prevalence of established pharmacy department policies regarding NHP use in Canadian hospital inpatient settings. Our secondary objectives are to describe the policies currently in place, including whether recommendations are based on published evidence, and rating the quality of that evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria; and to describe concordant and discordant recommendations between policies.
Benefits & Risks
The survey will not directly benefit any participants. However, we hope results of this survey will highlight opportunities for implementation and/or further development of Canadian inpatient pharmacy department NHP policies. No overt risks to participants are foreseen by completion of the survey.
Due to the inherent complexity and jurisdictional nature of the Canadian healthcare system, policy development is resource-intensive; therefore, there is no guarantee that the findings from this study will directly impact policy development at an institutional or regional level.
Data Confidentiality & Storage
The researchers will maintain the confidentiality of all responses. The information collected will NOT contain any personal identifiers. IP addresses will not be collected. The researchers will store any information collected for a minimum of five years on secured servers and/or password-protected, encrypted computers. All survey and policy data collected will only be published in aggregate form and will not identify any individual participants or institutional entities.
Study Consent & Participation
Your consent to participate in the SUPPLEMENT Study is implied by completion of the survey. Participation is voluntary and confidential, and you are free to withdraw at any time before your responses are submitted. If you are not familiar with the medication use policy framework for your pharmacy department in your health region, or believe another individual would be better suited to complete this survey, please forward a survey link to the respective party.
The survey takes approximately 5-10 minutes to complete. You may also return to complete a started survey at a different time. Note that the survey may be accessed from multiple electronic devices. The survey will remain open until January 31, 2020 23:59 MST.
The plan for this study has been reviewed for its adherence to ethical guidelines by the Health Research Ethics Board (REB 3) at the University of Alberta. For questions regarding the study, please contact the study investigators listed below. If you have any questions regarding ethical conduct or your rights as a research participant, you may contact the Health Research Ethics Board at 780-492-2615. This office is independent of the study investigators.
Study Investigator Contact Information
Jack Novovic, BHSc (Hons), PharmD - Pharmacy Resident, Alberta Health Services
Morgan Bharadia, BScPharm, PhD(c) - Principal Investigator, University of Alberta
Lauren Bresee, BScPharm, ACPR, MSc, PhD - Principal Investigator, University of Calgary