CPhA is proud to support Choosing Wisely Canada to help clinicians and patients engage in conversations about unnecessary tests and treatments.
Choosing Wisely Canada is the national voice for reducing unnecessary tests and treatments in Canada. Unnecessary tests and treatments expose patients to potential harm, consume precious health-care resources, and contribute to the climate crisis.
Current projects
- Climate-conscious recommendations for pharmacists
- Sustainable blood glucose monitoring in type 2 diabetes mellitus patients: Navigating environmental impact and patient education in diabetes care
- Pharmacist list: Eleven tests and treatments to question
Climate-conscious recommendations for pharmacists
Every test, treatment, and procedure contributes to material waste and carbon emissions. By reducing unnecessary testing or treatments, clinicians can make a positive contribution towards the health of patients and the planet.
Part of Choosing Wisely Canada’s new climate-conscious recommendations, CPhA and the Canadian Society of Hospital Pharmacists (CSHP) collaborated on 5 joint climate action recommendations for pharmacists:
- Don’t prescribe greenhouse gas-intensive metered-dose inhalers (MDIs) for asthma and/or COPD where an alternative inhaler with a lower carbon footprint (e.g. dry powder inhaler (DPI), soft-mist inhaler, or MDI with a low greenhouse gas potential propellant) containing medications with comparable efficacy is available, and where the patient has demonstrated adequate technique and patient preference has been considered.
- Don’t start or continue medications without an indication or where the risks outweigh the benefits.
- Don’t pour any pharmaceuticals or chemicals down sinks, toilets, drains or dispose of in the trash.
- Don’t print prescription or educational materials when providers and patients have access to digital communication.
- Don’t use disposable gloves when standard hand hygiene disinfection practices are safe and sufficient.
Sustainable blood glucose monitoring
Navigating environmental impact and patient education in diabetes care
Funded by a grant from Choosing Wisely Canada, CPhA has developed a series of practice tools, including algorithms, infographics and animated videos, focussed on the appropriate testing frequency of blood glucose in type 2 diabetes patients.
These resources aim to equip pharmacists with the knowledge to counsel patients, emphasizing the significance of judicious use of self-monitoring blood glucose supplies.
Helping integrate CWC recommendations into practice
These resources aim to help pharmacists implement the Choosing Wisely recommendation: "Don’t recommend routine or multiple daily self-glucose monitoring in adults with stable type 2 diabetes on agents that do not cause hypoglycemia."
The resource toolkit aims to enhance pharmacist knowledge, awareness and environmental stewardship, leading to improved patient care, reduced health-care spending and strides toward sustainable health-care practices.
Resources for pharmacists
Algorithm
Optimizing Blood Glucose Management in Type 2 Diabetes:
Guidelines for Effective Self-Monitoring Frequency
Infographic
Self-Monitoring of Blood Glucose
in Type 2 Diabetes: 5 Key Messages
Video
Case 1: Self blood glucose monitoring for
individuals on insulin
Video
Case 2: Self blood glucose monitoring for
pregnant individuals
Pharmacist list: Eleven tests and treatments to question
The Pharmacist list: Eleven tests and treatments to question, identifies eleven targeted, evidence-based recommendations that can support conversations between patients and clinicians about what care is really needed. In May 2024, the list was expanded from the initial “Six tests and treatments to question” to include five additional climate-conscious recommendations.
How the list was created
CPhA established its Choosing Wisely Canada top six recommendations in two phases. The first phase comprised a call to pharmacists and pharmacy researchers from across Canada for recommendations in the fall of 2016. During the second phase, an expert committee was formed to review and finalize the recommendations submitted from the call to pharmacists. The committee was composed of CPhA member association representatives, pharmacy researchers, CPhA Board of Directors and staff who have broad knowledge and experience in pharmacy practice and quality improvement. Criteria used by the committee to finalize the list included relevance to practising pharmacists, patient impact and the available evidence to support each recommendation. The final list was approved by CPhA member associations and the Board of Directors. To ensure the continued relevance of this resource, CPhA reviewed and updated the list in 2023.
In May 2024, five additional recommendations were added to the list as part of Choosing Wisely Canada’s climate-conscious recommendations, jointly developed by CPhA and the Canadian Society of Hospital Pharmacists.