Lauren C. Bresee

• BScPharm, MSc, PhD, ACPR
• Professor (Assistant) at University of Calgary

Purpose An individual’s location of residence may impact health, however, health services and outcomes research generally use a single point in time to define where an individual resides. While this estimate of residence becomes inaccurate when the study subject moves, the impact on observed associations is not known. This study quantifies the impa...

Background Antihyperglycemic drug utilization studies are conducted frequently and describe the uptake of new drug therapies across may jurisdictions. An increasingly important, yet often absent, aspect of these studies is the impact of rurality on drug utilization. Objective(s) The objective of this study was to explore the association between pl...

Objective To evaluate the impact of administering probiotics to prevent Clostridioides difficile infection (CDI) among patients receiving therapeutic antibiotics. Design Stepped-wedge cluster-randomized trial between September 1, 2016, and August 31, 2019. Setting This study was conducted in 4 acute-care hospitals across an integrated health regi...

Background Clostridioides difficile infection (CDI) is associated with considerable morbidity and mortality in hospitalized patients, especially among older adults. Probiotics have been evaluated to prevent hospital-acquired (HA) CDI in patients who are receiving systemic antibiotics, but the implementation of timely probiotic administration remain...

Background: The association between hydrochlorothiazide (HCTZ) and skin cancer remains controversial. Objective: To determine whether HCTZ is associated with an increased risk of skin cancer compared with angiotensin-converting enzyme inhibitors (ACEIs) and calcium channel blockers (CCBs). Methods: Two new-user, active comparator cohorts were...

Objectives: Upper gastrointestinal bleeding (UGIB) is a common emergency, with high rates of hospitalization and in-patient mortality compared to other GI diseases. Despite readmission rates being a common quality metric, little data is available for UGIBs. This study aimed to determine readmission rates for patients discharged following an UGIB....

Objective: To examine the intersection between location of residence along the rural-urban continuum (metropolitan, urban, and rural) and sulfonylurea dispensation records for the management of type 2 diabetes. Research design and methods: This retrospective cohort study used administrative health records of adult new metformin users between Apr...

In this study on medication adherence among newly diagnosed patients with uncomplicated, incident hypertension, we conducted a retrospective cohort study using available administrative and laboratory data from April 1, 2012 to March 31, 2017 in Alberta, Canada to understand the extent to which baseline laboratory assessment and/or subsequent follow...

BACKGROUND: Health state utility values are commonly used to provide summary measures of health‐related quality of life in studies of stroke. Contemporaneous summaries are needed as a benchmark to contextualize future observational studies and inform the effectiveness of interventions aimed at improving post‐stroke quality of life. METHODS AND RES...

This protocol outlines the planned methodology for a systematic review and meta-analysis. The primary objective of the review is to identify all-cause readmission rates for individuals hospitalized for an upper GI bleed (UGIB). Secondary objectives will include GI bleed-specific readmission rates, mortality (all-cause and GI bleed-specific), readmi...

Purpose: To evaluate the impact of concomitant use of conventional synthetic DMARDs (csCMARD) on adherence, switching and dose of biologic disease modifying antirheumatic drugs (bDMARD) in rheumatoid arthritis (RA) patients treated with bDMARDs. Patients and methods: This was a population-based cohort study conducted in five provinces of Canada...

Background A range of first line similarly effective medications ranging in price are recommended for treating uncomplicated hypertension. Considering drug costs alone, thiazides and thiazide-like diuretics are the most cost-efficient option. We determined incident prescribing of thiazides for newly diagnosed hypertension as first-line treatment in...

Background: Hospital-acquired Clostridioides difficile infection (HA-CDI) rates are highly variable over time, posing problems for research assessing interventions that might improve rates. By understanding seasonality in HA-CDI rates and the impacts that other factors such as influenza admissions might have on these rates, we can account for them...

Background: Clostridioides difficile infection (CDI) is the most common cause of infectious diarrhea in hospitalized patients. Probiotics have been studied as a measure to prevent CDI. Timely probiotic administration to at-risk patients receiving systemic antimicrobials presents significant challenges. We sought to determine optimal implementation...

Background: Antimicrobial stewardship programs (ASPs) are dedicated to improving antimicrobial use. Although clinical practice guidelines (CPGs) are available for the development of ASPs, it is unclear what the quality of these guidelines are. We therefore systematically reviewed published CPGs for the development of acute care hospital-based ASPs...

Objectives To measure the impact of an antimicrobial stewardship initiative on the rate of urine culture testing and antimicrobial prescribing for urinary tract infections (UTIs) between control and intervention sites. Secondary objectives included evaluation of potential harms of the intervention and identifying characteristics of the population p...

Background: Use of second-generation antipsychotics (SGA) has increased in recent years; however, their use and effect on metabolic outcomes has been poorly characterised in population-level studies.AimsThis study aimed to determine the associations between SGA use and metabolic indicators in a general population. Method: We used data from the C...

Background & aims: Although there have been meta-analyses of the effects of exercise prehabilitation on patients undergoing colorectal surgery, little is known about the effects of nutrition-only (oral nutritional supplements and/or counseling) and multi-modal (oral nutritional supplements and/or counseling with exercise) prehabilitation on clinic...

Background Research has shown that inpatients may not accurately report interacting with a pharmacist. Objective To determine accuracy of patients’ recollection of meeting with a pharmacist at 2 acute care teaching hospitals in Edmonton, Alberta, Canada. Methods Retrospective review of 391 surveyed patients discharged from April 2013 to March 201...

Background: Pharmacists are a valuable resource in the peri-operative care of patients. Recently, expanded scope of practice has enabled pharmacists to become more involved in clinical activities including collaborative prescribing. The surgical pre-admission clinic (PAC) at South Health Campus (SHC), a 269 bed hospital in Calgary, Alberta, has int...

Importance A clear message and call to action can affect the use of a medication with limited efficacy. Objectives To assess the association of the dissemination of an educational document about the lack of efficacy of docusate with docusate administration and whether changing docusate administration was associated with a change in administration...

Introduction: There is strong evidence from randomized controlled trials (RCTs) that second-generation antipsychotic (SGA) medications are associated with metabolic adverse events. However, with the recent increases in the use of SGAs worldwide and frequent off-label use, it is unclear whether these associations are generalizable to populations be...

p> ABSTRACT Background: Nasal-swab screening for methicillin-resistant Staphylo coccus aureus (MRSA) has a quicker turnaround time than other bacterial culture methods, with results available within 24 h. Although MRSA nasal-swab screening is not intended to guide antimicrobial therapy, this method may give clinicians additional information for e...

Background Infections following stroke are associated with increased risk of complications and mortality. We sought to determine if prophylactic antibiotics following acute stroke patients help to prevent infections. Methods We searched Embase (1974-), Medline (1946-), Cochrane Collaboration (1966-), and Pubmed (2015-). We also searched three major...

BACKGROUND: Published information evaluating frequency of and risk factors for vancomycin-induced acute kidney injury (AKI) in the pediatric intensive care unit (PICU) population is conflicting. OBJECTIVES: The primary objective was to describe the proportion of our PICU patients who developed AKI with intravenous (IV) vancomycin. The secondary obj...

Purpose: Results of a survey to determine the frequency of prescribing by Canadian hospital pharmacists with independent prescribing authority are reported. Methods: A Web-based questionnaire was used to collect data on the prescribing activities of a designated group of hospital-affiliated pharmacists in the province of Alberta who had been gra...

Antimicrobial resistance is a concern that is challenging the ability to treat common infections. Surveillance of antimicrobial use in pediatric acute care institutions is complicated because the common metric unit, the defined daily dose, is problematic for this population. OBJECTIVE: During a four-year period in which no specific antimicrobial st...

A safety signal regarding cases of AKI after exposure to serotonin-norepinephrine reuptake inhibitors (SNRIs) was identified by Health Canada. Therefore, this study assessed whether the use of SNRIs increases the risk of AKI compared with selective serotonin reuptake inhibitors (SSRIs) and examined the risk associated with each individual SNRI. Mul...

Medication administration omissions (MAO) are usually considered medication errors but not all MAO are clinically relevant. We determined the frequency of clinically relevant MAO of antimicrobial drugs in adult hospitals in Calgary, Alberta, Canada based on electronic medication administration record (eMAR). We examined 2011 data from eMAR records...

Objective: To compare antimicrobial utilization data derived from pharmacy dispensing records and nursing administration record data by 2 commonly used units of measure. Design, participants, and methods: Data from nursing administration records and pharmacy dispensing records were obtained for 32 medical wards. From nursing and pharmacy data, d...

Current epidemiologic knowledge about bipolar disorder (BD) in Canada is inadequate. To date, only 3 prevalence studies have been conducted: only 1 was based on a national sample, and none distinguished between BD I and II. The objective of this study was to estimate the prevalence of BD I and II in Canada in 2012. Data were obtained from the 2012...

Introduction Antimicrobial stewardship (AS) within acute care facilities is a requirement for Accreditation Canada's Required Organisational Practices. In order to obtain a baseline evaluation of current AS processes, a focus group approach was used to qualitatively assess frontline pharmacy staff and leadership perspectives on AS resources. Metho...

Vancomycin is widely used to treat infections caused by methicillin-resistant Staphylococcus aureus. Data for dosing and monitoring of this drug in pediatric patients are lacking, and clinicians who are treating children often follow guidelines established for adults. To examine the total daily doses of vancomycin required to reach therapeutic trou...

Background People with schizophrenia are at significantly greater risk of cardiovascular disease-related mortality. We set out to determine if people with and without schizophrenia who undergo coronary artery catheterization differ with respect to coronary anatomy, coronary artery disease management, or outcome. Methods and Results This study used...

Background: Morbidity due to cardiovascular disease is high among First Nations people. The extent to which this may be related to the likelihood of coronary angiography is unclear. We examined the likelihood of coronary angiography after acute myocardial infarction (MI) among First Nations and non-First Nations patients. Methods: Our study incl...

Objective To evaluate the relationship between initiation of atypical antipsychotic agents and the risk of hyperglycemic emergencies. Method We conducted a multicentre retrospective cohort study using administrative health data from 7 Canadian provinces and the UK Clinical Practice Research Datalink. Hospitalizations for hyperglycemic emergencies...

Background Drug benefit providers can decrease prescribing of specific medications through prior authorization policies. In Saskatchewan, certain second generation antipsychotics (SGAs) are recognized as first-line agents to manage schizophrenia; but, require prior authorization because their coverage is restricted in other conditions. We aimed to...

Background: IMS Brogan (IMS) monitors ambulatory antibacterial (AB) consumption using the Xponent®database, which samples ~60-70% of retail pharmacy dispensing records and estimates total use using a proprietary method. Many studies use IMS data for monitoring the effect of antimicrobial stewardship (AS) activities and identifying potetntial AS tar...

Background: Appropriate baseline quantification of antibacterial (AB) use is essential to antimicrobial stewardship (AS). As a result, we aimed to quantify and analyze trends in AB use Alberta, Canada (population: ~4 million). Health care is administered through 5 zones in Alberta; Calgary and Edmonton zones are urban cities with populations > 1 mi...

Metformin is considered the first-line antihyperglycemic therapy for type 2 diabetes, but should be used with caution in people with renal insufficiency. Our study objective was to describe the proportion of patients who have an assessment of kidney function (serum creatinine [SCr] and estimated glomerular filtration rate [eGFR]) around the time of...

Objective: In Canada, treatment of children and adolescents with antipsychotics is almost always off label. A single atypical agent, aripiprazole, only recently received regulatory authorization for use in the group aged 15 to 17 years. This regulatory approval was restricted to treatment of schizophrenia. The objective of this review was to summa...

Metformin is first-line therapy for people with type 2 diabetes. Due to potential lactic acidosis it is contraindicated in patients with estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2, although little is known about its use among patients with chronic kidney disease (CKD). The objective of this study was to determine the association...

We examined trends in prescription recommendations for treatment of bipolar disorder (BD) in Canada during 2002-2010. Data collected by IMS Brogan in a database known as the Canadian Disease and Therapeutic Index were used for this analysis. These data are collected from a representative physician panel who record each drug recommendation and reaso...

Objective: The objective of this study was to evaluate the temporal trends in the incidence of acute myocardial infarction (AMI) and receipt of revascularization procedures in people with and without mental illness. Hypothesis: Individuals with mental illness will have higher rates of AMI, and lower rates of revascularization compared to people wit...

Whether access to primary and specialist care has an impact on treatment for people with schizophrenia and comorbid cardiac disease is unclear. The objective of this study was to compare use of general health care and specialized cardiac care by people with schizophrenia and by the rest of the population. A population-based period-prevalence study...

We investigated the association between proteinuria, estimated glomerular filtration rate (eGFR), and risk of mortality and kidney failure in white, Chinese, and South Asian populations. Population-based cohort study. Participants from Alberta, Canada, with a serum creatinine and urine protein dipstick measurement from January 1, 2005, to December...

To compare the prevalence of cardiovascular risk factors (CV-RF) and disease (CV-D) and health care use in people with and without schizophrenia. SUBJECTS/MATERIALS AND METHODS: Data from the Canadian Community Health Survey (CCHS), cycle 3.1, were used. Prevalence of CV-RF, CV-D, and health care use were compared in those with and without schizoph...

To evaluate the prevalence of cardiovascular risk factors (CV-RF) and disease (CV-D) in people with schizophrenia. We conducted a period-prevalence study using a population-based cohort from Alberta administrative databases. Schizophrenia was identified using billing codes; all other individuals served as non-schizophrenic controls. Modifiable CV-R...

Heart failure (HF) is a common emergency depart-ment (ED) presentation and a leading reason for hospitalization. Canadian practice patterns for the management of acute HF have not been well described. To describe current treatment patterns of patients present-ing to the ED with acute HF and investigate whether these treatments influenced outcomes....

Cross-sectional studies have reported an association between major depressive episode (MDE) and obesity. The objective of this longitudinal analysis was to determine whether MDE increase the risk of becoming obese over a 10-year period. We used data from the Canadian National Population Health Survey (NPHS), a longitudinal study of a representative...

Although evidence-based guidelines for the treatment of type 2 diabetes mellitus provide clear recommendations for initial therapy, evidence on an optimal treatment strategy after secondary failure is unclear. To compare the efficacy of add-on therapy using basal insulin versus an additional oral antidiabetic agent in patients with type 2 diabetes...

The objective of this study was to evaluate the differential risk of diabetes among people with depression taking antidepressant therapy. A nested case control design was used to investigate the study objective. Data from the Canadian province of Saskatchewan was available from January 1, 1991 to December 31, 2001; the average length of follow-up w...

Although diabetes mellitus has a strong association with the presence of depression, it is unclear whether diabetes itself increases the risk of developing depression. The objective of our study was to evaluate whether people with diabetes have a greater incidence of depression than those without diabetes. We conducted a population-based retrospect...

The purpose of this study was to assess the history of previous depression in people with incident diabetes compared with people without diabetes. We conducted a population-based nested case-control study using the administrative databases of Saskatchewan Health to assess the study objective. We identified cases of type 2 diabetes based on diagnost...

Given that most deaths among patients with diabetes mellitus are due to cardiovascular disease, we sought to determine the extent to which medications proven to reduce cardiovascular mortality are prescribed for patients with type 2 diabetes who have symptomatic atherosclerosis (i.e., coronary artery disease [CAD], cerebrovascular disease [CBVD] or...