Marie-France Beauchesne

• Université de Montréal

Chronic obstructive pulmonary disease patient care must include confirming a diagnosis with postbronchodilator spirometry. Because of the clinical heterogeneity and the reality that airflow obstruction assessed by spirometry only partially reflects disease severity, a thorough clinical evaluation of the patient should include assessment of symptom...

Objectives: e-MEDRESP is a novel web-based tool that provides easily interpretable information on patient adherence to asthma/chronic obstructive pulmonary disease (COPD) medications, using pharmacy claims data. This study investigated the feasibility of implementing e-MEDRESP in primary care. Material and methods: In this 16-month prospective c...

Background Achieving asthma control is often difficult, despite the availability of effective medications. Because of their expertise, regular contact with patients, and accessibility, community pharmacists can play an important role in helping patients manage uncontrolled asthma. Objective To develop a community pharmacy-based intervention for im...

Objectives: e-MEDRESP is a novel web-based tool that provides easily interpretable information on patient adherence to asthma/chronic obstructive pulmonary disease medications, using pharmacy claims data. This study investigated the feasibility of implementing e-MEDRESP in primary care. Materials and Methods: In this 16-month prospective cohort stu...

Background In recent years, there has been growing interest in studying asthma treatment escalation patterns in the real-world setting, particularly with the advent of expensive biologic therapies. Healthcare administrative claims databases can be used to study treatment escalation patterns at a population-level; however, the reported definitions f...

Background False penicillin allergies lead to increased antimicrobial resistance, adverse effects, and health care costs by promoting the use of broad-spectrum antibiotics. The Infectious Diseases Society of America recommends the implementation of allergy testing. Objectives The primary objective of this research was to estimate the number of pha...

Objective: To evaluate the effect of digital-based reading versus paper-based reading on reading comprehension among students, trainees, and residents participating in health professional education. Introduction: Several reviews have examined the effects of reading media on reading comprehension; however, none have considered health professional...

Background Community pharmacists are best placed to improve medication adherence because they frequently interact with patients and have been trained to manage medication-related problems. Therefore, it is essential to equip pharmacists adequately to detect non-adherent patients quickly and intervene to improve medication adherence. Objective To d...

Background: Medication adherence in asthma and COPD is notoriously low. To intervene effectively, family physicians need to assess adherence accurately, which is a challenging endeavor. In collaboration family physicians and individuals with asthma or COPD, we aimed to explore the barriers and facilitators of assessing medication adherence in clin...

Background Community pharmacists have direct access to prescription refill information and regularly interact with their patients. Therefore, they are in a unique position to promote optimal medication use. Objectives To describe how community pharmacists in Quebec, Canada, identify nonadherent patients, monitor medication use and promote optimal...

Aim: To evaluate the current opinion, experience and educational preferences of pharmacists in Quebec concerning pharmacogenomics. Method: A web-based survey containing 25 questions was sent to all Quebec pharmacists. Results: Most pharmacists were willing to advise patients (81%) and physicians (84%) on treatment choices based on pharmacogenomic t...

In this guideline update, we highlight important and new findings related to pharmacological therapy of chronic obstructive pulmonary disease (COPD) that should change clinical practice and improve disease management. We present updated evidence, recommendations and expert clinical remarks on maintenance pharmacotherapy in patients with stable COPD...

Background: Respiratory distress protocols (RDPs) are protocolized prescriptions comprised of 3 medications (a benzodiazepine, an opioid, and an anticholinergic) administered simultaneously as an emergency treatment for respiratory distress in palliative care patients in the province of Quebec, Canada. However, data on appropriate use that justifi...

Background: Several epidemiological studies have suggested that the risk of depression is increased in patients with asthma, but the impact of asthma during pregnancy on postpartum depression remains unknown. Objective: To assess the association between maternal asthma and postpartum depression in a population-based cohort study retrieved from a...

Background Data on treatment expectation and perception towards vitamin K antagonists (VKAs), direct oral anticoagulants (DOACs), and low molecular weight heparins (LMWH) for the management of venous thromboembolism (VTE) are sparse. Methods Prospective observational study including subjects admitted to the hospital with a diagnosis of VTE and a pr...

The objective of this study is to evaluate whether a chronic obstructive pulmonary disease (COPD) self-management education program with coaching of a case manager improves patient-related outcomes and leads to practice changes in primary care. COPD patients from six family medicine clinics (FMCs) participated in a 1-year educational program offere...

Background: Inhaler technique and patient preferences are often overlooked when selecting maintenance treatments for patients with chronic obstructive pulmonary disease (COPD), but are important issues in ensuring drug efficacy and patient adherence. Few data on these issues are available for new inhalation devices. Objectives: To evaluate the i...

RATIONALE: Since the last published Canadian Thoracic Society (CTS) COPD guideline in 2007 and the 2008 update – highlights for primary care, many new clinical trials have challenged COPD treatment practices. The current Canadian position statement provides the reader with an update on pharmacotherapy of patients with COPD as reviewed by the CTS.OB...

Background: Maternal asthma has been found to be associated with an increased risk of hypertensive disorders of pregnancy (HDP), that is, gestational hypertension, preeclampsia, and eclampsia. There is limited data, however, regarding the relationship between the use of long-acting beta-agonists (LABAs) during pregnancy and these outcomes. Object...

Background: No studies have examined adherence or persistence to long-acting anticholinergics (LAAC) treatment episodes in patients with chronic obstructive pulmonary disease (COPD). Objective: To estimate 1-year adherence and 5-year persistence to LAAC during treatment episodes, and the likelihood of initiating a subsequent treatment episode....

Several authors have studied predictors of outcomes following a hospitalization for chronic obstructive pulmonary disease (COPD); however, few have reported outcomes following a first hospitalization for COPD. The objective is to develop a predictive mortality risk model in patients surviving a first hospitalization for COPD. This is a retrospectiv...

Approximately 15-20% of patients with chronic obstructive pulmonary disease (COPD) also display characteristics of asthma. In May 2014, the asthma-COPD overlap syndrome (ACOS) was briefly addressed in the Global Initiative for Asthma (GINA) and Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy documents. We evaluated how pulmon...

Social sciences are important for training in pharmacy faculties. The course set up at the Faculty of Pharmacy of the University of Montreal in 2011 is a very innovative way to meet this challenge. The purpose of this report is to share this experience by providing a synthetic description. Many students were able to develop new skills and strengthe...

Purpose: Several factors have been associated with the prescription of direct oral anticoagulants (DOAC) over warfarin such as younger age, fewer concomitant medications, and lower CHADS2 or bleeding scores. The primary objective of this study was to identify predictors of DOAC choice compared with warfarin for patients who are starting a new oral...

PurposeThere are very few studies on primary adherence (i.e., first filling of a prescription) to inhaled corticosteroids (ICS) in asthma patients; two have involved children. Moreover, adherence can be overestimated when considering only secondary adherence (i.e., following the medication recommendations for a defined period) and ignoring primary...

Teaching public health principles such as health promotion to healthcare professionals has gained attention in the last decade. The objective of this paper is to describe an innovative course that was developed in the Pharm.D programme in the Faculty of Pharmacy at the Université de Montréal with a focus on health promotion through community-based...

Atrial fibrillation (AF) is a common cardiovascular disease for which newer oral anticoagulants are available. The main objective of this study was to evaluate the appropriateness in prescriptions of direct oral anticoagulant (DOACs), more specifically apixaban, dabigatran and rivaroxaban. This was a singlecentre, retrospective study conducted in t...

This article was migrated. The article was not marked as recommended. This article aims at describing and analysing the way in which pharmacy students work together in the context of an innovative course on community health. The article uses content analysis of two focus groups held in 2015 with 14 students from the Faculty of Pharmacy at the Unive...

Background: Few studies have identified patterns and predictors of use of direct oral anticoagulants for venous thromboembolism (VTE). Objective: To describe the use of anticoagulants and assess predictors associated with the prescription of rivaroxaban over vitamin K antagonist (VKA) for the subsequent treatment of VTE. Methods: This cross-se...

Background: Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in Canada. Most patients with COPD receive long-term treatment with long-acting anticholinergics (LAAC) and/or long-acting β2-agonists (LABA). Adverse events (AEs) are also likely during long-term treatment with these medications. Objective: To evaluate...

Oxaliplatin plays a major role in the treatment of colorectal cancer (crc), but is associated with the development of neuropathies. The main objective of the present prospective study was to estimate the proportion of participants with grade 1, 2, 3, or 4 peripheral sensory neuropathies according to the U.S. National Cancer Institute's Common Termi...

Although it is a key-recommendation of all recent asthma guidelines, self-management education is still insufficiently offered in primary care settings. To demonstrate the benefits of an educational program offered at the site of primary care (Family Medicine Clinics- FMC) by trained asthma educators on patient outcomes and healthcare use. This was...

We previously reported an increased prevalence of any congenital malformation among women experiencing moderate-to-severe asthma exacerbations during the first trimester of pregnancy, based on a study in which 90.1% of the cohort of women were social welfare recipients. This study re-examined the association between asthma exacerbations and congeni...

Our previous work on the association between maternal asthma and congenital malformations was based on cohorts formed by women with public drug insurance, i.e., over-represented by women with lower socioeconomic status, questioning the generalizability of our findings. This study aimed to evaluate whether or not drug insurance status, as a proxy of...

Background: Novel oral anticoagulants are available for the management of atrial fibrillation and are considered more convenient to use than warfarin. Objective: The main objective of this study was to describe patterns of oral anticoagulant use in the 6 months period following the availability of dabigatran at our hospital. Methods: A cross-s...

Background: Insulin is commonly prescribed to treat hyperglycemia in the hospital setting, but is associated with a risk of hypoglycemia. The objective of this study was to determine the incidence rate and risk factors for hypoglycemia and hyperglycemia in hospitalized patients receiving insulin. Method: Retrospective cohort study analysing 58,496...

Purpose Daily adherence to inhaled corticosteroid (ICS) regimens is one of the most important factors linked to achieving optimal asthma control. Motivational interviewing (MI) is a client-centered communication style that focuses on enhancing intrinsic motivation to engage in appropriate self-management behaviors. MI has been shown to improve a va...

Adherence to inhaled corticosteroids (ICS) is a major issue in asthma. This study aimed to estimate the accuracy of the days' supply and number of refills allowed, variables recorded in Québec claims databases and used to estimate adherence, and to develop correction factors, if required. We hypothesised that the accuracy of the days' supply for IC...

Introduction. Les anticoagulants figurent parmi la liste des médicaments à haut risque de l’Institute for Safe Medication Pratices, Canada (ISMP). Objectif. L’objectif de cet article est d’identifier les forces et les faiblesses et proposer des suggestions d’amélioration pour la gestion sécuritaire de l’anticoagulothérapie en établissement de santé...

Background: Current recommendations for managing persistent asthma during pregnancy when low-dose inhaled corticosteroids (ICSs) are insufficient include adding a long-acting β₂-agonist (LABA) or increasing the ICS dose. However, there are no data to help clinicians evaluate the safest regimen during pregnancy. Objective: We sought to compare th...

Background Asthma exacerbations are common during pregnancy with a prevalence as high as 51.9% among women with severe asthma. Objective To compare the treatment of asthma exacerbations in an acute-care setting during and outside of pregnancy. Methods We formed a cohort of women who sought medical care for an asthma exacerbation at a teaching hos...

Objectif Décrire la qualité de la maîtrise glycémique de patients hospitalisés à l’unité de soins intensifs (USI) d’un hôpital d’enseignement et traités par perfusion intraveineuse (IV) d’insuline. Méthode Cette étude rétrospective incluait les patients admis à l’USI et traités par perfusion IV d’insuline durant au moins 12 h entre le 1er août et...

Objectif L’insuline est régulièrement utilisée pour le contrôle glycémique des patients hospitalisés, mais elle est associée à des risques importants. Les objectifs de cette étude étaient de décrire les forces et les faiblesses liées à l’utilisation sécuritaire de l’insuline dans un centre hospitalier universitaire pour recueillir les propositions...

Recent asthma guidelines endorse the safety of long-acting β2-agonists (LABAs) and of mild and moderate doses of inhaled corticosteroids (ICSs) when required to control asthma during pregnancy, yet do not state a preferred medication within each class. To estimate the relative perinatal safety with the use of salmeterol and formoterol (LABAs) and t...

Background: Medication adherence reduces disease morbidity. Data regarding changes in a patient's adherence before and after hospitalization and how this hospitalization influences a pharmacist's interventions are scarce. Objective: To assess changes in adherence to cardiovascular and respiratory medications in the year preceding and following a...

Only one study has investigated the combined effect of maternal asthma and obesity on perinatal outcomes; however, it did not consider small-for-gestational age and large-for-gestational age infants. OBJECTIVES: To examine the impact of obesity on perinatal outcomes among asthmatic women. METHODS: A cohort of 1386 pregnancies from asthmatic women w...

Background: Asthma during pregnancy usually requires treatment with controller medications about which more safety information is needed. The objectives are to assess the impact of the use of long-acting β2-agonists (LABAs) and the dose of inhaled corticosteroids (ICSs) during pregnancy on the prevalence of low birth weight (LBW), preterm birth (P...

Objective: To compare adherence to, and persistence with, antidepressants (AD) in Quebec patients who are covered by private and public drug insurance. Method: A matched cohort study was conducted using prescription claims databases: reMed, a medication data registry for Quebec residents covered by private drug insurance, and Régie de l'assuranc...

Acute exacerbation of chronic obstructive pulmonary disease (COPD) is associated with an accelerated decline in lung function and a significant decrease in health status. Maintenance therapy with respiratory medications can reduce the risk of such exacerbations. To determine whether respiratory maintenance medications were being prescribed in accor...

To describe changes in inhaled corticosteroid use during pregnancy and markers of uncontrolled asthma, and to evaluate the association between them. Population-based, cross-sectional study. Three administrative claims databases in Québec, Canada. A cohort of 4434 asthmatic women (4920 pregnancies) who delivered their infants between 1990 and 2002 a...

Asthma and chronic obstructive pulmonary disease (COPD) have a significant impact on patients' quality of life, and community pharmacists may be able to help improve asthma control.1–3 Less is known about the impact of pharmacists' interventions on COPD outcomes.4

There are conflicting results concerning the impact of maternal asthma during pregnancy on perinatal outcomes. The present study investigated the associations between maternal asthma during pregnancy and the risk of a small-for-gestational-age (SGA) infant, a low-birth-weight (LBW) infant, and preterm birth. A population-based cohort of 40,788 preg...

PURPOSE: Daily adherence to inhaled corticosteroid (ICS) regimens is one of the most important factors linked to achieving optimal asthma control. Motivational intervieiwing (MI) is a client-centred communication technique that focuses on enhancing intrinsic motivation to change and supporting self-efficacy. It has been shown to improve a variety o...

Common measures of adherence to prescribed medications derived from administrative databases reflect both patients' and physicians' behavior, even if the measures are often interpreted as reflecting only the patient's adherence. Adherence to inhaled corticosteroids (ICSs) has been shown to be low among patients with asthma. To develop a new measure...

Compared to inhaled corticosteroids (ICS), better use of leukotriene-receptor antagonists (LTRA) may lead to a greater reduction in exacerbations among asthmatic children in real-life settings. To test this hypothesis, we used the Quebec administrative databases and identified a cohort of 27,355 asthmatic children aged 5-15 years in whom ICS or LTR...

To assess the use of inhaled corticosteroids in children with persistent asthma, including patients' adherence to these drugs and physicians' prescribing patterns, by using a novel drug adherence measure, the Proportion of Prescribed Days Covered (PPDC). Retrospective analysis. Two administrative claims databases in Quebec, Canada. Two thousand thr...

Four studies investigating the association between inhaled corticosteroid (ICS) use during pregnancy and perinatal mortality reported no significantly increased risk. These studies must be interpreted with caution because they have insufficient statistical power and a lack of adjustment for potential confounders. We sought to evaluate whether asthm...

It has been reported that adverse fetal outcomes are more prevalent in pregnant women with asthma than they are in women without asthma. In our study, we investigated the effect that the severity of asthma during pregnancy has on the risk of a small for gestational age (SGA) infant, low birth weight (LBW), and preterm birth. A population-based coho...

The association between maternal asthma during pregnancy and perinatal mortality has been investigated in 21 studies, and a significantly increased risk among asthmatic women was found in 4 studies. However, these studies have methodologic limitations, such as lack of adjustment for cigarette smoking, a major risk factor for perinatal mortality. To...

The are conflicting results concerning the impact of maternal asthma during pregnancy on perinatal outcomes. We investigated the associations between maternal asthma during pregnancy and the risk of a small-for-gestational-age (SGA) infant, a low-birth-weight (LBW) infant, and preterm birth using a large population-based cohort. A population-based...

The benefits of inhaled corticosteroids (ICS) in reducing the mortality related to chronic obstructive pulmonary disease (COPD) are controversial. To estimate whether ICS in monotherapy or in combination with long-acting beta(2)-agonists (LABA) reduces the mortality rate among COPD patients compared to those treated with LABA monotherapy. Using dat...

Although reassuring data exist on the use of low-to-moderate doses of inhaled corticosteroids (ICSs) during pregnancy, there are inadequate data for women receiving high doses. To investigate the association between doses of ICS during the first trimester of pregnancy and the risk of congenital malformations among women with asthma. We conducted a...

Background Little is known about current pharmacists' interventions related to drug counselling and monitoring in asthma, along with the barriers and facilitators to these, in the province of Quebec. Objectives To identify and explore organizational, relational and professional factors that influence community pharmacists' interventions in asthma...

To evaluate the relationship between maternal asthma, its level of control and severity during pregnancy, and atopic dermatitis (AD) and allergic rhinitis (AR) incidence in children. A cohort of 26 265 singletons born to mothers with and without asthma (1990-2002) was constituted by use of 3 Quebec databases. Mothers with asthma had to have receive...

The extent to which childhood asthma incidence is influenced by asthma control and severity during pregnancy is unknown. We have studied this association during the child's first 10 yrs of life. A two-stage, case–control study, nested in a cohort of 8,226 children of asthmatic mothers, was conducted using three interlinked databases of Quebec, Cana...

Factors influencing community pharmacists' interventions have been identified, but little information is available regarding these factors in asthma care. To describe the type and frequency of pharmacists' asthma care interventions and to identify factors influencing those interventions. A pretested, self-administered questionnaire was mailed to al...

Thirteen studies investigating the association between asthma during pregnancy and perinatal mortality reported generally no increased risk. Most of these studies should be interpreted with caution because they were limited in terms of statistical power. A study was therefore undertaken to evaluate whether maternal asthma during pregnancy increases...

Extensive literature exists on potential risk factors for childhood asthma. To the authors' knowledge, no investigators have yet attempted to disentangle the effects of those determinants within a single study setting. The authors aimed to evaluate the independent effects of 47 potential determinants (from the prenatal, perinatal, and childhood per...

The combination of inhaled corticosteroids and long-acting inhaled beta(2)-adrenergic-agonists has become the standard therapy for many patients with moderate to severe persistent asthma. Whether the differences between budesonide/formoterol and fluticasone/salmeterol translate into differences in treatment outcomes in a real life setting is unknow...

Recent studies have found that asthmatic women pregnant with a female fetus reported more symptoms and had slightly lower lung function than women pregnant with a male fetus. In order to further investigate this association, we studied the effect of fetal sex on maternal asthma exacerbations and the use of asthma medications during pregnancy. A lar...

Disclosure This study was funded by Bayer Canada Inc. Marie-France Beauchesne has participated in continuing education programs sponsored by the pharmaceutical industry, such as GSK, BI, Pfizer, and AstraZeneca. She has also received grants from Merck Frosst, GSK, and AstraZeneca for some of her research projects. Lucie Blais is a recipient of a N...

Marie-France Beauchesne1,2,3, Marcel Julien2,4, Louis-André Julien2,4, Dominique Piquette4, Amélie Forget2, Manon Labrecque2,4, Lucie Blais1,2,31Faculty of Pharmacy, 4Faculty of Medicine, University of Montréal, Montréal, Québec, Canada; 2Hôpital du Sacré-Coeur de Montréal, Gouin Ouest, Montréal, Québec, Canada; 3Endowment Pharmaceutical Chair Astr...

This study was conducted to describe the different antibiotics that are used in the home management of chronic obstructive pulmonary disease (COPD) exacerbations and to estimate the failure rates following the initiation of the antibiotic. A cohort study was conducted. Patients enrolled in a COPD home management program were included in the analysi...

To determine the effectiveness of theophyllines in real clinical practice on moderate to severe exacerbations. A cohort of 36,492 chronic obstructive pulmonary disease (COPD) patients aged > or =50 years was reconstructed from the health administrative databases of the province of Quebec, Canada, between 1 January 1995 and 31 December 2002 to compa...

Periodic measurement of disease control is recommended to characterize asthma and monitor treatment. To elaborate and validate an asthma control score (ACS) for use in studies based on administrative health databases. Adult patients with asthma were recruited from a clinic. The ACS is based on the average number of doses of short-acting inhaled bet...

Most asthma patients prescribed maintenance asthma therapies still experience periods of asthma worsenings characterized by daytime or night-time symptoms, or an increased need for rescue medication. In fact, these episodes are highly prevalent even in patients with well-controlled disease. Published literature suggests that asthma worsenings likel...

Most asthma patients prescribed maintenance asthma therapies still experience periods of asthma worsenings characterized by daytime or nighttime symptoms, or an increased need for rescue medication. In fact, these episodes are highly prevalent even in patients with well-controlled disease. Published literature suggests that asthma worsenings likely...