Clinical Pharmacology & Toxicology

Division of the Department of Medicine at McMaster

Outstanding Features
The Division of Clinical Pharmacology & Toxicology (CPT) is one of the smallest in the Department but maintains the highest level of academic activity per member. Our division specializes in the development, critical appraisal, health technology assessment, appropriate utilization, and regulation of medications. Given that there are more than 10,000 drugs on the Canadian market, this requires extensive expertise. We maintain a wide range of clinical, educational, research and drug policy activities, as well as a variety of health care system leadership roles.

Clinically, our members are regular attendings on Internal Medicine CTUs at both hospital corporations, as well as Critical Care at St Joseph’s Healthcare Hamilton, Geriatrics services in Hamilton and Waterloo, ambulatory Rheumatology in Niagara region, and Emergency Department at HHS.

This year, we launched a formal Clinical Pharmacology Inpatient Consult Service at SJHH, with regular consultations as well as hospital-mandated reviews of expensive nonformulary medications, severe adverse drug reactions, and high dose opioid prescribing.

We play a major role in education with year-round supervision of medical students and residents, active supervision in undergraduate and postgraduate education at the Masters and Ph.D. level in health research methodology, medical sciences - pharmacology, eHealth, health sciences, and statistics. Members have won several education excellence awards and include or have trained current deans and vice-deans at Canadian universities.

The division leads research aimed at improving the quality of prescribing and medication utilization, including randomized management trials, observational studies using large health databases, systematic and scoping reviews, and qualitative studies. We maintain ongoing grant success at the CIHR level, and many of our members have been supported or are supported by highly competitive personnel awards. Our graduate and undergraduate students continue to receive recognition for their high-quality research. Our research benefits from direct practice and policy impact, given our many drug policy contacts in government, patient safety, and health technology assessment organizations.

One of the unique features of CPT is its involvement in health policy. Members provide leadership at federal, provincial and regional public pharmaceutical policy bodies, including assessment of new and old medications for reimbursement using best evidence on cost-effectiveness, formulary management, national pharmacare recommendations, methods for medication price-setting using international comparisons, decision support on medications for providers, etc.
Highlights This Year
Two major areas to highlight: First, the long-awaited Clinical Pharmacology Inpatient Consult Service (CPICS) which launched early in 2020, and will significantly expand our clinical, educational and research profile. We are actively working on the development of virtual visit consultation and follow-up patient screening and monitoring templates, initially concentrating on high-risk medications. Second, the division is actively recruiting a new faculty member with combined Internal Medicine – Clinical Pharmacology & Toxicology training. The recruitment notice can be found here.
Future Directions
Since drug therapies are an increasingly prevalent, complex and costly sector of health care, specialists with training in medicine, clinical pharmacology and evidence-based therapeutics, are in high demand but critically short supply. Thus a major immediate goal of the division is the recruitment of new members to allow us to address the significant needs within healthcare for therapeutics and toxicology consultation, within the university for undergraduate and postgraduate clinical pharmacology education, and to expand our involvement in health policy and research where unmet opportunities abound.

Dr. Anne Holbook, Division Director
Dr. Anne Holbook, Division Director

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