Expanded role for pharmacists means better patient care, experts say

Depending on the province you live in, your pharmacist can prescribe or take away medication, order and interpret lab tests and vaccinate patients. (Photo by Adam Berry/Getty Images)

TORONTO — Depending on the province you live in, your pharmacist can prescribe or take away medication, order and interpret lab tests and vaccinate patients.

A string of changes enforced earlier this year is giving more autonomy to these frontline health care workers and a new article published Monday in the Canadian Medical Association Journal suggests the expanded role is providing a valuable extra set of eyes on patient health.

The move had been in the works for about a decade, as a fledgling idea that took off in Alberta and B.C., then seeped into Ontario and Quebec, article co-author Dr. Cara Tannenbaum said.

Tannenbaum is a geriatrician and the inaugural Michel Saucier Endowed Chair in geriatric pharmacology at the University of Montreal.

“Over time for various reasons, even though pharmacists are trained in what different drugs can do they’ve become more of dispensers of medication and it’s been very frustrating,” Tannenbaum told Global News.

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“It really has been even more than 10 years that pharmacists feel the expertise they possess should be more valued by other health professionals and patients,” she said.

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Now, pharmacists can fill prescriptions without a doctor’s request, which could help if the doctor is on vacation or out of reach, for example. Pharmacists can also rescind prescriptions, especially if they notice that the drug could interact with other medications.

“Before if a pharmacist received a prescription, if the doctor wrote the prescription the pharmacist had to fill it,” Tannenbaum said. They’d flag the prescription and any concerns for the issuing doctor, though.

Pharmacists can also swap medications to resolve potential drug interaction or side effects and they can alter treatment based on their own testing. He or she could test a patient’s blood pressure before changing dosages for medication instead of waiting on a doctor’s appointment.

Read the full CMAJ article here.

“These regulations allow pharmacists to really step up and share in patient care rather than just dispense medication. All of this is very good,” Tannenbaum said.

She teaches in the Montreal university’s faculties of medicine and pharmacology, often times lecturing both faculties on the same subject. The doctors’ lecture could include diagnosing and looking at symptoms before touching on treatment at the end, but pharmacists’ lessons are solely based on dosage, side effects and how medications interact.

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Patients across the board could benefit from the broadened reach pharmacists have now. During flu season, for example, pharmacists in some provinces could play a role in making it easier for patients to get their annual flu shot.

But it’s seniors and Canadians with chronic conditions, like high blood pressure or diabetes, that could reap the most from this new help. This is because these groups may be taking more medications – once people take more than five to treat their conditions, the risk of adverse side effects climbs dramatically.

One of out every 200 seniors across Canada is hospitalized because of bad reactions to the medications they’re taking to keep them healthy, a Canadian Institute for Health Information report released earlier this year warned.

Read more: Canada’s seniors face high rates of hospitalizations from adverse drug reactions

A critical element to the success of cross-collaborating with fellow health care workers is the idea of “shared care,” Tannenbaum said.

For these changes to flow seamlessly, doctors, pharmacists, physiotherapists and any other specialists with a hand in a patient’s care need to communicate.

This could be trickier in some provinces – Quebec, for example, doesn’t have province-wide electronic health records set up yet.

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Phil Emberly, director of pharmacy innovation at the Canadian Pharmacists Association, said the changes should resolve backlog.

On weekends when he’s on shift at an Ottawa pharmacy, patients may come in requesting an urgent refill, but pharmacists had to get in touch with the doctor.

“In the past it was absolutely mandatory in every situation when a patient came in asking to have their prescription renewed, pharmacists had to contact their doctor by phone or fax for authorization,” Emberly said.

“It made it difficult to do this in a timely matter. ”

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