ISSUE #34 cont'd -- Information about

THE PHARMACIST’S ROLE

I have a new pharmacist. Well, actually I have two. A husband and wife team in a new neighbourhood pharmacy – Pharmasave on Commercial Drive just at Charles Street. The pharmacists’ names are Kunakar and Ja and I’m liking them a lot. Their pharmacy is small and friendly. Local artists’ work on the wall, a kids’ play area and an immediate feeling of welcome the minute you walk in the door. They are right there to make sure you find what you need. When I told them about this blog they were immediately interested and put up a poster outside their store. They said they have customers that would definitely be interested in reading it.

So, I thought I would sit down with them and find out what a pharmacist actually does. Is he or she simply there to fill my medications and tell me where to find things in the store or is there more to their job than that? Of course I found out that there is a lot more and just lately the pharmacist’s role has been increased.

Last week I sat down with Kunakar and he generously gave me more than an 1½ hour of his time which I greatly appreciated. But even more so I came to appreciate just what he and Ja can do for me.

First of all, Kunakar pointed out how a pharmacist can help me. He believes that the pharmacist should be seen as part of a team of the professionals and experts who oversee my health. Above all, the pharmacist is an expert on medications – both prescription and over-the-counter drugs, as well as vitamins and alternative type of treatments. In turn, his or her knowledge can give me more empowerment, more information and control over what I put in my body for treatment and health. Finally, all of this information can be provided to all the other health professionals I see enabling them to do a better job as well.

The most important thing, and the topic we discussed the longest, is a new role Kunakar and Ja, as pharmacists, can play in my life. This is new legislation just brought in and it’s especially ideal with a pharmacist who runs a smaller pharmacy and has the time to do this.

Very soon Kunakar and Ja will be sitting down with me to do a complete “medication” review, going over all the medications I take plus over-the-counter drugs, vitamins and other treatments like Echinacea to strengthen my immune system, as well as immunizations I have had. They will be asking me all kinds of questions about what I take, what dosage, how it is working for me, any side effects, any specific problems with anything, any sensitivities or allergies, and any medical conditions (for example blood pressure problems or diabetes). With all of that information they might be able to tell me if any of what I take might interact with something else and cause problems for me, for example mixing a herbal remedy with a prescribed medication. They can also make sure I understand what I am taking and that I am taking everything correctly and in the right dosage for me.

But that’s not all. They can inform me of all kinds of things such as:

> how I can tell if my medication is working or not;

> how I can remember to take my medications;

> how I might manage any side effects;

> what to do if I miss a dose;

> how to open those damn (sorry) bottles more easily;

> how best to use any devices such as puffers for asthma or any creams or 

      ointments;

> how to store my medications;

> how to dispose of any expired or unused medications;

> ways to organize my medications at home;

> and any first aid supplies I should have on hand.

For really thorough information on record I also need to let my pharmacists know any time I have been recently discharged from hospital, any medications I was given while in hospital, or if I am about to go to hospital for treatment. I should also tell them if I am having trouble taking my medications.

Maybe you are fortunate and your doctor tells you all of this. But not every doctor has the time. A pharmacist, especially in a smaller pharmacy, may have just that kind of time and it’s all very valuable. This way all my information is in one place. Kunakar and Ja will record the information I give them in a computer program called PharmaNet.

PharmaNet is a provincial database with a record of every medication I am prescribed in BC. It is administered by the Ministry of Health and the College of Pharmacists of BC. It is used in community pharmacies, hospital pharmacies, emergency departments, medical practices, the College of Pharmacists of BC and the College of Physicians & Surgeons of BC.

PharmaNet is not to be confused with PharmaCare which is the government plan that covers payment of medications. This includes being covered on the Medical Services Plan of B.C. (MSP) and Plan G which is for people who cannot afford their psychiatric drugs. (For more information about this plan go to http://www.health.gov.bc.ca/pharmacare/plans/index.html#plang)

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Something else my pharmacists can do is called “adaptation”. If I have been on a stable treatment for a chronic medical illness for at least 6 months and, for some reason, I can’t see my doctor but I need medication now, they can renew my prescription for up to 1 year without getting my doctor’s consent first. Of course, for pure courtesy, they would want to let my doctor know that this has been done. They should also do a follow-up down the road to see how it’s going. However, they can’t do this with certain types of medications such as narcotics, antibiotics, any type of medication that tends to be abused (such as benzodiazepines), or any other psychiatric drug. In exceptional cases, and depending on the professional judgment of the pharmacist, an emergency prescription refill may be dispensed in order to ensure continuity of treatment.

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One of the things I’m particularly pleased about is that Kunakar and Ja do what is called “speciality compounding”. I’m on an antidepressant called Paxil and I would like to slowly decrease it and possibly get off it altogether at some point. I have tried a number of times to cut down those little pink pills as small as possible but still I feel depressed within a day. What they can do though is do a special powder or liquid of the Paxil so I can decrease it in very tiny amounts making the effects and adjustment minimal. In short, they can prepare a medication, not available commercially, that would be, specifically for me. They can compound tablets, capsules, powders, lozenges, suppositories, creams, lotions, solutions, syrups and more.

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One more thing I would like to tell you about, and it is extremely important if I want my pharmacists, and my GP, to help me with my medications. It’s my part of the work. My role. When giving information to my pharmacists or my GP I need to be as specific as possible about everything. If I am experiencing side effects from something I need to tell them exactly what the effect is. For example, if I get a stomach ache every time I take an antihistamine I should describe specifically what it feels like. Is it a sharp pain? Is it a dull ache? Do I also feel nauseous? How long does it hurt? How soon after taking the drug do I get the stomach ache? Information like this can be even more valuable as my pharmacists (or GP) can then possibly pinpoint what is going on and may be able to recommend something to help. And as well as any physical symptoms I experience I can also let them know about any emotional symptoms that seem to occur after taking certain medications, or even vitamins. Tell your pharmacist and/or GP everything you can think of that seems connected to your medications.

I hope this interview and article might inspire you to go talk to your pharmacist and find out what he or she can do for you. Knowing more about what we put in our bodies gives us more power to make decisions about our own health. It’s our body and mind after all.

Caer Weber