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mars 16, 2018

I saw a Facebook post about how pharmacists provide more services than they used to. Is that happening in New Brunswick?


That must have been a post about Pharmacist Awareness Month. Every March, the Canadian Pharmacists Association celebrates Pharmacist Awareness Month. During this time, pharmacists across the country are encouraged to educate Canadians about the contributions that pharmacists make in the delivery health care.

I asked some patients what came to their minds when they thought about the role of a pharmacist in delivering health care, and all of them answered something about safely dispensing prescriptions. Given that Canadian pharmacies dispense over 600 million prescriptions per year, most patients naturally think of this service first. Indeed, pharmacists have received a tremendous amount of education and training to ensure that a medication being prescribed is safe and appropriate for a patient, and this is the primary task for many in the profession. However, in recent years, pharmacists’ scope of practice has expanded into several aspects of care which has improved the access and efficiency of many health services.

The injection of medications is one service that many patients have found beneficial.  Most New Brunswick pharmacists are trained to give intramuscular and subcutaneous injections of medications that their patients have been prescribed. Pharmacists are now vaccinating tens of thousands of patients annually against influenza and are also participating in vaccinations for shingles and some travel related illnesses. As well, some pharmacists in Saint John will soon be participating in a study in which they will be providing the TDaP (Tetanus, Diptheria, Perutssis) vaccine to their patients to see if pharmacist involvement improves overall vaccination rates within the market.

Patients often ask if vaccinations require prescriptions and many do. However, most pharmacists in the province are trained to prescribe for a variety of products, and several vaccines are included. On top of this, most pharmacists are certified to prescribe for a number of minor ailments (32 to be exact). These include a number of less serious medical conditions that don’t require lab or blood tests such as cold sores and uncomplicated urinary tract infections. Pharmacists do not have the ability to bill Medicare and so a small fee may be associated with this service.

Some pharmacists have additional prescribing privileges as the result of having entered into a collaborative practice agreement with a physician. A physician who is responsible for a patient’s care and authorized to prescribe drugs can have a written agreement with a pharmacist that allows he or she to order, manage or modify drug therapy according to the agreement. A perfect example of this is pharmacists in the province who are managing patients on the blood thinner Coumadin on behalf of physicians. Here, pharmacists are using a meter to measure the thinness of the blood and then using the results to alter the Coumadin dose either up or down to keep within a goal range. A physician writes the initial order and then has the ability to review the charts created by the pharmacist.

Within hospitals, pharmacists are also participating directly in the care of patients.  Several medications require dose adjustments according to factors such as kidney function, body weight or other medications the patient is taking that can interact. Many pharmacists are trained to make these adjustments so that the medication is safe for the patient. Furthermore, pharmacists commonly participate in rounds with other clinicians as a source of education on drug therapy when care plans are being developed for a patient.

Pharmacists continue to be the primary source for drug information for both patients and other healthcare professionals. For patients on multiple medications, it is a good idea to schedule time with your pharmacist to conduct review of everything that you are taking. Doing so ensures not only that you understand what your medications are for, but also that you are taking your medications at the right time of day and aren’t missing anything or taking a drug that your doctor is no longer prescribing. Talk to your pharmacist to determine if a medication review is right for you.

Ryan Kennedy (BSc., Doctorate of Pharmacy, MBA) is a pharmacist/owner at Jean Coutu in Saint John. His opinions expressed in this newspaper are published for educational and informational purposes only and are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis or treatment. Send your questions to