Managing medications including ensuring the accurate use of prescriptions, avoiding adverse reactions, and juggling costs can be daunting for caregivers and individuals with chronic illnesses. In Canada, over 400 types of medicines are dispensed regularly, with another 1,600+ ordered on an as-needed basis. Adverse drug reactions (ADRs) are the primary reason for nearly two-thirds of all hospital admissions and emergency room visits. Approximately 14% of patients do not fill prescriptions due to cost. Finding and consistently working with a local pharmacist can help you avoid problems and navigate these challenges. It will also add an invaluable member to your care support team.
The Role of Pharmacist
Highly trained professionals, with at least six years of training, and licensed through provincial bodies and the College of Pharmacists, pharmacists are experts on the treatment of disease through the application of medicines. By using only ONE pharmacist (ideally) or pharmacy on a consistent basis, both you and your care recipient can receive the full benefits of their knowledge and services. This includes:
* A complete review of all your care recipient’s medications every time a new or existing prescription is filled. This helps ensure that there are no accidental changes or potential interactions.
* Monitoring for potential medication interactions and side effects. This is important for older adults, as drugs tend to affect them differently and they are more likely to be on multiple medications.
* Extension of certain existing prescriptions if you run out, as well as connecting with your physician for refills and clarification if required.
* Recommendations on ways to administer medications, including blister packing and automatic dispensing programs to make it easier to remember dosages and frequency.
* Answers to questions about prescriptions: usage, side effects, potential interactions with over-the-counter drugs and supplements, proper storage and what to do if symptoms worsen.
* Advice on how to potentially reduce the number of prescriptions needed and the possibility of adjusting dosages, if needed, to suit an individual’s needs.
* Assistance in identifying and applying for specialized insurance plans to help offset the cost of certain medications.
Finding a Pharmacist to Match Your Needs
To identify the best pharmacist for your needs and to make sure you are able to take full advantage of their expertise and help, consider doing the following:
* Ask questions. Be in the know about why the person you are caring for is taking medications, and any potential side effects or interactions. The Canadian Deprescribing Network suggests five questions to ask your pharmacist, physician, specialist and/or nurse about any medication being prescribed:
1. Why is the care recipient taking this medication?
2. What are the potential benefits and harms of this medication?
3. Can it affect the person’s memory or cause them to fall?
4. Can they stop or reduce the dose of the medication?
5. Who do you follow-up with and when?
A good pharmacist should be able to address your questions and concerns in a considerate and timely manner.
Including Your Pharmacist to Your Care Team
* Inform your pharmacist about your care recipient’s needs and situation. This is particularly important when issues are complex, and/or there are foreseeable challenges to administrating the medication.
* Ask your pharmacist for advice BEFORE you visit your care recipient’s doctor in order to make the most of the next visit.
* Ask your pharmacy to fax lists of medications to family doctors, specialists, and dentists.
* If you are switching pharmacists, contact the pharmacy you want to transfer TO and that pharmacist will request the transfer of prescriptions and notes pertaining to your care recipient’s history.
* Apply for any applicable prescription assistance programs including Fair Pharmacare, BC’s income-based program for prescription medication coverage. While all prescriptions are submitted to Fair Pharmacare, BC residents must register, even if you are covered by MSP. To check if you are covered, call 1.800.663.7100 or go to https://pharmacare.moh.hnet.bc.ca. Your pharmacist can identify any prescriptions that are non-formulary (i.e. not covered) and those requiring a “special authority” (require physicians to apply on your care recipient’s behalf).
* Ask your pharmacist to help you understand how the different insurance programs overlap. Third party insurance providers, which often require proof of registration for Fair PharmaCare, generally follow Fair Pharmacare’s prescription coverage rules. However, some have their own forms for physicians to fill out in order to receive coverage for specific medications.
* Keep a list of current medications handy, and do not hesitate to discuss any unusual symptoms or concerns with your pharmacist, doctor and specialists.
Additional Resources Canadian Deprescribing Network, https://www.deprescribingnetwork.ca Adverse Drug Reactions in Canada, https://adrcanada.org