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Alberta pharmacists empowered by new regulations

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CALGARY, Alberta — “Our pharmacists are energized by these new powers,” says Stacy Johnson, director of professional pharmacy services at Safeway Pharmacy. Johnson was referring particularly to the situation in Alberta, whose pharmacists have so far been accorded the broadest powers. But Johnson says similar reactions in her professional staff are evident in the other provinces where the company operates and where there has also been a broadening of scope of the pharmacist’s role, though not yet to the extent of that role in Alberta.

Johnson oversees the pharmacy operations in Safeway’s 175 stores that have pharmacy departments spread across the four western provinces, British Columbia, Alberta, Saskatchewan and Manitoba, plus a few stores in the northwest corner of Ontario. The company was acquired by Sobeys Inc., the supermarket subsidiary of Empire Co., headquartered in Nova Scotia, in a deal that closed in the fall of 2013. The combined Sobeys and Safeway chains constitute Canada’s second-largest grocery operation.

“Since the introduction of the first of the new powers in 2007, pharmacists have had to take a new approach to their work, what they do with their day,” says Johnson. “They have to consider how they allocate their time between dispensing and providing the new services. The arrival of the registered technician category has, in situations where they are available, freed up the pharmacists to devote more time to interacting with patients, and that has been welcomed.”

Johnson says she considers that the amendment of regulations to authorize pharmacists to give injections constituted a real breakthrough in the process of changing the pharmacist’s role. “Pharmacists had to come out from behind the counter; it involved them in actually touching the patient. That function enabled pharmacists to develop the confidence that they now demonstrate all the time in their interaction with patients. It was really a stepping stone to their undertaking the other services the new regulations authorize.”

“The new powers have been phased in over several years, and in that time we have seen pharmacists’ confidence continue to grow,” Johnson adds. “I think they are particularly pleased with the reaction of patients. They see how much patients appreciate the convenience of being able to get an injection in the pharmacy, probably close to their home and at a time that suits their own schedules. Patients also see the benefits that result from their pharmacist delivering a comprehensive annual care plan or medication management assessment without their having to go through any other ­formalities.”

Johnson explains that patients do not necessarily request such services as care plans or medication management assessments, but they are usually receptive to the pharmacist’s suggestion that such an action is appropriate. The most frequently utilized services she lists are adaptation of a prescription, prescription renewal, immunizations and other injections.

Johnson describes the new services as “comparatively profitable,” but she says managing the financial aspects of the delivering of the services is still a work in progress. “We are still in the process of learning how best to achieve efficiencies with them — we are on our way to finding the sweet spot on the best way to deliver, but we are not completely there yet.”

Johnson says the pharmacists’ relationship with physicians, so far as their execution of the new powers is concerned, has gone well, perhaps better than some feared. “When the patient’s health is clearly the first concern of both the physician and the pharmacist and there is a frank exchange of views between them, a trust develops. In a typical good relationship the pharmacist has the courage to advocate without inhibition what he or she feels is in the best interests of the patient.”

Typical of the relationship that can develop is a situation reported to Johnson by one of her colleagues. An elderly patient had just had a new medication added to those he already was scheduled to take. The pharmacist sat down with the patient and his wife and went over the new medication care plan that was called for. The patient and his wife clearly gained through this explanation a better grasp of the implications of the new regime. What was unexpected was a subsequent call from the prescribing physician expressing his satisfaction with the understanding of the situation the patient and his wife had derived as a result of that pharmacist-patient interaction and his expressing his thanks for what the pharmacist had been able to accomplish.

Pharmacists are required to undertake specific training and certification to be able to carry out such functions as prescription adaptation and diabetes education. Johnson says the company encourages its pharmacists to qualify themselves appropriately, and there is progressively more adoption of such functions. “The early adopters show the way, really undertaking a leadership role, and their colleagues are often inspired to follow their models.”


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