Contemporary Community Pharmacy Practice Notes
- Presenter Information: John Papastergiou, BScPhm, PhD, Community Pharmacist/Owner and Assistant Professor.
- Location: Shoppers Drug Mart, GTA, high volume store
- Demographics: Large, diverse, multiethnic population
- Volume: 200,000 prescriptions filled annually (Cash: 18%, Government: 47%, Third party: 35%)
- Competitors: Several local independent pharmacies
- Nearby Health Facilities: Large community hospital
Challenges in Access to Care
- Statistics:
- 6 million Canadians do not have a family physician.
- 29% can’t access their family doctor timely.
- 29% of family physicians are planning to retire or change careers soon.
- Impact: Increased non-urgent visits to ERs, creating a burden on emergency care.
Key Sources
- Commonwealth Fund survey, 2022 (CIHI)
Expanded Scope of Practice for Pharmacists
Historical Timeline of Changes:
- 2012: Authorized to initiate therapy for smoking cessation and renew/adapt prescriptions.
- 2016: Increased authority to renew prescriptions for up to 12 months, admin injections.
- 2022: Authorized to prescribe for 13 minor ailments.
- 2023: Authorization to administer 15 additional vaccines, including flu for those > 2 years old.
Current Authorizations:
- Administer flu vaccines to patients > 2 years old.
- Conduct 4 Point-of-Care Tests (POCT).
Public Perception and Trust in Pharmacists
- Positive Impression: 95% of Canadians trust pharmacists.
- Healthcare Role: 96% view pharmacists as first contact within the health care system.
- Post-Pandemic Role:
- Increased view of pharmacists' roles in chronic disease management, prescribing, and vaccinations.
Paxlovid Prescribing Data
- Statistics: Cumulative total dispensed as of March 26, 2023, totaled 144,990.
- Timeline: Introduction of community pharmacy dispensing in April 2022, with pharmacist prescribing starting in December 2022.
Opportunities for Pharmacists
- Public Health Impact: Pharmacists can address chronic disease management gaps through community pharmacy clinics.
- Pharmacy Care Clinics: 78 clinics across multiple provinces with over 152,000 patients receiving care.
- 35% of these were for chronic conditions.
Point of Care Testing (POCT) Overview
- Definition: On-site testing performed during patient consultation.
- Benefits:
- Allows for real-time clinical decisions.
- Engages patients in self-management and monitoring their health.
Market Insight
- Projected Growth: $81.37 billion market by 2028 largely driven by the pandemic and advances in technology.
- Prevalence: Over 620 Canadians are diagnosed daily with diabetes-related complications.
- Pharmacists' Role: They see diabetes patients about 15 times a year, offering more opportunities for timely assessment and intervention.
- Goals: Promote A1C screenings and Diabetes MedsCheck services.
Key Statistics on Diabetes:
- $82 million spent annually on diabetes care.
- Potential to reduce amputations significantly by closing care gaps through pharmacy interventions.
Pharmacogenomics and its Importance
- Definition: Pharmacogenomic testing helps in informed prescribing, reducing adverse drug reactions and costs.
- Evidence: Emphasizes the role of genetics and demographic factors in drug response and therapy effectiveness.
- Evolving Roles: Pharmacies must adapt to evolving healthcare needs, such as walk-in clinics and comprehensive chronic disease management.
- Patient Accessibility: Patients benefit from reduced wait times and improved healthcare access through pharmacist-led initiatives and technology integration.
Conclusion
- Final Thoughts: The expansion of pharmacists' roles combined with the increased public trust creates significant opportunities within the healthcare system, ensuring better patient outcomes and bridging gaps in chronic disease management.