Government adds pharmacists into primary and community care

Adrian Dix
Photo by Chandra Bodalia

THE Ministry of Health is adding 50 new clinical pharmacists as part of primary-care network teams around the province.

These positions are being added as part of government’s new primary health-care strategy to deliver team-based care to all British Columbians.

“Fully utilizing the expertise of health professions and creating these new clinical pharmacist positions is another crucial step in establishing patient-centred, team-based care that addresses under-met needs, and gaps in care for patients dealing with complex conditions,” said Adrian Dix, Minister of Health.

The team-based clinical pharmacists will focus on working directly with patients with complex conditions, to reduce and manage medication-related problems, such as drug interactions, adverse medication side effects, duplicate medications, and help eliminate unneeded medications. The ministry is supporting this new developmental program, with $23 million over three years, and is working with University of British Columbia’s faculty of pharmaceutical sciences to manage the program.

“Embedding a clinical pharmacist in a patient’s primary-care team reduces the risk of adverse drug reactions, which rises with the complexity of the condition, a patient’s frailty, age and the number of medications prescribed. According to recent figures, over 600,000 British Columbians have a chronic medical condition of medium or high complexity, and 20% of those over 70 take at least five or more medications a day,” added Dix.

Through one-on-one patient care, these pharmacists will use their specialized knowledge to optimize their patients’ drug treatments through education and drug regimen adjustments with prescribers, so patients can realize better health outcomes and higher quality of life. These clinical pharmacists will also be able to promote safer and more appropriate prescribing by reviewing current evidence about different drug options with physicians and nurse practitioners in their team.

“Pharmacists play an important role in managing patients’ care and ensuring their medications are used to best effect. This innovative model, which integrates pharmacists into the primary health-care team, is fantastic news for British Columbians,” said Michael Coughtrie, dean of UBC’s faculty of pharmaceutical sciences. “Patients will benefit from the advanced skills and expertise that pharmacists bring. We are delighted to be working with the Ministry of Health on this important initiative.”

“Working together with local pharmacists has meant improved care for my patients,” said Dr. Eric Cadesky, President of Doctors of BC. “As physicians, we believe that pharmacists are important members of the health-care team in supporting chronic disease management and ensuring patient safety. When we all work to our scope of practice, we help each other provide the best quality of care for patients.”

By providing clinical pharmacist services directly in primary-care networks, patients will benefit, as their doctors, nurse practitioners and pharmacists work more closely together in team-based practices to share records and concentrate services around a patients’ specific health-care needs. In order to ensure the optimal care of patients, these new clinical pharmacists will also be working closely with other pharmacy service providers from both health authorities and community pharmacies.

UBC will recruit, train and coordinate the clinical pharmacists and evaluate the impact of this developmental program over the next three years. This will inform how primary care pharmacists can be best integrated and expanded into B.C.’s health-care system over the long term.

“Working with a pharmacist has been nothing but a positive experience for me,” said Linda Roseborough, a patient of the UBC Pharmacists Clinic. “The ability to have access to a clinician pharmacist who is able to take the time to understand my health and needs, and ensure I am receiving the right medications, tolerating them and adjusting them as necessary has made me confident with my care. Every patient should have a pharmacist as part of their primary care team, and I am thrilled that the great care I have received from my primary-care pharmacist will be available to many more patients throughout the province.”

At the heart of the Province’s new primary health-care strategy is a focus on team-based care that will see government fund these new pharmacist positions, in addition to recruiting 200 family doctors, and 200 nurse practitioners, to provide all British Columbians with faster and improved access to health care. Along with the creation of urgent primary-care centres, the strategy will put in place primary-care networks that link these centres, health-care providers, and community-based services and programs together to make it easier for comprehensive, co-ordinated care to be delivered.

 

Quick Facts:

According to the Canadian Institute for Health Information:

* In 2017, it is estimated that drug expenditures accounted for 16.4% of total health spending in Canada.

* Preventable medication-related illness and death in adults costs the Canadian health-care system an estimated $11 billion each year.

* Emergency department visits and hospital admissions, as a result of adverse medication-related events in Canadian seniors, is estimated to cost $35.7 million each year.

* Patients not taking their medications, as directed, are estimated to cost the Canadian health-care system $7 billion to $9 billion each year. Thirteen per cent of B.C. residents have chronic medical conditions of medium or high complexity, and represent 24% of health services.

* Currently, approximately 20% of B.C. residents over 70 years of age are taking at least five medications per day, and 16% are taking 10 or more.