Calgary Co-op’s three clinical pharmacists are on the move. For Aileen Coutts and her colleagues, work days differ from those of most neighbourhood pharmacists.
By Talbot Boggs
Photography by Ken Yau
Instead of spending their time behind the counter of their home pharmacies, they spend their time travelling to other Calgary Co-operative Assn. Ltd. pharmacies in the city, meeting patients, conducting medication reviews, consulting with patients about their chronic diseases, giving injections or delivering other specialized services.
Calgary Co-op came up with the idea of appointing clinical pharmacists to travel to group pharmacies about a year ago. Each of the three clinical pharmacists is responsible for eight pharmacies in the network, which they visit at least once every two weeks. Patient appointments are set up in advance, so Coutts and the other clinical pharmacists can see up to 10 patients per visit. To accommodate busy patients, the clinical pharmacists also deliver services to patients while they wait for their prescriptions.
“The way I am working now really is a reflection of how the world of pharmacy is changing,” says Coutts. “With training, pharmacists are taking on more responsibility, and the government is recognizing this and allowing us to bill for these services. It’s a great way to use my specialized expertise, provide greater service to patients near where they live, and save pharmacies and the healthcare system money all at the same time. I can also refer patients to Calgary Co-op pharmacists with certifications in diabetes, travel health, women’s health, geriatrics and compounding.
“A lot of pharmacies today are facing cost pressures because of declining revenues from lower generic prices and other factors, so this is a great way that pharmacies can save money on maintaining staff with specialized professional qualifications and still provide services and counselling for patients that they normally wouldn’t get,” Coutts says. “We can meet patients and do the initial assessments, and the rotation system gives us the ability to do follow-ups and ensure the patient is progressing according to plan.”
Coutts is a Certified Respiratory Educator who is authorized to administer medication by injection, has her additional prescribing authorization and is a tobacco reduction educator, and she is currently working to become a Certified Diabetes Educator. One advantage of Calgary Co-op’s approach is that the clinical pharmacists are able to apply their professional qualifications to meet the needs of specific communities.
For example, in the lower socio-economic areas of Calgary where there are more smokers, Coutts is able to use her respiratory educator certification and tobacco reduction training to offer one-to-one individualized smoking cessation counselling and participate in respiratory clinics in conjunction with Peak Pulmonary Function Laboratories, an Alberta laboratories and medical specialty centres partner.
Coutts remembers one patient – a smoker – who was always tired and out of breath, but had never been diagnosed with COPD. Coutts suspected this was the problem and booked the patient into the spirometry clinic, where her condition was confirmed. Coutts sent a fax to the patient’s family physician with a request for the appropriate inhalers based on the confirmed diagnosis by Peak’s respirologist and COPD guidelines. “Since then, her quality of life has improved and she is able to go out without having to feel so tired and breathless so easily,” Coutts says.
The northwest part of the city, on the other hand, is home to a more affluent area where many people are educated, more proactive about their health and, accordingly, need different services. “This approach really allows me to use my training to the fullest, to target it to the specific community and therefore provide greater benefit to patients,” Coutts says.
“It’s really important that we are there to make sure patients have the right information to help them manage their conditions. This type of role is really interesting professionally, provides benefits to both patients and pharmacies, and mirrors how the business of pharmacy is evolving.”