By Jack Kohane
At a time of profit squeezes in retail, there’s still some scratch to be had in the allergy category. It’s certainly a key department in Jack Halpern’s pharmacy. “The allergy section is very important in our business,” says the pharmacist/owner of a 1,000-sq.-ft. Peoples Drug Mart, located inside a busy midtown Toronto medical clinic. “That’s because seasonal and food allergies affect so many people, from young children to teens to seniors. It’s always a good starting point for pharmacists to discuss a patient’s lifestyle issues and any medication concerns.”
Halpern takes the initiative in counselling his allergy-suffering patients. “They often self-treat mild to moderate allergies, asking us for guidance about which OTC antihistamines, decongestants, combination products, or nasal sprays work best. I believe that effective counselling must be patient specific; however, there are counselling tips that apply to all patients.”
At times he feels like a detective. In trying to identify the culprit, Halpern encourages patients to keep a log regarding symptom onset, time of day, and environmental surroundings. “That helps narrow the list,” he nods.
Sales of allergy medications in Canada are widening. According to Ipsos Reid, the OTC allergy market in Canada is roughly a $190 million business, growing by 2-3 per cent per year. The key drivers of market growth: the growing incidence of allergies (seasonal and non-seasonal allergies) and longer lasting and more severe seasons (pollen and ragweed seasons).
“Pharmacists can play a role in managing the OTC allergy category by conveying up-to-date and accurate information for allergy sufferers,” says Kent Hatton, director of marketing, upper respiratory for Mississauga, Ont.-based Bayer. “Pharmacists can ensure they are well stocked with a variety of products to address different allergy symptoms and severities throughout different seasons.” Especially during peak allergy season in the spring.
Bolstering OTC sales is a recent spate of switches from prescription allergy medications to over-the-counter. According to statistics published by Euromonitor International, a UK-based market research firm, nasal sprays have experienced one of the fastest growth rates (20 to 25 per cent of Canadians suffer from allergic rhinitis), an increase of 4 per cent.
May is Food Allergy Awareness Month.
In the management of adverse reactions associated with food allergies and insect bites, epinephrine is the drug of choice to reverse the symptoms of anaphylaxis. So far, there is no cure for anaphylaxis – avoidance of allergenic food(s) is the only way to prevent an allergic reaction. Food Allergy Canada reports that about 2.5 million Canadians suffer from at least one food allergy, and the incidence is highest among young children (under three) with close to 6-8 per cent affected by food allergy.
Canadian allergists advise that an epinephrine auto-injector (such as EpiPen, distributed in Canada by Pfizer) is the first line of treatment for anaphylaxis and should be used first, before asthma puffers or any other medications.
“Pharmacists are the last step – sometimes the only one – in acquiring an EpiPen,” says Manon Genin, senior manager, corporate affairs, for Pfizer Canada Inc., headquartered in Kirkland, Quebec. “They play a critical role in helping patients understand the signs and symptoms of anaphylaxis and educating them on the proper use of their device. Even patients who are simply renewing their prescription for EpiPen should be reminded and retrained on its proper use.” This training can be as simple as reviewing the two steps of administration with patients and providing them with an EpiPen training device. Pharmacists, emphasizes Genin, “can ensure that patients understand the importance of having their prescription filled and renewed.”
“When dealing with allergies, prevention is always the optimal strategy, albeit a challenge,” pharmacist Jack Halpern acknowledges. But when prevention fails, effective pharmacist counselling for symptom management is critical. I can certainly recommend strategies to reduce mild allergy symptoms, but for more severe reactions, I advise patients to be evaluated by an allergist. Then as a team we can develop the right strategy for that patient.”
Jack Halpern’s top tips to counsel patients on allergies
- Get involved with your patients. Only by knowing them as people, not just as patients, will you enjoy a better appreciation of what’s going on in their lives.
- Ask patients open-ended questions to fully assess their current situation. Listen closely, then engage them in conversation to understand not only their illnesses but other factors that could be affecting their health.
- Stay abreast of current therapies to provide the most current care possible. The allergy category – especially seasonal allergies – is changing, with many new treatments available as OTCs. Study, read, learn.
- Always follow up with patients to help bring the care model full circle. Medication non-adherence is an enormous problem where pharmacists can play a role. Check in!