Travis Rieder, keynote speaker at last year’s Pharmacy U in Toronto, is an opioid addiction survivor. His book, In Pain, describes his journey from addiction to recovery. Here are some of his remarks from the 2019 Pharmacy U Toronto.
by Jane Auster
The theme of the 2019 PharmacyU Toronto conference resonated with a sold-out audience of engaged pharmacists. Through a diverse range of education sessions, attendees were able to learn about everything from making a difference with a smoking cessation program, and enhancing the prescription (evidence-based, high-quality natural health products to improve patient outcomes), to fulfilling pharmacists’ duty to opioid patients.
The day started with a powerful personal presentation by Travis Rieder, Assistant Director of Education Initiatives & Research Scholar at Johns Hopkins University, whose journey into opioid addiction began with a need for pain relief and descended into harrowing addiction. Here in Canada the numbers of opioid deaths are on the rise, and new strategies are required to handle this crisis.
Pharmacists have an important role to play in managing the opioid cycle through three key steps:
#1 Appropriate initiation
#2 Appropriate management
#3 Appropriate discontinuation
Here are just a few of the other PharmacyU Toronto highlights:
Pharmacists can also make a difference in patient obesity through nutrition and weight management counselling and strategies, said presenter Karen Riley, a consultant pharmacist providing medication therapy management services to patients in her community who also teaches for the University of Florida Pharm D and Masters of Medication Therapy Management programs. Obesity, she said, is no longer considered strictly a lifestyle decision. Factors such as family history, genetics, other health conditions, emotional factors all play a role in understanding this complex condition. Pharmacists are ideally positioned to take a more active role, and there are tools at their disposal to use. More pharmacists, she added, are using the smoking cessation 5As approach to help: Ask, Advise, Assess, Assist, and Arrange.
Pharmacists and caregivers – a new growth area
More and more caregivers are coming through pharmacists’ doors. In fact, there are 8.1 million caregivers in Canada, and this number is expected to grow exponentially with our aging population, said Mark Stolow, a social entrepreneur and changemaker and CEO of Huddol. Who are the caregivers? They are partners, clients, resources, allies in care. But who is caring for the caregivers?
Stolow said that pharmacists can play a much bigger part by supporting the caregivers as they support those close to them. “A great starting point is to make the caregiver part of the patient relationship. The caregiver needs to be an ally. Pharmacists can be involved (with caregivers) in making decisions about the choice of treatment, filling prescriptions, and ensuring adherence.” It’s all about acknowledging the caregiver as a partner in the patient’s healthcare management, recognizing caregivers as “peers in care,” and actively including them when communicating information about patients’ illness, management and treatment. This seems to be fertile new territory for pharmacists, as Stolow said he had not talked to any pharmacists who are actively tracking caregivers.
“There are opportunities to engage caregivers and win their loyalty. We did a Quebec pilot for pharmacists that included pharmacy training, development of a care kit, and creation of a multi-channel awareness campaign.” The pilot is expected to go cross-Canada in March.
Are you ready to adapt to new opportunities?
Kironmoy Datta led a panel discussion that posed this question to Chris Hartman of Ingersoll Pharmasave, Karim Ragheb, CEO of Liver Care Canada, and Stacey D’Angelo, pharmacist and co-founder of Wellth Pharmacy + Clinic.
“Impact, need and sustainability” are the three things Ragheb said he focuses on when he thinks of adding new services. “Focus on the patient experience,” advised Hartman. “People don’t necessarily say they go to a particular pharmacy but to a particular pharmacist.”
Social media should be added to any discussion of connecting with patients, D’Angelo said. Se regularly uses this as a tool to connect with patients, who are looking for more from their pharmacists.
In the past, pharmacists were the gatekeepers to drugs – that was their main function, said Ragheb. That is clear changing. “Pharmacists now have the authority to do much more.”
And, as D’Angelo added, “deprescribing is a big part of what pharmacists do now, believe it or not!”
Medical cannabis in the era of recreational cannabis?
Pharmacist Michael Kani, practising community pharmacist and owner of Michael’s Pharmacy in Saskatoon, Saskatchewan and a consultant to the Community Pharmacy Professionals Advancing Safety in Saskatchewan (COMPASS) program, explored this new world.
Is there still a role for medical cannabis now that recreational is more widely available? Medical cannabis has been around since 2001, while recreational marijuana only became legal in October, 2018. Where do pharmacists fit into this picture? By 2020 in Ontario, pharmacists will need to receive cannabis education – a move that may spread to other provinces.
It’s important to understand who is using medical versus recreational cannabis, Kani said. Those using medical cannabis tend to be older, wanting higher CBD but lower THC, and they are open to different forms of ingestion. Consumers of medical cannabis still want medical professionals involved in dispensing, and there continues to be less stigma around the medical version. Under the current cannabis act, pharmacists are not permitted to dispense cannabis, but that could change, and many pharmacists are showing an interest in exploring this new opportunity and being ready.
Even under the current legislation, pharmacists can play an important role, said Kani. “You can education parents and young patients about risks. You can identify risks and debunk myths. There’s no reason you can’t offer a cannabis consultation service. Pharmacists are well-placed to offer this service and use it as a gateway to other services.”
Pharmacists are ready to embrace the future!
Watch for updates on future Pharmacy U conferences at pharmacyu.ca