MSH HEALTH TIPS
A word with the pharmacist:
JUST WHAT THE DOCTOR ORDERED Ian Walker is a pharmacist with 29 years’ experience – 14 of them at Dale’s Pharmacy on the grounds of Markham Stouffville Hospital. He provides tips for managing medications, his team’s advice on side effects and the pharmacy’s ever-changing role. What does your pharmacy do? We ensure the needs of people entering the pharmacy are addressed. As well as dispensing prescription medicines we sell many other items including blood pressure monitors, diabetes blood glucose meters and many over-thecounter medications including vitamins, cough and cold product and analgesics. We also sell many home health care items and have staff that are trained to fit braces and support stockings. How has the role of pharmacy changed? The main role of the pharmacist and technicians is really not just simply putting pills in a bottle anymore. Our focus is to ensure what has been prescribed is appropriate and the dose is correct. There are so many other health care providers involved in the healthcare system today; people may go to their family doctor and get a referral to a specialist, whether a cardiologist, oncologist, urologist, gastroenterologist, dermatologist to name a few. Many times a new medication is prescribed to replace or be in addition to existing therapy. The patient may have been told
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Markham Stouffville Hospital Foundation
verbally by the other health care provider why but often doesn’t remember. So it is our job to make sure the whole puzzle is put together properly and the patient is taking the correct medication. We also provide scheduled one-onone medication reviews called a MedsCheck, where a pharmacist sits down with a patient to review all the medications the patient is taking. Technology has made medication histories and profiles easily retrievable. But it still requires someone with the knowledge of the medications purpose to determine if the therapy is appropriate: Does it duplicate something the patient is currently taking? Are there any drug interactions? These are some of the issues the pharmacist may address. In addition, pharmacies now administer flu shots and other vaccines not publicly funded that aren’t available at the doctor’s office. Instead of having to buy the vaccine and take it to the doctor’s office to be administered, people now have the option of buying it and having it administered at the pharmacy. What do patients need to be mindful of when it comes to their medications? Some people have memory issues, take many medications or their regimen becomes too complicated. For these patients we suggest and many physicians will order the medications to be dispensed in weekly blister packs which can be delivered on a weekly or monthly basis. So visually the patient or
caregiver can see exactly what medication is in the pack since the name and description of each medication is listed. If other family members are involved, all they had previously was a bottle to look at, now they can look at a date on the pack and say: “Well, your morning medication is still here, obviously you haven’t taken it.” What else should patients keep in mind? People should know what the medication has been prescribed for and the duration of the therapy – whether it is important to complete the prescription. There are many times where you assume the physician has told the patient exactly what has been prescribed and why. But many times this is not the case, for instance a patient may go to the Emergency Department for acute back pain and be prescribed pain medication and the patient often does not know if they are to complete all the medication or just take it until the symptoms subside. Again we try, to the best of our ability, to ensure the patient leaves knowing the reason the medication has been prescribed and for what duration and suggest following up with a family doctor if the condition does not improve. What should patients understand about side effects? This can prove challenging at times since printed information given to the patient when the medication is dispensed lists all possible side effects, even the ones that are extremely rare. We reinforce which ones are common and more likely to occur and what other ones to be aware of. I’ve seen it before: If we dwell on the potential negatives, people can be afraid to take the medication, and they don’t comply. Then they end up back at the doctor’s office or worse because the condition that they originally presented with hasn’t been treated. There are times though where we make suggestions and offer to call the physician to have a prescription changed if another medication may be better tolerated and provide the same end result. n