The Tablet: 2011 August/September

Fourth-year rotations • Internet Rx • Treatment for IBS

the tablet published by the British Columbia Pharmacy Association

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www.bcpharmacy.ca

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Volume 20. No. 4

AUG/SEP G/S 2011

What’s new with

Medication Review Services

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Pharmacists going the extra mile

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Up close with Marshall Moleschi

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VOLUME 20. NO.4

contents Editor-in-Chief Kate Hunter 604.269.2863, kate.hunter@bcpharmacy.ca

30 up close

16 on the cover

Senior Editor Elise Riedlinger 604.269.2866,elise.riedlinger@bcpharmacy.ca Advertising sales Heather Sell, OnTrack Media 604.639.7762, tablet@ontrackco.com The Tablet is published by the BCPhA. Views expressed herein do not necessarily reflect those of the Association. Contributed material is not guaranteed space and may be edited for brevity, clarity and content.

BCPhA offices: #1530-1200 West 73rd Avenue Vancouver, BC V6P 6G5 telephone: 604.261.2092 or toll-free in bc: 1.800.663.2840 fax: 604.261.2097 toll-free fax: 1.877.672.2211 e-mail: info@bcpharmacy.ca web: www.bcpharmacy.ca

22 frontline pharmacy

Pharmassist: 1.800.667.2190 For confidential counselling referral for employment or addiction related assistance Publication agreement #40810576

Features 16

Cover Article: Medication Reviews

Columns

Regulars

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President’s Message Getting involved

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IMS Brogan Cost influences

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CEO’s Message Sustainability in Med Reviews

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Products in Focus Osteoarthritis treatment

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Internet RX HCG diets

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DPIC Treatment for IBS

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Financial Matters Summer to-do’s

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Frontline Pharmacy Fourth-year rotations

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Policy Trends Health hot topics

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Career Opportunities Find a job in pharmacy

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Professional Services Clinical pharmacy services

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Active Ingredients First pharmacy tech registrants

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Member Services Welcoming the Class of 2011

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Up Close Marshall Moleschi

New medsforme materials

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Giving Back Pharmacists making a difference

Got a suggestion for an article in The Tablet?

Email info@bcpharmacy.ca with your story ideas.

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Aug/Sep 2011

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SMALL TALK

In the news Welcome “aboard”

Meeting with the Minister

BCPhA is proud to introduce three members who will be joining the Board of Directors in September 2011, including David Pavan, a Pharmacy Project Manager with Canada Safeway; Allison Nourse, a Pharmacy Innovations Specialist with uniPharm Wholesale Drugs Ltd.; and Nadeem Zia, a pharmacist with the Surrey Memorial Hospital Pharmacy. BCPhA is looking forward to their insight and expertise in the coming year as the role of pharmacy practice continues to evolve in British Columbia.

On June 28, 2011 BCPhA CEO Marnie Mitchell along with other representatives of the Association had the opportunity to meet with BC Minister of Health Mike de Jong to discuss the latest developments in pharmacy.

BCPhA has established a positive partnership with the Ministry of Health over the last few years, leading to new innovations, expansions to the scope of pharmacy practice, and better health care for patients across the province.

2011 Commitment to Care & Service Awards The Pharmacy Practice and Drugstore Canada Commitment to Care & Service Awards are now looking for nominations for 2011. These prestigious awards, now in their 19th year, are truly a celebration of the important and often unrecognized work of individuals and teams in community and hospital pharmacies across the country. If you know someone who is going above and beyond in their pharmacy care and service efforts, you can find out more details by logging into the member section of BCPhA’s website and going to Industry Events & Notices under the Keeping You Informed tab.

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“This was our first opportunity to meet with Minister de Jong since he took on his new cabinet portfolio,” said Mitchell. “Our conversations were very encouraging and we look forward to continuing to build this relationship in the coming months.”

BC Health Minister Mike de Jong

These included initiatives such as the new Medication Review Services and examples of patient case studies which continue to demonstrate that clinical pharmacy services are key to ensuring British Columbians receive the best possible outcomes from their medications.

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MEET THE BOARD

Meet…Greg Shepherd the expanding scope of practice and delivering quality patient care across the province. Only by doing so can we ensure that payers recognize the value of this service to patients and to the health care system. Pharmacists can no longer afford to be complacent in the status-quo, but need to continue to demonstrate the valuable service we provide to patients.

To most of us, this means changing the way we practice pharmacy right now.

What are you looking to achieve as President of the Board for the following year?

Greg Shepherd has recently taken on the position of Pharmacy Coordinator with Pharmasave Drugs (Pacific) Ltd. Prior to this new role, he managed pharmacy operations for three Pharmasave locations in Vancouver. Greg graduated from UBC in 1997 and began his career in the hospital setting at St. Paul’s Hospital. A few years later he shifted his career to community practice, working in both management and ownership roles with Shoppers Drug Mart. He became a BCPhA Board Member in 2009 and is now looking forward to taking on the role of BCPhA President in September 2011.

It’s been an extremely busy last few years and we’ve seen so much change in the profession. I hope to help maintain this momentum and positive direction for pharmacy in BC. There are major challenges still ahead, and we need to ensure that we have a strong voice and strong partnerships to achieve success.

If you had a month off to travel, where would you go?

When I was 21, I spent a couple weeks in Europe, but saw mostly the larger cities and popular tourist destinations. I’d like to travel closer to the French Riviera, the Mediterranean, and definitely spend some time in the wine regions of France and Italy.

What are the biggest trends in pharmacy right now?

Who do you most admire and why?

As the ever-changing economic landscape of health care continues, we are seeing pharmacists stepping up and embracing

I admire people who are motivated and have the ambition to be successful, yet at the same time maintain a definite sense

of balance and take the time to enjoy life.

It’s hard to do, and I really admire people who know how to do it well.

What advice would you give to pharmacists just starting out in their careers?

Appreciate and respect the history of our profession, but actively embrace the future. A pharmacy career can be filled with so many opportunities, and there isn’t just one way to “be a pharmacist.”

Explore it and create your own future.

What would you be if you weren’t a pharmacist?

I’d probably change gears completely and do something related to music, like a music producer. Music has been a significant part of my life, and while I do play some instruments, I think the creative side of working with other musicians and producing would be extremely fun and rewarding.

What’s next for Greg Shepherd?

During my career so far, I’ve experienced many aspects of pharmacy practice and have learned things each step of the way. I’m at a stage now where I am able to draw from the past 14 years as a pharmacist and I really enjoy what I’m doing. The future of pharmacy is now, and if you don’t keep looking forward, you’ll be left behind. So now I am looking forward to where our profession is headed, and I am very satisfied doing what I can to be part of it.

Board of Directors Shakeel Bhatti, Langley 604.534.6605, shakeelbhatti@shaw.ca

Derek Desrosiers, Richmond 604.276.5236, derekd@unipharm.com

Victor Ikari, Ashcroft 250.453.2553, vistar@telus.net

Greg Shepherd, Vancouver 604.317.9608, gshepherd@pharmasavebc.ca

Anar Dossa, Vancouver 604.875.4111, Ext. 62184, dossa@shaw.ca

Ralph Lai, Langley 604.881.3882, ralph_lai@owfg.com

Bill Bright, Calgary 403.410.4805, bbright@shoppersdrugmart.ca

Ken Foreman, Cloverdale 604.575-5740, kforeman@pharmasavebc.ca

Linda Lytle, Vancouver 604.733.1345, apothecary@shaw.ca

Don Cocar, Kelowna 250.808.1308, don@dycksdrugs.com

Caren Heughan, Victoria (250) 388-5181, carenheughan@gmail.com

John Tse, Richmond 604.272.7650, jtse@londondrugs.com

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Aug/Sep Jun/Jul 2011

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SHAKEEL BHATTI

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PRESIDENT

Last words and new beginnings Getting involved brings benefits to all

This September I will have

completed my term as President of the Board of BCPhA, and I would like to thank all the staff at BCPhA and board members for their support and help with the many tasks and challenges we have encountered this past year. My congratulations to Greg Shepherd, our incoming President and to David Pavan, Nadeem Zia and Allison Nourse, our three new board members. Also, my thanks to Derek Desrosiers, Past-President, for his guidance and help.

This past year has seen some significant changes in community pharmacy practice, the medication management project, enhanced vaccinations scope, changes to adaptation rules and “best possible medication history”, to mention just a few. At such a time, it is especially important to be engaged in the development and implementation of these changes and I am glad to see so many BCPhA members attending our conferences and events and volunteering their time to help mentor, teach and guide their peers.

programs in the future, so if you have a skill or specialization that you are willing to share, simply contact the association.

Many years ago (28 to be exact) when I was in pharmacy school, I attended a meeting of the local branch of the Pharmaceutical Society of Great Britain (Welsh Division). The Dean of the school was also there and late in the meeting, when it came to election time, he asked me to stand for the board of the local branch. I was elected and since then have continued to be involved! In that time I have achieved some success, in academia, hospital practice, community practice and business – yet much of my own success can be contributed to the mentoring and support that I have received from the various

So, if you are truly serious about having a successful career, then take a leaf from my book, and get involved!

I want to take this opportunity to thank all the volunteers, trainers and mentors that are involved in our programs. They have been a boon to the association and their peers - thank you all, very much!

I would also like to encourage more members to get involved in the association; as an institution we are only as strong as our membership and their collective wisdom, so please, if you value the progress we are making, take part in it! Involvement can be as simple as attending association events and participating in peer-to-peer dialogue, or volunteering as a trainer or mentor for one of the association programs. There will be more

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pharmacists and non-pharmacists that I have met during these years of volunteering. So, if you are truly serious about having a successful career, then take a leaf from my book, and get involved! Stand for election, be a mentor or trainer, or be a volunteer. Be part of the progress of your profession.

I have truly enjoyed my year as your President, and I hope to continue my involvement with the association for many years to come. Thank you!

MARNIE MITCHELL |

CEO

Sustainability key in Medication Reviews Summer projects and changes

So here we go with the summer edition of the Tablet. While some of our work slows down a bit when vacation schedules take hold, there are still a lot of projects that are keeping us pretty busy. And you’ll have had a glimpse (or glaring reveal) of some of them.

The latest phase of the Pharmacy Services Agreement came into effect on July 4 in a fairly smooth way, with the maximum dispensing fee now up to $10.00 and the generic price level dropping to 40 per cent of brand. One unique element on this round is that government also chose July 4 as the implementation date for its new policies regarding loyalty points and inducements.

I’d like to make a few points on this. One is that this is strictly a government policy and was not negotiated with us either as part of the PSA, or separately. The second point is that BCPhA has not taken any positions on loyalty programs and accordingly, has remained neutral on the new policy. Finally, as patients who have benefited from loyalty programs in the past have become aware of the loss of those benefits, we’ve tried to assist with the communications challenges by encouraging that patients be directed to the PharmaCare Help Desk.

Another key change this summer is the new patient eligibility criteria for the Medication Review Services taking effect on August 1. For the remainder of this government fiscal year (until March 31, 2012) only patients taking seven separate drugs dispensed in the last six months will be eligible for a Med Review paid by PharmaCare. Why such a large change and what will it mean?

One of the results of working in close partnership with government is you share ownership for the projects you develop

together. On this one, it was clear from early monitoring of activity that pharmacy uptake was very strong. In many ways this is a really positive result. Time after time clinical services programs experience low uptake, even when the available remuneration is reasonably attractive. Your collective strong response showed enthusiasm and capacity to add new services to benefit patients in BC with understanding and optimizing their medications. The whole structure of the clinical services funding under the PSA was built on the premise that it would take some time to ramp up capacity to provide new services.

In this instance, the premise was incorrect, and by a large margin. Making some changes was essential in the interests of sustainability of the program.

Working with our partners at Pharmaceutical Services Division, we concluded that the best way to manage the unexpectedly high expenditure was to adjust the patient criteria which will have the effect of roughly halving the eligibility of patients for whom Med Reviews were conducted and claimed in the first three months of the program. Evidence does indicate that patients on more medications are more likely to be experiencing difficulties in managing their medication therapies and, consequently, more likely to benefit from Medication Reviews. We will be assessing the impact of this change in criteria going forward, and particularly as we work with PSD on developing the clinical services program for 2012/13.

If you have some thoughts on these developments, or anything else, why not share them on the member discussion forum by logging in at www.bcpharmacy.ca and going to the BCPhA Community tab. Enjoy the rest of your summer!

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IMS BROGAN

Cost influence and customers’ selection of pharmacy

By Jamie Foley and Michelle Yang

There are more than 8,500 retail pharmacies across Canada, approximately 1,000 of which are in British Columbia. Pharmacies offer a variety of different services, prices, convenience and shopping experiences. As a result, customers have a great deal of choice in terms of where to have their prescription filled. A person’s decision to visit a particular pharmacy is influenced by various factors, including total cost (drug cost and professional fees) and convenience, as well as the type and quality of services offered. This brief analysis examines the impact of prescription pricing on the individual customer’s store selection.

How does cost differ across pharmacy types?

The cost of a prescription can vary depending on the type of pharmacy. To help illustrate this point, the average total eligible cost by pharmacy type was considered for several top products1 and displayed in Figure 1. Evident in this table is that Food/Mass consistently shows the lowest cost, while the costs between Chain/ Banner and Independents are more varied. For example, the average total eligible cost per claim for Crestor 10mg is $53.34 for Food/Mass, $59.76 for Chain/Banner and $60.61 for Independents.

Figure 1: Avg. Total Cost2 and Avg. Professional Fee, Private Pay Direct Drug Plans, Vancouver, April-May 2011 Avg. Total Cost per 30 day Claim3 Food/Mass

Independents

Top Products

Chain/ Banner

Crestor 10mg

$59.76

$53.34

$60.61

Nexium 40mg

$93.72

$87.82

$91.99

A measure of the average professional fee per claim showed minimal differences by pharmacy type (Chain/Banner = $9.44; Food/Mass = $9.16; Independents = $9.19)4. If it is assumed that ingredient cost is constant, and given the relatively small variability in professional fees, it can be concluded that differences in the total prescription cost are being driven by pharmacy and wholesale mark-up.

Do more costly customers visit the same types of stores as less costly customers?

Having established the variability in cost associated with the three different types of pharmacies, two distinctive groups of customers were further examined based on their total annual prescription drug cost in the June 2010 – May 2011 period. The goal of this was to determine if cost influences the customer’s choice of pharmacy type5.

The groups were defined as Low (under $200 per year in claims) and High (over $2,000 per year in claims). These groupings accounted for 69.2 per cent (3,344,745) of all claims made by 73.3 per cent (453,359) of customers, and the gaps between dollar bands were selected to ensure distinction of each examined customer group. Provided in Figures 2 and 3 are the proportion of total claims and customers represented by each of these groups, and the distribution of those claims by pharmacy type.

Figure 2: Share of Claims and Customers by Group, Private Pay Direct Drug Plans, Vancouver, June 2010 – May 2011 54%

60% 40%

25% 20%

Cipralex 10mg

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$75.19

$68.57

$102.02

$94.66

$107.47

Avg. Prof. Fee

$9.44

$9.16

$9.19

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5%

$73.38

Plavix 75mg

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17%

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0% Low

High Share of Claims

Share of Customers

Figure 3: Distribution of Claims by Pharmacy Type and Group, Private Pay Direct Drug Plans, Vancouver, June 2010 – May 2011

it’s possible that a perceived difference in the services offered

by Independent stores versus other pharmacy types may be instrumental in this trend.

100%

50%

9%

13%

37%

33%

54%

53%

0% Low Independants

High Food/Mass

Chain/Banner

The proportion of claims at Chain/Banner was similar across customer groups (from 54 per cent in the Low group to 53 per cent in the High group). Conversely, the share of claims associated with Independent stores increases as the customer’s total cost increases (from 9 per cent in the Low group to 13 per cent in the High group), while for Food/Mass it decreases (from 37 per cent in the Low group to 33 per cent in the High group). Consider that customers with higher expenditure are usually i) taking an expensive drug that might have a complex administration, ii) are taking multiple medications and feel they need advice on how to take these appropriately, or iii) some combination of the two (Kozyrskyj et al., 2005). As a result,

Conclusion This preliminary investigation suggests that a customer’s pharmacy choice changes depending on their prescription drug expenditure, and while cost is an influential factor, there may also be other factors contributing to their decision. Additional investigations might examine how these results vary by demographic factors and disease state, as well as any potential influence specialty products may have.

Notes 1. Including Crestor 10mg, Nexium 40mg, Cipralex 10mg and Plavix 75mg 2. Total cost includes ingredient cost, mark-up and professional fee.

3. A 30-day claim is defined as any claim where the days supplied was reported as 30.

4. Note that professional fees will vary from store to story. The figures here represent an average across all stores in the group.

5. A customer’s total cost can be driven by the volume of drug dispensed, type of therapy, or a combination of these.

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CAMERON ZAREMBA | INTERNET RX

links to diet-related articles with sound advice and tips, such as: “5 Reasons Women Should Still Take Vitamin D”; “10 Things That Can Sabotage Your Weight Loss”; “Vitamins and Supplements: Do They Work?”, and “Diets that Promote Health (And Always Have)”. This is sensible information for anybody and everybody.

GLENN SCHOENROTH | FINANCIAL MATTERS

HCG diet information A few physicians in our area prescribe low-dose HCG (human chorionic gonadotropin) for weight loss. We also get frequent inquiries for supplies related to various HCG regimens that have been obtained presumably via the Internet – typically syringes and empty sterile vials to dilute the injection. So what is the appeal of HCG, and does it work? It may come as a surprise that the diet has been around since the 1950’s and the latest incarnation is pretty much identical to the original.

In a nutshell, the proponents of HCG claim that at low doses it specifically targets fat and spares muscle tissue when used in conjunction with an extremely low daily intake of 500 calories.

Weight loss is typically about one pound per day. It is used in cycles of 21 to 30 days duration. It apparently is supposed to act as a powerful appetite suppressant, making the hunger pangs less severe than expected for the calorie intake allowed.

Does it work? Well, yes, weight loss will occur – this is pretty much guaranteed if one restricts food intake to 500 calories per day for an extended period. Is it any better than other crash diets? It doesn’t appear to be. There were several clinical trials (many were randomized, controlled, and blinded) in the 80’s and 90’s that show no difference from placebo for overall weight loss, hunger suppression, and post-diet weight gain. A metaanalysis in 1995 of 24 trials concluded there was no evidence to support the claims of proponents. The studies used HCG by injection. A recent twist on the diet is the promotion of homeopathic sublingual HCG drops – which is puzzling because this actually flies in the face of basic homeopathic principles.

The drops are used in conjunction with calorie restriction, so weight loss is no surprise. Oh, the power of positive thinking!

Search “HCG diet studies” to track down the details mentioned above. A website I found quite useful for diet information is www.health.usnews.com/best-diet. Look on the right side of the page for a summary of today’s most popular diets, with comments on the pros and cons of each approach. There are

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Your summer financial to-do list Summer is a great time to look at all those financial to-do’s that tend to get put off when you’re busy. Here are five easy things to check off (between relaxing at the beach and firing up the barbeque): 1. Maximize your tax-free account. One of best tax breaks in years is the Tax-Free Savings Account (TFSA). With your TFSA, you can earn tax-free investment income, very similar to an RRSP. Any adult can contribute up to $5,000 annually to a TFSA, and contribution room accumulates starting from 2009. So if you haven’t opened your TFSA yet, you could contribute up to $15,000 now (as can your adult family members).

2. Maximize your tax-deferred account. While we’re on the subject of paying less tax, let’s not forget about your RRSP (or your Individual Pension Plan if you have one). Check your Notice of Assessment to determine how much you can contribute. Remember the earlier you contribute, the more you benefit from taxdeferred compound growth over time. So get a jump on your 2011 contribution! (You don’t have to wait until the deadline next year).

3. Take advantage of historically low rates on spousal loans. If you have a lower-income spouse, you may benefit from setting up a spousal loan arrangement. When properly set up, you can effectively transfer the tax liability on investment income to your

lower-income spouse, who pays taxes at a lower rate. The key here is to work with your legal advisor to properly set it up. Currently the Canada Revenue Agency-prescribed rate on spousal loans is just one per cent (until September 30, after which rates may go up). So now is a great time to consider this strategy.

4. Make a list of where you’re keeping all your financial information. If you have ever been involved in settling someone’s estate, you probably know how useful it is to have an inventory of all information pertaining to that person’s financial situation. Such an inventory would round up in one place information about your bank accounts, investment accounts, assets, insurance, pensions, and advisors. It can reduce the stress for family members when settling your estate, and make it easier for executors, trustees and advisors to do their jobs.

5. Put the “success” in succession. It’s a good idea to have a succession plan for your practice in case you have a health problem or worse, and someone else needs to take over either temporarily or permanently. And it’s definitely a good idea to have a succession plan if you’re approaching retirement age.

This article is provided by Glenn Schoenroth, B. Econ, CIM, Vice President & Portfolio Manager, RBC Dominion Securities, which is a member of the Canadian Investor Protection Fund. This article is for information purposes only. Please consult with a professional advisor before taking any action based on information in this article.

Glenn can be reached at 604-257-7196.

MIKE CUNNINGHAM | POLICY TRENDS

of BC is offering a weekly contest on its newly created Healthy Families BC website. Every week for six weeks, new registrants to the website will qualify for prizes worth up to $500 such as kitchen appliances and cookware, as well as be entered into a grand prize draw for $5000 worth of groceries and customized meal plans by a registered dietician. Healthy Families BC is the Ministry of Health’s health promotion and prevention strategy, targeted at reducing chronic diseases and obesity levels in BC through healthy eating and physical activity. The $68.7-million strategy will see the implementation of a variety of healthy living programs to improve health and promote wellness across the province.

And the Government taketh away . . .

Since July 4, 2011 pharmacies in BC are no longer allowed to offer incentives such as loyalty points or rewards on the portion of prescriptions paid for by PharmaCare. According to a June 29, 2011 Information Bulletin from the Ministry of Health, this new policy has been implemented in order to prevent taxpayer money from subsidizing these programs.

As part of the revised PharmaCare Enrolment Agreement that went into effect on October 15, 2010, pharmacies agreed to restrict the use of incentives to only the portion paid out-ofpocket by a patient. PharmaCare deferred this policy until July 4 in order to allow sufficient transition time for pharmacies.

British Columbians who are covered by an employer/unionpaid drug plan or who pay for drugs out-of-pocket will not be affected by this policy change.

Province supports kicking butts Nicotine replacement therapies will soon be available to all BC smokers at no cost and smoking cessation prescription drugs will be covered under PharmaCare.

Starting September 30, 2011, British Columbians will have the choice of either a free supply for up to 12 weeks of nicotine gum or patches to help quit tobacco, or obtaining coverage of prescribed smoking cessation drugs through PharmaCare. The program will cost an estimated $15 million to $25 million based on the number of individuals who participate.

Hot topics in health The Government giveth . . .

In an interesting twist on motivating British

Each year, more than 6,000 British Columbians die from tobacco use. The cost to the BC economy is approximately $2.3 billion annually, including $605 million for direct health care costs.

As part of the consultation, the government will look at ensuring that the provision of nicotine replacement therapies and smoking cessation prescription drugs is looked at through a rural lens, making sure products are accessible to all BC smokers regardless of where they live.

Columbians to make healthier food choices, the Government

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BCPhA Pharmacy Practice Development Program BCPhA has recognized the need to support community pharmacists in the transition towards clinical pharmacy services.

After listening to feedback, the Association has developed a pharmacy practice development program focused on clinical pharmacy services.

The program offers practical skills which can be easily implemented in the workplace. You will leave the workshop with the confidence and preparedness to deliver clinical pharmacy services and build long term relationships with your patients.

Whether you want to learn new competencies or refresh your current level of skills to support practice change, this course is for you.

Visit www.bcpharmacy.ca for full details and dates of our 2011 workshops.

If health, wellness and balance are important to you… build your career as a pharmacist in one of our growing number of stores.

As one of Canada’s most respected grocery companies, Thrifty Foods is committed to providing a complete range of Health and Wellness services to our customers.

Through our in-store Pharmacies, and in conjunction with our Vitamins and More departments, Thrifty Foods shoppers have access to knowledgeable consultative advice on a complete range of pharmaceutical and health/nutrition supplement products.

As a member of our growing team, you can expect a culture that values its employees and recognizes the contribution they bring to their work. That value and recognition is embodied in the respect Thrifty Foods has for an equitable work-life balance; a balance that actually affords you the time to build a career and have a life.

Bring your professionalism and your dreams to Thrifty Foods’ new frontier and become an important part of an important company as we grow together.

Contact us by email at: pharmacyrecruitment@thriftyfoods.com 12

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PARKASH RAGSDALE

|

DIRECTOR, PROFESSIONAL SERVICES

Value added clinical pharmacy services

BC pharmacists are offering more clinical pharmacy services to their patients than ever before, including best possible medication histories, resolution of drug related problems, administration of flu shots, and refills in convenient locations across the province.

Medication Review Services Update Pharmacists have again demonstrated a willingness to take on another clinical pharmacy service to improve patient care.

Over 50,000 BC residents have received a medication review service since the program launched April 1, 2011! Effective August 1, the patient eligibility criteria for Medication Review Services are changing (see page 18 for details). Queries from pharmacists and changes to the program have also prompted a revision to the Medication Review Services: Policies, Procedures and Guidelines for Pharmacists document, which is available on the PharmaCare website. It now clarifies the intent of and changes to the program, answers questions, and expands on details from the first version of the guidelines. In addition, more documentation tools for pharmacists will be included to assist the process of collecting and producing a BPMH for the patient.

BCPhA Pharmacy Practice Development Program Focus should continue to be on delivering quality health care in an effective and efficient manner. BCPhA’s Pharmacy Practice Development Program targets improving your interview and therapeutic relationship-building skills. The program will also address managing change within the community pharmacy setting. Throughout the program you will gain insight on delivering clinical pharmacy services, including Medication Review Services as instructors will demonstrate how to apply the lessons to practice scenarios. Furthermore, you will have the opportunity to practice these lessons yourself with standardized patients.

BCPhA has now run three successful PPD Program workshops with very positive feedback. Many participants reported learning or improving on foundational skills, many of which can be applied to Medication Review Services. Here are some changes participants plan to make as a result of the program: “Participate in more med reviews to improve outcomes for my patients”, “Build long-term therapeutic relationships”, “Change my ways in speaking with patients to allow for informed, shared decision-making” and “Be more involved with the patient’s medication outcome.” Don’t miss out on our next workshop on September 18. Space is limited to 40 registrants per workshop.

For more information or to register please visit www.bcpharmacy.ca

BC Medication Management Project Update As of July 22, 2011, 7,110 patients have been seen and 14,108 encounters have been documented, with the total value of services billed at $668,650. Feedback from pharmacists has highlighted some of the benefits of being part of the project, including best practice training sessions, having pharmacy assistants trained to support pharmacist delivery of clinical services, support of pharmacy practice leaders, and one-onone support from practice support consultants. All of these efforts are paying off as reported by a project participant who commented that she now has much more confidence and a higher acuity in identifying medication management issues with her patients than when the project began.

BCPhA Administration of Injections Workshops Get ready for the next flu season! Patients are expecting flu shots from their pharmacist more than ever before. There are now 1,200 authorized pharmacists in the province! Our July workshop in Vancouver is fully booked, but there are still spaces left for August 27 (Kelowna) and September 10 (Nanaimo). Get trained now to ensure you are ready to immunize this flu season!

For more details please visit www.bcpharmacy.ca

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PRODUCTS IN FOCUS

Health Canada approves first NSAID-PPI combination to treat osteoarthritis AstraZeneca Canada Inc. announced

The approval of VIMOVO was supported by data from a clinical development program, including results from the PN400-301 and PN400- 302 studies, which demonstrated that subjects taking VIMOVO experienced significantly fewer gastric ulcers and NSAID-associated upper GI adverse events, had significantly less treatment discontinuations, and as measured through patient reports of dyspepsia and heartburn, had better upper gastrointestinal tolerability compared to subjects receiving enteric-coated naproxen alone.2 Osteoarthritis, which affects three million Canadians,3 is the most common form of arthritis and is a degenerative joint disease caused by the breakdown and eventual loss of the cartilage of one or more joints. A common misconception is that arthritis is a disease of the elderly. In fact almost 60 per cent (58 per cent) of arthritis patients are under the age of 65.4 While many patients with osteoarthritis treat their symptoms with NSAIDs, 87 per cent of chronic NSAID-users are at increased risk of gastrointestinal (GI) complications.5 An estimated 1,900 Canadians die every year from complications associated with NSAID consumption.6 Risk factors for NSAID-associated upper GI clinical events include: age, history of GI events, concomitant use of oral corticosteroids and anticoagulants, high-dose/multiple NSAID use and concomitant use of aspirin.7 A new survey of Canadian osteoarthritis patients found 37 per cent of patients at risk of NSAID-associated GI complications were not aware they were at risk and the majority could not identify risk factors for developing GI side effects associated with NSAID use. In addition, 33 per cent of patients with osteoarthritis discontinued their GI medication because they started to “feel better” (45 per cent) and preferred to take less medication (40 per cent).8 Thirty per cent of respondents experienced GI complications as a result of stopping their GI medication continuing on their NSAID therapy.

For more information, please visit AstraZeneca’s website at www.astrazeneca.ca.

References available upon request; please contact the BCPhA Communications team.

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GIG3135

recently that Health Canada has approved VIMOVO® modified-release tablets for the treatment of the signs and symptoms of osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis and to decrease the risk of developing gastric ulcers in patients at risk of developing non-steroidal anti-inflammatory drug (NSAID)-associated gastric ulcers.1 VIMOVO is the first fixed-dose combination of enteric-coated naproxen, an NSAID, and immediate-release esomeprazole, a proton pump inhibitor (PPI).

Anyone can make an error.

Protect yourself.

Preventing dispensing errors and the potential injuries to clients is the focus of this educational series.

To help you understand and deal with these issues, Grain Insurance and Guarantee Company has commissioned a series of articles from Ms. Marie Berry, B.A., B.Sc. (Pharm), LL.B. Ms. Berry is a pharmacist and lawyer specializing in health care law. You can find her article at http://graininsurance.com/ pharmacy/page_bcpa.html For more information about the specialized insurance products that can protect all you’ve worked for, contact Stephen or Stuart Adams at 604-251-3571 or 1-877-251-4079, or email pharmacy@theadamsgroup.ca

CYRIL LOPEZ |

DIRECTOR, MEMBER AND CORPORATE SERVICES

A special welcome to our newest members – the class of 2011 “BCPhA must mean every one of you. Speak to your colleagues about the value of membership and invite them to join the team. The question is no longer why become a member, but, why not?”

On behalf of the rest of the membership, I would like to extend a very special welcome to our newest general members. It is a very special time, a new life ahead! You are now a registered health care professional! Embrace and enjoy the status!

You are also a leader in the profession, as you have chosen to become a BCPhA member. Thank you for honouring and contributing to the collective effort of members who have advanced pharmacy to its present status. Now maximize the benefits available to you. Once your application is processed, you will receive the Member Benefits Booklet providing details of the many benefits available, your membership pin (wear it proudly) and your plastic membership card (keep it handy to recall your membership number and renewal date). Later, you will receive your personal professional liability insurance policy and certificate from the insurer (keep this in a safe place).

Mark your calendars for the annual (three day) conference in Victoria’s Delta Ocean Pointe on May 24, 2012. Check out the 2011 event on our website to get a sense of the fun and learning you get in just two days. Besides, the sessions are eligible to count towards your PDAP CE-Plus requirements. This fall, we are also going to offer limited full conference registrations at a very special price!

You can subscribe to the Canadian Pharmacists Letter at a 40 per cent discount besides other professional journals and databases. Love travelling? Then you must check out the packages from UniGlobe Geo Travel - updated frequently and at competitive prices. Besides malpractice insurance, our program offers tenants protection as well. I changed my policy to Intact when I saw the cost and their coverage program – call Manjit at Adams Cambie Insurance Ltd to compare with your current policy. Our Individual and Group Extended Health Care Plans are among the best value for money. Our partners, Johnstone Benefits will assist you decide what works best for your needs.

OK, you got the certificate and the job. Now, instead of spending everything you earn like I did after my CA, develop a wealth management plan. The idea of working is to build wealth so you can retire, right? We have RBC Dominion Services and Financial Literacy Counsel to offer you complimentary advice on developing and maintaining a good financial lifestyle. That call will be time well spent. It may seem too early, sure, but is the smart thing to do, now. Ask me !!

Explore, go online at www.bcpharmacy.ca and check out the many resources available. With a single mouse click, you can access the many career opportunities available across BC, whether with an independent, banner or chain. Or, take charge of your career path and post your resume so our corporate members can find you. Both owners and job-hunting pharmacists call it a great service because it is offered to a targeted audience. Visit www.medsforme.ca as well. Make sure Thank you, new and continuing members, for supporting BCPhA. you participate in the BCPhA Wages and Benefits Survey to be released shortly. Benchmark your salary discussions with survey data. If you have not obtained your authority, register now for the next administration of injection workshop NEW CAR PURCHASE PLANS (next one in August). The flu season is round the member benefit partner All Makes & Models since 1985 corner. Seats are also filling for the Pharmacy Practice Development workshops that provide visit us online: Te l : 6 0 4 - 2 7 0 - 4 4 6 6 To l l F r e e : 1 - 8 8 8 - 3 8 5 - 4 4 6 6 training for Medication Reviews (next one in P R O GROU P B C . C A 39 0 H owa r d Av e. B ur na by, B C , V5B 3P 8 September).

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ON THE COVER | MEDICATION REVIEWS

New medsforme shelf talkers

Pharmacy Manager Goli Naghibi

The numbers speak for themselves about the success of Medication Review Services. More than 50,000 patients have had medication reviews since the launch of the services on April 1.

To help promote the services to patients, the BCPhA is working with the BC Ministry of Health to deliver medsforme materials to pharmacies throughout the province. The medsforme materials, which are being distributed to pharmacies in August, will promote the service and its beneďŹ ts to patients.

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More than 50,000 patients benefit from Medication Reviews

By Krista Martin

The promotional materials include medsforme bags that patients can use to bring their medications to the scheduled service, medsforme bagstuffers, and engaging shelf talkers.

Materials are available to all pharmacies in the province.

Pharmacies requesting additional materials may request the digital artwork to provide to printers or download a PDF version of the materials from the “Pharmacists” section on www.medsforme.ca.

Like many pharmacists, Goli Naghibi, is excited about promoting the new medsforme materials to patients. Naghibi is the Pharmacy Manager of Pharmalife Pharmacy in North Vancouver and has been a BCPhA general member since November 2009.

“Every pharmacist knows how to count pills, but the Medication Review Services are about stepping out and doing more. As a pharmacist, you want to be the person who is available to answer questions about patient health,” said Naghibi.

She recalls a diabetic patient who came in for the service at the end of May. The patient was taking three medications to help manage her illness. Despite being diligent in taking her medication, the patient was hypoglycemic and suffering from the shakes. Naghibi turned to Medication Review Services to investigate further.

“Being a diabetic is a full-time job with a lot of health risks associated with it,” said Naghibi. “We discussed her medications during a medication review and I confirmed that she was taking

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ON THE COVER | MEDICATION REVIEWS

the right ones, so I gave her a log book and asked her to keep track of when and how she was taking her medications. She logged her medication usage into the log book four times a day, measuring her blood sugar each time and also recording her diet.”

Still, the patient’s health was faltering and her condition remained unmanageable. Naghibi reviewed the dosage of her patient’s medication and consulted with the patient’s specialist before reducing her insulin intake by five units, also making dietary recommendations. The difference to the patient’s health and overall well-being improved drastically with each passing day. Ten days later, that small ripple produced a huge wave.

“Through the medication review, we were able to help her manage her diabetes and improve her overall health,” said Naghibi, who shared the Best Possible Medication History and log book with the patient’s specialist. Naghibi said the specialist was appreciative of the help and attributed the improved health status of the patient to the changes made by Naghibi in the review.

Naghibi’s success story is just one of many since the introduction of medication continued on page 19 reviews. These stories reflect the changing roles of traditional

New eligibility changes to the Medication Review Services In July, the BC Ministry of Health announced changes to Medication Review Services that came into effect on August 1, 2011.

Since the service was launched on April 1, the uptake from community pharmacists has substantially exceeded expectations.

As a result, the Pharmaceutical Services Division, in collaboration with BC Pharmacy Association, has introduced changes within the program – with the aim of creating a sustainable model that will support those patients who are expected to have the greatest benefit.

The changes came into effect on August 1, 2011 and are as follows: Patient Eligibility - A patient must have at least seven medications* that have been entered into PharmaNet within the last six months to be eligible for any of the three Medication Review Services. *Medications are defined as any prescription medication, non-prescription drug product, compounded drug product and injection that has a Drug Identification Number (DIN) or Product Identification Number (PIN).

New medsforme materials will be distributed throughout the province.

Naghibi at her North Vancouver pharmacy

In addition to the eligibility changes, there are also some changes to the documentation requirements and new templates developed to better capture the information required from patients.

Data gathered since the introduction of the services in April indicate that a significant portion of the population will still be eligible under the new eligibility criteria.

Full details can be found on BCPhA’s website at http://www.bcpharmacy.ca/ medication-reviews

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Top 30 Pharmacists

Medsforme is joining Facebook and Twitter Head over and check out the newly renovated www.medsforme.ca!

Medsforme.ca is now sporting three sections complete with relevant information for patients, health groups and

pharmacists. The site contains the latest news for Medication Review Services, BC Medication Management Project (BCMMP) and other clinical pharmacy services. You can catch up with colleagues and friends of pharmacy

through the new blog, and see the latest medsforme videos.

Go ahead and join the conversation online. Sign into Facebook and “like” our medsforme page and “follow” us on Twitter!

The BC Medication Management Project, which is slated to end January 2012 is still going strong. See below for the top 30 pharmacists who have provided service to more than 100 patients since the project’s launch in September 2010!

Congratulations to our top 30:

pharmacy and the rewards that come with them. While some pharmacists may find it challenging at first, more are feeling confident and are developing their own methods for incorporating the new services into their practice.

“We approach the medication reviews in two ways,” explains Naghibi, whose pharmacy is located in Capilano Mall. “When patients come into the pharmacy, we ask them to come back after store hours so the technicians can document the patient’s information prior to the appointment.

Naghibi’s tactic works well for the pharmacy, where customers frequently pop in to have prescriptions filled while they’re shopping. It also helps Naghibi focus her time with patients and ensure they are receiving the best service.

The personal touch offered by Naghibi helps patients take ownership for their health, a prime factor in the success of Medication Review Services for both the pharmacist and the patient.

John Shaske, ChristopherJuozaitis, Bernice Li, Cherryl Pacheco, George Pettie, Nadeem Zia, Nafisa Merali, Gurdev Hayre, Dona Radomsky, Laura Wilson, Christine Lo, Cindy Larsen, Kevin Cox, Lynn Pollock, Melissa Helmer, Alexander Tam, Maria Bucsit, Livia Chan, Oi Chi Wong, Jack Ran, Shelley Behl, Simin Mirpourzadeh, Victor Ikari, Erika Pfahl, Jolly Gill, Marie Stuart, Nancy Dyck, Roger Herrick, Jennifer Mah, Saira Mithani

“In our pharmacy, patients feel open to ask questions and this is what every pharmacy should be like. Counselling is important because it helps patients trust you and it makes them want to understand more about their health.”

Look out for the medsforme materials at your pharmacy in the upcoming weeks.

To find out how more about Medication Review Services, go to www.medsforme.ca or contact Krista Martin, Communications Specialist, 604-269-2867, krista.martin@bcpharmacy.ca.

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DPIC

Evidence of efficacy for treatment of Irritable Bowel Syndrome

By Karen Wlock BSc (Pharm), RPh, CSPI. Medical Review: Debra Kent, B.A., Pharm.D., DABAT

The bottom line Irritable bowel syndrome (IBS) is a chronic and usually intermittent disorder, characterised by episodes of pain associated with bloating and altered bowel habits, in the absence of any structural abnormality or organic lesion.1,2 In the developed world, IBS is the most commonly diagnosed gastrointestinal disorder, with prevalence in the general population estimated between 5 per cent and 25 per cent,1,3 with two-thirds of patients being female.3 IBS accounts for 12 per cent of visits to GPs and 28 to 36 percent of visits to gastroenterologists.3,4 Proposed pathologic mechanisms include post-infectious development, mucosal inflammation, visceral hypersensitivity of muscles and nerves, altered motility, altered central nervous system modulation of the gut, and imbalance of serotonin.2,5,6,7 Management of IBS presents challenges; patients become frustrated with coping with persistent symptoms and clinicians disappointed with limitations of therapeutic options.

No therapy has been shown to alter the long-term natural course of the condition and no gold-standard for treatment exists.8 As symptoms fluctuate over time, treatment is often directed at managing predominant symptoms when they occur. 9,10 What’s the

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evidence of efficacy for available therapeutic options?

Fiber and bulking agents - are often recommended.11 A review of 17 RCTs (n=1363) revealed that soluble fiber (psyllium, ispaghula, calcium polycarbophil) was more effective than placebo for reduction of global symptoms and constipation, whereas insoluble fiber (corn or wheat bran) showed no significant difference compared with placebo, and in some cases worsened clinical outcome; no evidence was found suggesting either type of fiber resulted in relief of pain.12 Another review of 12 RCTs (n=591) evaluating therapy with psyllium, ispaghula, bran, or unspecified fiber showed no significant effect when only high-quality studies were included (seven of 12 RCTs).11,13 A Cochrane review of 11 studies using fiber showed a lack of benefit for pain, global assessment or symptom score.14 Antispasmodics - may be tried empirically and are usually scheduled before meals for patients with postprandial pain or “as needed” for acute attacks.15,16 Reduced colonic diameter and increased small bowel transit time have been documented in IBS.13 Antispasmodics may decrease pain and stool frequency by reducing contraction of the colon and transit time13,15 and are considered first

line therapy.17 A review of 22 RCTs (n=1778) comparing 12 different antispasmodics (including pinaverium, trimebutine and dicyclomine) showed a statistically significant effect of therapy; persistent symptoms occurred in 39 percent and 56 per cent of patients receiving treatment and placebo, respectively (NNT=5).13 When specific agents were assessed, pinaverium (3 RCTs, n=188) showed a statistically significant effect of therapy; persistent symptoms occurred in 28 per cent and 61 percent of patients receiving treatment and placebo, respectively (NNT=3).13,14 Trimebutine (3 RCTS, n=140) did not show significant benefit.13,14

also cause relaxation of the gastroesophageal sphincter, which may cause gastroesophageal reflux; therefore, enteric-coated (EC) products are often used to bypass the upper GI tract, and limit effects to the lower GI tract.21,22 Some evidence exists to suggest that EC peppermint oil capsules may be modestly effective in reducing pain, bloating and gas associated with IBS.5 A metaanalysis of four RCTs (n=392), with one study using EC capsules, revealed a statistically significant effect of treatment compared to placebo, with persistent symptoms in 26 per cent and 65 per cent of patients receiving treatment and placebo, respectively (NNT=2.5).11,13

Loperamide – is considered the antimotility agent of choice for diarrhea. Most clinicians suggest use of this agent “as needed”; however, for severe diarrhea scheduled dosing for a short time may be required.15 It may prevent diarrhea when taken prior to a meal or an activity, which often leads to this symptom.10,15,17 Two RCTs (n=42) evaluating loperamide in IBS with diarrhea showed that 100 per cent of loperamide-treated patients had improved stool consistency, but there was no greater effect compared to placebo for relief of pain, global symptoms or bloating.11,15

Probiotics - are live microbial food supplements containing lactobacillus and bifidobacteria, which retain viability during storage and transit through the stomach and small intestine.4 These bacteria multiply and live on the surface of epithelial cells in the small intestine, and act as a barrier to harmful microorganisms by producing substances with an antibiotic effect, as well as stimulating immune processes.4 Compared to controls, patients with IBS have been shown to have significantly lower concentrations of lactobacilli and bifidobacteria, and higher concentrations of Streptococcus, E. coli and Clostridia.23 Bacterial overgrowth of the small intestine occurs in up to 78 per cent of patients with IBS and may be directly responsible for development of symptoms.23 It is thought that fermentation, with formation of hydrogen, methane and carbon dioxide, results in distention of the small intestine, and production of the sensation of bloating, discomfort, and disruption of motility.23 By increasing the concentration of probiotic-type bacteria and decreasing the concentration of Streptococcus, probiotic therapy has been documented to modify fermentation in the large intestine.23

Laxatives – No RCTs have been conducted, comparing laxatives to placebo.7,11 These agents may be considered for use in IBS with constipation.17 Fiber supplementation is 1.5 times more likely to relieve patients of constipation compared to use of placebo and should be tried before other laxatives.15 Antidepressants - As in treatment of neuropathic pain, increased pain threshold may be the mechanism of action of these agents; present data does not support improvement in co-existing depression as the cause for improvement of symptoms.18 TCAs are considered second line therapy in the U.K., if antispasmodics, laxatives or loperamide have not provided sufficient relief; SSRIs may be considered if TCAs are ineffective.17 A meta-analysis of 13 RCTS (n=789) assessing desipramine, trimipramine, amitriptyline, imipramine, doxepin, fluoxetine, paroxetine, and citalopram concluded that in the short-term, treatment is effective, with NNT=4 to prevent persistence of symptoms. TCAs and SSRIs were found equally effective.18 Another meta-analysis of five RCTs (n=>220) assessing SSRIs, including fluoxetine, paroxetine and citalopram, showed a trend for improvement of pain, however, there was no statistically significant evidence for improvement of pain, bloating or other symptoms.19 A Cochrane review of six studies using antidepressants showed a lack of benefit for pain and global assessment.14 Herbal Medicines - A Cochrane review of 75 RCTs (n=7957; range 45-453) evaluated effects of 71 different herbal preparations (single herbs or mixtures of two to 20 different herbs); some herbal medicines improved symptoms such as pain, diarrhea and/ or constipation.20 The methodological quality of the majority of the trials was generally poor; small, poor quality trials with positive findings are more likely to demonstrate exaggerated effects. The review concluded herbal medicines may be promising, however, it is premature to recommend their routine use.

Peppermint Oil - Menthol, in peppermint oil, may relax smooth muscle in the gut by a calcium channel blocking effect, and may

Two meta-analyses of probiotic therapy of 16 RCTs have been conducted.2,4 Combined data suggest a modest improvement in overall symptoms. A great number of limitations of the studies were identified including variations in measured outcomes, length of therapy, and number, type, dosage and strengths of probiotics, and lack of standardized diagnostic criteria and quality-of-life assessments.

Summary: Evidence of efficacy for most treatments of irritable bowel syndrome is weak. As most treatments are directed at the predominant symptoms and restricted to the time symptoms are occurring, agents providing effective short-term relief are desired.

Fiber, antispasmodic agents and peppermint oil may be effective to produce short-term relief in some individuals. With the limited therapeutic options currently available, decreasing and accepting, rather than eliminating symptoms, appears to be a reasonable goal for patients with IBS.10 References available upon request or visit http://dpic.org for more information.

DPIC Drug Info Service hours are 0900-1600 hours on weekdays.

Call 604-707-2787 in the Lower Mainland, or 1-866-298-5909 tollfree from the rest of BC

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FRONTLINE PHARMACY

Fourth-year rotations the view from both sides

By Lori Bonertz and Gina Chang

Lori Bonertz

Gina Chang

Gina Chang completed a fourth-year rotation at our pharmacy earlier this year. When I discovered that she enjoys writing as much as I do, we brainstormed an idea for a column that we could co-write. Discussing the preceptor-student dynamic seemed the obvious choice.

The preceptor’s outlook: Lori Bonertz Adult education has progressed a lot in recent years. We know that sitting in large lecture halls is not the best way to absorb information and not the most satisfying way to teach. We’ve seen continuing education evolve, being offered in an array of formats and incorporating case studies and real-life situations. However, many of us now fulfilling the role of preceptor were not taught how to teach. While the UBC students come prepared to complete a number of assignments and activities, I feel I can use more guidance.

While there are not many references specifically on teaching pharmacy students, we can extrapolate from general adult education resources, guides for teaching medical students, and even parenting manuals and sport coaching courses. One excellent web site is: http://medicaleducation.wetpaint.com/

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Tips for teachers: •

Model the skills you want the learner to develop, e.g. motivational interviewing, active listening.

•

Be enthusiastic.

•

Provide feedback often and be specific. “You explained the possible adverse effects of doxycycline very well” rather than a generic “Good job”.

“You did not ask the patient whether he had any other medical conditions but you were clear as to when he should seek medical attention if his symptoms don’t respond.” Keep in mind that most people will need to hear more positive feedback in proportion to negative feedback to feel that they have been successful (i.e. equal amounts of positive and negative feedback will leave the learner discouraged.)

•

Don’t feel pressured to know all the answers. It is more important to know where to find the answers.

Ensure that you orientate a student sufficiently – expected hours of work, dress code, staff room rules, availability of references, names and roles of staff. In addition to achieving the set goals of the course, a student rotation can offer a range of activities.

My opinion is that during a rotation, pharmacy students should perform the minimum amount of dispensing to be competent and understand how a dispensing software program works and spend the majority of their time in pharmaceutical care activities. In addition, there can be opportunities for the individual to gain a better understanding of the roles of different health care providers. Our pharmacy has a wound-care/ostomy nurse, a travel nurse, a foot-care nurse, and a certified fitter on staff and we arrange for students to spend time with each of them. We are also fortunate to have contacts at many departments in our local hospital and the staff members are willing to accommodate pharmacy students for several hours to a whole day. It is difficult to obtain this type of experience once a pharmacist is practicing but it can be very useful for gaining a big-picture perspective. Our fourth-year students were extremely helpful in recruiting pregnant women for a study being conducted by UBC CORE (Collaboration for Outcomes Research and Evaluation) researchers. They also learned how to input data in the BC Medication Management system. This program regularly offers courses for pharmacy students to learn the system.

•

Be proactive in solving problems and trying out different roles in the dispensary.

•

Reflect at the end of each day to help you remember what you learned. Four weeks or eight weeks can go by like a blur!

•

Ask. No question is a stupid question.

What we appreciate in preceptors •

Challenge the students to step outside of their comfort zone to do certain activities. Rotations provide one of the safest environments in which to conquer weaknesses!

•

“Reserve” problems and questions encountered in the pharmacy for the students to solve and answer (Is melatonin safe in pregnancy? Can quetiapine be used in a patient receiving amiodarone?). Given the opportunities to tackle problems, students not only learn more actively but also gain a sense of satisfaction by contributing to the team.

•

Make students feel welcome – some may be a long way from home and an invitation to dinner or to attend a local event is a bonus (think of this as a recruitment opportunity).

What we appreciate in students

•

Professionalism – Punctuality – Enthusiasm - Curiosity - Initiative and the ability to pursue individual learning goals (think of this as a potential employment opportunity.)

Identify the students’ strengths but do point out areas that they should work on. ‘Tis better to know thyself before graduating than during thy practice!

•

Take the time to brainstorm and arrange shadowing opportunities with local health care providers.

The student’s outlook: Gina Chang To the practicing community pharmacists, we students are a curious group. Like a two-way sponge, we absorb knowledge from their years of experience and wisdom, but also release knowledge about latest clinical updates learned in the classroom setting. It is this unique relationship between preceptor and student that can galvanize enriching discussions and mutual learning. Nevertheless, at this pivotal time in pharmacy practice, we particularly look to preceptors as our ultimate mentors when modeling our own practice. Yes, in the academic setting, students have heard much about the Blueprint for Pharmacy from speakers from a diversity of backgrounds, but what is it like in real action, executed by practicing pharmacists? My fourthyear community pharmacy rotation was an eye-opener. From participating in a palliative care group to enrolling patients in CORE studies; from appointment-based medication management sessions to successful smoking cessation consults sparking off from a simple question at the pick-up window— I learned that anything is possible for a determined pharmacist. The preceptor’s practice can provide courage and optimism in serving beyond the dispensary and leaping forward in our practice.

Tips for students •

My fourth-year rotation experience was extremely fulfilling: in addition to the usual requirements of the clerkship, I was given the chance to shadow and interact with other health care professionals in numerous unique settings, an opportunity that I am sure many pharmacists would envy. I especially appreciated how I was able to follow through an entire workflow through the perspectives of the patient: learning about insulin pump supplies then sitting through a dietician’s consultation with a diabetic patient about carbohydrate counting; or listening to a family discussing their trip destinations with the physician at the travel clinic then watching new prescriptions turn into vaccines that were administered to them by a nurse.

If learning from powerpoint slides and textbooks is somewhat flat compared to experiential learning, then I can confidently say that my experience this year in Fort St. John was rounded in every aspect, thanks to the preceptors’ resourcefulness and efforts in packing the two months with action. By empowering us with more empathy for the patients and awareness of the work of other health care professionals, these valuable clerkship experiences can definitely make us better pharmacists in the future.

Come prepared with a clear objective for the day and for the week.

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GIVING BACK

Going the Extra Mile Making a difference both in and outside the Pharmacy

By Elise Riedlinger, with contribution from Regina Nebrida

Not only are pharmacists reinvesting in community and clinical pharmacy services through programs such as Medication Review Services, they are also giving back to society through volunteer opportunities and charity events. Take for example, John Cameron, a resident of Squamish, BC and a general member of the BCPhA for over 10 years, who will be participating in the GrandFondo Whistler on September 10.

Though an avid cyclist for 20 years, this will be John’s first foray into a ride that will entail cycling 120 kilometers from Vancouver to Whistler with a total elevation gain of over 6,000 feet. That’s equivalent to going up more than 28,121 flights of stairs! John will be riding with over 30 other Team Diabetes members in order to raise money for the Canadian Diabetes Association.

Unlike many Team Diabetes participants, John has no personal connection to diabetes.

Rather, he first heard about the program through a close friend who is taking part in the fundraising event as an on-site physician. Team Diabetes also really resonated with him because of its emphasis on a healthy lifestyle, allowing people of all fitness levels to ride, hike, walk or run in several exciting events across Canada and internationally.

“I liked that it promoted an active lifestyle while it helps so many people,” John said. “A healthy lifestyle makes such a difference with diabetes - it’s not just about medication.”

And he would certainly know. As a Pharmacy Manager in Shoppers Drug Mart in Chieftain Centre, he sees so many of his patients suffering from this serious disease.

“A growing segment of the population and a large percentage of our clientele are dealing with diabetes,” he said. He often recommends to patients that they improve their health through diet and exercise as much as they can.

“It makes such a difference. Simply find something active you like to do.”

The patients at his pharmacy have also been cheering him on since he signed up for the GranFondo ride. John has already raised $1200 – well over the minimum requirement of $800 - with a good percentage coming from his colleagues, including fellow pharmacists and physicians.

Pharmacy Manager John Cameron rides with Team Diabetes

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“My goal is simply to raise as much as I can,” he stated.

The soft spoken and unassuming pharmacist does admit that his biggest hurdle was the daunting task to get donations for his fundraising campaign. “Now, I’m open to do fundraising again! Insulin is not a cure. I feel good for the impact this will bring,” he said.

John also admits that his previous cycling trip to Italy last year re-ignited his desire to road ride again. He spent a full week mountain biking and a full week road biking during his vacation up the Adriatic Coast. Next year, he’s hoping to go back for some sightseeing in Rome – and more biking, of course.

Now, working full-time at the pharmacy leaves John to train simply, “Whenever I can.”

“I split my time between mountain biking and road biking. But my focus is not really on training, I still want it to be enjoyable and get the miles in.”

“I’m in no danger of winning the ride,” he joked. “I just want to do it and be able to have fun.”

To help John raise more funds, please go to https://ocp.diabetes.ca/Pledge/ csSearchResult.asp?prId=td

Did you know?

According to a recent report of the Canadian Diabetes Association entitled, Canada at the Tipping Point – Charting a New Path, April 2011, diabetes prevalence is at epidemic levels across Canada and is continuing to grow. In 2010, 2.7 million (7.6 per cent) people in Canada have diabetes. It is estimated that this number will grow by 1.5 million over this decade to 4.2 million (10.8 per cent) by 2020. That means more than 20 people are diagnosed with diabetes every hour of every day.

For more information about the many and exciting Team Diabetes events please contact: rebecca.taylor@diabetes.ca / 604-732-1331 ext. 246 or visit www.teamdiabetes.ca.

Pharmacy donates medication to those who need it most Greg Oksanen and Jane Wareing, owners of the Courtenay-run Living Room Pharmacy may have a living room couch on their logo, but they’ve hardly been lounging around in their spare time. Instead, as was first reported through BC Local News, they have been working with the Dawn to Dawn CARE-A-VAN program, a mobile health care unit that supports homeless and at-risk individuals in the Comox Valley.

First approached with the idea by their close friend and program co-ordinator Helen Boyd, Oksanen and Wareing have been donating basic medications to the program, which is run completely by volunteers, including a handful of nurses and physicians who work on board.

“We sat down in a group and created what I like to call ‘the deserted island formula’ – basically whatever you would need most were you stranded on an island” said Oksanen, a Pharmacy Manager and BCPhA general member since 1993.

“It’s very interesting from a pharmacy point of view,” he said. “We looked at the question of what is sustainable, what these patients really need, and what will do the most to help prevent further complications.”

Their donations include non-prescription medications, such as those for rehydration therapy or open wounds, and are replenished as needed.

The program has been running for around two years now and despite the recent newspaper article, Oksanen notes that he tries to keep a low profile in regards to his involvement.

“Most of our patients at the pharmacy don’t know about our involvement,” he admits.

“There’s nothing in it for us from a marketing perspective - we’re just trying to do what can to help.”

Dawn to Dawn’s CARE-A-VAN is only the third of such programs in North America, and according to Oksanen, the most comprehensive. You can find out more information about the CARE-A-VAN program at http://dawntodawn.org/care-a-van-project/

Living Room Pharmacy owners Jane Wareing and Greg Oskanen.

CAREER OPPORTUNITIES

employee share ownership plan, flexible hours with no 24-hour pharmacies in all our locations. As health care practitioners, our primary focus is healthy living. Working in partnership with internal resources and other health care providers in the communities, we deliver the best possible care to all our patients. We understand the importance of a healthy work/life balance. We support continuing education and offer various in-house training programs. Please contact: Kay Sajid at kay.sajid@loblaw.ca, Tel: 1.877.628.5562 Fax: 1.866.628.5329, www.drugstorepharmacy. ca, A member of Loblaw Companies Ltd Canada’s largest private sector employer.

ARE YOU MAXIMIZING THE VALUE OF YOUR MEMBER BENEFITS? Corporate Members can place free Career Opportunities listing in these columns and on the web. Next deadline for Career Opportunity listings in the Tablet is Thursday, September 15.

General Members looking for new career opportunities get free access to PostYour-Resume. To learn more, log in and visit the Career Opportunities. The BCPhA Career Opportunities connects our members like no other job board, bringing member employers and potential employees together, and it is free!

GOLDEN

ALDERGROVE Part-time Staff Pharmacist and Pharmacy Technician. In business since 1922, Otter Co-op is a successful $115M retail operation, located minutes east of Langley. Due to our tremendous growth and expansion plans, we are accepting applications for Part-time Staff Pharmacist and Pharmacy Technician. We provide an excellent pharmacy practice environment with personal growth and career development opportunities. Our benefit package includes extended health, pension contributions and a very competitive salary. If you are highly motivated to provide excellent pharmacy care and customer service, please apply to: Hisham Metwally, Pharmacy Manager, Otter Co-op, Box 4200, 3600- 248th Street, Aldergrove, BC. V4W 2V1, email: pharmacymgr@otter-coop.com, fax: 604.856.3101.

BURNABY Busy pharmacy is looking for a self-motivated, well-organized, efficient pharmacist to join our dynamic team in Burnaby. This position will be full-time. As our environment is patient care focused, we work in a dedicated team and relaxed environment.

Excellent hours; no evenings and no shift work. We provide excellent compensation, comprehensive benefit package and expansion opportunities. Interested candidates should fax resume to (778) 737-2889 or email your resume to khtong@ shaw.ca Please include “Career Opportunity” in the subject line.

COQUITLAM Full-time Pharmacy Technician. Specialized, high quality patient care pharmacy looking for an energized full-time technician. Very unique and rewarding environment with a focus on high-level patient support with exceptional customer service. Successful applicant must be able to work well in fast paced environment. Organization, attention to detail, and excellent communication skills are a must. A perfect opportunity to be challenged with continual learning opportunities and advancement. Hours: Mon to Fri (no eve/no wknds). Competitive salary and benefits. If you are seeking a truly innovative work environment, please fax resume to Kelly Loewen at 1.866.246.7796 or Phone: 604.468.3395 DUNCAN Full-time Staff Pharmacist required. If you are a pharmacist who is looking for a great opportunity that provides growth, development and a great work environment then we have the opportunity for you! What is in it for you? Excellent compensation and benefits plan, relocation allowance, on-going career development and training programs, opportunity to work with seasoned professionals, participate in our customer clinic day events, annual bonus plan, company stock purchase plan, employee discount program, comprehensive health and dental benefits,

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Peoples Drug Mart Golden, BC is currently seeking a full-time pharmacist. The store hours are Mon. to Sat. 9:00am to 6:00pm. The dispensary is not open Sundays (although we may expand our hours) or statutory holidays. You will enjoy the clinical aspects of your profession-extensive patient counselling and communications with other health care professionals. Our compensation package starts with a negotiable generous salary (depending on experience). Relocation assistance is available.

Our benefits include 100% medical, dental and life insurance premiums. A retention bonus incentive is payable after the first full year and reviewed every year. We also offer a “student loan” repayment program. License fees to the College of Pharmacists and BCPhA Association Membership fees are included. We offer a rewarding RRSP plan. Holidays start at four weeks per year. The candidate is also entitled to one educational trip to any destination in BC or Alberta per year. If golf or skiing is your interest, we will offer a paid membership of your choice.

Please contact: Michael Hoenmans, Pharmacist/Owner, pdm135@pdmstores.com, Peoples Drug Mart #135, Phone: 250.955.0602, Fax: 250.955.0394.

GRAND FORKS Pharmasave Grand Forks is currently looking for full-time pharmacists (40hrs/wk). Potential for possible future ownership.

Join our team and help deliver pharmaceutical care to our friendly, loyal customers. Our pharmacy staff are encouraged to spend time with patients and go beyond the pharmacy counter to use their professional training to its fullest potential. We enjoy giving our customers the best service and at the same time create a pleasant working environment with friendly staff and customers. We offer competitive wages and benefits as well as payment of professional dues and continuing education.

Interested candidates are invited to send their resume to Pharmasave 106, Box 998, Grand Forks, BC. V0H 1H0, Tel: 250.442.3515, Fax: 250.442.3225, Email: ps106@shaw.ca 100 MILE HOUSE Full-time pharmacist position available in the South Cariboo region of B.C. Located two hours from Kamloops and five hours from Vancouver by car. The position provides a diverse work experience in a community setting. The area offers many enjoyable outdoor recreational opportunities with its rainbow trout fishing, boating lakes, cross-country skiing, bike trails, downhill ski area and two golf courses. Premium annual salary up to $130,000 (to start depending on experience), benefit package (4 weeks holidays to start) and relocation assistance provided. Great hours, open 9:00am to 5:30pm (Closed Sundays & Stat. Holidays) Contact: Gordon Dickie, Donex Pharmacy & Department Store, PO Box 40, 145 South Birch Ave. 100 Mile House, B.C. V0K 2E0, Phone: 250.395.4004, Fax: 250.395.2683, Email: gordd@donex.ca INVERMERE Full-time position for pharmacist at Lambert Kipp Pharmacy - a Family owned business located in the Columbia Valley.

Opportunities for outdoor and indoor activities abound. We are a compounding pharmacy with a fully equipped lab.

Our compounding interests include bio-identical hormone replacement therapy, topical analgesics, veterinary prescriptions

www.bcpharmacy.ca

and dermatology. For more information, Contact: Doug Kipp at 250.342.6612. Submit resumes to: Doug Kipp, BSc Pharm, Lambert Kipp Pharmacy, Box 2919, Invermere, BC. V0A 1K0 KELOWNA Pharmasave Kelowna, Glenmore Clinic pharmacy adjacent to medical clinic. Open 7 days per week: Mon. to Fri. 9 am to 7 pm, Sat. 9 am to 5 pm, Sun. 10 am to 5 pm. Looking for a part-time pharmacist. Contact: Craig Tostenson, Phone: 250.861.4443, e-mail: craigtos@shaw.ca MAPLE RIDGE Peoples Pharmacy in Maple Ridge is looking for a qualified, permanent, part-time Staff Pharmacist. The candidate must be familiar with KROLL software, friendly, effective and efficient in dispensing prescriptions in a timely manner to the best customers in the province of BC. Very competitive salary and benefits to be discussed. Please email your resume with references satthari@gmail.com PORT COQUITLAM Part-time Pharmacist needed for Peoples Drug Mart, Port Coquitlam. Join our dynamic team to deliver pharmaceutical care to our friendly, loyal customer base where you are an integral part of their well-being. We offer competitive compensation and a great working environment. Work weekdays and every second weekend. Reply in confidence to: Lap Wu. Peoples Drug Mart #29, 2529 Shaughnessy Street.

Port Coquitlam, V3C 3G1, Cell: 604.377.2669. lap.wu@shawcable.com RICHMOND HealthPlus Pharmacy is looking for a part-time licensed pharmacist to work Saturday shifts. Hours of operation for Saturday are 10:30 am to 4:30 pm. We will offer a competitive wage of $50/hour. There will be a pharmacy technician on duty. Punjabi speaking individual is an asset. Please contact: daulakh15@shaw.ca SURREY Tired of shift work? Want a better opportunity to practice clinical pharmacy? Our pharmacy looks after over 1500 long term care beds. Our pharmacists participate in dispensing to front store and long term care residents. They attend medication reviews, care conferences on a weekly basis. Our pharmacists provide nursing in-services. They enjoy a friendly, supportive work environment. The pharmacy is specifically designed to complement the pharmacist’s practice. The work load is shared among 6 pharmacists. Find out how rewarding it is when your advice makes a difference in people’s lives. Ideal for a hospital or retail trained pharmacist or ideal for a new graduate. Our wage and benefit package is competitive. You would be working 9:00am to 5:30pm. No-Sunday’s. Your work schedule would be more conductive to family life. We currently have an opening for a Full-time pharmacist. Please give me a call Godfriet Keller, work: 604.583. 5312, or email me back if you are interested godfriet@shaw.ca Full-time and Part-time Pharmacists required. Pharmacy specializes in Mental Health and Addiction services. Experience in Methadone Maintenance an asset. Excellent wages and flexible hours. If interested, please email your resume C/O of Cheli McDonald to healthcentrerx@gmail.com or fax to 604.608.3230 Community Care Pharmacy is looking for a full-time Licensed Pharmacy Technician. Community Care is a pharmacy specializing in long term care. You would be working with 6 pharmacist and 4 pharmacy technicians. Our wage and benefit package is competitive. Hours are 9 to 5:30, no Sundays. Your work schedule would be more conductive to family life. Please give me a call Godfriet Keller work 604.583.5312 Email: godfriet@shaw.ca

Part-time pharmacist needed for independent community pharmacy. Friendly environment, flexible shifts and no evenings.

We offer a competitive wage. Must be able to work some weekends. New Grads Welcome! Please fax your resume.

Contact: Tel. 604.543.6677, Fax 604.543.4433 Permanent part-time or full-time pharmacist needed in Whalley (Surrey). Highly competitive salary and benefits for friendly pharmacist dedicated to customer service. Contact: capitalcare@shaw.ca or 604.780.4413.

TOFINO Full-time Pharmacist position required (or Flex Time). Pleasant working environment in scenic Tofino. Interested applicants please contact Tel: 250-725-3101 or Email: tofinopharmacy@gmail.com.

VANCOUVER Pharmasave Granville and Pender, located in downtown Vancouver, is looking for an experienced Pharmacist. The position is full-time (40 hours/week) Monday to Friday (with occasional weekends). Experience in retail pharmacy is not required but would be an asset. Prior knowledge of Kroll, injection training certification and compression stocking fitting experience would be a definite asset. We offer a competitive salary and benefits package. Our store hours are from 7:00am to 8:00pm Monday to Friday, 9am to 5:30pm on Saturday and 9am to 5:00pm Sunday. We are located near the seabus and skytrain terminals making for an easy commute. If you are interested please forward your resume. Attention: Jordan Tolton, Email: ps252@telus.net Tel: 604.801.6991, Fax Number: 604.801.6993 Full-time pharmacist position available for a centrally located independent pharmacy in Vancouver. Competitive wages and benefits. NO Evening shifts, Sundays or Statutory Holidays.

We invite experienced pharmacists as well as new grads to apply. Interested applicants may forward your enquiries or your resume in confidence to S. Rayani at 604-618-9581.

Part-time pharmacist needed. We are currently looking for a part-time pharmacist for our location in Chinatown. Flexible hours, no evenings or Sundays. We offer competitive wages and if interested, please call Mary at 604.683.6381 or fax: 604.683.8623.

Full-time and Part-time Pharmacists required. Pharmacy specializes in Mental Health and Addiction services. Experience in Methadone Maintenance an asset. Excellent wages and flexible hours. If interested, please email your resume C/O of Cheli McDonald to healthcentrerx@gmail.com or fax to 604.608.3230 Pharmacist required for downtown methadone pharmacy.

Variable shifts available during the week. Part time leading to full time in the near future. Pay and benefits to be negotiated.

If interested, please contact Mojtaba Rahimi at 604.681.2272 for more information or fax resumes to 604.681.3372.

centered practice with a desirable and friendly population. All applications are confidential. Compensation is commensurate with experience. Please submit applications to jobs@victoriapharmacy.com Pharmasave James Bay in beautiful Victoria requires a parttime pharmacist. Victoria is known for the mildest weather in Canada and to top it off our store is located two short blocks from the scenic waterfront so you can enjoy the view on your lunch! We are looking for a team player who likes having fun while practicing the profession of pharmacy. Patient care is our main focus and we pride ourselves on the excellent customer service we provide as well as reaching out to the community with free delivery 6 days a week. We have a pleasant, consistent and manageable pace of work with solid technician support, plus whole store camaraderie to assist in getting the job done. Compensation package includes full benefits package, RRSP, covering College licensing fees and BCPHA membership. Over and above the compensation package is the pleasant and flexible atmosphere our non-corporate store provides. If you are interested in this opportunity to break free of the corporate rat race, let us have coffee and discuss the package. Contact Jeff McInnes, Owner. Tel: 250.383.7196, cell: 250.818.6564, or e-mail: ps130mgr@telus.net Are you looking to be part of a growing organization that supports work life balance with a positive work environment and supportive management team? If your answer is yes, we have an opportunity for you! As a member of our growing team, you can expect a culture which supports mutual respect, integrity, teamwork and communication. We are participating in

the BCPhA Medication Management Project. The purpose of the project is to improve patient care; drug therapy outcomes and sustainability of the health care system by having pharmacists provide medication management services to patients in a community setting. This position has a competitive benefits package with a schedule that allows a person to fully enjoy the fun West Coast Lifestyle. Position includes $46.00 per hour, RSP package, benefits and full pharmacy technician coverage. To apply please forward your CV along with cover letter to Mike Forbes, at mforbes@forbespharmacy.ca, Forbes Pharmacy is located in beautiful Victoria, BC where you can golf, bike and hike all year round.

CAREER OPPORTUNITIES THROUGHOUT BRITISH COLUMBIA COSTCO PHARMACY - part-time staff pharmacists and certified technicians required for various locations across British Columbia (Vancouver, Burnaby, Richmond, Surrey, Abbotsford, Port Coquitlam, Langley, Langford, Nanaimo, Kelowna, Kamloops and Prince George) Costco Pharmacy provides a practice environment which enhances patient care and equipped with semi-private and private counselling areas. We have a great working environment, opportunities for advancement in addition to highly competitive rates.

Our benefit package includes; extended health coverage, contribution to company pension, RRSP plans and CE reimbursement. Costco Pharmacy is seeking ambitious, highenergy Certified Pharmacy Technicians, who enjoy working in a fast-paced team environment. If you are highly motivated to provide excellent pharmacy care and customer service and

“Amazing programs and great services when you join the Peoples group ” Chris Dreyer Lytton Peoples Pharmacy

If being a successful owner operator in retail pharmacy is part of your life plan, Peoples Drug Mart is the proven program that will help you achieve your goals. For as little as $100 per month, the Peoples program offers opportunities that are unique to independent pharmacies and provides financial benefits that are unparalleled.

If you own an independent pharmacy or have plans to, call us today.

Part-time or full-time pharmacist position, Mon. to Fri. no evenings. Part-time position ideal for semi-retired pharmacist.

Wages commensurate with experience. East End Pharmacy in Vancouver. Contact: Raj, 604.255.9890 or Fax: 604.255.9815 Permanent full-time pharmacist required. Busy independent pharmacy seeking highly motivated pharmacist. Competitive salary and benefits package, College fees covered. Hours: Monday to Friday, 9am to 5:30pm. Please email: ken@buckshonrx.com or fax 604.254.6454 VICTORIA Staff Pharmacist Position - Opportunity to work as a staff pharmacist at the UVic Campus Pharmacy, Shelbourne Plaza Pharmacy and Cadboro Bay Compounding Pharmacy owned and operated by Naz Rayani. We are looking for an engaged, clinically oriented, outgoing full–time pharmacist to work at our unique community pharmacies. Our focus is on a patient

Helping People Live Better Lives To learn more about the Peoples Drug Mart and Peoples Pharmacy programs, contact:

Frank Fidyk 778-678-6717 or Ian Maxwell 604-431-3595 ext 23 email: fgfidyk@telus.net email: ianm@pdmstores.com www.peoplesdrugmart.com

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NEW MEMBERS General

would like to inquire about available positions please Call, Fax or Email your resumes to: Ed Toth, BSP, Pharmacy Operations Manager, Western Canada, Phone: 604.444.9344, Fax: 425.427.7735, E-mail: etoth@costco.com

license, vehicle and a willingness to travel throughout BC. A competitive salary and benefit package will be available to the successful candidate. Reply in confidence by Friday May 6th to: khansell@pharmasavebc.ca

HBC PHARMACY GROUP - Discover a challenging and rewarding career as a Pharmacist with Zellers or Bay Pharmacy and help to ensure the quality of life for all Canadians! It’s not just about filling prescriptions: You’ll serve as a primary health care advisor who gives patients guidance to help make good choices about their health. Join our Pharmacy Team and see why HBC is considered the preferred place to work. Making a difference in your life and the lives of others! We offer competitive wages; incentives for remote locations, benefits; including a shopping discount, as well as opportunities for career development. Please forward your resume in confidence to either HBC Head Office, Attn: National Recruitment Manager, Pharmacy, catherine.williams@ hbc.com or BC Regional Pharmacy, Attn: Regional Pharmacy Operations Manager, 604-340-8179; janey.johnson@hbc.com

REXALL - Since 1904, Rexall has been a trusted name in retail pharmacy. Rexall is also the flagship pharmacy for Katz Group Canada, a leading drug store company and the largest integrated retail pharmacy network in Canada, with more than 1,800 corporate, independent and franchise pharmacies across the country. As the umbrella brand for a family of pharmacies including the Rexall, Rexall Pharma Plus, The Medicine Shoppe, Guardian and I.D.A. banners, Rexall is dedicated to the health and well-being of our customers and patients and strives to provide the best possible pharmacy care in a pharmacy first environment. Our Long Term Care Pharmacists provide highly specialized clinical and medication management services for residents of nursing homes, retirement residences, assisted living facilities and group homes through dedicated pharmacies. Full-time and Parttime Staff Pharmacist positions in Abbotsford. Part-time Staff Pharmacist positions available in Victoria. If you are interested in applying or would like to learn more about this opportunity, please contact a member of our team: Omar Saad, Regional Pharmacy Director osaad@rexall.ca, Luiza Albuletu, Pharmacy Recruitment Manager lalbuletu@rexall.ca

LONDON DRUGS - is accepting applications for pharmacist positions throughout BC. Pharmacists will have the opportunity to be involved with various patient care initiatives offered at London Drugs such as INR monitoring, Long Term Care, Certified Diabetes Education, immunization and various clinics such as osteoporosis screening, heart health, diabetes, sun and smoking cessation. We offer competitive salary and benefit package, moving allowances, professional working environment, scheduled meal breaks, semi-private counseling booths, automated robotic dispensing machines and employé discounts. Please apply in confidence to: Shawn Sangha, B.Sc. (Pharm), London Drugs Ltd. Pharmacy Operations Manager, BC. Tel: 604.272.7469, Fax: 604.448.1075 E-mail: ssangha@londondrugs.com OVERWAITEA FOOD GROUP- consisting of Overwaitea Foods, Save-On-Foods, PriceSmart Foods, Urban Fare and Coopers Foods are hiring. Staff Pharmacist positions are available in 100 Mile House, Campbell River, Chilliwack, Cranbrook, Creston, Fernie, Fort Nelson, Grand Forks, Kelowna, Kitimat, Mission, Nanaimo, Parksville, Penticton, Prince George, Prince Rupert, Quesnel, Squamish, Terrace, Williams Lake, Fort McMurray, Red Deer and Lethbridge in Alberta. Relief Pharmacist floater positions and technicians n British Columbia and Alberta are also available. We provide an excellent pharmacy practice environment with personal growth and career development potential. Very competitive wages and benefits including a Pharmacist incentive plan. Contact: Chi Quon, Regional Pharmacy Manager, 604.881.3574, fax: 604.882.7896, chi_quon@owfg.com, www.saveonfoods.com

THRIFTY FOODS - Bring your professionalism and your dreams to Thrifty Foods new frontier and become an important part of our company as we grow together.

Pharmacy manager and staff positions available. Thrifty Foods Pharmacy is committed to offering a comprehensive pharmacy service to these communities. Competitive wages and benefits. Interested candidates are invited to submit their resumes to Nafeesa Shaikh, Pharmacy Recruitment and Retention Specialist, Sobeys Pharmacy Group. Toll Free #: 1-800-790-0733 x. 7704 Phone #: (902) 468-1000 x. 7704, Fax #: (877) 662-1955 BUSINESS OPPORTUNITIES Port Alberni - A super community pharmacy for sale. Viable Rx department. Price will include 2700 sqft. Strata lot. Easier financing if required. Alberni Valley economy is on rebound.

Tel: 250.723.9323, Fax: 250.723.8221 Rewarding Ownership Opportunity! Enjoy the best of both worlds and be in business for yourself instead of by yourself.

Unique business opportunity for the right person. Seeking a pharmacist/partner for Surrey, BC area. Contact: Tel: 604.543.6677.

Kaslo Drugs in BC is for Sale. A good store in a great location. It has had good profits for 20+ years. Owner willing to carry part of purchase price. Contact: 250.353.2224, fax: 250.353.2336 or email: jmorris@netidea.com

PEOPLES DRUG MART and PEOPLES PHARMACY- have several locations throughout beautiful British Columbia offering a desired combination of employment opportunity and unbeatable lifestyle. Contact: Smita Natha, Professional Services Manager, Peoples Drug Mart, 520-4400 Dominion Street, Burnaby, BC. V5G 4G3 Tel: 604.431.3595 (ext. 26), Fax: 604.431.3596, Email: smitan@pdmstores.com PHARMASAVE - B.C.’s largest and most successful group of independently owned community pharmacies. This is a vibrant and growing organization representing over 120 locations throughout the province. In response to this exciting growth, the regional Pharmacy Department is currently recruiting a BC Licensed Pharmacist for the position of Pharmacy Coordinator. Reporting to the Regional Manager, Pharmacy the successful candidate will be responsible for providing support and expertise to Pharmasave storeowners in the areas of pharmacy program implementation, pharmacy operations support, financial analysis and staff training to improve pharmacy performance and profitability. Required Attributes: Self-motivated, confident with a positive/ enthusiastic attitude, Exceptional communication and presentation skills, Team player with the ability to work effectively under minimal supervision, Flexible and innovative with the ability to prioritize and manage multiple projects, Superior computer skills with common software applications including Kroll and Microsoft Office. Minimum 5 years pharmacy management experience in BC. Valid driver’s

At PHARMASAVE we understand that you want to be in business for yourself, not by yourself. You can have the best of both worlds! Maintain your freedom and independence while having access to the most comprehensive retail and professional programs in the industry. Pharmasave’s proven products, programs and strong national Brand are always at your service. Pharmasave is unlike any other independent pharmacy venture in Canada. We are a true cooperative that is 100% member owned and governed. With Pharmasave, not only do you benefit from owning your own business, but you also share in the economic advantages of a 400+ strong group of stores. Plus, you will be an owner in an organization that delivers all of its profits directly back to you, the shareholder. Allow us to demonstrate the advantages of Pharmasave. If you are a storeowner or a pharmacist interested in purchasing a pharmacy, or if you are planning on selling your business, please give us a call. PHARMASAVE’S only priority is you and your success! CONTACT: Dave Reston, CEO, Pharmasave Pacific, tel: 604.575.5730 or 1.800.665.3344, Email: dreston@pharmasavebc.ca

Ritesh Acharya, Kirn Singh Bains, Tina Barrett, Wesley Bedford, Amanda Boehm, Colleen Brady, Kyle Brewer, Andrea Brodie, Junghun Chae, Connie Chan, Christine Hau-Yung Cheng, Winnie Cheng, Lynnette Chiu, Rosanne Chow, Elyse Clancy, Holly Coates, Brent Darrach, Bimal Davda, Darryl Deadmarsh, Jovan Dzombeta, Pamela Engar, Kathryn Esquivel, Julianna Fang, Russell Farhadikazerooni, Graham Foster, Vanessa Gauthier, Ranjeet Gill, Jocelyn Ha, Tannis Hartwig, Janice Harvey, Daniel Hauser, Emily Ho, Jana Horkoff, Jason Howden, Cheryl Howley, Gregory Hutchinson, Alana Isakovic, Hanea Ismail, Karima Jiwa, Christopher Kemppainen, Harpreet Khtaria, Nathan Klaassen, Robert Krahn, Fatima Ladha, Kequyen Lam, Sin Man Lam, Ada Lee, Jenny Lee, Frank Leung, Nina Li, Zaccheus Lim, Beatrice Louie, Melissa Lowe, Lusanna Lui, Korey Mailey, Sonica Mann, Michael Matys, Karen McLennan, Sarah McRae, Cameron Mertke, Jacqueline Ming, Bahar Mokarami, Amir Mokhtari, Melanie Nelson, Leah Neumann, Graeme Nevins, Amy Newport, Andy Nguyen, Charles Park, Katayon Parsa, Maria Pasimio, Kim Pelingon, Matthew Penner, Rebecca Petersen, Travis Petrisor, Michelle Pitt, Ramin Pournaghibi, Ahmad Rahimi, Harpreet Sandhu, James Saunders, Thazhath Sebastian, Ahmed Sharabas, Heather Shivas, Jillian Sims, Howard Singer, , Cala Smith, Michelle Sun, Katsiaryna Sushkevich, Priscilla Szeto, Danny Tam, Ward Taylor, Melodie Tong, Bou Lee Too, Galen Toy, Simon Tremblay, Jeremy Tse, Jason Ullattikulam, Arcyditha Uy, Kristen Wareham, Iain Watt, Stephanie Whittaker, Janet Wong, Odelia Wong, Shauna Woodrow, Albert Wu, Ho Bun Yeung, Julian Yoo, Sabiha Zafar, Omid Zargaran, Julia Zazoulina and Julia Zhu Corporate Gaetz Pharmacy, Metrocare Pharmacy,Venus Pharmacy

ASSOCIATION CONTACTS Marnie Mitchell Chief Executive Officer 604.269.2860, marnie.mitchell@bcpharmacy.ca Parkash Ragsdale Deputy CEO, Director, Professional Services 604.269.2862, parkash.ragsdale@bcpharmacy.ca Cyril Lopez Director, Member and Corporate Services 604.269.2869, cyril.lopez@bcpharmacy.ca Kate Hunter Director, Communications 604.269.2863, kate.hunter@bcpharmacy.ca Elise Riedlinger, Manager, Communications 604.269.2866, elise.riedlinger@bcpharmacy.ca Krista Martin, Communications Specialist, 604-269-2867, krista.martin@bcpharmacy.ca.

Riva Pickering, Coordinator, Professional Services, 604-261-2092, riva.pickering@bcpharmacy.ca Bryce Wong Manager, Professional Services 604.269.2865, bryce.wong@bcpharmacy.ca Linda Tinnion Assistant, Member Services 604.269.2864, linda.tinnion@bcpharmacy.ca Ray Chow Database Administrator, Member & Corporate Services 604.269.2868, ray.chow@bcpharmacy.ca Pam Ratcliff Executive Assistant 604.269.2861, pam.ratcliff@bcpharmacy.ca Starr Rempel Receptionist and Administrative Assistant 604.261.2092, starr.rempel@bcpharmacy.ca

604.261.2092, Toll-free: 1.800.663.2840 info@bcpharmacy.ca, www.bcpharmacy.ca

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www.bcpharmacy.ca

ACTIVE INGREDIENTS

First pharmacy technician registrants celebrated On June 17, 2011 the College of Pharmacists of BC held a celebratory lunch to officially welcome the inaugural group of 21 pharmacy technician registrants from around the province.

The regulation process establishes a pharmacy technician as an independent health care professional and new registrant of the College who is directly responsible and accountable for an expanded scope of technical functions related to prescription preparation and processing.

The event was attended by the Assistant Deputy Minister Bob Nakagawa and Parkash Ragsdale, BCPhA’s Deputy CEO and Director, Professional Services.

“It was great to attend this celebration on behalf of the BCPhA,” said Ragsdale. “As pharmacists continue to expand scope of practice, regulated technicians will play an important role in the advancement of pharmacy as a whole.”

The regulation of pharmacy technicians, which follows a national process, is on a voluntary basis and expected to progress slowly as technicians who choose to, complete the comprehensive educational requirements of the program.

Further details on the process can be found on the College website at www.bcpharmacists.org

(back row L-R) Sukhjit Bains, Cheryl Knight, Roberta Wiebe, Onnolee Osbourne, Michael Higashi, Phillip Dunn (front row L-R) Ricky Brar, Darlene Bonnier, Bonnie M. Hill, Jody Penner, Doreen Leong (Director – Registrations and Special Projects for CPBC), Yonette Harrod, Edeana Vivian, Sorell Wellon, Lori DeCou (Director – Communications for CPBC)

Randy Konrad (Chair of CPBC Board) and Hua Ma

Lori Tanaka (Admin. Asst. – Communications for CPBC), Lori DeCou (Director – Communications for CPBC), Kitty Chiu (Interim Executive Assistant - Registrars, Human Resources & Facilities for CPBC

Pharmacy Technician Registrant, Edeana Vivian

Pharmacy Technician Registrant, Ricky Brar

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UP CLOSE

A Fond Farewell to Marshall Moleschi

by Kate Hunter

After six years as Registrar of the College of Pharmacists of BC, Marshall Moleschi is preparing to take on a new challenge.

His next role will be as Registrar of the Ontario College of Pharmacists – and he’ll be taking some lessons learned with him as he moves to Toronto.

“I will definitely be taking things from my time in British Columbia,” says Moleschi, who officially ends his term on August 31. “The difference that pharmacists can make. The way they have stepped up to the plate and made a real difference to our province.”

Moleschi began his pharmacy career at the age of 15, stocking shelves at a pharmacy in Langley. He then went on to study pharmacy at UBC and graduated in 1974.

“After graduating I went into community pharmacy in Kitimat and Prince Rupert,” he describes. “I loved my time in community pharmacy. Meeting 200 people in a day and seeing the difference I could make in their lives.”

“The biggest challenge has been taking the profession to the place of decision making,” he continues. “It takes confidence within the profession as well as partnerships between the College, the BCPhA, UBC and the Provincial Government.”

Moleschi led the college through several major initiatives during his term as Registrar including new legislation (HPA and POSDA), new technology (eDrug and eHealth), a new class of registrants (regulated pharmacy technicians), new scopes of practice and influencing health policy. Looking ahead to his new chapter in Ontario, Moleschi sees clear comparisons with British Columbia.

He says: “We have accomplished a lot in BC and Ontario is asking for something similar. On a personal level, I am looking forward to helping create an environment similar to the one we have in British Columbia.”

“We have accomplished a lot in BC and Ontario is asking for something similar.”

After seven years in community pharmacy, Moleschi moved into a hospital setting where he spent the next 25 years, eventually becoming Director of Pharmacy for the Northern Health Authority and Administrator for Prince George Hospital. He admits this was an interesting time to be in a hospital pharmacy setting, as he witnessed it shift to a more clinical focus.

He explains: “Through those years in hospital pharmacy, it evolved to become a very clinical profession. Pharmacists were spending more time on the wards with patients instead of in the pharmacy.”

As a Past President of both the College Board and the Board of the BC Pharmacy Association, Moleschi readily accepted the challenge to become College Registrar in 2005. Describing his motives for taking the role, Moleschi refers to the ‘vision’ of the Council at that time and their desire to have pharmacists step out from behind the dispensing counter and make decisions.

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THE TABLET

Aug/Sep 2011

www.bcpharmacy.ca

It is true to say that pharmacy in BC has evolved over the last few years with the introduction of adaptations, injection authority and the recent launch of medication review services.

So, after all these years, what lasting memories will Moleschi be taking with him to Ontario?

“I have taken tremendous satisfaction out of seeing endorsement of what pharmacists can do,” he explains.

“A few months ago I went to talk to a group of UBC students about the need for pharmacists to evolve and move towards the professional judgment model. Not long afterwards my niece sent me a link to a You Tube clip of these students doing a pharmacy skit, mimicking the Old Spice adverts.

“The skit was promoting adaptations and even though it was funny, I could also see that they got what we had been talking about. That’s their future!”

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