The Tablet - Feb/Mar 2015

Anticoagulation Therapy Management • Medications Return Campaign • Focus on Acetaminophen

tablet

published by the British Columbia Pharmacy Association | www.bcpharmacy.ca | Volume 24. No. 1

FEB/MAR 2015

Cardiovascular Risk Management New pharmacist health coaching program with Green Shield Canada

A voice for community pharmacy

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THE TABLET

FEB/MAR 2015 | VOLUME 24. NO. 1

contents Editor in Chief Angie Gaddy 604.269.2863, angie.gaddy@bcpharmacy.ca Senior Editor Elise Steeves 604.269.2866, elise.steeves@bcpharmacy.ca Advertising Sales Shannon Ward, OnTrack Media 604.639.7763, 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.

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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

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Features

Columns

Regulars

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Annual Conference 2015 May 21 to 23

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5

Meet Aaron Sihota Pharmacist

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On the Cover:

President’s Message Building the reputation of the profession

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10

CEO’s Message Pharmacists need to make the case for clinical services

DPIC Focus on acetaminophen

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Clinicare Pharmacists Tolerance to prophylactic migraine medications

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Career Listings Find a job in pharmacy

Cardiovascular Risk Management Pharmacist health coaching program

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Anticoagulation Therapy Management New training program

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Practice Review Program College of Pharmacists of BC

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Genomics for Precision Drug Therapy BCPhA advancing research project

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Weight Loss Products What pharmacists need to know

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Medications Return Campaign Fish can’t say no to drugs

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Member Services BCPhA student ambassadors

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Pharmacy Practice Support Regulatory compliance support

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Government Relations Pharmacy Day 2015

Got a suggestion for an article in The Tablet?

Email info@bcpharmacy.ca with your story ideas.

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Feb/Mar 2015

A voice for community pharmacy

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SMALL TALK

In the news Nominate a pharmacist!

Do you have a colleague who goes above and beyond to contribute to the profession of pharmacy? If so, be sure to nominate them for one of the BCPhA Pharmacy Awards, which will be presented at this year’s conference in Victoria running May 21 to 23, 2015.

The Voice for Pharmacy Award will recognize a member’s significant role in promoting the value of pharmacists, the profession and the Association, and underscores the critical role of advocacy with government, health-care stakeholders and the community.

It’s also now easier than ever before to nominate someone using the online nomination form with only a few quick questions. To learn more, visit www. bcpharmacy.ca/awards.

These prestigious awards recognize members of the pharmacy community for distinguished service, achievement, mentorship and innovation.

The Pharmacy Leadership Award will recognize an owner, manager or pharmacist in a leadership role who supports staff pharmacists in embracing expanded scope and provides outstanding clinical services to patients.

Coverage limits for blood glucose test strips

Last year, two new awards were added: the Voice for Pharmacy Award and Pharmacy Leadership Award.

Nominations close March 31, 2015.

Reminder: On January 1, 2015, PharmaCare introduced new annual quantity limits on blood glucose test strips. A patient’s annual limit will be based on the diabetes treatment they are receiving.

The change was based on research showing that more frequent blood glucose testing has a limited benefit for most people with diabetes who do not use insulin.

A new poster has been created by the Ministry of Health that focuses on helping patients understand what the annual limits are and what to do if they cannot test at the appropriate frequency with the annual limit. Copies of the poster will be mailed out to all pharmacies in February.

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MEET AARON SIHOTA, PHARMACIST

Meet...Aaron Sihota, pharmacist Future Leader Award. He served as a BCPhA Student Ambassador since the program first launched in 2011. He was recently invited as a guest speaker at Interface 2014, Canada’s only digital health international summit, to discuss the future of health-care delivery and how to reimagine and disrupt the retail pharmacy care model.

What are you most proud of?

Aaron Sihota is a recent graduate from the UBC Faculty of Pharmaceutical Sciences and has a keen interest in advancing community pharmacy practice and the application of innovative solutions to address today’s health-care issues.

As a new pharmacist, Sihota is currently involved with the establishment and implementation of patient-focused professional services, including travel health and specialized compounding at Sina Pharmacy, a newly-opened independent pharmacy in downtown Vancouver.

As a pharmacy student, Sihota served on the Pharmacy Undergraduate Student (PhUS) Council in various roles including a one-year term as president, and two terms representing the faculty on the UBC Senate. He has worked with the BCPhA and College of Pharmacists to advocate for community practice and health-care advancement initiatives, including the creation of a student observer seat on the College’s Board of Directors. Sihota was recently the recipient of the 2014 Pharmacy Practice + Commitment to Care & Service Award for Student Leadership, and the 2014 BC Pharmacy Association

I feel there is always room for growth and learning. I’m proud to have worked with and learned from so many amazing individuals, who are inspirational in all that they do, including creating a dialogue and awareness of the impact of pharmacy in our communities.

Where do you see yourself in five years? Ten? A good clinician, and working with others to provide health-care leadership and innovation to ensure that the health needs of our communities are being addressed.

If you weren’t a pharmacist, what would you be?

I would still be involved in the healthcare sphere in some capacity, likely in the context of health advocacy/change leadership.

What motto do you live by?

“Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it’s the only thing that ever has.”

Which living person do you most admire?

My grandfather.

What do you see as the biggest challenge ahead for pharmacy in BC? How to effectively market our role as care providers to other health-care professionals and the public. Pharmacists are often cited as being trustworthy but not at the top when it comes to being valued. More emphasis will have to be placed on tracking outcomes for pharmacist-led interventions so that payers see the measurable value in investing in pharmacy services, including better patient care and overall cost savings to our health-care system.

What excites you most about the future of pharmacy?

The overall cost of health care in Canada is staggering, and the need to maximize efficiencies in how care and wellness is provided to Canadians is essential.

Pharmacy has a significant role and opportunity in adding value and focusing on the provision of outcome-based care. The emergence of digital health technology day-to-day monitoring and medication adherence tracking will reshape the pharmacist patient relationship and lead to a more personalized healthcare experience. From monitoring blood glucose to sleep efficiency, many patients are taking charge of their own health information with the help of digital tools.

Pharmacists are best positioned to make sense of all this patient generated data. We already had the largest pharmacy chain in the United States Walgreens partner with Qualcomm to create a digital platform to enable remote patient monitoring of biometric data. Also prescribing for minor ailments by pharmacists will be critical to ensure timely and effective provision of care in BC.

What talent would you like to have?

The ability to learn new languages quickly.

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Feb/Mar 2015

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DAVID PAVAN | PRESIDENT

Building the reputation of the profession

In recent years, there has been a lot of talk about how pharmacists are trusted by their patients - in fact, it was just recently announced that we're again among the top three "most trusted professionals in Canada" in the annual Ipsos Reid survey.

During my many years as a pharmacist, I’ve certainly seen how patients have confidence in, and depend on, us as pharmacists.

Whether it’s to recommend an OTC product, counsel them on a new prescription, manage their complex medication regiments, provide immunizations or just check in with them as a longtime care provider, we are an important piece in the delivery of sustainable health care.

While as pharmacists we each have a role to play in our own practice by developing these personal relationships and proving our value on a day-to-day basis, the challenge – and opportunity – for the profession, and more specifically the Association, is to build on that reputation on a broader scale. In other words, not just with our patients, who we have the chance to impact on a daily basis, but in our interaction with government, the regulatory body, and the third party-payers who we rely on to support and move our profession forward.

Our annual Medication Returns campaign shows social corporate responsibility and the newly developed regulatory compliance bootcamps demonstrate our commitment to payers and ensure we maintain pharmacy’s reputation in following regulations.

The upcoming Pharmacy Day at the legislature – on March 23 – also aims to strengthen our reputation. I participated in the

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event last year, and was truly impressed by the conversations that happened with cabinet ministers, MLAs, and senior government officials. We heard from MLAs who saw pharmacy’s role in health care as vital and important. Whether we were able to talk to them about their own experiences or those of a family member with a chronic condition, it put a human face on the business side of pharmacy. I was proud to be a pharmacist that day and showcase our profession to those who are making the decisions, and yet surprisingly unfamiliar with the profession.

This year, we are again constructing a “mock pharmacy” in the legislature and will share the new and exciting opportunities pharmacy brings to health care. In addition to the demonstrating the many services available in community pharmacy, we will include the launch of the “Genomics for Precision Drug Therapy in the Community Pharmacy” project, the Green Shield Canada cardiovascular project, as well as the potential that exists for point-of-care testing with anticoagulation management.

Pharmacy Day is the culmination of the larger Pharmacist Awareness Month that runs in March, and also allows pharmacists all across Canada to demonstrate the real value we add to the health-care system.

We have the trust of our patients. Pharmacy now needs to build awareness with those impacting the profession who may not be as familiar with our role in providing patient care and improving health outcomes. It is time for everyone to step forward and do their part.

GERALDINE VANCE | CEO

Pharmacists need to make the case for clinical services

In this issue of The Tablet there is information on our partnership with Green Shield Canada (GSC) that will see BC pharmacists working with patients who are dealing with cardiovascular disease. Building on the success of a pilot project that Green Shield supported in Ontario, the cardiovascular risk management program is being offered to eligible patients in BC and Ontario who have extended health coverage with GSC. There are a number of things that make this program exciting – it allows pharmacists to work with their patients to address the leading cause of death and hospitalization, the service will be standardized to ensure consistent care is delivered to patients regardless of where they live, and the results will be evaluated to ensure the value to the patient and GSC is there.

One of the things that has been missing in the delivery of many clinical services offered by pharmacists in Canada is evaluation. Well-intended programs like Medication Reviews and even immunization services have begun without criteria established at the outset to assess success and measure the service once it‘s being delivered. This leaves pharmacist-delivered clinical services up for debate in terms of whether they are “worth it.” Decisions about the future of some services are being made based on hunches and best guesses rather than the facts. This leaves pharmacy clinical services in a vulnerable position.

The pilot project in Ontario on pharmacist interventions with patients with cardiovascular disease proved, with solid data, that patients managed their blood pressure more effectively and that costs for their medications went down. This is just the evidence that is needed to prove what pharmacists have instinctively known as a result of their interactions with their patients – continuity of care produces better health outcomes and saves money.

Physicians have long understood the value of longitudinal relationships with their patients – and so have those patients fortunate enough to have a long-term relationship with their family doctor and/or their specialist. And physicians have done a good job of getting the data to prove the positive impact that

“Decisions about the future of some services are being made based on hunches and best guesses rather than the facts. This leaves pharmacy clinical services in a vulnerable position.” these relationships have on health outcomes and costs to the health-care system.

Frankly, it’s high time pharmacists started to build the same case to show the value they provide. (continued on page 8)

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GERALDINE VANCE | CEO

Patients who have a long-term relationship with their pharmacists understand and experience the value of that relationship.

For those with chronic conditions, like heart disease or asthma, the pharmacist is an important partner in their health care. Pharmacists are not a replacement for their physicians but can be an important conduit, explaining how and why medications are important to a patient’s health and stepping in when there is a problem with those medications.

I know from firsthand experience over many years the role our pharmacist plays. My husband has a chronic disease that requires him to be on multiple medications. There have been issues of side effects, allergic reactions and the like over the years. Without our pharmacist’s help these issues could have turned into serious problems. Having an up-to-date medication history, that includes all of the non-prescription medications my guy is on, is essential. This has been invaluable on our trips to the ER. So, we know that our pharmacist has positively impacted his health. But unless there are numbers to prove this, it is simply a nice anecdote of how great pharmacists are.

As resources get ever scarcer, everyone in the health-care system must make the case for why they matter and what solutions they bring to the problems. I have no doubt that pharmacists have much to offer in this regard. And our partnership with GSC will help build our case.

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Feb/Mar 2015

Welcome to the newest members of the BCPhA! Pharmacist (General) members: Mohamed Abdelhameed, Ossama Abou Assi, Jyoti Adhikary, Bashar AlJawazneh, Terry Alford, Mahad Ali-Yusuf, Dalia Amin, Siamak Anbarani, Mehri Asgari-Ardestani, Briana Barker, William Beley, Timothy Blunt, Tanya Borton, Paul Botros, Pauldeep Bratch, Shamsuddin Budhwani, Christopher Carter, Bikramjeet Chahal, Jolene Chan, Livia Chan, Karen Chau, Yajvendrasinh Chauhan, Kin Yuen Cheng, Jin Cheong, Shane Cherrington, Ayumi Chiba, Oscar Co, Jenny Creus, Patrick Dalwadi, Sharinder Dinza, Khaled El Beialy, Aly El Defrawy, Fayroz Elgazar, Jennifer Fan, Mina Filata, Sukhbir Gohal, Subhashchandra Gohil, Baher Habib, Rob Hawkins, Ashley Hilliard, Helen Hua, Julianna Hui, Fong Huynh, Suzan Iskander, Dustin Jones, Richard Jones, Maryam Kabiri-Khaljzadeh, Ramandeep Karbar, Moez Karim, Sumit Khanna, Queenie Lau, Hee Jean Lee, Kathryn Leong, Stephen Little, Man Yi Lui, Amani Ma'ayah, Tarek Mahmoud, Mehdi Majdzadeh Ardakani, Connie Mak, Ying-Wen Mao, Naglaa Mehanna, Bishoi Mikhail, Amira Mohamed, Priya Mohini, Bilal Mouneimne, Diana Mundiyamkal, Kim Nguyen, Rochelle Ong, Bhavikkumar Pandya, Amarvir Parhar, Neha Parmar, Aditi Patel, Jatinkumar Patel, Shital Patel, Viveksagar Patel, Joan Kuh Pinson, Nidhi Punj, Sheeva Qaaboos, Farah Qassar, Abdul Rahim, Rupalkumari Rathod, Tara Ricketts, Daniel Saad, Keungwon Seo, Mahmoud Shaheed, Nasir Shaik, Adam Smollan, Poojan Soni, Jordan Stewart, Brett Sunku, Jessica Tom, Vishal Trivedi, Jennifer Tung, Danny Wong, Erica Wong, Ken Wong, Alex Xu, Jennifer Yaholnitsky, Jianxing Yang and Sarah Yoo.

Pharmacy (Corporate) members: Alert Bay Drugs, Anita's Pharmacy, Bond Street Pharmacy, Carmi Remedy's Rx, Oliver Pharmacy, Pharmasave Health Centre #005, and Shoppers Simply Pharmacy #3082.

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CYRIL LOPEZ, CHIEF OPERATING OFFICER

BCPhA Student Ambassadors We welcome our newest members, David and Sharni.

David Cai, who studied pharmacology at the University of Alberta before getting into the UBC Faculty of Pharmaceutical Sciences, exudes many leadership qualities, is a strong public speaker, and is internally motivated toward his goals. David feels especially passionate toward networking, having attended last year's Professional Development Week in Vancouver, the Pharmacy U conferences, Pharmacy Undergraduate Society Speed Networking events, and several BCPhA Speaker Series sessions, and hopes to share and inspire this passion with fellow students. He is very well-versed in the initiatives being driven by the BCPhA and has high recognition among his classmates from the many other roles he's taken on since joining the pharmacy family.

BCPhA’s newest Student Ambassadors: second year David Cai and first year Sharni Sandhar.

Photo credit: Adam Smylie.

Sharni Sandhar will be joining us as our first ambassador from the Class of 2018. Sharni is originally from Japan, studied pharmacology at the University of Toronto before joining UBC, and has a contagious smile and attitude. She chose this career knowing that she wanted to be a positive influence for people overwhelmed by medical issues and is passionate about the efficiency of health-care systems. She hopes to be involved in discussions with students about the direction of pharmacy and to learn more about how we can advocate expanding our profession in the health-care system.

It has been three years since the start of the BCPhA Ambassador program, whose mission is “to provide a channel of communication between UBC pharmacy and the BCPhA. Through this, we hope to share the BCPhA vision with our fellow students, as well as provide an accessible pipeline to convey students’ concerns to the Association.

It’s a pleasure to have these new students – and our returning progroup_ad_v3.ai 13/11/2008 4:23:24 PM We also pledge to attend and promote all BCPhA-sponsored events, as ambassadors – on board. well as assist, or arrange for volunteers to assist, in BCPhA programs.”

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The current group consists of ambassadors on campus, including Andrea Silver, fourth year; Renée Dagenais, fourth year; Adam Smylie, third year; Jason Alessio, third year; Kevin Sin, second year; David Cai, second year; and Sharni Sandhar, first year; as well as an illustrious alumni group of Jaydee Puri, Aaron Sihota, and Dawei Ji. Y

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DRUG AND POISON INFORMATION CENTRE

Poison Prevention Week: Focus on acetaminophen

by Raymond Li, B.Sc. (Pharm.), M.Sc. Reviewed by Debra Kent, PharmD, DABAT, FAACT, R.Ph., and Chris DeWitt, MD, FRCPC, FACMT

Case: A 52-year-old woman was seen in hospital for possible sepsis. A high serum acetaminophen level, increased creatinine, and severely elevated liver enzymes, INR, and lactate were found on the initial workup. She had been taking acetaminophen with codeine and extra strength

Who gets poisoned and why? DPIC’s experience

acetaminophen chronically for arthritis pain. Despite the

Children five years and younger

antidote and aggressive supportive care, she developed

Almost all of the 783 APAP exposures in this age group were unintentional and included 160 therapeutic errors. Common scenarios included products within easy reach, double doses, and confused measurements. Most of these exposures were managed at home, but there were still more than 110 hospital visits and several hospital admissions as a result.

encephalopathy and died on her ninth hospital day.

Acetaminophen (acetyl-p-aminophenol, APAP) poisoning is the leading cause of liver failure in the western world and is a public health problem.1 The BC Drug and Poison Information Centre (DPIC) helped manage more than 1,900 acetaminophen poisonings and overdoses in 2014. Many, like the case above, were potentially preventable, but the issues are complex. For National Poison Prevention Week (March 15 to 21, 2015), we would like to highlight acetaminophen poisoning and what pharmacists can do to help.

Toxicity Acetaminophen at normal doses (up to 75 mg/kg/d for children under 12 years and up to 4,000 mg/d in adults) is generally safe, although there is evidence that some patients may have toxicity at lower doses.2 With excessive dose, liver damage (caused by a reactive metabolite that is normally detoxified by glutathione) is the main toxic effect. N-acetylcysteine, a glutathione precursor, is very effective in preventing and treating liver damage from acetaminophen when used early, but its effectiveness decreases with time once a toxic exposure has occurred.3 Patients who delay seeking medical attention after an acute overdose or those who have taken excessive amounts over time due to therapeutic error or misuse are at risk for more severe outcomes.

If untreated, a toxic APAP exposure may progress to acute liver

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failure with coagulopathy, renal failure, metabolic acidosis, and encephalopathy. About one-third of patients who develop acute liver failure will die without a transplant.4 Early coma and acidosis before liver damage can also occur in massive overdose due to mitochondrial dysfunction.5

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Older children and adolescents aged six to 19 years In this age group, the majority (80 per cent) of the almost 300 exposures were intentional, leading to almost 200 hospital visits and over 100 hospital admissions.

Adults 20 years and older In adults, suspected suicide accounted for 46 per cent of the 829 exposures, while misuse, abuse, and unintentional therapeutic error accounted for 41 per cent. Adult APAP poisonings led to almost 600 hospital visits and over 300 admissions in BC last year. While most hospitalisations involved intentional overdose, 36 hospital admissions were for unintentional overdose. Five patients died.

Factors associated with APAP overdose are numerous and beyond the scope of this article. However, a few points from the literature are notable: • Intentional overdose: Availability has been identified as a main reason for choosing APAP for overdose. In one study, half of the patients who overdosed on APAP took the overdose less than an hour after thinking about it; two-thirds of these took what was already in the home.6

• Unintentional overdose: In one survey, patients with chronic or ongoing pain were more likely (odds ratio [OR] 4.6-4.9) to take more than four grams of acetaminophen per day. Reading the label did not reduce that risk, but knowledge that APAP was an ingredient, knowledge of the labelled per-dose and daily maximums, and having the attitude of starting with low doses (increasing as necessary) were associated with lower risk (OR 0.5-0.6).7 Prevention and the pharmacist’s role10,11 Efforts to reduce intentional and unintentional poisonings have been made at the regulatory and industry level, with the U.S. and U.K. leading the way. Examples include restricting availability, improving packaging and labelling, reformulating products and reducing recommended doses, and awareness campaigns.2,8-10 Examining all the prevention options is beyond the scope of this article. However, pharmacists play an important role in the safe use of acetaminophen, and given its widespread use, individual efforts may save a liver or a life: • Encourage patients to check ingredients and doses, and help them understand labels

• Encourage patients to use the lowest effective dose and increase only if needed; counsel patients, especially those with chronic pain, not to exceed recommended doses • Consider lowering maximum daily dose in patients with chronic liver disease and in those taking other potentially hepatotoxic pharmaceuticals including natural and herbal products.

• Ask about other acetaminophen use when dispensing or recommending a product with acetaminophen, and ensure patients understand the total amount of acetaminophen from all sources that they can safely take • Ensure caregivers understand how to dose children’s acetaminophen products – provide the proper dose for a child’s age and weight, demonstrate dosing devices • Encourage safe storage and disposal of all medications.

For more patient education tips on acetaminophen, visit http:// www.safemedicationuse.ca/newsletter/newsletter_Acetaminophen. html and http://www.knowyourdose.org/.

If you suspect an overdose, call the Poison Control Centre at 604.682.5050 or 1.800.567.8911.

References available upon request at info@bcpharmacy.ca.

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DEREK DESROSIERS | DIRECTOR, PHARMACY PRACTICE SUPPORT

Regulatory compliance support

Pharmacy payer audits were a subject that garnered a lot of attention in 2014. Topics such as requirements of a prescription, electronic signatures and six-month prescription renewals in residential care facilities and homes are all audit-related issues that the Association escalated and resolved on behalf of members in the past year. Through significant involvement in member audit-related issues, we have noted new trends and vulnerabilities.

This year we are continuing to offer the Regulatory Compliance Bootcamps in various locations across the province and are exploring how to reach members in more rural areas. We’ll continue to explore ways including the bootcamps, eTraining, and policy and procedure manual templates, in which to support members in meeting regulatory requirements in addition to advocating with stakeholders on fair approaches to pharmacy audits.

Last fall we launched the first of our Regulatory Compliance Bootcamps (seven scheduled to date) to assist members in understanding both pharmacy and payer requirements to mitigate the risk of penalties associated with audit assessments. These workshops are particularly valuable because they use real-life examples and errors we have seen in many different audits. It’s been great to see the workshops filled with participants asking many thoughtful questions and provoking good discussion with us and among their peers. With the rules and regulations governing pharmacy continuously changing, the workshops have highlighted the need to regularly review workflow processes and habitual practices to ensure that one is still practicing in line with current pharmacy practice and payer requirements (which we are calling “regulatory requirements”).

Many of these resources and information on upcoming educational opportunities are available on the members' side of www. bcpharmacy.ca under Pharmacy Practice Support - Regulatory Compliance Support.

Based on participant feedback the workshops have been essential for staff pharmacists, pharmacy managers and owners in equipping themselves with the knowledge to assess and enhance their own compliance practices to reduce the potential audit implications, which can have significant financial implications. For example, in one PharmaCare audit, every dollar of error resulted in seven hundred times its value in audit recovery (based on extrapolation), meaning non-compliance of a few hundred dollars can translate into hundreds of thousands of dollars in audit recovery. So, the financial impact can be significant.

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But don’t take our word for it. Here’s feedback from past attendees: “This was an EXCELLENT program and EVERY registrant in the province should be required to attend!!”

"The presentations were crisp and to the point. As with anytime a group of pharmacists get together, the ‘war stories’ we can all share, create as much information as that being presented."

"This workshop is a must for new pharmacies, pharmacies wishing to expand their business, as well as any person(s) within your business that are responsible for Third Party Risk Assessment. The workshop is an excellent source of information, where you can receive real-time answers from the association to provide guidance on all aspects of your pharmacy practice."

“The audit approach has changed. When I see the examples of the basis of audit claw backs, I am shocked. They are going by the book.

For sure such a workshop, with its real life examples, would support our staff in understanding that compliance is a key process.”

CLINICARE PHARMACISTS

Tolerance to prophylactic migraine medications

By Larry Leung B.Sc. (Pharm.), R.Ph., and Jason Min, B.Sc. (Pharm.), R.Ph. One of the most challenging referrals we have had recently involved a patient who was experiencing a potential tolerance to her prophylactic migraine medications. This was an especially difficult case due to the lack of knowledge and available literature on how to best identify and manage the development of tolerance.

The patient: • 40- to 50-year-old female • Migraines for the last 17 years • Usually one to two migraines/week while on medications • Increasingly frequent migraines over the last six months; now two to three migraines/week • Sumatriptan and ibuprofen continue to work well for acute abortive therapy Medication history: • • • • •

Sumatriptan 100mg po stat dose prn Ibuprofen 400mg po stat dose prn Propranolol 80mg po bid Magnesium citrate 200mg po bid Zopiclone 7.5mg 1/2 tablet po hs prn

Our first priority was to ensure that the increase in migraine frequency was truly due to a tolerance to her prophylactic medications rather than a change in disease. We met with the patient and obtained a thorough history of her migraines including changes in modifiable risk factors, exposure to possible triggers, or changes in symptomology of the migraines. She was not exposed to any of her known triggers including caffeine, strong scents, and oversleeping. There were no changes in the presentation of the migraine, nor were there any changes in her diet or lifestyle.

Secondly, we needed to ensure that her medication use did not change. Medication overuse headaches are a common concern in patients with chronic migraines. As migraines become more frequent, they may develop into chronic daily headaches that begin to resemble tension-type headaches. Triptan use should be limited to less than 10 days per month and non-opioid analgesics

should be limited to less than 15 days per month to avoid medication overuse headaches. Despite her recent increase in migraines, she only had a small increase in the number of acute abortive medications and was still under the recommended monthly doses.

We conducted a literature search and found one systematic review from 2011 that addressed the potential causes and mechanisms for tolerance to migraine medications. According to the study, multiple reasons may contribute to tolerance, including pharmacokinetic, pharmacodynamic, behavioural, and cross-tolerance causes. The authors proposed a one to eight per cent estimated incidence of a patient developing a tolerance to migraine prophylaxis medications. Given that many of the prophylactic medications can exert effects through the endogenous opioid system, the authors believed this mechanism was the reason an eventual loss of medication efficacy develops.

There were conflicting results as to whether propranolol specifically had the potential for tolerance and the study did not indicate a timeline for this development.

Based on the guidelines, we recommended the addition of a second medication for prophylaxis. Since our patient occasionally uses zopiclone for insomnia, we recommended the addition of amitriptyline 10mg hs to be titrated as tolerated with a follow-up in two weeks. We also recommended an increase in magnesium citrate dose to 300mg bid to meet the recommended dose. An eventual discontinuation of zopiclone and propranolol may be considered if the amitriptyline trial proves beneficial. Other firstline options could have been considered as well. What would you have chosen?

Larry Leung and Jason Min are directors of Clinicare Pharmacists Inc. and lecturers at UBC. They have been working collaboratively with several First Nations across BC delivering clinical pharmacy services since 2010 and are creators of Canada’s first pharmacyspecific elective course entitled Pharmaceutical Care in Aboriginal Health at UBC. References available upon request; please contact the BCPhA Communications team.

www.bcpharmacy.ca

Feb/Mar 2015

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GOVERNMENT RELATIONS

Pharmacy Day 2015: Pharmacy is an opportunity for better health care

by Letlotlo “Coco” Lefoka The BC Pharmacy Association will host Pharmacy Day at the legislature on March 23, 2015. The goal of Pharmacy Day is for pharmacists to directly engage MLAs about the vital role they play in BC’s health-care system. Pharmacy Day is also an opportunity for pharmacists to advocate for legislative and policy measures that will improve pharmacy services in the province.

The Association is aiming to build on the success of the Pharmacy Day held in March 2014. For last year’s Pharmacy Day, the BCPhA built a pharmacy exhibit at the BC legislature. The exhibit demonstrated medication dispensing services and Medication Reviews. Volunteer pharmacists also administered 23 immunizations to MLAs, government officials and legislative staff. The exhibit also featured three clinical services – diabetes care, anticoagulation management and asthma support – that pharmacists could readily offer to British Columbians.

Money will no doubt be on the minds of MLAs as they will be in the midst of debating and voting on the provincial budget. Health care is the province’s largest expenditure. But we are not there asking for money. We are there to demonstrate the work we’re doing to help British Columbia.

That innovation, efficiency and alternative service delivery models provide the only solutions to BC’s health-care challenges is well known. This is particularly the case when it comes to the costs associated with providing care to seniors, a demographic that is fast growing in BC. One area where the BC government can improve seniors’ health care while reducing costs is working with pharmacists on making warfarin testing in pharmacies broadly

This year’s focus is on how pharmacy services offer BC an opportunity to deliver better, more efficient and cost effective health care. Specifically, the BCPhA will be educating MLAs about how the current health-care model imposes needless limitations on pharmacists that result in an underutilization of their skills, training and expertise. The Association will be placing particular emphasis on showing how pharmacists are part of a solution to healthcare system problems.

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available across the province. Point-of-care testing for warfarin makes good clinical and financial sense, and the BCPhA will use Pharmacy Day to make the case for it.

On the innovation front, the Association will be highlighting the potential of the “Genomics for Precision Drug Therapy in the Community Pharmacy” project to help pave the way for accessible personalized medicine. The potential of this innovation to reduce drug costs and improve health outcomes is significant.

Pharmacy offers opportunities for better health care in BC. So, on Pharmacy Day MLAs will be urged to do their part to lead the change needed to ensure BC makes the most of these opportunities.

BCPHA ANNUAL CONFERENCE 2015

Stand Out. Brand yourself.

Define your practice.

Save the date! The BCPhA Annual Conference 2015 is heading to Victoria from May 21 to 23 and promises to bring a new host of speakers and sessions to pique your interest.

This year’s theme is Stand Out. Brand yourself. Define your practice. Our keynote, educational sessions and social events will focus on ways pharmacists can differentiate themselves in an increasingly competitive marketplace and find their niche in the everevolving health-care environment. As always, our speakers will address hot topics of interest to members – legislation compliance, best practice standards and more.

Keynote speaker Meghan Telpner is a Toronto-based nutritionista whose humorous, engaging and real approach to healthy living has garnered a world-wide following and extensive media attention. Her online cooking courses and brand new school, the Academy of Culinary Nutrition, offer inspired training for life. Meghan’s bestselling and awardwinning book UnDiet: Eat Your Way to Vibrant Health is creating a revolution in how people think about their health.

Read more about the full conference program online at www.bcpharmacy.ca/conference and in the April/May issue of The Tablet.

PHARMACIST AWARENESS MONTH

Pharmacist Awareness Month: Pharmacists are #MoreThanPills March is Pharmacist Awareness Month. That means the BC Pharmacy Association will be working to raise the professional profile of pharmacists across the province.

Often only thought of as “pill dispensers” by the public, the BCPhA’s awareness campaign will highlight the other important health-care counseling services that pharmacists provide and how pharmacists are one of the most accessible health-care providers for patients.

The BCPhA will work to raise awareness with media throughout the province with a campaign tagline highlighting that pharmacists do a lot “More Than Pills”.

We encourage members to share the #MoreThanPills hashtag in their own digital content.

The campaign will focus on four areas of innovation and opportunity pharmacy brings to health care: medication adherence including the new cardiovascular risk management program with Green Shield Canada; immunization services; the Genomics for Precision Drug Therapy project; and point-of-care testing for warfarin patients.

The #MoreThanPills campaign will culminate with Pharmacy Day at the

www.bcpharmacy.ca

legislature on March 23. There, pharmacists will interact with MLAs and government staff on the various services and innovations that pharmacy provides outside of “pill dispensing”.

The BCPhA is looking for pharmacy members willing to be profiled or serve as spokespeople with their local media during Pharmacist Awareness Month. If you’d like to participate in raising awareness of the pharmacy profession, please contact communications manager Elise Steeves at elise.steeves@bcpharmacy.ca or 604.269.2866.

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CARDIOVASCULAR RISK MANAGEMENT

BC pharmacists provide cardiovascular health coaching program

by Elise Steeves

Heart disease and stroke are among the leading causes of death and hospitalization in Canada. In 2008, nearly 30 per cent of all deaths reported were due to cardiovascular disease. Hypertension, a risk factor for the development of cardiovascular disease, affects more than 20 per cent of Canadians over the age of 20, although the actual number is likely much higher as many individuals remain undiagnosed. About 40 per cent of Canadians have high cholesterol.

By the numbers

More than

144,000

65

Age under which patients are eligible

40% 4

British Columbians who are Green Shield Canada plan participants

Percentage of Canadians with high cholesterol

million Canadians are affected by hypertension

Pharmacists will be compensated for their services by GSC: $60 for the initial consultation and $20 for each follow-up to a maximum of three follow-up consultations per year.

$60

To control high blood pressure and cholesterol, individuals commonly rely on medications, in addition to adopting healthy lifestyle changes.

This is where community pharmacists come in: Evidence suggests that pharmacists can positively influence adherence to both drugs and health behaviours. And, because they’re so accessible, pharmacists can perform more frequent interventions with patients.

Now, the BC Pharmacy Association (BCPhA) and Ontario Pharmacists Association (OPA) are partnering with Green Shield Canada (GSC) to launch a new pharmacist counselling service focused on cardiovascular health that will make the most of these opportunities.

Beginning this February, the Pharmacist Health Coaching – Cardiovascular Program is a cognitive service provided by pharmacists that focuses on cardiovascular health and offers blood pressure and cholesterol management to patients. Pharmacists will be paid for the counselling services they provide after taking a mandatory training course.

Under the program, pharmacists will offer eligible patients support and counselling on managing high blood pressure and high cholesterol through counselling sessions over a one year period. Its main objective is to empower patients diagnosed with hypertension and elevated cholesterol to take ownership and responsibility for their overall cardiovascular health. It will focus on diet, exercise, smoking cessation, drug adherence and personal health monitoring.

“High blood pressure and high cholesterol are primary risk factors for cardiovascular disease – we applaud the pharmacy associations and Green Shield Canada for implementing a program that will go a long way in helping those living with these risks to control their blood pressure and cholesterol levels, make lifestyle changes, and improve their medication regimens,” said Dr. Gavin Arthur, Director, Promote Recovery, Heart and Stroke Foundation. (continued on page 18)

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CARDIOVASCULAR RISK MANAGEMENT

The program is based on a successful pilot project sponsored by GSC in partnership with OPA last year (see sidebar for further details). That project provided clear evidence that a significant percentage of patients who received a pharmacist’s services had lower blood pressure, lower body mass indexes and improved medication compliance. This improved compliance led to reduced drug costs.

“Our experience shows that a key element of managing overall health benefits costs for our clients is helping their employees better manage their personal health. And pharmacists have a natural point of interaction with them,” said Steve Bradie, president and CEO of Green Shield Canada.

“Through this investment in health management, our goal is to not only improve health outcomes and influence drug therapy adherence, but also lower overall plan costs and, in the end, deliver savings to the Canadian health-care system.”

Each pharmacist delivering the service is required to complete a short, mandatory orientation and training course available online (visit www.bcpharmacy.ca/etraining to learn more). Pharmacists who have completed the mandatory training are also expected to stay current and maintain competencies in cardiovascular health management and motivational interviewing.

“We’re confident this new program will demonstrate the benefits of pharmacist intervention in managing high blood pressure and high cholesterol and be of significant benefit to your patients,” said Derek Desrosiers, BCPhA director of pharmacy practice support.

Impact of Community Pharmacist Interventions in Hypertension Management on Patient Outcomes: A randomized controlled trial There is a growing awareness across Canada and internationally that pharmacists are an underutilized resource when it comes to chronic disease management. Hypertension is the most prevalent chronic disease in Canada with more than four million Canadians afflicted, less than one third of who have their blood pressure under control.

This study aimed to examine the impact of a six-month, pharmacist-led hypertension management program on patient health outcomes. It involved a randomized controlled trial with more than 150 patients and 38 community pharmacies across Ontario.

“We congratulate Green Shield Canada on undertaking this innovative approach to improving health outcomes while also reducing medication costs.”

The program improved systolic blood pressure by 13.5mm Hg, led to a quadrupling in the number of patients whose blood pressure is under control, and increased adherence to medication therapy by 15 per cent.

Patient eligibility

The study demonstrated that a pharmacistled hypertension management program can significantly improve patient blood pressure and adherence to medication therapy in a very short, six-month time frame.

Pharmacists will determine patient eligibility based on review of a patient’s medication history, likely done at the time of dispensing. The BC program will be available to patients with both high blood pressure and high cholesterol, and who meet all three of the following criteria: 1. Have GSC extended health and drug benefit coverage 2. Are under 65 years of age 3. Are treated with a cardiovascular drug regimen that includes at least one qualifying drug from each of the two categories below: 

Antihypertensive agents ¨ Thiazide/thiazide-like Diuretic ¨ Beta-blocker ¨ Long-acting Calcium Channel Blocker ¨ ACE Inhibitor ¨ Angiotensin II Receptor Blocker ¨ Renin Inhibitors

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In addition to achieving these positive health outcomes, the program reduced antihypertensive medication costs by more than 31 per cent.

Patients reported a very high level of satisfaction with pharmacist services and about a quarter of the employed patients reported being more productive at work as a result of participating in the study.

From an employer perspective, incorporating a pharmacist-led chronic disease management program in their benefit plans can therefore not only help contain drug therapy costs in the short term but also lead to healthier, more productive employees.

 Cholesterol lowering agents ¨ HMG-CoA Reductase Inhibitor ¨ Ezetimibe

18

Perhaps more importantly, the improvements in health outcomes were observed for a younger patient population than has traditionally been the subject of research in this area. Improving blood pressure control in this population can translate into a significant reduction in the risk for cardiovascular disease and stroke and better long-term outcomes.

www.bcpharmacy.ca

NEW TRAINING PROGRAM

Anticoagulation Therapy Management for Pharmacists The BCPhA is pleased to announce a new program that will enable pharmacists to offer anticoagulation therapy management to patients.

There are approximately 62,000 British Columbians who are currently on warfarin therapy for anticoagulation management. The average warfarin patient has their blood tested every four weeks (12 to 16 tests annually) at a laboratory. The laboratory reports the results back to the physician, who then contacts the patient to provide instruction on any necessary dosage adjustments. These adjustments are often made at a community pharmacy.

However, patient care and outcomes, as well as the costs of this service, can be better managed by implementing point-of-care testing right in community pharmacies.

To move forward with expanding these services to a broad spectrum of pharmacies, the BCPhA has licensed an online learning program through the University of Florida.

Anticoagulation Therapy Management for Pharmacists has now been accredited by the Canadian Council on Continuing Education in Pharmacy (CCCEP) for 40.5 CE hours.

This course is intended for pharmacists who manage or who plan to manage patients who have diseases and disorders requiring anticoagulation therapy. The major course objective is for pharmacists to achieve a high level of confidence with patients who require anticoagulation and with their primary care physician.

This confidence is the result of a greater depth of understanding the patient’s disease state, the therapy used and the monitoring parameters for patients receiving anticoagulation agents.

Course Objectives • Relate how pharmacokinetics and pharmacodymanics principles are used to achieve and maintain anticoagulation control within the patient’s therapy goals.

• Describe the complexities of managing drug therapy and other treatment modalities.

• Summarize how pharmaceutical care is applied for patients requiring anticoagulation therapy.

• Use effective interpersonal skills to better educate patients, caregivers, and other healthcare professionals regarding safe and optimal anticoagulation therapy.

• Design an anticoagulation management service for effective patient care.

• Document anticoagulation therapy for patients receiving such therapy.

The course takes an average of 12 weeks to complete and will cost $625 USD for BCPhA members (a significant discount off the original $795 USD for non-members). Each pharmacist completing all parts of the course will receive a Record of Completion from the University of Florida’s College of Pharmacy.

To learn more or start your training, visit www.bcpharmacy.ca/etraining.

www.bcpharmacy.ca

DAWN AC Anticoagulation software To make the most of these new opportunities and maximize your efficiencies with anticoagulation management, pharmacy organizations should also consider a software application called DAWN AC Anticoagulation software.

DAWN AC Anticoagulation management software is the global market leader for managing large anticoagulation clinics.

It is designed to help you establish a more efficient, effective and safer way of managing your patients.

The BCPhA has negotiated an exclusive distributorship and pricing for licensing for this application. London Drugs has already implemented this new software in six pharmacy locations in BC. The key benefits of the DAWN AC Anticoagulation software are: • Increased productivity (e.g. 22 per cent increase in productivity within six months; a doubling of patient numbers without the need for extra resources. An average of 600-700 patients per health-care professional is achieved by users.)

• Increased patient safety (e.g. 64 per cent reduction in non-attenders; 27 per cent decrease in emergency admissions for adverse events) • Improved patient experience (e.g. patient turnaround in clinic cut to five to 20 minutes from 45 to 50 minutes) • Improved patient outcomes (multicentred randomized clinical trial shows a 10 per cent increase in percentage time in therapeutic range compared to manual dosing) For more information about the DAWN software, please contact Cyril Lopez at cyril.lopez@bcpharmacy.ca or 604.269.2869.

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PRACTICE REVIEW PROGRAM

College launches the Practice Review Program

The College of Pharmacists of BC has recently announced the launch of the Practice Review Program.

Under the Practice Review Program, every pharmacist, pharmacy technician and pharmacy will be reviewed in-person at least once every six years. The College recently hired and trained compliance officers – all practicing pharmacists – to conduct the reviews.

The Practice Review Program is comprehensive in scope and is first launching across all BC community pharmacies. It will expand later to hospital pharmacies and other practice settings.

A practice review consists of two parts: the Pharmacy Review and the Pharmacy Professionals Review. These reviews are designed to be reasonably non-disruptive to daily operations, as compliance officers will mainly be observing practice settings and individual registrants.

Pharmacy Review The Pharmacy Review is the process in which a compliance officer will review the pharmacy site. It is based on the existing inspections process, and is grounded in College standards, guidelines, and provincial legislation. It will take approximately half a day.

Pharmacy managers should have started receiving emails from the College to confirm dates, schedule staff, and complete the Pharmacy Pre-Review prior to the compliance officer’s visit. The Pharmacy Pre-Review contains all of the review items that a compliance officer will be looking at, and it helps the pharmacy manager prepare for the on-site review. It also enables the pharmacy manager to make any necessary corrective actions prior to the compliance officer’s arrival.

A Pharmacy Pre-Review Tutorial is available online at www.bcpharmacists.org/ to guide the pharmacy manager through the process.

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Pharmacy Professionals Review The Pharmacy Professionals Review occurs after the Pharmacy Review and takes approximately half a day per registrant.

Compliance officers will observe each pharmacist and pharmacy technician as they perform their work and assess them using the four Board-approved current focus areas: • Patient Identification (ensuring the right patient gets the right medication) • PharmaNet Profile Check (ensuring medications are appropriate and work safely together) • Counselling (ensuring patients understand why and how to take the medication safely) • Documentation (ensuring accurate records are kept for each prescription) Results of the Pharmacy Professionals Review will be shared with the registrant immediately. If action items are assigned, they have 30 days to complete them and submit any supporting documentation to their compliance officer.

All pharmacists and pharmacy technicians are required to participate in the Practice Review Program.

The Practice Review Program is a new and progressive method to ensure that pharmacists and pharmacy technicians comply with College standards, guidelines, and provincial legislation in order to provide quality care. The program also establishes a consistent, equitable and fair process of assessing pharmacy operations across the province. It is expected to evolve over time as the pharmacy profession changes.

Visit the College’s website at www.bcpharmacists.org for more information and support tools on the Practice Review Program.

Submitted by the College of Pharmacists of BC.

GENOMICS FOR PRECISION DRUG THERAPY

BCPhA advancing research project on medication selection and dosage guided by DNA

The 18-month research project “Genomics for Precision Drug Therapy in the Community Pharmacy” is underway.

Announced last fall, the project is funded by BC Pharmacy Association (BCPhA) and Genome BC, with research done by a team at UBC’s Faculty of Pharmaceutical Sciences. The project will develop standard operating procedures for the collection of patient DNA samples by community pharmacists and the processing and sequencing of the samples at UBC. A key element of the project is to design patient education and the appropriate consent materials.

Patients who are currently taking the commonly prescribed drug, warfarin, will be part of the study. Analysis will be done to determine how DNA information would have altered the drug dosage patients were prescribed. There will be up to 25 pharmacies across the province that are participating and will gather saliva samples from 200 patients. Those samples will be shipped back to UBC for analysis.

The BCPhA began training participating pharmacies in early February with plans for pharmacists to begin recruiting patients – about 10 patients per pharmacy – and collecting their DNA samples this spring.

“We’re working through the protocols to ensure the proper handling of patient information, ensuring the integrity of the DNA sample and its transport from the pharmacy to the UBC lab and ensuring we can do this on a province-wide basis,” said BCPhA CEO Geraldine Vance.

Ernst & Young’s Health-Care Advisory Services team began meetings with key stakeholders, ranging from the Office of the Information and Privacy Commissioner to the Doctors of BC and

private insurance companies, last month gathering their input on the project. This robust stakeholder engagement process will look at issues such as physician/pharmacist communication of results and how best to offer the testing in community pharmacies across the country.

Genetic testing has often been viewed as a way to identify potential diseases. This project focuses on using DNA to make medication selection and dosing decisions for commonlyprescribed medications. It uses community pharmacists as the health-care provider to collect patient genetic information and help guide drug therapy decisions.

The protocols developed during the project will be applicable for all medications that are impacted by a person’s DNA. This project makes the science of pharmacogenomics accessible to patients in their communities and brings the promise of personalized medicine one step closer to being a reality.

Pharmacists own a key role in that.

“We’re very excited about this project, because that’s going to be interplay between physician, patient and the pharmacist,” said Brad Popovich, chief scientific officer for Genome BC. Lead UBC researcher Corey Nislow, whose lab will process the DNA samples, agrees.

“By centering the information provider in the pharmacy with the pharmacist, we’re going to provide a level of continuity of care that you can’t get from a specialist,” he said.

To learn more about the project, visit www.bcpharmacy.ca/genome.

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WEIGHT LOSS PRODUCTS

Weight loss products: What pharmacists need to know

by Amy Pezzente Companies that distribute WLPs claim their products increase energy, flush fat, “cleanse” and more, such as: • Curb food cravings (ingredients like: chickweed, bee pollen, fennel) • Make you feel full so you don’t overeat (ingredients like: guar gum, psyllium or polyethylene glycol) • Speed up your metabolism (ingredients like: caffeine, guarana, yerba mate, B-complex vitamins, synephrine (aka citrus aurantium, bitter orange, zhi shi) • Slow down fat production (ingredients like: green tea, hydroxycitric acid, flax seed) • Prevent absorption of dietary fats (ingredients like: chondroitin).

Why pharmacists are important Every day, youth in British Columbia are at risk for cardiac arrest, seizures, liver toxicity, and other dangers because of deliberate misuse of over-the-counter, easily accessible weight loss products (WLPs).

As one of the most accessible health-care providers, pharmacists play a key role in educating the public about the health risks associated with misuse of WLPs. Using an evidence-informed approach, pharmacists have a responsibility to provide appropriate recommendations about prescription and non-prescription drugs and supplements, including WLPs. Problems with weight loss products Use of WLPs can seem like a magical solution for someone seeking to lose weight. Labels on WLPs entice people by using photos of plump bellies shrinking down to become fit abdominals, or a thin model smiling with a tape measure around her waist. These products offer the promise of weight loss with no required change in diet or exercise, yet provide little or no clinical research to back up these claims.

When someone seeks to purchase a WLP, they have no shortage of choices.

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Health risks of weight loss products Some may think WLPs are relatively harmless, but several of the ingredients in these products have been found to have harmful adverse effects, such as: • Increased heart rate and blood pressure • Agitation and sleeplessness • Diarrhea and rectal bleeding • Kidney and liver damage Since 2007, Health Canada has issued at least 45 “risk communications” involving more than 170 WLPs.

www.bcpharmacy.ca

In May 2009, a popular stimulant drug was pulled from shelves in the U.S. after its use led to 23 cases of liver toxicity and one death. In February 2014, Health Canada recalled another popular cleansing drug due to a combined effect of active ingredients that posed serious health risks (e.g., dehydration and/or electrolyte imbalance). Because Health Canada does not test all weight loss products for safety, there’s no guarantee that the ingredients in every product are safe or fully disclosed.

In 2009, the Food and Drug Administration discovered potentially dangerous unlisted ingredients in 69 different WLPs. Because some manufacturers do not list all ingredients on their product labels, consumers may unknowingly take ingredients such as: • Sibutramine: a previously available prescription WLP withdrawn from the market worldwide because of an association with increased risk of hypertension, heart attack and stroke • Ephedrine derivatives • Rimonabant: an unapproved appetite suppressant with significant psychiatric adverse effects • Phenytoin: an anti-seizure drug • Phenolphthalein: an experimental drug that may cause cancer.

Health risks for youth taking weight loss products Demand for WLPs is rising; total annual spending on WLPs is now up to $44 billion in North America, and we are seeing more adverse health effects of WLPs in youth.

Some youth are so preoccupied with losing weight that they overlook any potential health risks. Because WLPs are available over-the-counter and online, youth have easy access to these products without medical advice and may be more likely to misuse them. Up to 50 per cent of patients with an eating disorder use WLPs. In fact, because WLPs are so readily accessible, youth are known to take them: • Above the label recommended dose • When they are already at a normal weight or underweight • Without a doctor’s supervision, and/or • In combination with other WLPs, laxatives or diuretics.

Taking excessive doses of a WLP or combining WLPs can be extremely hazardous. An overdose of a stimulantcontaining product could raise blood pressure to dangerously high levels, increasing risk of a heart attack or stroke.

Taking fat-blocking WLPs along with laxatives or diuretics could cause diarrhea, fluid loss and electrolyte imbalance, or

prevent absorption of required nutrients such as fat-soluble vitamins or certain prescribed medications. Misuse of WLPs that have a risk for liver or kidney damage increases the possibility of lifethreatening organ failure. It’s imperative that pharmacists recognize signs of WLP misuse, such as: • Repeat visits to the WLP section; • Purchases of excessive quantities of WLPS; • Purchaser appears normal-tounderweight, wears baggy clothing, or looks tired (e.g., under-eye bags); and • Purchases of other diet products (e.g., diet soda), laxatives or diuretics.

Call to action Misuse of WLPs can be dangerous or even life-threatening in some cases.

Pharmacists can play a key role in counselling youth regarding the potential health risks and limited benefits of WLPs. Furthermore, pharmacists can offer advice on lifestyle changes necessary to achieve and sustain a healthy weight.

A concerted effort is required to reduce, and prevent harm to youth by educating on appropriate use of WLPs and the risks of false, unsafe, and unregulated WLPs. Pharmacists should consider what products are being stocked on their

www.bcpharmacy.ca

shelves. If WLPs are being sold, ideally, they should be stocked in clear view of the pharmacists, who can monitor for potential abuse. Pharmacists could consider stocking WLPs behind the pharmacy counter so pharmacists can educate the consumer, explain the health risks, and deter sales of WLPs when misuse is suspected.

For more information, visit: www.hc-sc.gc.ca/ hl-vs/iyh-vsv/med/nat-prod-adulter-eng.php About the author: Amy Pezzente works for the Jessie’s Legacy Eating Disorders Prevention Program, where she coordinates the Provincial Eating Disorders Awareness (PEDAW) campaign. Amy presents at schools, conferences, and workplaces on disordered eating, self-esteem, and body image. She is also an Eating Disorders Peer Support Worker at the Kelty Mental Health Resource Centre, where she assists people of all ages who are struggling with eating disorders from the perspective of having fully recovered from an eating disorder herself. She is also the coordinator for the Looking Glass Foundation for Eating Disorders Online Support Groups. The field of eating disorders holds a very precious and delicate place in her heart and she has an intense passion for it. If you’d like to get in touch with Amy, contact her at pedaw@familyservices.bc.ca.

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MEDICATIONS RETURN CAMPAIGN

Fish can’t say no to drugs That’s the catchy phrase that won a recent Capital Regional District slogan contest for the BC Medications Return Program and inspired a new video created by the BCPhA with support from the Health Products Stewardship Association.

For the past five years, the BCPhA has played a leading role in promoting the medication returns through an annual campaign that reminds residents to take a closer look in their medicine cabinets.

Chances are many of us will find prescription drugs, vitamins, and over-thecounter products that are expired or we no longer use.

Flushing medication down the toilet means it ends up in the ocean, where it can have a negative effect on fish and the marine environment. Medications in household garbage can easily be found by children, pets and wildlife.

So what should people do? Return expired and unused medications to the more than 1,100 BC pharmacies that participate in the program.

This year, the BCPhA has also teamed up with the regional districts of the Central Okanagan, Comox Valley, Nanaimo, North Okanagan and Metro Vancouver for joint news releases and cross-promotion.

Pharmacist Wendy Mays participated in the promotional video developed to create awareness of the Medications Return Program.

Did you know?

In 2009, BC residents returned just over 50,000 kg of expired and unused medications through the BC Medications Return Program. In comparison, last year more than 95,000 kg were returned to pharmacies.

You can view the new promotional video online at www.bcpharmacy.ca/med-return.

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What’s acceptable through the BC Medications Return Program?

YES

NO

ü All prescription drugs ü Over-the-counter medications (including pills/liquids) ü Natural Health Products in oral dosage forms (including vitamins and traditional Chinese medicines) ü Anti-fungal creams ü Anti-bacterial creams ü Inhalers ü Patches

û Sharps, syringes or needles û Cosmetics û Empty pill bottles û Shampoos û Mouthwash û Antiperspirants û Antiseptics û Pharmaceuticals from farms/hospitals û Pharmacy waste produced by the pharmacy û Expired samples from doctor’s office

Any liquid or cream medications should be kept in their original container with any personal information removed or blacked out, and solid medications such as pills should be combined into a small bag.

The vial/bottle (except liquid medications) should be recycled where facilities exist. The maximum weight for a full container is 23 kg.

Free promotional materials including bookmarks (available in English, Punjabi and Chinese), brochures and display stickers are available for pharmacies to order year-round at www.healthsteward.ca.

THE RIGHT MIX Evolution happens and we’ve been there!

Pharmacy practice continues to expand in scope. Wynward is here to support that progress. In collaboration with BCPhA, Wynward recognizes the need to be responsive on emerging trends, while at the same time delivering The Right Mix on product, price, and service experience for your insurance needs. wynward.com

www.bcpharmacy.ca

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CAREER LISTINGS

focused pharmacy experience, and we intend to fully implement the scope of practice of a pharmacy technician. To apply, please send resume to armstrongpharmacy@telus.net.

ARE YOU MAXIMIZING THE VALUE OF YOUR MEMBER BENEFITS? Pharmacy members can place free Career Opportunities listings in this section and on the BCPhA website. Job postings for pharmacy technicians and assistants are also distributed by the Pharmacy Technician Society of British Columbia (PTSBC). A new enhancement to the best pharmacy job board in BC!

CRESTON Pharmacist – full-time

Pharmacist members looking for new career opportunities can post their resumes for free on the Hire-aPharmacist page. To learn more, visit the Recruitment section of bcpharmacy.ca ALDERGROVE Pharmacy technician – full-time In business since 1922, Otter Co-op is a successful $200M retail operation, located minutes east of Langley. Due to our tremendous growth and expansion plans, we are accepting applications for a full-time pharmacy technician. We provide an excellent pharmacy practice environment with personal growth and career development opportunities. If you are highly motivated to provide excellent pharmacy care and customer service please contact Hisham by email at pharmacymgr@otter-coop. com or fax 604.856.3101.

ARMSTRONG Pharmacist – full-time We are independently owned pharmacy in the North Okanagan region seeking a clinicallyorientated pharmacist. Our modified workflow allows pharmacists to work completely separate from dispensing functions in order to focus on quality pharmacist services, clinical interventions, and follow up with patients. We have great relationships with our patients, local physicians, and other members of the community health-care team. We are seeking a pharmacist who is willing to continue to foster and build these relationships. Experience what it's like to work with a team that will fully support you in developing new and creative ways to improve the health of our community while making full use of our growing scope of practice. We offer great hours and a competitive wage and benefit package. Please send resumes to gaarscott@gmail.com.

Pharmacy technician – full-time Independent pharmacy in the North Okanagan seeking pharmacy technician. Candidates must be fully registered with the College of Pharmacists of BC (CPBC). Excellent communication skills and experience with being part of a team is required. We are currently changing our workflow to have a patient-

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Overwaitea Food Group, one of Western Canada’s leading food and consumer-goods retailer, operates more than 100 pharmacies in BC and Alberta under the following banners: Save On Foods, PriceSmart Foods, Coopers Foods, Urban Fare and Overwaitea Pharmacy. We provide a very professional pharmacy practice environment and are committed to: challenging and growing our staff, caring for people, healthy living for our shoppers and patients, innovation, and investing in our future. Join the Overwaitea Food Group and make your career prescription complete! For more information on career opportunities, please contact or forward your resume in confidence to Brent Darrach, regional manager, pharmacy operations, at pharmacyemployment@owfg.com.

Pharmacist – full-time or part-time We are currently looking for a full-time or part-time pharmacist to join our friendly, professional team. We take pride in providing superior patient care in a thriving community pharmacy. Pharmacists overlap on weekdays and work alongside two or three pharmacy assistants to allow the provision of prompt and courteous pharmacy services. If you are a motivated pharmacist looking for a rewarding career, please contact us for more information about this opportunity. Please visit www. crestonvalleybc.com to learn more about our community and surrounding area. Please send resumes to Jody McBlain, owner, at pharmasave282@gmail.com, fax 250.428.9082 or please call 250.428.9080.

DELTA Pharmacist – full-time We are looking for full-time pharmacists for our Lower Mainland pharmacy. Experience with WinRX/Kroll and Microsoft Office (Word, Excel, etc.) are necessary. The successful applicant is required to have at least one to two years of experience working in a community pharmacy and to be injection certified. Pharmacists must also have a good working knowledge of PharmaCare and third party billing policies, knowledge of Medication Reviews, and experience with blister packing.

Pharmacists must be strong communicators, clinically oriented, and willing to further their pharmacy practice and patient-centered care.

Wages start at $37/hour and increases steadily with experience. Full medical and dental benefits are provided after a trial period of three months. Please send resumes to shafik@ wescanapharmacy.com.

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Pharmacy technician or assistant – full-time We are looking for full-time pharmacy assistants or registered pharmacy technicians for our Lower Mainland pharmacy. Experience with WinRX and Microsoft Office (Word, Excel, etc.) are assets. Start date is immediate upon hiring. Compensation is between $12-18 depending on the applicant’s experience.

Medical and dental benefits are provided after a trial period of three months. If interested, kindly send a resume and cover letter to shafik@ wescanapharmacy.com. Thank you!

FORT ST. JOHN Pharmacist – full-time Seeking a full-time pharmacist to start in May to fill in for a one year maternity leave. We are seeking a highly motivated individual who has experience and strong multi-tasking skills. Join a clinical and patient-oriented team with an experienced group of pharmacists, assistants and technicians. We offer a very competitive salary and benefits package. Please send resumes to Irvin Tang, associate, at asdm274@ shoppersdrugmart.ca or please call directly 250.785.6155.

KAMLOOPS Pharmacist – part-time Manshadi Pharmacy (477 Paul Street, Kamloops) is looking to hire a part-time motivated pharmacist to work in a wellestablished independent retail pharmacy. We specialize in diabetic care, compounding and home health-care products. Great team that supports our pharmacist. We prefer a longterm commitment. Kamloops is a great place to be. We are close to two ski hills, Sun Peaks and Harper Mountain, and dozens of nearby lakes. Good community to raise a family with all needed amenities. Please send resumes to Missagh Manshadi, pharmacist/owner at missagh@manshadipharmacy.com, learn more at www.manshadipharmacy.com, fax 1.250.434.2527 or please call 1.250.574.0111.

Pharmacy technician – full-time Manshadi Pharmacy (477 Paul Street, Kamloops) is looking to hire a full-time motivated pharmacy technician to work in a well-established independent retail pharmacy.

We specialize in diabetic care, compounding and home health-care products. Great team that supports our pharmacist. We prefer a long-term commitment. Kamloops is a great place to be. We are close to two ski hills, Sun Peaks and Harper Mountain, and dozens of nearby lakes. Good community to raise a family with all needed amenities. Please send resumes to Missagh Manshadi, pharmacist/ owner at missagh@manshadipharmacy.com, fax 1.250.434.2527 or please call 1.250.574.0111.

CAREER LISTINGS

London Drugs has a part-time opportunity in Kelowna. Join a clinical and patient-focused team using the latest robotic dispensing machines plus counselling booths and counselling rooms. Competitive salary and compensation packages, scheduled meal breaks and opportunities to advance to roles such as travel medicine, long-term care, pharmacy management, CDE, injection pharmacist and patient care pharmacists. Please send resumes to Shawn Sangha, pharmacy operations manager, at ssangha@londondrugs.com.

including long-term care, mental health and addictions services. We are looking for hardworking pharmacists that are committed to helping the residents of Keremeos manage their medication related issues. The right applicant will have the opportunity to progress into an ownership position in this very successful store. Specific requirements include proficiency in Kroll pharmacy software and injection certification. Pharmacists with at least two years of experience are encouraged to apply. Interested applicants are encouraged to send their resume and cover letter via email to Sameer Premji, pharmacy operations, at spremji@forewest.ca.

KEREMEOS

LANGLEY

KELOWNA Pharmacist – part-time

Pharmacist – full-time Pharmasave Keremeos has an opening for a pharmacist. The town of Keremeos, BC is located in the beautiful Similkameen Valley close to Penticton, BC. Our pharmacy is engaged in a variety of clinical services

Pharmacist – full-time We are looking for full-time pharmacist. Hours of operation are 9:30am to 5:30pm, Monday to Saturday, closed Sundays and holidays.

Candidates must have excellent communication

and marketing skills. Compounding and injection training would be an asset. Please submit resume to the listed email address. Please send resumes to pharmacy@langleyrx.com.

MAPLE RIDGE Pharmacy assistant – full-time Pharmasave in Maple Ridge is looking for an experienced full-time pharmacy assistant to work at our location. We require an assistant that has at least one year of pharmacy experience and is proficient with Kroll pharmacy software. Experience preparing blister packs, good communication skills, and the ability to work well in a team setting is required. If you are interested in this position, please respond to this posting with your cover letter and resume. Please send resumes to Sameer Premji, pharmacy operations, at spremji@forewest.ca.

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Contact Richard Seto or Doug Chan for your no obligation quote.

TEL: 604 255 4616 TOLL FREE: 1 800 255 6789

www.bcpharmacy.ca

Feb/Mar 2015

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CAREER LISTINGS

NANAIMO Pharmacist – part-time London Drugs has a part-time opportunity in Nanaimo. Join a clinical and patient-focused team using the latest robotic dispensing machines plus counselling booths and counselling rooms. Competitive salary and compensation packages, scheduled meal breaks and opportunities to advance to roles such as travel medicine, long-term care, pharmacy management, CDE, injection pharmacist and patient care pharmacists. Please send resumes to Shawn Sangha, Rx operations manager, at ssangha@londondrugs.com or fax 604.448.1075.

Pharmacist – relief We are looking for a relief pharmacist to step in and help when needed at our long-term care pharmacy in Nanaimo. Please see full job description at www.bcpharmacy.ca/jobs for more information. Experience working with long-term care will be considered an asset.

Please send resumes to jobs@carerx.ca.

Key responsibilities include: checking prescriptions for accuracy, counseling on prescription medications, OTC counseling, health management consulting, and collaboration with pharmacy assistant to accurately dispense prescription medications.

Qualifications: Bachelor of Pharmacy, license to practice in the province seeking employment, superior interpersonal skills, strong verbal and written communication skills, commitment to providing exceptional customer service, and computer proficiency.

Work hours: flex schedule - some weekends and evenings. Please send resumes to sabeeh@ globalhealthmanagement.ca.

Pharmacy technician or assistant – full-time Pharmasave Columbia Square is looking for a full-time compounding technician/assistant.

Experience with compounding is preferred.

PCCA or Medisca compounding training is a definite asset! Minimum two years experience working as an assistant, and experience with Kroll software is required. Candidates must be hard-working, organized, quick to learn, and good with calculations. Excellent communication and customer service skills are a must. Located across the street from the New Westminster skytrain station. Please reply with resume to pharmacy.ps275@shaw.ca or please call 604.525.5608.

Desired qualifications: Experience working in a pharmacy considered an asset and efficient time management abilities. Job duties: receiving deliveries and orders; counting

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Pharmacy manager – full-time Seeking full-time pharmacy manager for busy independent community pharmacy outside of Nanaimo. Full technician support, pharmacist overlap. Must have excellent communication skills and time management. Should be fluent in Kroll software. Potential for partial ownership for right individual. Rotating weekends. Competitve salary dependent upon qualifications and interest. Please send resumes to steveer217@gmail.com.

Pharmacist – part-time

Pharmacist – full-time

Pharmacy assistant – full-time

NANAIMO

PITT MEADOWS

NEW WESTMINSTER

NORTH VANCOUVER

and managing inventory; assisting pharmacy technicians with daily duties; ensuring proper storage of pharmaceutical products; data entry; answering phone calls; assisting with invoicing and mailing; and providing administrative support as required. Please send resumes to cole.mcclay@carerx.ca.

Part-time pharmacist required to work two 10-hour shifts on Saturdays and Sundays, with two to three four-hour evening shifts during the week depending on the volume of prescriptions. Qualifications: BC pharmacist license, knowledge of how to operate Kroll software, two years Canadian pharmacy experience (exceptions can be made), must hold (or acquire) professional liability insurance (as required by the College of Pharmacists of BC), and basic knowledge of how to operate a POS system. Competitive compensation. Please email your resume to Karam, manager, at karamrx1@gmail.com, fax 604.465.8809, phone 604.465.8807.

PRINCE GEORGE Pharmacist – part-time London Drugs has a part-time opportunity in Prince George. Join a clinical and patientfocused team using the latest robotic dispensing machines plus counselling booths and counselling rooms. Competitive salary and compensation packages, scheduled meal breaks and opportunities to advance to roles such as travel medicine, long-term care, pharmacy management, CDE, injection pharmacist and patient care pharmacists. Please send resumes to Shawn Sangha, Rx operations manager, at ssangha@londondrugs.com or fax 604.448.1075.

RICHMOND Pharmacist – part-time Centric health is currently hiring a part time bilingual pharmacist for its new pharmacy (community/retail). Interested in making health-care history? Learn more at https://hire. jobvite.com/j?cj=o0Xf0fwW&s=BC_Pharmacy_ Association. At Centric Health we offer innovative health and wellness solutions. Our

www.bcpharmacy.ca

unique brand of care includes physiotherapy, rehabilitation, assessments, specialty pharmacy, and surgical and medical centres. Centric Health has 2,800 dedicated health-care professionals, consultants and support staff in 600 locations across the country. We provide services nationally and operate over 150 clinics, seven surgical centers, service over 20,000 beds, and fill over 700,000 prescriptions per month and own one of only three fully accredited private hospitals in Ontario. Please contact Vittoria Gambelluri, talent advisor, human resources at 416.619.9428 or apply online.

Pharmacy technician – full-time uniPHARM Wholesale drugs and Medicine Centre pharmacies are looking for a full-time regulated pharmacy technician to assist with pharmaceutical supply duties, billing, and inventory management. The ability to learn and adapt to new software systems is required. A minimum of three years work experience in a pharmacy is required. Only successful candidates will be contacted. Please send resumes to Allison Nourse via email at allisonn@uniPHARM.com.

Pharmacy assistant – full-time Centric Health is currently hiring full time Pharmacy Assistant for its new pharmacy (community/retail).Interested in making healthcare history? Learn more at https://hire. jobvite.com/j?cj=o2Xf0fwY&s=BC_Pharmacy_ Association. At Centric Health we offer innovative health and wellness solutions. Our unique brand of care includes physiotherapy, rehabilitation, assessments, specialty pharmacy, and surgical and medical centres. Centric Health has 2,800 dedicated health-care professionals, consultants and support staff in 600 locations across the country. We provide services nationally and operate over 150 clinics, seven surgical centers, service over 20,000 beds, and fill over 700,000 prescriptions per month and own one of only three fully accredited private hospitals in Ontario. Please contact Vittoria Gambelluri, talent advisor, human resources at 416.619.9428 or apply online.

Pharmacy assistant – full-time uniPHARM Wholesale drugs and Medicine Centre pharmacies are looking for a full-time pharmacy assistant to assist with various pharmacy tasks. The ability to learn and adapt to new software systems is required. There is potential of having to travel within the Lower Mainland, and sometimes other regions within BC, to various pharmacy locations. A minimum of one year work experience in a pharmacy is required. Only successful candidates will be contacted. Please send resumes to Allison Nourse via email at allisonn@uniPHARM.com.

Pharmacy assistant – part-time Looking for part-time pharmacy assistant, Monday to Friday. Please send resumes to sheena.poonja@target.com or please call 604.234.2021.

CAREER LISTINGS

SURREY Pharmacy manager – full-time Mandatory skills: strong Kroll support, computer-savvy, strong communication skills, very business-minded, strong financial acumen and attentive leadership skills. The ideal candidate must be supportive and responsible for the overall growth of the pharmacy while bringing strong passion, enthusiasm and energy to maintain a balanced success. You will be responsible for the day to day store operations and maintaining a professional, cohesive working relationship with the front store manager and staff. The manager will be a catalyst in the execution of excellent patient care, while working closely with the attached medical clinic and its physicians. Please send resumes to pharmasave091@shaw.ca.

Pharmacist – full-time Are you looking to get out from behind the counter and do some real clinical patient care?

As a growing company, NAZ’s Pharmacy is looking for a pharmacist to join our group.

We are a group of independent, communitybased pharmacies that provide patientcentered practices. Our pharmacists require the following individual qualifications: highly motivated with a strong work ethic, strong customer service skills, good communication and leadership skills, ability to work proactively as a member of a dynamic and energetic team, willingness to actively participate in patients’ health-care outcomes, and various managed care initiatives. We offer stability, competitive wage and benefits package. We pride ourselves on our dedication to our employees and interest in long-term relationships. Please send resumes to hr@nazpharmacy.com, fax 604.608.3230 or please call 604.603.7923.

Pharmacy technician – full-time Immediate opening for a pharmacy technician.

Previous experience an asset and applicant must possess excellent communication skills.

Please send resumes to Nafisa, pharmacist/ manager at nafisam@telus.net or fax 604.325.3276.

Pharmacy assistant – full-time Key responsibilities of a Shoppers Drug Mart pharmacy assistant include: patient greeting and confirmation of accuracy of all pertinent prescription information prior to filling; data entry of patient care information into HealthWatch; handling customer prescription pick-up; accurate dispensing of prescription medications; third party adjudication.

Qualifications: Experience as a pharmacy assistant is mandatory, excellent organizational skills, strong motivation to succeed, demonstrated customer service experience, and proficient computer data/entry skills. Start date: Immediate. Hours: Flexible schedule including weekends/evenings (full availability required). Please apply by emailing your resume to Natalia, pharmacy manager at asdm267@

shoppersdrugmart.ca or apply online at https:// www.hrapply.com/shoppers/AppJobView.jsp?lin k=1048222&page=AppJobList.jsp&op=reset or fax 604.588.6451 or please call 604.588.6451.

TOFINO Pharmacist – full-time Pharmasave Tofino is a new health centre that provides a unique community pharmacy experience. We are currently recruiting for a full-time pharmacist to join our team on the west coast of British Columbia. This position is geared toward a hard-working, lifestyle orientated individual. The successful candidate must be injection trained and committed to providing exceptional pharmacy services. Essential qualities: professional, confident, reliable, positive, organized, detail orientated, and outstanding communication skills. Please send resumes to Laura, owner, at info@epicpharmacy.ca or learn more at www. epicpharmacy.ca, fax 250.725.1249 or please call 250.725.4949.

VANCOUVER Pharmacist – full-time We are a well-established, fast-paced independent community pharmacy currently looking for a motivated, focused and diligent full-time pharmacist to join our expanding team.

We are a dynamic, clinical-based dispensary who works with multidisciplinary health-care professionals to provide excellent customer service and quality patient focused care.

Successful candidates must be registered and in good standing with CPBC, possess strong and effective communication and organizational skills, and the ability to work effectively in a team environment as well as independently.

Experience with adaptations, administering injections and med reviews an asset. No evenings. Position to start immediately. If interested, please send in a cover letter and your resume to vancouverpharma@gmail.com.

New grads are welcome to apply.

Pharmacist – part-time Part-time pharmacist position available, experienced in retail pharmacy, exceptional communication and organization skills, familiar with Telus RxA or RxT program, and able to work productively as a member of a dynamic team. If required, willing to work at two different pharmacy locations, both in the Lower Mainland. Please, no phone calls about this job.

Please send resumes to ymm@yyoung.com or fax 604.630.1001.

Pharmacy technician – full-time We are looking to hire a full-time registered pharmacy technician to join our team. The successful applicant must be a registered, regulated pharmacy technician with at least two years’ experience working in a pharmacy dispensary and must be fluent in English.

Knowledge and use of Microsoft outlook,

www.bcpharmacy.ca

word, excel and excellent computer skills are a necessity. You will be dealing with all aspects of dispensary operations and will be providing excellent, quick customer service, answering phones, dispensing and entering and processing prescriptions on our computer system. You must be a highly motivated team player.

Compensation will be in the mid $20/hour range depending on experience. Full benefits only after three months successful probation period. Non-registered technicians please do not apply. Please send resumes to michelle@ macdonaldsrx.com.

Pharmacy technician – full-time Immediate opening for a pharmacy technician.

Previous experience an asset and applicant must possess excellent communication skills.

Please send resumes to Nafisa, pharmacist/ manager at nafisam@telus.net or fax 604.325.3276.

Pharmacy assistant – full-time We are looking to hire a full-time pharmacy assistant to join our team. The successful applicant must have at least two years experience working in a pharmacy dispensary and must be fluent in English. Knowledge and use of Microsoft Office and excellent computer skills are a necessity. You will be dealing with all aspects of dispensary operations and will be providing excellent and quick customer service, answering phones, dispensing and entering and processing prescriptions on our computer system. You must be a highly motivated team player. Competitive compensation rate based on experience. Full benefits available after three months successful probation period. Send resumes only to michelle@macdonaldsrx.com.

Pharmacy assistant – full-time Established independent pharmacy seeking full-time pharmacy assistant to join our team.

Responsibilities include: Greeting patients at prescription drop-off and pick-up; receiving and entering prescriptions; preparing and compounding medications; cashier duties and inventory maintenance; and general work place organization. Assets: Good customer service skills; prior pharmacy experience or graduation from a pharmacy assistant school; general knowledge of government/private insurance; ability to operate Kroll computer software; Cantonese and/or Mandarin speaking skills desirable. We offer competitive wages with excellent training and support. If you are interested in the position, please submit your resume with email address and phone number to mjsrxmanager@gmail.com.

VICTORIA Pharmacist – full-time Are you looking for an opportunity with an established independent pharmacy chain that is looking to grow and expand its focus on patient care, and clinical specialization? We take patient follow-up to a whole new level. We are looking

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CAREER LISTINGS

for energetic pharmacists who want to practice their full scope of clinical skills and help us bring top-notch health care to our customers. Heart Pharmacy IDA owned by Naz Rayani are looking for an engaged, clinically-oriented and outgoing full-time pharmacist to work at our unique community pharmacies. Please send resumes to jobs@victoriapharmacy.com.

Pharmacist – part-time London Drugs has a part-time opportunity in Victoria. Join a clinical and patient-focused team using the latest robotic dispensing machines plus counselling booths and counselling rooms.

Competitive salary and compensation packages, scheduled meal breaks and opportunities to advance to roles such as travel medicine, long-term care, pharmacy management, CDE, injection pharmacist and patient care pharmacists. Please send resumes to Shawn Sangha, pharmacy operations manager, at ssangha@londondrugs.com or fax 604.448.1075.

Pharmacy technician – full-time Pharmacy technician required to work at Heart Pharmacy IDA owned and operated by Naz Rayani. Our focus is on patient-centered practice with a desirable and friendly population.

All applications are confidential. Compensation is commensurate with experience. Please send resumes to jobs@victoriapharmacy.com.

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Feb/Mar 2015

OPPORTUNITIES ACROSS BC

OPPORTUNITIES OUTSIDE BC

LOWER MAINLAND

ALBERTA

Pharmacist – part-time

Pharmacist – full-time, float

London Drugs has a part-time opportunity in the Lower Mainland. Join a clinical and patient focused team using the latest robotic dispensing machines plus counseling booths and counseling rooms. Competitive salary and compensation packages, scheduled meal breaks and opportunities to advance to roles such as travel medicine, long term care, pharmacy management, CDE, injection pharmacist and patient care pharmacists. Please send resumes to Shawn Sangha, pharmacy operations manager, at ssangha@londondrugs.com.

The Overwaitea Food Group (OFG) proudly provides professional, patient-centered care through more than 80 pharmacies across BC and Alberta. We are a leading-edge food and consumer goods retailer known for our belief that well-being is about prevention, not just intervention. And thanks to the breadth and depth of our well-established health related offerings, our pharmacists are in a unique position to counsel clients about nutrition and wellness. At OFG, we're committed to fostering a work environment that encourages personal growth, training and career opportunities and provides continuous learning. We offer an attractive compensation package and our extensive benefits package for full-time pharmacists is one of the industries finest. Learn more about what we have to offer. Please send resumes to pharmacyemployment@owfg.com.

ACROSS BC Pharmacist – full-time, float The Overwaitea Food Group (OFG) proudly provides professional, patient-centered care through more than 110 pharmacies across BC and Alberta. We’re a leading-edge food and consumer goods retailer known for our belief that well-being is about prevention, not just intervention. And thanks to the breadth and depth of our well-established health related offerings, our pharmacists are in a unique position to counsel clients about nutrition and wellness. At OFG, we're committed to fostering a work environment that encourages personal growth, training and career opportunities and provides continuous learning. We offer an attractive compensation package and our extensive benefits package for full-time pharmacists is one of the industries finest. Learn more about what we have to offer. Please send resumes to pharmacyemployment@owfg.com.

www.bcpharmacy.ca

CAREER LISTINGS

BUSINESS OPPORTUNITIES Lower Mainland - Pharmacy for sale The pharmacy for sale is a patient care focused pharmacy, strategically located next to a medical walk-in clinic. This is a truly turnkey opportunity with trained staff and an established clientele in place. It is located in a densely populated area that includes commercial and residential developments.

This pharmacy is driven by sales of medically required products, making the revenue of this business recession resistant. As the pharmacist and owner you will be supported by one of Canada’s leading health-care companies. Asking price is $249,000. Interested in buying this pharmacy? Contact Paul Savage at Pacific Business Brokers Inc. to learn more, psavage@ pacificbusinessbrokers.com or 604.218.3001.

Vancouver - Pharmacy for sale Busy pharmacy for sale with doctor's clinic. ~50,000 Rx/yr. Mainly walk-in, blister pack, methadone. Cloud Pharmacy. Please send resumes to hr@cloudpharmacy.ca or please call 1.877.331.4411.

WHAT IS IMPORTANT TO YOU IS IMPORTANT TO US. Pharmasave is the best choice for independent business in BC. Maintain your freedom while having access to the most comprehensive retail and professional programs in the industry and our strong national brand.

We are a true cooperative, 100 per cent member-owned and governed. Benefit from owning your own business, and also share in the economic advantages of a strong group of 500+ stores. If you are a store owner, or a pharmacist interested in purchasing a pharmacy, or are planning on selling your business, please give us a call. Our only priority is you and your success!

Contact Dave Reston, CEO, Pharmasave Pacific, 1.800.665.3344, 604.575.5730 or dreston@ pharmasavebc.ca.

Are you thinking of selling your pharmacy?

Overwaitea Food Group may be interested. If you would like more information please contact via email only to pharmacybuyer1@gmail.com.

Forewest Holdings partners with local pharmacists to own 34 Pharmasave locations.

We have been partnering with local pharmacists for more than 30 years. We are currently looking for opportunities to acquire more community pharmacies in BC and Alberta.

Please contact us if you are ready to sell all or part of your store. Forewest is also always looking for pharmacists who would like to become part owners of a pharmacy. Under the Forewest program you become a shareholder of your store and receive your FULL pro-rata share of its income in addition to your normal salary. We have several ownership opportunities available at this time. Please contact either

Gordon Gooding at ggooding@forewest.ca, 604.309.7405; or Don Fraser at dmmkfraser@ hotmail.com, 604.788.9315.

Peoples Drug Mart is an established and proven pharmacy banner that will make your pharmacy business more successful and profitable. We provide outstanding marketing support and services for a low monthly fee. Unlike other banners, Peoples Drug Mart does not charge a percentage of sales. Our belief is that the profits from your hard work should stay in your business. With Peoples, you get the best of both worlds, outstanding support and services, and the ability to maintain your profits. If you are interested in purchasing, selling or opening a new pharmacy, please contact Frank Cucca, toll free: 1.877.450.6006, ext. 18 or 604.619.4846 or email frankc@pdmstores.com.

ASSOCIATION CONTACTS Geraldine Vance Chief Executive Officer 604.269.2860 geraldine.vance@bcpharmacy.ca Cyril Lopez Chief Operating Officer 604.269.2869 cyril.lopez@bcpharmacy.ca Derek Desrosiers Director, Pharmacy Practice Support 604.269.2862 derek.desrosiers@bcpharmacy.ca Angie Gaddy Director, Communications 604.269.2863 angie.gaddy@bcpharmacy.ca Letlotlo “Coco” Lefoka Manager, Public Affairs 604.269.2868 coco.lefoka@bcpharmacy.ca Vince Lee Manager, Marketing 604.269.2867 vince.lee@bcpharmacy.ca Bryce Wong Manager, Pharmacy Practice Support 604.269.2865 bryce.wong@bcpharmacy.ca Elise Steeves Manager, Communications 604.269.2866 elise.steeves@bcpharmacy.ca Nelson Chen Coordinator, Pharmacy Practice Support 604.269.2880 nelson.chen@bcpharmacy.ca Ray Chow Database Administrator, Member & Corporate Services 604.269.2882 ray.chow@bcpharmacy.ca Maria dela Cruz Executive Assistant & Project Coordinator 604.269.2861 maria.delacruz@bcpharmacy.ca Linda Tinnion Assistant, Member Services 604.269.2864 linda.tinnion@bcpharmacy.ca Starr Rempel Administrative Assistant Member & Corporate Services 604.261.2092 starr.rempel@bcpharmacy.ca 604.261.2092, Toll-free: 1.800.663.2840 info@bcpharmacy

SAVE THE DATE!

BCPhA Annual Conference 2015 May 21 to 23 at the Delta Victoria Ocean Pointe Resort and Spa in Victoria, BC Visit www.bcpharmacy.ca to learn more and register!